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Biomedical subjects

R D Reynolds

Publications and source records attributed to R D Reynolds.

At least 37 records · Page 2Linked to original sources
PubMed1996

Use of the Mogen clamp for neonatal circumcision.

Most newborn circumcisions performed in the United States are done with either a Gomco clamp or a Plastibell device. The Mogen clamp, devised by a jewish mohel, provides a quick and simple surgical alternative. The foreskin is freed from the glans by blunt dissection, but no dorsal slit is made. A dorsal hemostat is placed, and traction is applied to bring the foreskin forward. Placement of the Mogen clamp follows the angle of the corona to avoid removing excess skin ventrally and to obtain a superior cosmetic result. The clamp crushes the foreskin along a line that is 1 mm wide, and the foreskin is excised distal to the clamp. After removal of the clamp, the glans is liberated by pulling the crush line apart. The procedure usually takes three to four minutes and is virtually bloodless.

Circumcision, Male↗
PubMed1995

Intestinal perforation from trauma to an inguinal hernia.

Inguinal hernias are most feared to result in incarceration and strangulation of intra-abdominal structures. Blunt abdominal blows have previously been reported to cause traumatic perforation of bowel that overlays the defect of any abdominal wall hernia. To my knowledge, this case report is the first to show that bowel perforation may be caused by direct trauma to an inguinal hernia that contains a loop of small bowel. It is proposed that the force of the blow first opposes the walls of the incoming and outgoing bowel, sealing the loop. Then, additional pressure that is applied will raise the loop's intraluminal pressure to the point that traumatic perforation occurs. A simple experiment on a necropsy specimen showed that the proposed mechanism is plausible. This case points out another risk of leaving an inguinal hernia unrepaired.

Abdominal Injuries↗
PubMed1995

A family practice article filing system.

An organized article filing system can be a timesaver for the busy clinician. A comprehensive, specialty-based filing system for the family physician is presented. The full system uses about 700 three-tab manila folders. Each major medical specialty heading is placed on an empty center-tab folder. Subfolders within each major heading are all right- or left-tab folders, alternating for each successive major heading. Topics that overlap specialty are cross-referenced. Additional major headings are included for presenting symptoms, procedures, practice management topics, society membership, licensure, etc. The resulting filing system is intuitive to use since articles are filed by the specialty to which the the topic is most closely related. Journal articles and associated patient education materials may be filed in the same folder for quick retrieval.

Computers↗
PubMed1995

Nebulized bacteriostatic saline as a cause of bronchitis.

BACKGROUND: The purpose of this study was to determine whether nebulized bacteriostatic saline, which contains the preservative benzyl alcohol, is an irritant to the tracheobronchial mucosa in healthy adults. METHODS: A randomized, double-blind, placebo-controlled study was conducted with 10 healthy adults who inhaled 3 mL of either bacteriostatic saline or saline placebo by nebulizer four times a day for 2 weeks. Pulmonary function tests and bronchoscopy with biopsy were performed immediately before and after the 2-week nebulization period. RESULTS: Nine of 10 volunteers were compliant with the study protocol. Four of five volunteers who used nebulized bacteriostatic saline developed bronchitic symptoms and had bronchoscopic evidence of bronchitis. The fifth remained healthy. Four volunteers used nebulized saline (placebo). Two of these four became ill, one with a much more severe bronchitis than any of the bacteriostatic saline volunteers, and one with pharyngitis. Bronchoscopic biopsies showed a lymphocytic mucosal infiltrate in those who became ill while using nebulized bacteriostatic saline and a polymorphonuclear mucosal infiltrate in those who became ill while using nebulized saline placebo. CONCLUSIONS: Nebulization of bacteriostatic saline, containing benzyl alcohol as its preservative, causes bronchitis in healthy adults. Even nebulization of sterile saline may be associated with bronchitis and pharyngitis. Physicians who prescribe nebulized medications must pay close attention to the bronchodilator diluent.

Adult↗
PubMed1995

The 'Modified U' technique: a refined method of Norplant removal.

Norplant removal has been much more difficult for many physicians than might have been anticipated. Dr Untung Praptohardjo of Indonesia recently developed the "U" technique, speeding the time required to remove the six Norplant implants to an average of 7 minutes. In his technique, a unique oval-ring-tipped forceps with an internal diameter of 2.2 mm is used to reach through a 4-mm incision to firmly grasp each of the implants. The incision is made parallel to the implants between the lower tips of implants 3 and 4. The "U" technique requires grasping the implant within 4 mm to 5 mm of its tip. This preliminary paper describes the "Modified U" technique, which allows the physician who is removing the implants to grasp them anywhere along their shaft, not just near the tip. The Modified U technique involves the use of an improved ring-tipped forceps with a circular tip rather than the oval tip used in the "U" technique. This instrument, called Norgrasp, is a modification of the vas deferens fixation forceps used in the no-scalpel vasectomy (NSV) technique. In another adaptation of NSV instruments, an NSV dissecting forceps (a sharpened, curved hemostat) is used to free the implants from their tissue envelope and quickly deliver them through the skin incision. Using the Modified U technique, the time required to remove Norplant implants in 20 patients in the United States has ranged from 8 to 13 minutes. Improperly placed implants are readily removed with this technique. The Modified U technique requires a minimal incision and offers both the physician and the patient a speedy, positive removal.

Dermatologic Surgical Procedures↗
PubMed1994

Plasma pyridoxal phosphate in anxiety disorders.

One hundred and eighty-nine subjects with either generalized anxiety disorder, panic disorder, or obsessive-compulsive disorder were evaluated for plasma pyridoxal phosphate (PLP) levels and compared with normal controls. There was no difference in plasma PLP levels between the anxiety disorder groups and normal controls. Low levels of plasma PLP were found in 42% of the controls. Our results suggest that previous reports of low PLP levels in psychiatric patients are unlikely to be significant in the etiology of the psychiatric disorders.

Adult↗
PubMed1994

Cost of Norplant.

Explore the source record for details and available documents.

Drug Implants↗
PubMed1994

Accurate dosing of pediatric medications.

Dosing of pediatric medications must be accurate. Combining constants in the usual calculation for amoxicillin dosing derives the Rule of Six (6 mg/lb per dose) for dosing. This rule generalizes to most pediatric antibiotics. The Decimal Move Rule (0.1 mL/lb per dose) can be used to dose many over-the-counter cough and cold remedies, bronchodilators, and iron preparations. A number of helpful hints to improve compliance and three comprehensive dosing tables are presented.

Anti-Bacterial Agents↗
PubMed1994

Pyridoxal 5'-phosphate related changes in retention of 1,25-dihydroxy vitamin D-receptor ligands in rat intestinal mucosa cell nuclei.

After feeding rats a vitamin B-6-deficient diet, we observed a decrease in pyridoxal 5'-phosphate concentrations in intestinal mucosa cells to 32 and 48% of control in cytoplasm and cell nuclei, respectively. Correlation analysis suggested that there were two pyridoxal 5'-phosphate pools in the nuclei: a "mobile" pool (equivalent to about 5% the concentration of the cytoplasmic pyridoxal 5'-phosphate), and a "stable" pool, which was independent of cytoplasmic fluctuations of pyridoxal 5'-phosphate (about 9 pmol pyridoxal 5'-phosphate/mg DNA). Reduction in pyridoxal 5'-phosphate content in the cells of vitamin B-6-deficient animals was accompanied by a substantial increase in 1,25-dihydroxyvitamin D-receptor ligand concentration in the cell nuclei (76.6 +/- 19.7 vs 762 +/- 291 fmol/mg DNA, mean +/- SEM). The degree of 1,25-dihydroxyvitamin D accumulation in the nuclei appeared to be an exponential function of the "mobile" nuclear pyridoxal 5'-phosphate concentration. Semilogarithmic transformation of the data yielded a straight line, representing an inverse correlation between the cytoplasm-related nuclear pool of pyridoxal 5'-phosphate and the logarithm of the 1,25-dihydroxyvitamin D concentration in the nuclei (r = -0.95). These data suggest that pyridoxal 5'-phosphate may be related to 1,25-dihydroxyvitamin D retention in the nuclei, possibly through interaction of the pyridoxal 5'-phosphate with the vitamin D receptor protein in the nuclei.

Alkaline Phosphatase↗
PubMed1994

Vitamin supplements: current controversies.

Supplemental use of vitamins to prevent disease constitutes a major commercial enterprise in the United States. The efficacy of such use, or even the need for intakes above that which can be supplied by means of diet alone, has been the source of considerable controversy in the medical and scientific fields. Recently published data have given strong support to several of the claims for major benefits of disease prevention, including that of cancer, cardiovascular disease, carpal tunnel syndrome, and neural tube defects, to name just a few. The purported benefits for supplemental vitamin usage are discussed for these diseases, along with a call for a re-evaluation of the underlying philosophy of the Recommended Dietary Allowances, or consideration of their abolition, based on newly emerging data.

Antioxidants↗
PubMed1994

Vas deferens occlusion during no-scalpel vasectomy.

The increasing popularity of the no-scalpel vasectomy (NSV) technique in the United States is driven by patient demand for surgical procedures presumed to be less invasive and by the somewhat lower complication rate of the NSV technique. The NSV technique addresses vasal delivery but not vasal occlusion. Intraluminal red-hot wire cautery with sheath closure over the inguinal end of the cut vas (Schmidt's method) has the lowest failure rate of all reasonable vas occlusion methods. The anatomical relationships of scrotal layers can be unclear during the NSV technique. Accurate identification of the sheath layer is critical to sheath interruption if this method of occlusion is to be used. Placement of an absorbable purse-string suture for sheath interruption during the NSV procedure is described. Special attention must be given to placement of one suture bite in the deep (posterior) sheath wall. The vasal occlusion technique described in this paper blends a refined method of vasal delivery (NSV) with the most effective method of vasal occlusion (cautery with sheath interruption).

Animals↗
PubMed1993

Treatment of myelodysplastic syndromes with daily oral idarubicin. A phase I-II study.

BACKGROUND: Idarubicin, a new anthracycline analogue, is available in an oral preparation, and responses have been observed using relatively aggressive therapy in patients with myelodysplastic syndromes (MDS). The authors studied whether a chronic low-dose schedule would be effective but less myelotoxic. METHODS: Forty-two patients with MDS received daily low-dose oral idarubicin in 5-week courses that included 3 weeks of treatment, followed by a 2-week rest period. Doses were escalated when possible after the second course, and each patient was to receive six courses. RESULTS: Only one partial response was observed. Although no patient had fatal bone marrow toxicity, only eight patients received the full six courses, primarily because of myelosuppression. CONCLUSIONS: This schedule of oral idarubicin is relatively safe but produces fewer responses than are reported with the high-dose pulse regimens.

Administration, Oral↗