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Biomedical subjects

M Besser

Publications and source records attributed to M Besser.

99 records · Page 6Linked to original sources
PubMed1982

Evaluation of CSF shunt patency by means of technetium-99m DTPA.

Evaluation of 192 cerebrospinal fluid shunts was performed using 1 mCi of technetium-99m DTPA which was injected into the shunt tubing. This was found to be a safe, simple method of evaluating shunt patency. No complications were noted with this procedure, nor was there any documented case of infection related to the injection of the isotope. The sensitivity of the test for evaluation of patency was 97%, specificity 90%, and accuracy 93%. Various patterns of tracer clearance are noted and discussed. The role on this test as an aid in making management decisions is detailed.

Adolescent↗
PubMedDate not supplied

Transfer rates from freestanding birth centers. A comparison with the National Birth Center Study.

This article reviews retrospective data derived from Sharp The BirthPlace. San Diego for 1993-94 and from the University of California. Irvine, Birthing Center for 1994 and compares these findings to data obtained from the National Birth Center Study (NBCS). The focus of this article is on intrapartum transfer rates from the two freestanding birth centers as a critical clinical indicator. Cause-specific transfer rates were calculated for eight clinical conditions. Data suggest that cause-specific intrapartum transfer rates are influenced by factors such as risk profile of the client population, distance to the referral center and mechanisms of transfer, definitions and diagnostic criteria used, and clinical practice guidelines. Reports from the literature, such as NBCS data, might serve as points of reference, but are likely not appropriate baseline indicators (benchmarks of "best practice") for clinical events, against which individual performance can be measured; rather, these benchmarks should be individually defined, based on characteristics unique to each birth center.

Birthing Centers↗
PubMedDate not supplied

Levels of lead in blood and bone of women giving birth in a Boston hospital.

Blood lead levels declined among Americans aged 1-74 y between the years 1976 and 1991 (National Health and Examination Survey [NHANES III]). In 1990, umbilical cord blood lead levels were surveyed among 223 women who gave birth in a Boston hospital obstetrical service. In a survey conducted 10 y earlier, women had a mean umbilical cord blood lead level of 6.56 micrograms/dl (standard deviation = 3.19). In another subgroup of 41 women who were 1-4 wk postpartum, bone lead levels were surveyed with a K-x-ray fluorescence instrument and by analysis of venous blood lead levels. In 1990, umbilical cord blood lead levels were very low (i.e., mean and median of 1.19 [standard deviation = 1.32] and 1.0 micrograms/dl, respectively. In the subgroup of postpartum women, lead levels in cortical bone (i.e., tibia) and trabecular bone (i.e., patella) were also low (i.e., tibia mean and median of 4.5 [standard deviation = 4.0] and 4 micrograms/g bone mineral, respectively); patella mean and median of 5.8 [standard deviation = 4.5] and 5 micrograms/g, respectively). Maternal age was the only factor associated (i.e., borderline [p=.076]) with bone lead. Umbilical cord blood lead levels among women served by this Boston hospital from 1980 to 1990 declined dramatically, thus paralleling the National Health and Examination Survey. Bone lead levels were also low, but lead remains a reproductive hazard to women in select high-risk groups.

Adolescent↗
PubMedDate not supplied

Ventricular volume in infantile hydrocephalus and its relationship to intracranial pressure and cerebrospinal fluid clearance before and after treatment. A preliminary study.

The present study examines ventricular volume before and after shunting in 16 infants with hydrocephalus and mixed aetiology and relates this parameter to rates of cerebrospinal fluid clearance, intracranial pressure and outcome. Following treatment all patients showed reduction in intracranial pressure and amelioration of the clinical manifestations of hydrocephalus. Nevertheless, 4 patients showed persistence of marked ventriculomegaly, 4 had moderate ventricular enlargement, while 8 showed small or normal ventricles. Although the series was small there appeared to be a clear correlation between persistent ventriculomegaly, poor cerebrospinal fluid clearance and poor outcome despite reduction in intracranial pressure. The question is raised as to whether pressure-determined cerebrospinal fluid drainage provides optimum treatment of hydrocephalus in infants given the particular physical characteristics pertaining to the non-rigid cranium.

Cephalometry↗