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Biomedical subjects

L Bailey

Publications and source records attributed to L Bailey.

At least 55 records · Page 3Linked to original sources
PubMed1994

Analysis of condylar position changes: a test of validity of posteroanterior cephalometric and 20-degree lateral cephalometric techniques enhanced by digital subtraction.

This preclinical study was designed to evaluate 20-degree lateral cephalometric and posteroanterior cephalometric techniques with digital subtraction enhancement for their ability to detect 1-, 2-, and 3-mm shifts in condylar position in two of three planes of space (horizontal or transverse and vertical). The model used was a dry human skull with a complete mandible mounted on a microscopic stage with positioning accuracy to 0.1 mm in x, y, and z planes. Analysis of variance showed no significant difference from expected values in the transverse plane (posteroanterior cephalogram only). There were significant differences in the sagittal plane (20-degree lateral cephalogram only) for the 2- and 3-mm shifts (P < .001). There were no significant differences among expected values in the vertical plane for individual increments or for increment comparisons. The magnitude of standard deviations and of the absolute value of differences indicates markedly increased variability for both techniques as compared to tomograms produced with cephalostat repositioning. The authors conclude that even with precise repositioning and digital subtraction enhancement, cephalometric radiographs are inadequate for clinical monitoring of condylar position.

Analysis of Variance↗
PubMed1993

Pseudoaneurysms of the aorta after cardiac surgery or chest trauma.

Between March 1982 and June 1992, 17 patients (age: 21-76 years) were diagnosed with pseudoaneurysm of the thoracic aorta (PTA). Four PTAs developed post-trauma while 13 developed after aortic or cardiac surgery. Unusual presentations included: dyspnea, hoarseness, dysphagia, massive hemoptysis (2 degrees to aortobronchial fistula), massive hematemesis (2 degrees to aorto-esophageal fistula), superior vena cava syndrome, paralyzed right hemidiaphragm, and herald bleeding from the sternotomy. The interval between initial operation and recognition of PTA varied from three months to eight years while the four posttraumatic PTAs presented 5 to 26 years postinjury. The sites of postoperative PTA were: the aortotomy (3), proximal vein graft anastomosis (4), aortic cannulation site (2), and distal anastomosis of ascending aortic graft replacement (4). Aortography was very sensitive, outlining the false aneurysm in 13/13. Five patients had transesophageal echo-cardiography with one false negative. Seven patients died (41%), three from postoperative PTAs from massive hemorrhage intraoperatively and four from sepsis and multiorgan failure following repair. We conclude that patients who have previously had aortic or cardiac surgery or a history of blunt chest trauma presenting with unusual cardiorespiratory symptoms should be aggressively evaluated for PTA. Due to the magnitude of the operative problems encountered, repair of PTA is associated with a significantly high rate of mortality.

Adult↗
PubMed1993

A major outbreak of foodborne gastroenteritis among Air Force personnel during Operation Desert Storm.

An outbreak of foodborne gastroenteritis affected 648 United States Air Force personnel stationed in Jeddah, Saudi Arabia during Operation Desert Storm. The implicated food source was a locally catered meal. Despite the presence of an aggressive Air Force public health program, foodborne illness had a major impact on manpower and medical resources during a critical phase of military operations. It is the recommendation of the authors that the Air Force not rely on local caterers during future deployments.

Aerospace Medicine↗
PubMed1992

Survey of 3765 cardiopulmonary resuscitations in British hospitals (the BRESUS Study): methods and overall results.

OBJECTIVE: To determine the circumstances, incidence, and outcome of cardiopulmonary resuscitation in British hospitals. DESIGN: Hospitals registered all cardiopulmonary resuscitation attempts for 12 months or longer and followed survival to one year. SETTING: 12 metropolitan, provincial, teaching, and non-teaching hospitals across Britain. SUBJECTS: 3765 patients in whom a resuscitation attempt was performed, including 927 in whom the onset of arrest was outside the hospital. MAIN OUTCOME MEASURE: Survival after initial resuscitation, at 24 hours, at discharge from hospital, and at one year, calculated by the life table method. RESULTS: There were 417 known survivors at one year, with 214 lost to follow up. By life table analysis for every eight attempted resuscitations there were three immediate survivors, two at 24 hours, 1.5 leaving hospital alive, and one alive at one year. Survival at one year was 12.5% including out of hospital cases and 15.0% not including these cases. Each hospital year averaged 30 survivors at one year: three who had an arrest outside hospital, seven who had one in the accident and emergency department, seven in the cardiac care unit, 10 in the general wards, and three in other, non-ward areas. Within the hospitals survival rates were best in those who had an arrest in the accident and emergency department, the cardiac care unit, or other specialised units. Outcome varied 12-fold in subgroups defined by age, type of arrest, and place of arrest. CONCLUSION: 71% of the mortality at one year in patients undergoing attempted resuscitation occurred during the initial arrest. Hospital resuscitation is life saving and cost effective and warrants appropriate attention, training, coordination, and equipment.

Age Factors↗
PubMed1991

Growth factors in pathogenesis of coronary arterial restenosis.

Restenosis occurs in 25% to 55% of patients within 6 months of successful angioplasty. The major histologic component of the restenotic lesion is intimal hyperplasia, which is almost certainly driven by growth factors. After vascular injury, smooth muscle cells proliferate, reaching a maximum rate at day 2. Smooth muscle cell proliferation diminishes as the vessel surface is re-endothelialized at about day 7, and by week 4 the smooth muscle cell mitotic rate returns to baseline of less than 1% per day. The events of the histologic evolution of arterial injury can be used to create a hypothetical paradigm for the role of growth factors in restenosis. Restenosis might logically be prevented by an inhibitory intervention at any of the various steps in the healing process.

Animals↗
PubMed1991

Decortication for childhood empyema. The primary provider's peccadillo.

Of the 31 children treated for empyema thoracis secondary to pneumonitis at the Loma Linda University Medical Center, Loma Linda, Calif, from 1980 to 1990, 23 responded to prompt directed antibiotic therapy coupled with drainage, usually tube thoracostomy. All patients were cured clinically; some demonstrated residual pleural reaction with chest roentgenography or computed tomography that resolved over time. Decortication was necessary in eight severely ill children; three required concurrent lung resection for abscess. Distinct from the nonoperated group, there was a pattern of initial antibiotic trials in these patients averaging 6.5 different drugs plus delayed drainage of effusions. Delay in the initiation of antibiotic therapy was six times longer for the operated vs the nonoperated group. Delay to tube thoracostomy was 18 days for the decorticated children compared with 5.4 days for the nondecorticated children. All eight children responded completely and rapidly to their decortications. Roentgenographic changes lagged considerably behind the clinical course of the child, and computed tomographic scans provided better identification of chest tube placement but little information predictive of the need for decortication. Decortication for empyema seldom is necessary when a child is treated promptly with appropriate antibiotics directed by thoracentesis findings, and drainage, usually tube thoracostomy. The criterion for decortication is persistent sepsis, not the roentgenographic appearance of the chest.

Adolescent↗
PubMed1991

Medication group in a day hospital.

Many psychiatric outpatients need maintenance psychotropic medication, but noncompliance remains a major problem. One-half of psychiatric outpatients do not take their medications as prescribed. Medication compliance can be increased by proper and timely education regarding the psychiatric illness and the need for medication. A medication group in a day hospital setting is described which encourages the patient to take an active role in ensuring his best possible health. The goals of this group are to increase compliance by increasing understanding of psychiatric illness, actions and side effects of medications, how to cope with side effects, and how to avoid drug interactions. Fears and myths regarding use of medication are dealt with. Ongoing and repetitive discussions regarding medication use have been found to be useful and increase compliance.

Chicago↗
PubMed1991

Estazolam treatment of insomnia in generalized anxiety disorder: a placebo-controlled study.

Estazolam, a triazolobenzodiazepine with an intermediate elimination half-life, has been shown previously to be an effective and safe hypnotic in insomniacs without concomitant psychiatric illness. Our study of the efficacy of estazolam in patients with insomnia associated with generalized anxiety disorder began when 108 patients meeting criteria for generalized anxiety disorder (mean total score of Hamilton Rating Scale for Anxiety [HAM-A] = 22.0 +/- 3.1 [SD]) and insomnia were given single-blind placebo for 7 nights. Nine patients whose anxiety and/or insomnia improved were dropped as placebo responders. The remaining 99 patients were randomly allocated (1:1) to double-blind treatment with either estazolam 2.0 mg or matching placebo for 7 nights. Hypnotic efficacy, as determined by patient-completed sleep questionnaires, was statistically significant for estazolam 2.0 mg versus placebo for all sleep indices (p less than 0.01). Patients treated with estazolam 2.0 mg showed significantly greater improvement in anxiety than those receiving placebo on the mean total score of HAM-A ([placebo, -3.4; estazolam, -7.1; p less than 0.001] and without the insomnia item [placebo, -2.7; estazolam, -5.5; p less than 0.001]). Anxiety scores on the State-Trait Anxiety Inventory showed greater improvement in the estazolam group, but without statistical significance (p = 0.237). Estazolam 2.0 mg is an effective hypnotic in patients with generalized anxiety disorder and appears to have a favorable anxiolytic action.

Adult↗
PubMed1991

A satellite system for assisted reproductive technologies: an evaluation.

The University of North Carolina at Chapel Hill (UNC) Satellite System for Assisted Reproductive Technologies (ART) was initiated in 1984, and now serves most of North Carolina and parts of two adjoining states. The system was established to enhance the care of infertile couples at the community level, to assure a sufficiently large volume of patients at UNC Hospitals to support appropriate quality control measures, and to allow couples undergoing ART to have most of their care in their own community. This paper reports an assessment of the outcome of this program. Neither pregnancy rates, nor any other measurable result of the program differed between patients managed in the satellites and those cared for at UNC Hospitals.

Delivery of Health Care↗
PubMed1990

An alternative approach to nonpalpable breast biopsies.

Traditionally, when a negative specimen radiograph is obtained during biopsy of a nonpalpable breast lesion, immediate re-excision is performed in an attempt to successfully remove the lesion. Based on a retrospective study of the biopsy results of 792 nonpalpable breast lesions, the authors suggest delaying the re-excision, despite a negative specimen x-ray, until postoperative mammography confirms the persistence of the lesion. Utilization of this approach was associated with a comparably low incidence of missed lesions (3%) and had the added advantages of preserving breast tissue and decreasing operative time.

Biopsy↗
PubMed1990

Wellness centers.

Explore the source record for details and available documents.

Ambulatory Care Facilities↗
PubMed1990

[Direct removal of dentobacterial plaque using an oral rinse before brushing].

A study was conducted to evaluate the ability of a dental rinse to remove dental plaque. The hypothesis was tested that plaque, as a complex soil comprising microorganisms, cell debris, salivary deposits and other ill-defined organic and inorganic components, would be susceptible to removal by a rinse with high detersive action. A rinse was prepared based on the principles applied to formulation of products for cleansing biologic surfaces, including anionic and nonionic surfactants, sodium benzoate, and auxiliary cleansing agents. Subjects randomly selected from a dental clinic population were scored for plaque area on the lingual and buccal surfaces of the Ramfjord teeth using the Turesky modification of the Quigley-Hein Index. The subjects then rinsed 30 seconds with 15 ml of product, and stainable plaque area was scored again. The rinsing reduced average plaque scores by an average of 13-20%, a very high level of significance. A placebo rinse and a conventional mouthwash removed 2.0% and 1.3% stainable plaque, respectively. The experimental rinse substantially Increased the number of surfaces that were totally free of plaque.

Adult↗