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Biomedical subjects

J T Davidson

Publications and source records attributed to J T Davidson.

At least 37 records · Page 2Linked to original sources
PubMed1986

Early recognition and successful management of pelvic cellulitis following hemorrhoidal banding.

Reports have focused attention on a rare but potentially serious complication following rubber band ligation of internal hemorrhoids: pelvic cellulitis with progression to shock and death. This report documents the successful treatment of pelvic cellulitis. The timely use of broad-spectrum antibiotics at an early stage is critical. Emphasis is placed on early recognition and treatment of this potentially fatal complication.

Adult↗
PubMed1985

An investigation of the role of lactic acid production in the causation of metabolic acidosis resulting from raised intracranial pressure in rabbits.

Intracranial pressure (ICP) was acutely raised in anaesthetized rabbits by the injection of saline into the cisterna magna. The raised ICP was maintained at 200 mm Hg for 3 min after which it was allowed to return to baseline values. The profound metabolic acidosis produced (mean base deficit reaching 17.99 +/- SD 4.06 mmol/1 30 min after raised ICP) was found to be in part related to an increase in arterial blood lactate (from mean 7.04 +/- SD 3.26 mmol/l before raised ICP to mean 13.57 +/- SD 5.28 mmol/l 30 min after raised ICP). It would appear that systemic sympathetic nervous system discharge consequent upon raising ICP results in intense vasoconstriction and thus an increase in anaerobic metabolism and inorganic acid production.

Acidosis↗
PubMed1985

Ruptured aneurysm of the internal iliac artery.

Our case and others reported in the literature illustrate that isolated aneurysms of the internal iliac artery are uncommon lesions with a highly lethal potential. The classic signs of ruptured abdominal aneurysm--pain, palpable mass, and shock--are usually altered with rupture of these aneurysms because of their deep location in the pelvis. Rectal examination will aid diagnosis. Surgical management of IIA aneurysms 4 cm or larger is indicated at the time of diagnosis, since rupture is usually fatal.

Aged↗
PubMed1985

[Initial studies on the intraoperative use of spinally administered somatostatin].

7 cases are reported demonstrating that intrathecal or epidural administration of somatostatin intraoperatively reduced the requirement for other anaesthetics. Somatostatin acts as a potent analgesic, which does not impair circulatory parameters and which possesses no centrally depressing effect. Spinal administration of somatostatin could therefore gain importance in high-risk category patients with normal metabolism.

Adult↗
PubMed1985

Unsuccessful control of abdominal aortic aneurysm by bypass and ligation.

Two patients developed abdominal aortic aneurysm rupture following bilateral iliac artery ligation and axillobifemoral bypass. The first patient developed his rupture several weeks after outflow ligation and apparent thrombosis of the aneurysm. At autopsy, the aneurysmal rupture occurred in the left posterior junction between the thrombosed aneurysm and the normal aorta. In the second case, the aneurysm was not completely thrombosed and plans were in progress for thrombosis of the aneurysm when the patient developed frank rupture, necessitating operative intervention. The authors await the published experience of others with bilateral common iliac artery ligation and extra-anatomic bypass for abdominal aortic aneurysm, but these authors do not currently recommend this management plan.

Aged↗
PubMed1984

[Isoflurane].

Explore the source record for details and available documents.

Humans↗
PubMed1984

Hypobaric spinal anesthesia in the operative management of orthopedic emergencies in geriatric patients.

Hypobaric spinal anesthesia was administered to 40 patients undergoing lower limb surgery. Twenty-nine of the patients were debilitated geriatric patients who presented with orthopedic emergencies, in most cases a fractured hip. Hypobaric spinal anesthesia was found to be a simple and safe procedure that provided adequate analgesia. Due to its inherent nature, hypobaric spinal anesthesia does not necessitate positioning of the patient on the injured, painful side (unlike hyperbaric spinal or epidural anesthesia) and, therefore, facilitates a smooth and painless transfer of the patient to the operating table. Complications encountered were similar to those following hyperbaric anesthesia.

Adult↗
PubMed1983

Vaginal delivery following previous cesarean birth.

Because of the rising cesarean birth rate in the United States, renewed interest in vaginal delivery after prior abdominal operation has been evident. In a prospective collaborative study 789 patients were evaluated for inclusion into this investigation. Of the 717 subjects who entered the study 162 chose to attempt vaginal birth and 101 were successful. Desire for tubal sterilization and the lack of prior vaginal delivery were significant correlates of the group selecting repeat abdominal birth and of those who were unsuccessful when vaginal delivery was attempted. There were eight dehiscences and three uterine ruptures among the 717 patients and none was related to catastrophic outcome for the mother or neonate. Perinatal losses (12) were not related to uterine rupture or method of delivery. There were no significant differences in uterine disruption between patients selecting either route of delivery. Likewise ancillary factors such as a prior febrile puerperium (endometritis), number of prior cesarean births, low-vertical uterine incisions, recurrent operative indications, the use of epidural anesthesia, or oxytocin administration were not discriminating factors in whether women chose to attempt or were successful in completing vaginal delivery after prior abdominal birth. From our data vaginal birth after cesarean section appears to be safe if conducted in a carefully selected population that is closely monitored in a prospective manner.

Cesarean Section↗
PubMed1983

Physostigmine antagonizes morphine-induced respiratory depression in human subjects.

The effect of physostigmine on the respiratory depression induced by morphine was studied in human subjects who received morphine as part of their preanesthetic medication. After pretreatment with droperidol (2.5-5 mg, iv) to prevent nausea, the change in minute ventilation was measured in 16 patients in response to increasing concentrations of inspired CO2 (CO2-response curve) by the rebreathing method. This was repeated 30 min after morphine (0.166 mg/kg, iv) in nine subjects and in seven controls who did not receive morphine and again 5-10 min after physostigmine (13-33 micrograms/kg, iv) in all subjects. All subjects were given N-butylhyoscine hydrobromide (5 mg, iv) to antagonize any peripheral cholinergic effects of physostigmine. Morphine decreased the mean slope of the CO2-response curve from 1.78 +/- 0.18 to 1.12 +/- 0.14 1 X min-1 X mmHg-1 (P less than 0.01) and increased the alveolar PCO2 for a fixed minute ventilation (position of curve) from 45.0 +/- 1.3 to 51.9 +/- 1.5 mmHg (P less than 0.001). Physostigmine restored the mean slope after morphine to control value, i.e., 1.79 +/- 0.231 X min-1 X mmHg-1, and position to 46.2 +/- 1.2 mmHg (P less than 0.001). Physostigmine did not increase the slope or alter the position of the CO2-response curves of subjects given droperidol alone. The authors conclude that physostigmine can reverse the respiratory depressant effect of morphine and restore the sensitivity of the respiratory center of CO2, presumably by raising acetylcholine levels in the brain after these have been reduced by morphine.

Adolescent↗
PubMed1983

Intravenous albumin administration in acid aspiration syndrome in rabbits.

The possible value of albumin in a rabbit model of the acid aspiration syndrome was studied. Hydrochloric acid was instilled into the respiratory tracts of three groups of rabbits: Group A received a high intravenous dose of human albumin (1.5 gm/kg body weight); Group B (control) was given Hartmann's solution, and Group C a low dose of albumin (0.25 gm/kg body weight). The total amount of intravenous fluids was identical in all groups. Serum and pulmonary edema fluid (PEF) concentrations of total protein were highest in Group A. Simultaneous concentration gradients between serum and PEF for total protein, human and rabbit albumin, and globulin fractions were not statistically different in the three groups. In Group A, PEF appeared first and PaO2, static compliance, and hematocrit decreased significantly more than those of the two other groups. Survival of animals in Group C was highest. An additional Group (D) of rabbits received the same high dose of albumin without acid aspiration. In Group D hematocrit decreased while serum total protein and pulmonary function remained unchanged. It seems that a high dose of albumin causes a further deterioration of lung function following acid aspiration because of extravasation into the interstitial space. The administration of low doses of albumin was not different than Hartmann's solution, but led to the best survival in our model.

Animals↗
PubMed1983

Crohn's disease of the esophagus.

In 1932 Crohn, Ginzburg, and Oppenheimer described a distinct pathologic and clinical entity characterized by a chronic inflammatory process of unknown etiology involving the terminal ileum. Since then, Crohn's disease has been recognized in all portions of the alimentary canal from mouth to anus. Crohn's disease of the esophagus is a rare process. Such a patient is reported with a review of the literature. A review of the English literature reveals reports of 20 patients with Crohn's disease of the esophagus. One-third of these patients had regional enteritis requiring resection. Esophageal stricture, stenosis, or fistula were frequent complications requiring resection. Regional esophagitis is difficult to distinguish from carcinoma, frequently leads to esophagitis, and is associated with a higher mortality rate than Crohn's disease in other portions of the alimentary tract.

Adolescent↗