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Biomedical subjects

M E Mitchell

Publications and source records attributed to M E Mitchell.

At least 91 records · Page 5Linked to original sources
PubMed1992

Positive effect of a nutrition instruction model on the dietary behavior of a selected group of elderly.

The effectiveness of the Nutrition Instruction Model to promote a positive change in the dietary behavior in a selected group of the elderly was tested. Subjects were one hundred and four adults, aged 65 and over, who were assigned to three groups. The experimental group received nutrition education based on the components of the model. The other two groups received nutrition education via the lecture approach or no intervention. The experimental subjects showed the greatest positive dietary behavior change. The study results suggest that the Nutrition Instruction Model may be effective in leading to dietary behavior change in the elderly.

Aged↗
PubMed1991

Intraoperative cardiovascular collapse secondary to latex allergy.

An apparent allergic reaction has been noted in children undergoing open urological surgery. This condition is characterized by precipitous hypotension, tachycardia and upper body flushing, and it often causes termination of the procedure. Latex allergy has been identified as the possible inciting event. Contact of latex rubber gloves with intra-abdominal structures (handling bowel) appears to be the most dramatic trigger mechanism for this reaction. We report on 10 patients with latex allergy, 6 of whom have myelomeningocele, who have undergone reconstructive surgery. Severe anaphylactic shock developed intraoperatively in 5 patients and during a barium enema performed with a latex catheter in 1 patient. These 6 patients had previous allergic reactions to latex material, which was not detected preoperatively. In the remaining 4 patients latex allergy was diagnosed preoperatively. A total of 6 patients agreed to a skin prick test to liquid latex. Three patients reacted with a wheal size greater than or equal to a histamine control at a dilution of 1:1,000 and 3 patients at 1:100. In contrast, none of the 5 normal controls reacted to any of the concentrations including full strength latex. A history of exposure to latex products (balloons, surgical gloves, catheters, condoms and so forth) with allergic reactions should heighten surgeon awareness of a potentially severe intraoperative reaction. Furthermore, a skin prick test may be used to screen high risk patients such as those with myelomeningocele. A protocol involving preoperative corticosteroid and antihistamine therapy is recommended.

Adolescent↗
PubMed1991

Dietary carnitine effects on carnitine concentrations in urine and milk in lactating women.

The effect of dietary carnitine on urinary excretion of free and total carnitine and on breast-milk secretion of the carnitine fractions in 15 control and 16 lactating women aged 21-40 y was measured. Free and total carnitine excretions, obtained from 24-h urine collections, correlated with carnitine consumed on the collection day (P less than 0.03, P less than 0.01, respectively) but not with the mean intake calculated from 3-d diet records. The immediate responses of the control and lactating groups were not significantly different. Urinary excretion of carnitine (n = 31) was 82 +/- 13 mumol/d for free excretion and 226 +/- 22 mumol/d for total excretion. Milk free, acid-soluble acyl-, acid-insoluble acyl-, or total carnitine did not correlate with dietary carnitine or with the duration of lactation (1-10 mo). Milk total carnitine was 45 +/- 3 mumol/L. With the carnitine content of breast milk remaining stable for greater than or equal to 10 mo, the importance of exogenous carnitine throughout infancy is suggested.

Carnitine↗
PubMed1991

Gastric bladder reconstruction.

Overall, stomach is an ideal tissue that is readily accessible for bladder augmentation or substitution. It has excellent muscle backing for antireflux and continence procedures. Its fibroelastic characteristics allow construction of a capacious and compliant reservoir. It has special merit in patients who have been irradiated by virtue of being rarely involved in the field of radiation; in patients with short bowel, because it usually is not associated with congenital abnormalities of the gastrointestinal tract; in patients with renal compromise and metabolic acidosis, because of its ability to secrete chloride and hydrogen ions; in patients with chronic urinary infections; and in patients with difficulty with catheterization because of excessive mucus.

Acidosis↗
PubMed1991

Magnetic resonance imaging of a seminal vesicle cyst and a review of the imaging modalities.

Magnetic resonance imaging (MRI) is invaluable in the diagnosis of pelvic pathology as demonstrated here by its use in the diagnosis of a seminal vesicle cyst. Comparison is made with computed tomography, ultrasonography and voiding cystourethrography (VCUG). MRI provides precise, anatomical detail, far superior to other modalities. The advantages and disadvantages of older diagnostic modalities, such as intravenous pyelogram, VCUG and seminal vesiculography, are discussed in this article.

Adolescent↗
PubMed1990

Cloacal exstrophy reconstruction for urinary continence.

From 1978 to 1989 we treated 16 patients with cloacal exstrophy, including 8 who have been treated since birth. To achieve urinary continence bladder reconstruction was required in 12 patients, including 3 ileocystoplasties, 4 gastrocystoplasties and 5 gastric continent urinary reservoirs. All 12 patients underwent simultaneous bladder neck/urethral continence procedures. Of the 12 patients with completed reconstruction 10 were evaluable for continence. All 10 patients are dry for periods of 3 or more hours, and 5 are totally dry day and night. All but 1 patient are totally dependent on clean intermittent catheterization. Followup ranges from 2 to 66 months, and all except 1 patient have stable upper tract function. Patients with cloacal exstrophy can undergo reconstruction in a fashion to maintain urinary continence, and stomach is the ideal tissue for such reconstruction.

Adolescent↗
PubMed1990

Long term effects of gastrocystoplasty in rats.

Twenty prepubescent rats underwent microsurgical gastrocystoplasty by a technique which is described. An equal number of control rats had their bladders opened and closed. Rats were sacrificed at 16 to 18 months postoperatively. There were no differences in final weight, serum electrolytes, or renal function between the two groups. Prominent histopathologic changes of the bladder occurred in the gastrocystoplasty group. These changes included papillomas present in five of the 15 rats surviving long term. No significant changes occurred in the bladders of the control group of rats. Possible etiologies and the significance of the rats. Possible etiologies and the significance of the gastrocystoplasty related lesions are discussed.

Animals↗
PubMed1990

Ectopic ureter presenting as a psoas abscess.

Psoas abscesses are uncommon infections whose etiology may be primary or secondary. We report on a boy with ureteral ectopia presenting as a secondary psoas abscess. The diagnosis of a psoas abscess is protean and should be considered in all patients, particularly children, who present with acute thigh or hip pain and fever.

Abscess↗
PubMed1990

Intercellular adhesion molecule-1 (ICAM-1) in cellular immune reactions in the human central nervous system.

Cryostat sections of human central nervous system (CNS) tissue samples from 10 cases of multiple sclerosis (MS), 11 cases with inflammation and necrosis, and 24 normal controls were immunostained with antibodies to intercellular adhesion molecule-1 (ICAM-1) and its integrin ligand lymphocyte function-associated molecule-1 (LFA-1). In 18 controls, small numbers of CNS microvessels were ICAM-1-positive. There were more numerous ICAM-1-positive vessels in active MS plaque edges, viral encephalitis lesions, infarcts, and in six controls. Within active MS plaques and in viral infections, mononuclear cells and some glia also were ICAM-1-positive. Mononuclear but not CNS resident cells were LFA-1-positive. Thus, CNS vessel ICAM-1 expression is variable in amount in postmortem samples of normal human CNS tissue, may increase early and focally in cellular immune reactions, and, via binding of LFA-1, may promote leukocyte influx into the CNS. Intercellular adhesion molecule-1 expression on parenchymal cells may indicate additional interactions with LFA-1 on inflammatory cells in diverse CNS lesions.

Antigens, Differentiation↗
PubMed1990

Physiology of lower urinary tract obstruction.

One of the major dilemmas facing pediatric urologists today is discerning obstruction in the dilated urinary tract. Apparently similar anatomic obstructions can result in very dissimilar consequences. The authors focus on the physiologic response of the bladder and upper tracts to infravesical obstruction. They caution against treatment focused merely on the obstruction, noting that the entire urinary tract must be addressed.

Animals↗
PubMed1989

Anti-neutrophil-elastase defenses of the lower respiratory tract in alpha 1-antitrypsin deficiency directly augmented with an aerosol of alpha 1-antitrypsin.

STUDY OBJECTIVE: To determine if aerosolization of purified human plasma alpha 1-antitrypsin is an effective means for increasing lower respiratory anti-neutrophil-elastase defenses in alpha 1-antitrypsin deficiency. DESIGN: Nonrandomized, before-and-after trial with a 7-day treatment period. Companion studies in animals to determine lung epithelial permeability to alpha 1-antitrypsin. PATIENTS: Twelve patients with homozygous Z-type alpha 1-antitrypsin deficiency and mild to moderate emphysema. INTERVENTIONS: Aerosol administration of human plasma alpha 1-antitrypsin, 100 mg every 12 hours for 7 days. Single, 100-mg aerosol dose to anesthetized sheep with indwelling thoracic lymph duct catheters for direct assessment of lung permeability. MEASUREMENTS AND MAIN RESULTS: Treatment resulted in increased alpha 1-antitrypsin levels in the lung epithelial lining fluid (0.28 +/- 0.07 microM before therapy to 5.86 +/- 1.03 microM after therapy) and increased anti-neutrophil-elastase capacity (0.78 +/- 0.38 microM before therapy to 4.16 +/- 0.95 microM after therapy). Aerosolized alpha 1-antitrypsin diffused across the respiratory epithelium and entered lung interstitial lymph (in sheep) and reached the systemic circulation (in sheep and humans). No side effects were noted. CONCLUSION: Short-term aerosol administration of human plasma alpha 1-antitrypsin to patients with alpha 1-antitrypsin deficiency is safe and feasible, resulting in a return to normal of anti-neutrophil-elastase defenses in the lower respiratory tract. The aerosol approach, therefore, merits serious long-term evaluation as an alternative to other parenteral forms of administering therapeutic proteins.

Aerosols↗
PubMed1989

Posterior urethral valves in siblings.

The etiology and incidence of posterior urethral valves is unknown. We report on a pair of non-twin siblings with identical pathology stemming from type I posterior urethral valves as well as discordance in a pair of monozygotic twins. Familial posterior urethral valves have been reported before in both twin and non-twin siblings. The occurrence of identical pathology in non-twin siblings suggests the possibility of an inherited trait as does its occurrence in identical twins. However, non-identical clinical manifestation is as common as is identical presentation in both groups. There are also instances of discordance in monozygotic twins suggesting the possibility of a random mutation. As such, we recommend urologic evaluation of the male siblings of affected patients with posterior urethral valves. Further prospective and retrospective analyses are needed to define the genetic etiology of valves.

Diabetic Nephropathies↗