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Biomedical subjects

P Potter

Publications and source records attributed to P Potter.

17 recordsLinked to original sources
PubMed1992

Does DeLee suction at the perineum prevent meconium aspiration syndrome?

OBJECTIVE: We attempted to determine the impact of "early" (before delivery of the chest) oronasopharyngeal DeLee suctioning at the perineum in the prevention of meconium aspiration syndrome and to confirm that meconium aspiration syndrome is a postnatal event. STUDY DESIGN: We compared infants with meconium-stained fluid who underwent "early" oronasopharyngeal DeLee suctioning with a similar group of infants whose airways were suctioned "late" (after chest delivery). Practicing obstetricians did not know the study was being conducted by the pediatric staff, and an independent observer documented whether obstetricians performed "early" or "late" oronasopharyngeal DeLee suctioning. Immediate postnatal tracheal suctioning was performed in both groups. The study was conducted in a private tertiary care center averaging 5800 deliveries annually. A consecutive sample of 438 infants with meconium-stained fluid was analyzed. Of these infants, 221 received "early" oronasopharyngeal DeLee suctioning, while 217 infants were suctioned "late". RESULTS: Of the 438 infants with meconium-stained fluid, meconium aspiration syndrome developed in 38 (9%). These infants had higher rates of fetal distress (i.e., abnormal fetal heart rates) and lower Apgar scores (< or = 6) than infants without meconium aspiration syndrome (58% vs 17% and 65% vs 13%, respectively; p < 0.001). Forty-five percent of the infants with meconium aspiration syndrome had renal failure during the first 20 hours of life. In spite of "early" oronasopharyngeal DeLee suctioning, 53% of the infants in this group had meconium below the vocal cords and meconium aspiration syndrome developed in 7%. The time of oronasopharyngeal DeLee suctioning did not affect the rate of meconium aspiration syndrome or the presence of meconium below the vocal cords. CONCLUSIONS: We concluded that "early" oronasopharyngeal DeLee suctioning at the perineum does not affect the rate of meconium aspiration syndrome. We speculate that meconium aspiration syndrome is predominantly an intrauterine event associated with fetal distress and that meconium in the airways is merely a "marker" of previous fetal hypoxia.

Chi-Square Distribution↗
PubMed1991

Functionally active complement proteins C6 and C7 detected in C6- and C7-deficient individuals.

Two sensitive sandwich ELISAs based on monoclonal antibodies directed to native C6 and C7 allowed the detection and quantitation of these complement proteins in 20 out of 37 serum samples from individuals who had previously been classified as deficient in these proteins as assessed by immunochemical and/or functional assays. Furthermore, serum from four C6-deficient and one combined C6-/C7-deficient individual showed an increase in the terminal complement complex (TCC) and a decrease in native C6 and C7 after complement activation as assayed by specific ELISAs. Despite their (incomplete) deficiencies, these individuals therefore possess functionally active terminal complement proteins with respect to their ability to generate the TCC. As these individuals have no history of a susceptibility to neisserial infections, even low concentrations of functionally active C6 and C7 may provide sufficient protection against those micro-organisms whose destruction requires TCC formation.

Antibodies, Monoclonal↗
PubMed1991

Immersed clo insulation in marine work suits using human and thermal manikin data.

The immersed clo value of a series of 11 marine work suits has been measured using both humans and a thermal manikin. In still water, there is no significant difference in the measurements. Turbulent water significantly reduces the immersed clo value. The manikin errs on the safe side and consistently overestimates this decrement in insulation, and the reasons for this are discussed. Not intended to replace human physiological testing, the manikin is an excellent apparatus for the examination of conditions not easily or ethically possible to represent using humans. A good fitting suit with efficient neck, wrist and ankle closures which reduce flushing of water is essential to make an effective marine work suit.

Adult↗
PubMed1989

Collaboration by consortium.

Recognizing that collaboration is essential for the continuing development of the nursing profession, nursing leaders in the St. Louis area organized the Nursing Consortium for Research in Practice, uniting four university schools of nursing and four large hospitals. The aim of consortium is to assist nursing faculty and nursing service personnel in the conduct of collaborative clinical research. The consortium also seeks to educate nurses about research as a component of professional nursing practice and to assist them in implementing research findings in clinical practice. The efforts of the consortium during its first four years are discussed.

Clinical Nursing Research↗
PubMed1987

Leuko-araiosis.

Problems in the literature in the appraisal of brain deep white-matter changes are considered. The identification of the changes with Binswanger's disease alone is rejected, and evidence is reviewed that demonstrates that they are associated with cognitive impairment and, to some extent, with vascular disease. Possible causes of white-matter changes and their relationships to Alzheimer's disease are examined, and it is argued that a neutral term, exact enough to define white-matter changes, sufficient as a description or label, and demanding enough to require precise clinical and imaging descriptions is needed. We suggest herein the term "leuko-araiosis" on the basis of Greek etymology and Hippocratic usage.

Brain↗
PubMed1987

Treatment of Mooren's ulcer with cyclosporin A: report of three cases.

Three patients with severe, bilateral, progressive Mooren's ulcers, unresponsive to medical and surgical therapy, were treated with cyclosporin A. All three responded rapidly to the drug and there has been no recurrence of the Mooren's ulcers since (average follow-up 14 months). Peripheral blood T lymphocyte subsets were estimated prior to and during treatment. No significant abnormalities were found initially. Suppressor cells increased on treatment, and a corresponding drop of the helper/suppressor cell ratio occurred in two patients.

Aged↗
PubMed1986

Leuko-araiosis: an ancient term for a new problem.

Recent research with computerized tomography (CT) and magnetic resonance imaging (MR) of the brain has revealed a type of tissue change for which no fitting term exists. The change appears as areas of decreased density on CT and changed signals of the white matter in MR images. Because neither a definite pathological change nor a specific clinical deficit has been linked with the CT and MR changes, a designation is required that limits itself to describing the changes themselves. We propose "leuko-araiosis". The Greek root leuko-, signifying "white", has found wide usage in modern medical terminology: e.g. leucine, leukocyte, leukorrhoea. Also several precedents exist for its application to the white matter of the central nervous system: e.g. leukoencephalitis, leukomyelitis, leukotomy. Araios is an adjective meaning "rarefield", and the suffix -osis converts the adjective to a noun meaning "rarefaction, diminution of density", a word used in the Hippocratic Collection to describe a state of excessive porosity of the lung. A descriptive term precludes premature presuppositions and encourages the search for causes.

Brain↗
PubMed1985

A simple and sensitive method of acetylcholine identification and assay. Bioassay combined with minicolumn gel filtration or high-performance liquid chromatography.

A modified technique of acetylcholine assay on the guinea pig ileum has been combined with either minivolume gel filtration or high-performance liquid chromatography separation of the samples. In addition, labeled acetylcholine (14C-ACh) was eluted with unlabeled acetylcholine or with the samples expected to contain acetylcholine, and their elution profiles were compared by bioassay plus radioassay of eluate fractions. When the elution of both biological activity and label occurred in the same eluates, it was concluded that the substance assayed on guinea pig ileum was acetylcholine. The method was sensitive to 0.5 ng (1.8 pmol) of acetylcholine and its reproducibility was within 5%. It thus represents a substantial improvement in chemical specificity over the previous bioassay method described by Paton and Vizi (1969).

Acetylcholine↗
PubMed1979

The effect of propranolol and dimethylpropranolol on cardiac conduction.

Isolated dog hearts perfused with blood from a donor dogand driven at two heart rates were used to compare the effects of propranolol with those of its quaternary ammonium derivative on atrial, atrioventricular (AV) nodal, and His-Purkinje conduction. Propranolol slowed only AV-nodal conduction, increasing the minimal conduction time and the effect of prematurity, without affecting fatigue. Practolol did not have this effect. Dimethylpropranolol had similar but not identical effects on the AV node, but also slowed atrial and ventricular conduction. In contrast with the quaternary derivative of lidocaine, dimethylpropranolol's effect on atrial and ventricular conduction was not dependent on the heart rate. The effect of dimethylpropranolol on ventricular conduction was observed at doses lower than those reported by others to be antiarrhythmic.

Animals↗
PubMed1976

Echoencephalographs of 100 consecutive acute psychiatric admissions.

Echoencephalography (ECHO) on 100 consecutive acute short-term psychiatric admissions showed a high (12 per cent) incidence of abnormalities. Incidence of midline ECHO abnormalities was 2 per cent, comparable to similar studies. Ventricular enlargement accounted for the majority of ECHO abnormalities. This study also confirmed a previous report of a relationship between third ventricular size and response to treatment. Use of the ECHO as a screening test for these patients was safe and rapid. Correlative studies tended to confirm ECHO findings.

Adolescent↗
PubMedDate not supplied

Steroids and bowel rest versus elemental diet in the treatment of patients with Crohn's disease: the effects on protein metabolism and immune function.

Recent studies have shown an elemental diet to be as effective as bowel rest plus steroids in the management of acute Crohn's disease. In order to investigate the metabolic and immunological effects of these two therapies, six patients with an acute inflammatory attack of ileal Crohn's disease were randomly assigned to receive steroids or elemental diet for 7 days. Immunological and protein metabolic studies were performed before and after therapy, protein kinetic rates being measured by the method of constant intravenous infusion of 14C-labeled leucine tracer. Clinical and symptomatic improvement was noted in all six patients with significant falls in sedimentation rate and platelet counts and increases in albumin concentrations. Both forms of treatment increased plasma amino acid flux and oxidation rates, whole body protein turnover and rates of incorporation of amino acid into albumin. However, the increased rates of protein metabolism in the patients given steroids were at the expense of body protein stores with a net (average) loss of 58 g of nitrogen over 7 days. While both forms of therapy were associated with suppression of lymphocyte subsets, complement and circulating immune complexes only the steroid regimen was associated with suppression of in vivo IgG synthesis rates. The results indicated that both forms of therapy were associated with clinical improvement, increases in protein turnover and evidence of reduced inflammatory activity. However, the beneficial effects of steroid regimen must be balanced against the deleterious effects on body protein stores; steroids and bowel rest without nutritional support should be avoided in malnourished patients.

Adult↗