Biomedical subjects

M A Glover

Publications and source records attributed to M A Glover.

4 recordsLinked to original sources

PubMed2005

Diving medicine.

Recreational diving developed in the late 1940s when self-contained underwater breathing apparatus (SCUBA) first became available for civilian use. At the same time the development of the commercial airliner, in particular the jet airliner, made possible the concept of international travel for pleasure as opposed to business. Over the past 50 years the number of international tourists has increased by over 2500% from a mere 25 million in 1950 to over 700 million in 2002 (Treadwell TL. Trends in travel. In: Zuckerman JN, editor. Principles and practice of travel medicine, 2001; p. 2-6). The popularity of recreational diving has also increased over the same period from an activity experienced by a small number of individuals in the early 1950s to an activity today enjoyed by many millions. The combination of increased international travel and the means by which to enter and explore the underwater world has led to diving becoming increasingly popular as a tourist activity.

Adolescent↗

PubMed2000

Primary blast injury: pathophysiology and implications for treatment. Part III: Injury to the central nervous system and the limbs.

There are some structures in which changes consistent with primary blast may be found despite secondary and tertiary blast being the most frequent sources of injury. The Central Nervous System for example, especially the brain, is well protected yet there are historical and experimental accounts of damage which cannot be attributed to secondary or tertiary blast or even air embolism resulting from pulmonary disruption. Similarly, analysis and experimental simulation of specific skeletal injuries has shown that primary blast alone can fracture bones and that it is likely to be responsible for limb avulsions in victims exposed to stress waves of sufficiently high intensity.

Blast Injuries↗

PubMed1999

The pathophysiology of primary blast injury and its implications for treatment. Part II: The auditory structures and abdomen.

The authors have previously considered the mechanisms by which primary blast injury affects the respiratory and cardiovascular systems and what deductions may be made about management of the resulting injuries. This article considers the somatic effects of primary blast on abdominal and auditory structures. These injuries are usually of less immediate concern but require accurate management in order to avoid late mortality and morbidity and to return the casualty to full function. Recognition of likely injury patterns is vital to the instigation of correct management. The tympanic membrane, for instance, is easily damaged by blast and such an injury may be complicated by ossicular disruption, perilymph fistula or forceful distribution of squamous epithelium around air filled spaces with potential to form cholesteatoma. Abdominal organs can be severely disrupted by primary blast. The treatment of such injuries is not dissimilar to that of any other cause of abdominal trauma. The most challenging aspect is the identification of intestinal intramural haemorrhage and discrimination between those lesions destined for perforation or for spontaneous recovery. In this article the range and mechanism of injury are described for each system, drawing on experience from other modes of injury closely related to blast, followed by suggestions for their management established from literature reviews and experimental work undertaken by the authors during periods of full time research.

Abdominal Injuries↗

PubMed1998

The pathophysiology of primary blast injury and its implications for treatment. Part I: The thorax.

There is insufficient evidence to support a definitive approach to the clinical management of primary pulmonary blast injury. Post-blast cardiovascular and pulmonary changes are reviewed in this paper in order to highlight important aspects in the immediate management of the blast injured casualty. Blast profiles and theoretical mechanisms of injury vary widely but all result in mechanical disruption and cause similar pathological, physiological and biochemical responses. Some patients may present acutely, while others appear unharmed and develop respiratory failure 12-24 hours later. Treatment outcome may depend on the judicious use of resuscitative fluids and respiratory support. The roles of supplementary oxygen and assisted ventilation remain controversial although administration of high inspired oxygen concentrations and respiratory support may be unavoidable. The advantage of pharmacological manipulation of reflex mechanisms is as yet unproven. Hyperbaric therapy may improve survival in pulmonary blast injury.

Blast Injuries↗