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Biomedical subjects

M L Norton

Publications and source records attributed to M L Norton.

36 records · Page 2Linked to original sources
PubMed1972

Law and the surgeon.

Explore the source record for details and available documents.

Abortion, Spontaneous↗
PubMedDate not supplied

Medical computers from the manufacturer's viewpoint.

The recent surge in the scope of computer applications in medical care has brought with it great strides in patient care, but it has also created a variety of concerns to manufacturers of medical software. The spate of product liability suits, with its potentially crippling effects in terms of product development, makes it increasingly vital that manufacturers engage in prospective planning, to anticipate problems and take steps before legal action ensues, so that all parties--the manufacturer, the hospital, and ultimately, the patient--benefit from the availability of new technology. The Food and Drug Administration (FDA) and Congress are similarly grappling with the implications of this new technology, to assure that patient care is not compromised by products that have not yet been fully tested. The tension between the desire to make technology available to the public and the realities of the present regulatory and litigious climate is the key dilemma facing manufacturers of medical software.

Commerce↗
PubMedDate not supplied

Endotracheal intubation and Venturi (jet) ventilation for laser microsurgery of the larynx.

Meeting the exacting requirements for microsurgery of the larynx is a challenge for the anesthesiologist. To accomplish, the necessary dissection, the otolaryngologist has several requirements. They are a quiet relaxed field, excellent illumination with magnification, binocular vision for depth perception, and, above all, an unobstructed field. The management of anesthesia for suspension microsurgery on the larynx presents many problems, the most vexing of which is the fact that the otolaryngologist and anesthesiologist are in competition for access to the patient's airway. In sharing this, neither has been able to perform with the degree of control that he would like due to either inadequate operating conditions or insufficient access to ventilatory mechanisms. Several anesthetic techniques have been used for inspection or operative laryngoscopy: topical anesthesia, apneic techniques, translaryngeal topical anesthesia, chest respirator, neuroleptanalgesia, and general endotracheal anesthesia with muscle relaxants. The latter has proven most popular, particularly in children, because ventilation and surgical conditions are considered to be most controllable. However, the presence of the requisite endotracheal tube obscures the full view of the larynx and vocal cords, and the tube may itself become obstructed. Additionally, use of the laser involves the further risk of heat effects on the endotracheal tube if the beam hits the tube. This report presents our experience and development of the combined technique of endotracheal intubation and Venturi (jet) ventilation. We believe it represents the safest available approach while providing near ideal working conditions for the otolaryngologist during laser microsurgery of the larynx.

Adolescent↗
PubMedDate not supplied

Atlantoaxial instability revisited. An alert for endoscopists.

Atlantoaxial instability in rheumatoid arthritis patients presents a particular hazard for endoscopists. The basic pathology, while well known to orthopedists, is not common knowledge among bronchoesophagologists or anesthesiologists. The paper describes the syndrome, potential complications and possible approaches to avoiding serious neurologic sequellae.

Arthritis, Rheumatoid↗
PubMedDate not supplied

Corneal injuries during general anesthesia.

A corneal abrasion is the most common eye complication during general anesthesia and recovery. It is painful, may progress to inflammation of the uveal tract, and in the presence of contamination may lead to a serious infection. Both eyes may be involved, as the two reported cases show. Possible causes include mask friction on the open eye or other careless technics. Treatment includes local application of an antibiotic ointment and an eye pressure patch. In addition, a cycloplegic and mydriatic solution is instilled to prevent synechiae (in the presence of a secondary iridocyclitis) and to relieve the pain associated with spasm of the iris and ciliary muscle. Topical application of local anesthetics should be avoided, as they delay regeneration of corneal epithelium and may promote keratitis.

Adult↗
PubMedDate not supplied

Hereditary hemochromatosis.

Genetic (hereditary) hemochromatosis is probably the most common autosomal recessive disorder found in white Americans, of whom about 5/1,000 (0.5 percent) are homozygous for the associated gene. The hemochromatosis gene is probably located close to the HLA-A locus on the short arm of chromosome 6. Homozygous individuals may develop severe and potentially lethal hemochromatosis, especially after age 39. Hereditary hemochromatosis involves an increased rate of iron absorption from the gut with subsequent progressive storage of iron in soft organs of the body. Excess iron storage eventually produces pituitary, pancreatic, cardiac, and liver dysfunction and death may result from cardiac arrhythmias, congestive heart failure, and/or hepatic failure or cancer. Early diagnosis can prevent these excess iron-induced problems. Iron overload owing to HLA-linked hereditary hemochromatosis can be distinguished from other causes of hemochromatosis by liver biopsies and interpretations. Patients at risk for genetic hemochromatosis should be screened, identified, and treated as early as age 20 to prevent or minimize the deadly complications of hemochromatosis. Population screening should include measurements of serum iron concentration, total iron binding capacity (TIBC), percent saturation of transferrin, and serum ferritin concentrations. Family members of hereditary hemochromatosis patients are at increased risk and should be tested. Screening, identification and early treatment (phlebotomies, sometimes in combination with the use of Desferal or other iron-chelating agents) may help prevent or reduce iron-related organ damage and premature deaths. Early diagnosis and treatment will reduce the population of aging individuals with severe, complicated hemochromatosis and dramatically reduce medical costs (billions of U.S. dollars per annum) associated with the management of this disease.

Adult↗