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Biomedical subjects

M E Foley

Publications and source records attributed to M E Foley.

15 recordsLinked to original sources
PubMed1992

En bloc radical vulvectomy and lymphadenectomy with modifications of separate groin incisions.

A new modification of radical vulvectomy and lymphadenectomy through separate groin incisions involves dissection of the intervening skin bridge and allows an en bloc dissection. The results in 26 women treated with this technique are compared with those of seven treated with separate incisions without an en bloc dissection. All 33 women had squamous carcinoma of the vulva and were treated between 1985-1989. The incidence of advanced disease was high, with nodal metastases present in 52% of cases. Dissection of the tissue beneath the skin bridge did not alter the morbidity of the procedure in terms of the incidence of wound infection, number of units of blood transfused, or duration of hospitalization. The only case of an isolated recurrence in the skin bridge occurred in a woman who did not have an en bloc dissection, although there was no significant difference in the overall local recurrence rate between the groups. Further evaluation with larger numbers is required, but we suggest that an en bloc dissection using separate incisions may reduce the risk of isolated recurrence in the skin bridge, particularly in patients with advanced disease.

Adult↗
PubMed1991

Midazolam for conscious sedation during pediatric oncology procedures: safety and recovery parameters.

Multiple bone marrow aspirations or biopsies and lumbar punctures are a necessary part of the diagnosis and treatment of many pediatric cancer patients. Pharmacologic sedation may decrease the distress associated with these procedures. Midazolam (MDZ, Versed) is a water-soluble, rapid-onset, short-duration benzodiazepine that has not been studied widely in children. We prospectively evaluated safety and recovery parameters for intravenous MDZ used for conscious sedation by oncologists (without an anesthesiologist in attendance) for 70 procedures (bone marrow aspirations, lumbar punctures, or bone marrow aspirations plus lumbar punctures) in 24 ambulatory pediatric cancer patients, aged 1.5 to 15.5 years. MDZ was used alone or in combination with morphine or fentanyl. Respiratory rate, oxygen saturation, blood pressure, and heart rate were monitored. Sedation, anxiolysis, and recovery were assessed with a behavior score and a modified recovery room discharge score. Restraint was not required in 45% of the procedures. In no case was a respiratory rate less than 12 observed. In nine procedures (13%), an oxygen saturation less than or equal to 90 occurred, all within 10 minutes after the last dose of MDZ. Ten procedures (14%) required verbal stimulation to take deeper breaths. Two patients did not respond immediately to verbal stimulation and received face-mask oxygen. Hypoxemia was not correlated with opioid use. Hypoxemia appears to be related to total MDZ dose and may occur with normal respiratory rates; all cases resolved with verbal stimulation or face-mask oxygen without specific airway maneuvers or assisted ventilation. Heart rate and blood pressure remained stable in all 70 procedures.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Cytological screening history of patients with early invasive cervical cancer.

The value of population screening for cervical cancer has recently been questioned. The purpose of this study was to examine the cytological screening history in 100 consecutive patients undergoing Wertheim's hysterectomy for early invasive cervical cancer. Twenty three per cent of the patients were never screened; the screening history was unavailable in 11%; the patient was referred appropriately in 21%; there was a delay in referral for gynaecological assessment in 21%; the patient's previous cervical smear before referral was normal in 24%. If population screening in Ireland is to have an impact on mortality from cervical cancer, the results of this study indicate that greater attention needs to be given not only to extending the number of women screened, but also to increasing the frequency of screening and to improving the clinical response to an abnormal smear.

Adenocarcinoma↗
PubMed1989

Influence of clothing and body-fat insulation on thermal adjustments to cold-water stress.

Male volunteers were divided into a low body fat (L) group (X = 10.6%, N = 5) and moderate fat (M) group (X = 18.6%, N = 5). Each was dressed in both dry suit plus medium insulation undergarment (DS-M) and dry suit plus heavy insulation (DS-H) and immersed in 10 and 15 degrees C water for 3 h. In 10 degrees C water, through not significantly different, rectal temperature (Tre) at h 3 was slightly higher in M (DS-M 36.4 degrees C, DS-H 36.5 degrees C) compared with L (DS-M 35.9 degrees C, DS-H 36.3 degrees C), whereas mean skin temperature (Tsk) and metabolic rate (MR) were in general, slightly lower for M(DS-M 23.6 degrees C, 184 W; DS-H 25.5 degrees C, 147 W, respectively). Over time the metabolic and thermal responses tended to stabilize after 120 min of immersion in both groups. Similar responses were observed in 15 degrees C water. These data suggested that despite the variation in body fatness, minimal thermal differences between groups were noted because of the attenuating effects of the insulated clothing.

Adaptation, Biological↗
PubMed1979

Effect of intrauterine contraceptive device on uterine haemostasis: a morphological study.

The effect of the intrauterine contraceptive device (IUCD) on uterine haemostasis was studied at various stages of the menstrual cycle in a series of 46 patients by light- and electron-microscopy and by following the distribution of an infusion of 51Cr-labelled autologous platelets. The endometrium in contact with the IUCD in the majority of cases showed grooving with atrophy and mild chronic inflammation in the surrounding tissues. The adjacent stroma also showed increased vascularity and occasional foci of haemorrhage but the increased blood loss associated with the presence of the IUCD could not be attributed to mechanical erosion or stromal blood vessels by the device. During menstruation the presence of an IUCD does not appear to inhibit the formation of fibrin/platelet thrombi although both in control and IUCD patients there was a striking paucity of platelet/fibrin thrombi in circumstances where their formation should be enhanced. In contrast to other workers we have not observed that gaps or breaks in the endothelial lining of endometrial blood vessels occur with any greater frequency in patients fitted with an IUCD. The principal mechanism by which uterine haemostasis is achieved remains to be established.

Adult↗
PubMed1978

Heparin-like activity in uterine fluid.

Uterine fluid was collected from a group of normal patients and a group of patients with menorrhagia. Heparin-like activity was detected in 34 out of 38 samples using an anti-Xa heparin assay. The heparin-like activity in uterine fluid was inhibited by adding the heparin antagonist hexadimethrine bromide to the assay. Concentrations of fibrinogen-fibrin degradation products (FDPs) were measured in five samples of uterine fluid. FDPs in the concentration detected had no effect on the anti-Xa assay. Heparin-like activity was higher in the group with menorrhagia, although the differences were not significant. Heparin-like activity increased throughout the menstrual cycle and decreased during menstruation, suggesting a possible cyclical variation in activity. There was no correlation between mast cell numbers in the endometrium and myometrium and heparin-like activity in uterine fluid and no correlation between the numbers and the stage in the menstrual cycle. In a few patients with intrauterine contraceptive devices (IUCDs) heparin-like activity was increased.

Body Fluids↗
PubMed1978

Viscosity, haematocrit, fibrinogen and plasma proteins in maternal and cord blood.

The viscosity at low shear rate of whole blood, plasma and serum, the haematocrit, plasma fibrinogen, plasma proteins, and IgM were measured in maternal and cord blood immediately following delivery. The whole blood viscosity in maternal blood (mean 19.96 +/- 3.74 centipoise or c/p) was similar to cord blood viscosity (mean 19.44 +/- 4.28 c/p). The mean haematocrit in maternal blood (0.385 +/- 0.026) was significantly lower than the cord haematocrit (0.488 +/- 0.39). Mean plasma viscosity (1.86 +/- 0.47 c/p) and plasma fibrinogen (4.25 +/- 0.75 g/litre) in maternal blood were significantly higher than cord plasma viscosity (1.12 +/- 0.19 c/p) and cord plasma fibrinogen (1.81 +/- 0.61 g/l). Mean serum viscosity (1.22 +/- 0.28 c/p) and mean IgM levels (2.38 +/- 0.36 g/l) in maternal blood were significantly higher than cord serum viscosity (0.90 +/- 0.15 c/p) and cord IgM (0.48 +/- 0.06 g/l). The low low levels of IgM and fibrinogen may protect the fetus from the increased viscosity that could be expected in association with a high haematocrit.

Blood Proteins↗
PubMed1978

Production of fibrinolytic enzymes by macrophages on intrauterine contraceptive devices.

Intrauterine contraceptive devices (IUCDs) were removed from 44 patients with a variety of clinical conditions, and incubated in culture media. Following incubation for up to 96 hours the total numbers of macrophages on each device were counted. The Lippes loop and Saf-T- Coil had higher counts than the Copper 7. The counts on all devices were higher at mid-cycle and during menstruation and significantly higher in patients with menorrhagia and intermenstrual bleeding (P less than 0.0005). Samples of culture media were taken on a number of occasions for up to 96 hours for fibrinolytic studies, and fibrinolytic activity increased with time in 10 of 16 cases where fibrinolytic activity was detected. There was a weak positive correlation between the number of cells on each of the 10 devices which produced a rise in fibrinolytic activity and the highest level of activity produced by each of the devices (r = +0.59; P less than 0.05). Plasminogen activator activity was maximum early in the incubation period, while plasmin-like activity predominated in later samples. The possible role of macrophages in IUCDs in causing menorrhagia is discussed.

Cell Count↗
PubMed1977

An in-vitro study of acidosis, platelet function, and perinatal cerebral intraventricular haemorrhage.

Platelet aggregation in response to adenosine diphosphate was studied in umbilical-vein blood from 24 term infants. The pH of platelet-rich plasma was experimentally reduced by adding increasing concentrations of lactic acid or by exposure to carbon dioxide. Aggregation was significantly impaired by acidosis and there was a significant positive correlation between falling pH and impaired platelet aggregation in both experiments. Impaired platelet aggregation secondary to acidosis may be a factor in perinatal intracerebral haemorrhage.

Acidosis↗
PubMed1977

Haemostatic mechanisms in maternal, umbilical vein and umbilical artery blood at the time of delivery.

Studies of the haemostatic mechanism were made on paired samples from the umbilical vein and artery and from a maternal peripheral vein immediately following delivery in 80 healthy patients with uncomplicated pregnancies. Neonatal blood showed a significant decrease in clotting 'activity' and platelet function, and a significant increase in fibrinolytic activity. The umbilical vein, in in comparison to the umbilical artery, showed increased clotting 'activity' increased platelet function and decreased fibrinolytic activity. The possible adverse influence of the placenta on haemostasis in the fetus and newborn is discussed.

Blood Coagulation↗
PubMedDate not supplied

Issues in the 70's.

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History, 20th Century↗