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Biomedical subjects

J Holder

Publications and source records attributed to J Holder.

34 records · Page 2Linked to original sources

Interdigital neuroma. Local cutaneous changes after corticosteroid injection.

Interdigital neuroma was diagnosed in a patient who was treated subsequently with a local corticosteroid injection. Two to 3 weeks after injection, a 2.5 x 1.5-cm area of hyperpigmentation, thinning of the skin, and subcutaneous fat atrophy developed at the site of the injection. Occurrence of these side effects depends on the solubility of the steroid preparation, the dosage, and the anatomic site and depth of the injection. When using local corticosteroid injections to treat interdigital neuromas, the physician should be familiar with the properties and recommended dosage of the given steroid. The injection should be deep enough so that the cortisone solution does not leak into the subcutaneous area. The possibility of skin atrophy and altered pigmentation should be discussed with all patients.

Adipose Tissue↗

Ability of laboratory methods to predict in-use efficacy of antimicrobial preservatives in an experimental cosmetic.

The abilities of nine antimicrobial systems to preserve an experimental water-based cosmetic formulation were evaluated by six microbiological challenge tests: the U.S. Pharmacopeia test; the British Pharmacopeia test; the Cosmetic, Toiletry, and Fragrance Association test; the rapid screen test; the sequential challenge test; and the post-use test. The antimicrobial systems contained various combinations and amounts of two parabens and a quaternary compound in order to provide a broad range of preservation. The results obtained were compared with the abilities of the formulations to support maintenance and growth of microorganisms in microfloras obtained from human axilla areas and finger skin during an 8-week simulated in-use test. Without statistical analysis all of the tests predicted the results obtained with well-preserved or poorly preserved formulations. The rapid screen test was the best test for predicting differences at intermediate levels of preservation. Statistically, all of the tests were equivalent predictors of preservation efficacy in the in-use test (P = 0.05). At the P = 0.10 level, only the U.S. Pharmacopeia, British Pharmacopeia, rapid screen, Cosmetic, Toiletry, and Fragrance Association tests were significantly predictive. The results of prediction by a test, based on the preservative levels used, agreed well with the in-use test results (P = 0.01). A total of 20% of the formulations that contained excessive microbial levels contained human axilla microorganisms. The levels of preservation in failed products were similar to the levels of preservation in unused controls.

Axilla↗

Residents' attitudes toward the legal system and court testimony in child abuse.

Resident physicians' contacts with the legal system during management of abused children may influence their attitudes, which were evaluated in a pilot survey completed by 42 pediatric and medicine/pediatric residents. Although negative attitudes toward attorneys were common, almost all of the residents considered general and hearing-specific legal training to be a legitimate part of their residency program. They reported lower levels of stress of court testimony than expected by the authors. Most who had testified in court believed their testimony had been needed and helpful, but all who believed their testimony had been a waste of time were senior-level residents. Although most residents believed the laws and courts usually work for protecting children, only 8 of the 20 residents who had previously testified in court responded affirmatively, and none of the 10 senior residents who had previously testified held this belief. The disillusionment of senior-level residents appeared to affect attitudes toward patient care less than expected, in that 90% of those who planned to enter private practice indicated they would perform physical abuse evaluations and 70% planned to perform sexual abuse evaluations. Only one resident who did not expect to perform the evaluations gave as a reason the prospect of having to testify in court.

Arkansas↗

[Arthroscopic surgery at the knee joint].

384 patients were subjected to arthroscopy in 1980 and 1981. Pathological findings were obtained in 361 patients, mainly lesions of the meniscus. In 51 patients (approx. 14% of the cases) arthrotomy became necessary for various reasons. 310 patients were subjected to surgery, using the arthroscope. Follow-up examinations showed that the postoperative healing phase and hence also the postoperative inpatient period were significantly reduced compared with those patients who had been subjected to arthrotomy with the same therapeutic effect. Patients who have undergone arthroscopy re-attain their full knee-joint function much earlier than those on whom arthrotomy was performed. Hence, their ability to work is restored more quickly, and they are much sooner able to resume their sports activities.

Adolescent↗

Arteriography after carotid endarterectomy.

Of 55 patients undergoing carotid endarterectomy, 16 had abnormal postoperative angiograms by accepted literature criteria. Five of the 16 were symptomatic. The other 11 were neurologically stable or improved from their preoperative condition. None of the 16 patients underwent reoperation. Of those 11 who had abnormal postoperative angiograms but a good clinical result, four had a second postoperative angiogram some months later that demonstrated marked improvement in the appearance of the endarterectomy site. Patients undergoing carotid endarterectomy should not be subjected to routine postoperative angiography without clinical indications nor should they undergo reoperation on the basis of angiographic findings alone without consideration of their clinical status.

Adult↗

Iodine-123-Rose bengal: An improved hepatobiliary imaging agent.

A practical method for preparing )23-I-rose bengal that allows for its rapid and efficient incorporation into the molecule is reported. Administration of 123-I-rose bengal to normal healthy patients showing the normal uptake and excretory pattern visualized with this radio pharmaceutical is also presented. The overall reduction in imaging time and radiation exposure together with the improved images possible should greatly improve our diagnostic capabilities in evaluating the jaundiced patient.

Humans↗

Changes in the canine femoropatellar joint space in the postsurgical, cruciate-deficient stifle joint.

In this study, we investigate the factors that influence changes in articular cartilage thickness in naturally occurring osteoarthritis of the canine stifle joint. Fifty-eight dogs with QA secondary to cranial cruciate ligament deficiency were examined radiographically at 0, 7, and 13 months using 90 degree flexed mediolateral radiographs of both stifle joints. The femoropatellar joint space widths were measured using a computer-assisted video image analysis system. The femoropatellar joint space widths were found to be significantly increased in index joints as compared to contralateral joints. In addition, there was a significant increase in femoropatellar joint space (FPJS) width over the course of the study, particularly between entry and 7 months. Factors that might influence the degree of femoropatellar joint space increase (bodyweight, age, sex, disease duration, radiographic score) were investigated using regression analysis. Body weight at baseline showed a moderate to strong relationship with change in FPJS between 0 and 7 months (Pearson's partial correlation r = 0.417, p = .006). This relationship was less strong for change in femoropatellar joint space between 7 and 13 months (r = 0.324, p = .036).

Animals↗