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Biomedical subjects

K Schroeder

Publications and source records attributed to K Schroeder.

64 records · Page 4Linked to original sources
PubMed1984

Gastrointestinal microecology in the critically ill neonate.

The fecal and gastric microflora of 178 critically ill neonates was compared with that of 30 normal full-term infants. Significant findings included increased frequency of single species retrieval and decreased frequency of mixed aerobic-anaerobic fecal cultures in the ill infants. Also noted were increased retrieval of pathogenic organisms, ie, staphylococcus aureus from gastric and fecal cultures of the ill infants, and decreased retrieval rates of Escherichia coli enterococcus, B fragilis, and other anaerobes in the feces of this group. Yeast retrieval was increased in the feces of the ill neonates. Statistical analysis showed that delivery route, birth weight, and antibiotic therapy were significantly related to the retrieval rates of certain organisms in the gastric and fecal flora of the ill neonate. Given the breast-fed and formula-fed infants have different normal floral patterns, this study suggests that the flora of the ill neonate conforms to a different pattern. Implications in the prevention and treatment of various neonatal septic processes may be drawn from this data.

Birth Weight↗
PubMed1984

Pharmacokinetics of clindamycin phosphate in the first year of life.

The pharmacokinetics of intravenously administered clindamycin phosphate was studied in 40 children less than 1 year of age. Mean peak serum concentrations were 10.92 micrograms/ml in premature infants less than 4 weeks of age, 10.45 micrograms/ml in term infants greater than 4 weeks, and 12.69 micrograms/ml in term infants less than 4 weeks of age. Mean trough concentrations were 5.52, 2.8, and 3.03 micrograms/ml, respectively, in the same groups. Serum half-life was significantly longer (8.68 vs 3.60 hours) in premature compared with term infants less than 4 weeks of age. Both premature and term infants less than 4 weeks had significantly decreased clearance when compared with infants greater than 4 weeks (0.294 and 0.678, respectively, vs 1.58 L/hr). Clearance was significantly greater (1.919 vs 0.310 L/hr) and serum half-life less (1.75 vs 7.57 hours) in infants with body weight greater than 3.5 kg. On the basis of these data it is recommended that in infants greater than 4 weeks or greater than 3.5 kg, intravenous clindamycin dosage be 20 mg/kg/day in four divided doses. In premature neonates less than 4 weeks, the dose should be reduced to 15 mg/kg/day in three divided doses. Term infants greater than 1 week of age may also receive 20 mg/kg/day in four doses.

Clindamycin↗
PubMed1984

Echo-Doppler angle determination for noninvasive transmitral blood velocity calculations in normal and porcine bioprosthetic mitral valves.

Doppler incident angle (DA) determination is a critical factor in the noninvasive attempt to measure transmitral blood velocity (TMBV) and to estimate volumetric flow. The error in TMBV varies with the cosine of DA. Using an echo-Doppler duplex scanner (DS), we studied transmitral flow velocities in 10 normal subjects (Group I) and 10 asymptomatic patients with procine mitral valve (PMV) bioprostheses. A 3-MHz scanhead with three medium focused rotating transducers was positioned at the left ventricular apex, and standard apical four-chamber views of the heart were obtained. The position of the Doppler sample volume (SV) was adjusted within the valve orifice until the maximal power of the Doppler audio spectra reflecting TMBV was recorded by a spectral analyzer. At this location of the SV, images were recorded and protractors were used to estimate DA. DA ranged from 10 to 40 degrees (x = 22.5 degrees +/- 10.8 degrees) in Group I and from 0 to 15 degrees (x = 4.5 degrees +/- 5.0 degrees) in Group II. Mean values of DA in Groups I and II were significantly different (p less than 0.01). We conclude: (1) in normal subjects, DA measured from the apex into the MV varies significantly and thus may compromise the accuracy of TMBV measurements; (2) the truncated funnel shape of the stent of the PMV bioprosthesis allows a DA less than 15 degrees and thus a smaller error in TMBV calculations.

Adult↗
PubMed1982

Superiority of two-dimensional echocardiography in the diagnosis of congenitally bicuspid aortic valve.

This study compares the role of M-mode and two-dimensional echocardiography in the evaluation of the nonstenotic, congenitally bicuspid aortic valve. Ten asymptomatic healthy subjects (age 20-35 years) with a systolic ejection click and short systolic murmur were evaluated. M-mode echocardiograms were entirely normal. The aortic root, diastolic closure line, eccentricity index of the aortic valve, and left ventricular size and function were normal in every subject. The two-dimensional parasternal long axis view of the aortic root was also normal in all patients with bicuspid aortic valves; there were no abnormalities of systolic excursion of the aortic cusps and doming of the aortic valve was absent. Images obtained in the two-dimensional parasternal short axis view of the aortic root at the level of the aortic valve revealed only two cusps, anterior and posterior, in all patients. The classic closure pattern of the normal tricuspid aortic valve forming a "Y" was absent in every subject. Instead, a horizontal closure line along the "X" axis was demonstrated in all patients; changing the angulation of the transducer in various positions did not alter this pattern. All subjects had increased reflectance of echoes along the line of diastolic closure, probably resulting from redundancy of the aortic cusp tissue. We conclude that because of the inability of the M-mode echocardiographic technique to accurately diagnose this condition in the study group, two-dimensional echocardiography should be the technique of choice in the evaluation of patients with a suspected bicuspid aortic valve. Recognition of this condition is important in view of its susceptibility to subacute bacterial endocarditis, aortic stenosis, and regurgitation.

Adult↗
PubMedDate not supplied

Fluoxetine improves emotional incontinence.

Emotional incontinence is a behavioural syndrome characterized by involuntary weeping, grimacing, and/or laughter. We investigated the efficacy of fluoxetine in 13 patients with emotional incontinence. All 13 patients demonstrated dramatic improvement in emotional lability within 3 to 14 days.

Adult↗