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Biomedical subjects

J M Sutherland

Publications and source records attributed to J M Sutherland.

At least 19 recordsLinked to original sources
PubMed1989

A multicenter randomized, placebo-controlled trial of surfactant therapy for respiratory distress syndrome.

We carried out a multicenter randomized, placebo-controlled trial to evaluate the efficacy and safety of surfactant in the treatment of respiratory distress syndrome. The study population was made up of newborn infants weighing 750 to 1750 g who were receiving assisted ventilation with 40 percent or more oxygen. The eligible infants received a single dose of either surfactant (100 mg of phospholipid per kilogram of body weight [4 ml per kilogram]) or an air placebo (4 ml per kilogram), administered into the trachea within eight hours of birth by an investigator not involved in the clinical care of the infant. When compared with the infants who received the placebo (n = 81), the infants who were treated with surfactant (n = 78) had a 0.12 greater average increase in the ratio of arterial to alveolar oxygen tension (P less than 0.0001), a 0.20 greater average decrease in the fractional inspiratory oxygen concentration (P less than 0.0001), and a 0.26-kPa greater average decrease in the mean airway pressure (P less than 0.0001) during the 72 hours after treatment. Pneumothorax was less frequent among the infants treated with surfactant than in the control group (13 percent vs. 37 percent; P = 0.0005). There were no statistically significant differences between the groups in the proportion of infants in each of five ordered clinical-status categories on day 7 (P = 0.08) or day 28 (P = 0.75) after treatment. There were also no significant differences between the groups in the frequency of bronchopulmonary dysplasia, patent ductus arteriosus, necrotizing enterocolitis, or periventricular-intraventricular hemorrhage. In each group, 17 percent of the infants died by day 28. We conclude that treatment with the single-dose surfactant regimen used in this study reduces the severity of respiratory distress during the 72 hours after treatment and decreases the frequency of pneumothorax, but that it does not significantly improve clinical status later in the neonatal period and does not reduce neonatal mortality. Further study of different surfactant regimens and patient-selection criteria will be required to determine whether this initial improvement can be translated into reductions in mortality or serious morbidity.

Bronchopulmonary Dysplasia↗
PubMed1984

High malformation rates and decreased mortality in infants of diabetic mothers managed after the first trimester of pregnancy (1956-1978).

Over a period of 23 years we accumulated data on 182 pregnant juvenile diabetic subjects during pregnancy, labor, and delivery. Diabetic subjects were evaluated generally after the first trimester of pregnancy. Data examined included diabetic class, maternal complications of pregnancy, and infant morbidity and mortality. Data were analyzed in two periods-before and after 1970. In the second period, maternal polyhydramnios and acidosis rates improved, neonatal problems of homeostasis did not change significantly, and combined fetal and neonatal losses fell from 34.7% to 16.4%. The neonatal malformation rate, however, increased from 1.4% to 16.8% and was not influenced by maternal age or diabetic class.

Adolescent↗
PubMed1984

The effect of bilateral medial meniscectomy on articular cartilage of the hip joint.

Bilateral medial meniscectomy of the knee joint was undertaken in 4 mature greyhounds. Four greyhounds of similar age served as nonsurgical controls. Six months after meniscectomy, all animals were sacrificed and femoral head articular cartilage (FHC) examined for collagen, uronic acid, galactosamine, glucosamine and hyaluronic acid (HA) content. The sequential extractability of proteoglycans (PG) with non-dissociative (0.5 M GuHCl) and dissociative (0.4 M GuHCl) solvents was also investigated. The levels of collagen, uronic acid, galactosamine and glucosamine of the FHC of the meniscectomized group remained normal relative to FHC taken from the control greyhounds but the level of HA was significantly depressed (p less than 0.05). The amount of PG extracted by 0.5 M GuHCl from the FHC of the meniscectomized group was 2.5 X that extracted from control cartilage. In addition, subsequent extraction of the residues with 4.0 M GuHCl only released half the amounts of PG extracted from control FHC under the same conditions.

Animals↗
PubMed1983

The effects of postoperative joint immobilization on articular cartilage degeneration following meniscectomy.

Bilateral medial meniscectomy was performed in 12 mature greyhounds. One knee joint of half the group was immobilized by a Kirschner splint for a period of 5 weeks immediately following meniscectomy, after which the device was removed and the animals were allowed free movement for a further 21 weeks before sacrifice. Three greyhounds served as controls. While the collagen levels of articular cartilage from the femoral condyles and tibial plateaus of meniscectomized animals were the same as that of controls, differences were found for proteoglycan (PG) content and extractability using nondissociative conditions (0.5 M guanidinium hydrochloride (GuHCl) but not dissociative conditions (4.0 M GuHCl). With nondissociative conditions, twice as much PG was extracted from medial femoral condyle of meniscectomized animals encouraged to bear weight on joints immediately after surgery compared to that from controls or animals in whom joints were immobilized after surgery. Proteoglycans from medial tibial plateau cartilage of the free contralateral joints of the immobilized group were more readily extracted using 0.5 M GuHCl and also showed a statistically significant depression of uronic acid levels relative to both controls and tissues of other surfaces. The data suggest that postoperative management of meniscectomy in the human may be more important than has hitherto been recognized.

Animals↗
PubMed1979

Doctor at court.

Explore the source record for details and available documents.

Expert Testimony↗
PubMed1979

Neonatal hotline telephone network.

By simplifying the process by which telephone contacts are made, improved communications were established between a university-affiliated newborn intensive care center and some of the community hospital nurseries that it serves as a regional resource. Initiation of the improved system of communications was associated with a significant improvement in the survival of infants transferred from the community hospitals to the regional care facility.

Body Temperature↗
PubMed1977

Prune-belly syndrome associated with Potter (renal nonfunction) syndrome.

Three fatal cases of prune-belly syndrome were associated with nonrenal features of Potter syndrome. The abdominal muscle hypoplasia is thought to be a result of large kidneys compression the developing abdominal musculature during a critical phase of fetal development. Thus, Potter syndrome and prune-belly syndrome may coexist when nonfunctioning large kidneys result in oligohydramnios. A teratogenic role of cytomegalovirus inclusion disease and other viruses is possible in the pathogenesis of these syndromes.

Abdominal Muscles↗
PubMed1976

Computer-assisted newborn intensive care.

A minicomputer has been programmed to aid in the intensive care of high-risk newborn babies. The computer provides 24-hour on-line access to physiologic and environmental data and controls the heating of infant incubators. The control algorithm limits fluctuations in the incubator chamber and protects the infant against escape from neutral thermal conditions. The mortality rate for 105 infants cared for using the computerized systems was significantly reduced when compared to that of 105 matched high-risk infants cared for using standard non-computer-assisted techniques in the same nursery setting.

Computers↗
PubMed1975

Essential (hereditary or senile) tremor.

Sixteen cases (eight in males and eight in females) of essential (hereditary or senile) tremor were collected over a two-year period. Ten patients had near relatives with a similar disorder. All but one patient had a tremor of the upper limbs which was absent when the arms were at rest, but which appeared on movement, and was made worse by emotion. The severity of the tremor varied considerably from patient to patient, and often was temporarily lessened by alcohol. The tremor involved the head and neck in six subjects and the legs in two. One subject has associated neurological abnormalities probably due to cerebral arteriosclerosis. Otherwise no neurological abnormality except tremor was present in any patient. No patient showed evidences of Parkinsonism. To the time of collection of the series the tremor had been present for periods of between one and 62 years. Many patients with essential tremor are not severely enough affected to warrant therapy. Propranolol, a beta-adrenergic blocking agent, appears to reduce the tremor in at least some patients who need treatment.

Adolescent↗