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Biomedical subjects

M A Duncan

Publications and source records attributed to M A Duncan.

29 records · Page 2Linked to original sources
PubMed1983

Incidence, recovery, and management of serratus anterior muscle palsy after axillary node dissection.

The purposes of this study were to determine the occurrence of serratus anterior muscle weakness after axillary node dissection, to monitor the recovery of serratus anterior muscle strength, and to compare shoulder range of motion in palsied and nonpalsied groups. Thirty-six patients were studied who had 40 axillary node dissections for breast carcinoma or malignant melanoma. Range of motion and manual muscle tests were done preoperatively and at specific postoperative intervals by two observers. To regain range of motion, all subjects were treated daily while hospitalized and as needed when outpatients. Twelve of the 40 dissections (30%) resulted in serratus anterior muscle palsy after surgery. Strength was normal in all the palsied shoulders by the sixth month after surgery. Both the palsied and nonpalsied groups had comparable range of motion at each assessment. The mechanism of long thoracic nerve injury and the clinical significance of serratus anterior muscle palsy are discussed as well as the rationale for early detection and proper physical therapy management. This study suggests that serratus anterior muscle palsy is a frequent but reversible event after axillary node dissection.

Adult↗
PubMed1981

Early versus delayed shoulder motion following axillary dissection: a randomized prospective study.

The role and timing of physical therapy following axillary dissection for melanoma, or in conjunction with modified radical mastectomy has not been extensively studied. A prospective randomized clinical trial was carried out over an 18-month period in the Surgery Branch, National Cancer Institute (NCI) and Department of Rehabilitation Medicine, Clinical Center, in which patients were assigned to receive one of two postoperative physical therapy regimens. Patients were assigned to receive graduated increases in allowed range of motion (ROM), either beginning on postoperative day 1 (early) or day 7 (delayed). All patients were advanced to full pain-free ROM when the suction catheters were removed. A total of 36 patients with 40 axillary dissections (19 for melanoma, 21 for breast cancer) were included in this study. Patients randomized to receive early motion had more total wound drainage (805 +/- 516 cc vs. 420 +/- 301 cc, p < 0.01), more days of drainage (10.3 +/- 5.3 vs. 6.2 +/- 2.7, p < 0.01), and later postoperative day of discharge (12.8 +/- 5.1 days vs. 9.2 +/- 4.0 days, p < 0.02) than did patients who started motion on day 7. Wound complications including infection and small areas of skin breakdown occurred more frequently in the early group (seven patients vs. one patient, p < 0.02). No significant differences in the per cent of patients achieving functional ROM could be identified between these two groups at one, three or six months after operation. Transient serratus anterior palsy (12 patients) and latissimus dorsi palsy (2 patients) occurred in approximately 30% of all patients, regardless of group (breast vs. melanoma, early vs. delayed), but returned to normal in all patients. The early institution of flexion and abduction exercises following axillary dissection thus appears to have a deleterious effect on wound healing and drainage. Adequate functional ROM is attained in all patients with a minimum of complications when active motion exercises are delayed for up to 7 days after axillary dissection.

Adult↗
PubMed1978

Salmonella serotypes isolated from the aquatic environment (Wabash River, Indiana, 1973-1976).

During 1973-1976, 833 isolations of salmonellae were made from the aquatic biosphere of the Wabash River, Lafayette, Ind. Of the isolants, 643 were definitively serotyped. Salmonella typhimurium represented 34.4% of the cultures. Salmonella eimsbuettel previously had not been recognized in Indiana. A total of 35 serotypes and 1 untypable group C1 was obtained from the aquatic samples, ie, river water, river bottom sediment, fish, and mussels. Most of the isolants were presumed to be of human origin, because many samplings were made in close proximity to sewage treatment plant outfalls. During the survey period, epidemic salmonellosis had not been reported for the Lafayette-West Lafayette metropolitan area.

Indiana↗
PubMed1976

Canine salmonellosis: A review and report of dog to child transmission of Salmonella enteritidis.

Dogs have been shown to harbor 53 salmonellae serotypes. Multiple simultaneous infections with 2 to 4 serotypes have been observed. The prevalence of canine salmonellosis may be a high as 27 per cent. Salmonella typhimurium and S. anatum are the most common etiologic agents. Dogs commonly experience a sub-clinical course of salmonellosis. Some investigators state that the dog may serve as a source of human infections. A few reports in the literature have documented this fact. The transmissions of S. enteritidis from dog to child is described in this article.

Ampicillin↗
PubMed1976

The treatment of salmonellosis in Equidae.

Among 23 Equidae in which various treatment or management regimens for salmonellosis were observed and evaluated, 9 horses were infected with Salmonella typhimurium and 8 with S anatum; an aged mule harbored S newport, and 1 isolant was not identified. Four dual sero-type infections occurred: 3 typhimurium/anatum and 1 anatum/newington. The results obtained with various antimicrobials in therapy of peracute, acute, and chronic infections were discouraging or questionable with regard to efficacy against salmonellae per se. The antimicrobial resistance patterns of the salmonellae and coliforms from the same fecal sample of the patient were determined. Salmonellae cultured from feces prior to, during, and following treatment with a variety of drugs were often sensitive to the antimicrobial administered during these periods. Drug sensitivity or resistance appeared to have little, if any, bearing on eliminating salmonellae from the feces or organs of infected Equidae.

Ampicillin↗
PubMed1976

Salmonellosis in Equidae: a study of 23 cases.

Salmonellosis in Equidae is a serious global problem. The prevalence may range from 0.36% to 27%. Probably 5% to 10% of the equine population in the U.S. is or has been infected. Over 40 serotypes of Salmonella have been cultured from Equidae. S. typhimurium (66.31%), S. enteritidis (9.6%), S. newport (5.16%) and S. heidelberg (4.89%) have been the most common equine isolates. The clinical and bacteriological studies of 23 naturally occurring infections in a large veterinary hospital were studied. Nine patients were infected with S. typhimurium, 8 with S. anatum, 1 with S. newport, 4 with dual serotype infections (3-S. typhimurium/S. anatum and 1 S. anatum/S. newington) and 1 untyped Salmonella. The roles of physical, surgical and environmental stress factors were analyzed. The fecal shedder state persisted for over 3 1/2 months. Feces of a foal contained 10(5) salmonella per gram. Salmonella were isolated from the feces of horses during and following antimicrobial therapy regimes. Supportive and symptomatic treatment as well as good nursing care are imperative in handling cases of equine salmonellosis.

Animals↗
PubMed1976

A survey of aquarium fishes, their foods, and environmental water for salmonellae.

The presence of salmonellae in the pet shop environment, fishes, aquarium water, and in a variety of commercially prepared and natural fish foods was determined. Salmonellosis attributed to turtles purchased from pet shops has been responsible for an estimated 280,000 human cases annually in the United States. The possibility that aquarium fishes, or their food and aquatic habitat might also serve as sources of human salmonellosis was deemed worthy of clarification. Results of the present survey indicate that this is probably not correct, and a public health hazarddoes not exist.

Aeromonas↗
PubMed1975

Canine salmonellosis: prevalence, epizootiology, signs, and public health significance.

Of 53 salmonella serotypes isolated from dogs, S typhimurium and S anatum have been the most commonly isolated. Surveys have disclosed that over 20% of the dogs in a population may be infected. Simultaneous, multiple infections with 2 or more serotypes are not unusual. Nonclinical salmonellosis occurs in most cases. The severe form of the disease is manifested by diarrhea, vomiting, fever, depression, abortion, and death. Dogs may remain carriers and fecal shedders and thus serve as sources of salmonellosis for man and other animals. A number of documented transmissions from dogs to human beings have been recorded. Such infections in man have been severe.

Abortion, Veterinary↗