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Biomedical subjects

R E Miller

Publications and source records attributed to R E Miller.

At least 199 records · Page 11Linked to original sources
PubMed1982

Gastrointestinal response to minute doses of glucagon.

Small doses of glucagon are effective when performing a biphasic gastrointestinal (GI) examination. The authors conducted a controlled double-blind crossover study to determine the optimum and smallest effective doses and the onset and duration of drug action. Fifteen men received a placebo and 0.025, 0.05, 0.1, and 0.2 mg of glucagon intravenously. Hypotonicity of the stomach, duodenum, and small bowel was adequate with 0.1 mg of glucagon. Low-dose glucagon makes the biphasic upper GI examination short and practical. There is no need to delay the second phase of the examination or the small-bowel follow-through.

Adult↗
PubMed1982

Lesions missed on small-bowel follow-through: analysis and recommendations.

Forty-two surgically confirmed small-bowel lesions that were not detected by small-bowel follow-through but were demonstrated by enteroclysis were analyzed to determine why small-bowel follow-through had failed to detect them. Thirty lesions (71%) were not seen in retrospect; this was attributed to technical inadequacies. Twelve lesions (29%) were seen in retrospect. Of these, two (17%) of the lesions had been missed originally because of perceptive errors, seven (58%) because of combined perceptive and technical errors, and three (25%) because of interpretive errors. The preponderance of technical errors emphasizes the need for improvements in the small-bowel follow-through technique. More frequent fluoroscopy and more thorough compression of all filled segments, as is performed in enteroclysis, and a decreased reliance on overhead radiographs should decrease the error rate in the routine small-bowel follow-through examination.

Contrast Media↗
PubMed1982

Pediatric counseling and subsequent use of smoke detectors.

Effects of a brief educational and purchase program concerning home fires and smoke detectors by two pediatricians were compared to "routine" counseling without such a program using two groups each of 120 patients of well children. Inspection performed four to six weeks after the office visits showed that of 55 experimental group parents without detectors prior to the program, 26 purchased and 19 installed them correctly. No control group parents did so.

Adult↗
PubMed1982

Evaluation of 12 colon-cleansing regimens with single-contrast barium enema.

In a study of patient preparation for barium enemas, 1,435 patients were examined at six different institutions with 12 different preparation protocols. There were 2,870 films evaluated a total of 7,839 times by seven different radiologists who were blind to both the institution and the preparations used. The statistical design, randomization, and analysis of the data obtained was performed by one of the authors, a statistician, and the following conclusions were made: Dulcolax (bisacodyl) plus 2 L tapwater enema is better than all the other protocols in all parts of the colon for both genders and all ages. Dulcolax or castor oil or X-Prep, each with 2 L water enema, are logically similar and better than the other protocols. Water enema only or castor oil only are the least effective protocols.

Barium Sulfate↗
PubMed1981

Nonsurgical pneumoperitoneum.

The radiographic evidence of free air in the abdomen is usually associated with gastrointestinal perforations which represent a surgical emergency. However, pneumoperitoneum may also develop in a variety of benign conditions and following diagnostic or therapeutic procedures. This article provides a comprehensive list of nonsurgical causes of pneumoperitoneum.

Humans↗
PubMed1981

Pancreatic somatostatin secretion is suppressed by splanchnic nerve stimulation.

The pancreases of fasted mongrel puppies (n = 4) were isolated and perfused in a non-recirculating system with an oxygenated Krebs Ringer bicarbonate buffer. The gland remained in situ and innervated. Bilateral stimulation of the splanchnic trunks (20 V, 5 Hz, 1 msec) resulted in a significant decrease in somatostatin (57 +/- 10%, p less than 0.01) and insulin (71 +/- 3%, p less than 0.01), secretion rates, together with a significant increase in pancreatic perfusion pressure (53 +/- 6%, p less than 0.05). Perfusate glucose concentration remained constant during stimulation. No difference was found between three, three minute stimulations in any one dog, but significant differences were found among the dogs in the prestimulation somatostatin secretion rate in spite of the similarities in the buffer glucose concentration.

Animals↗
PubMed1981

Oat-bran intake selectively lowers serum low-density lipoprotein cholesterol concentrations of hypercholesterolemic men.

To evaluate selected metabolic effects of plant fibers, we fed control and oat-bran diets in an alternating sequence to eight men with previously documented hypercholesterolemia. The two solid diets differed only in the inclusion of 100 g of oat bran in the test diet. We randomized diet sequences and the measured intakes of carbohydrate, protein, fat, and cholesterol were virtually identical on the two diets. Serum total cholesterol concentrations were stable on control diets whereas a progressive reduction was observed in seven men on oat-bran diets. On oat-bran diets, average reductions in serum total cholesterol concentrations were 13% (p less than 0.01, N = 8); plasma low-density lipoprotein cholesterol concentrations were 14% lower (p less than 0.05) while high-density lipoprotein cholesterol concentrations were not changed. Fasting and postprandial serum glucose, insulin, and triglyceride concentrations were similar on the two diets. Fecal excretion of total bile acids was 54% higher (p less than 0.001) on oat-bran diets than on control diets but neutral steroid excretion was slightly lower while on oat bran. Palatable and inexpensive high-fiber foods such as oat bran may have a role in the treatment of certain patients with hypercholesterolemia.

Adult↗
PubMed1981

Grid selection for oral cholecystography.

A radiographic and fluoroscopic unit was modified to image without a grid, with one 6:1 grid, and with two crossed 6:1 grids, placed with the strips at right angles (equivalent to a 12:1 grid). Fifty patients were studied in all three modes in both horizontal and upright positions. The crossed 6:1 grids were superior in 80% of cases. In those cases where no grid or one grid was superior, there was a shorter exposure time or no movement by the patient. High-ratio grids should be used for routine cholecystography combined with shorter exposure times for the initial procedure.

Cholecystography↗
PubMed1981

Efficacy study of the small-bowel examination.

Retrospective analysis of 1,020 conventional antegrade small-bowel examinations revealed that the variable which correlated most highly with abnormal radiographic findings was the clinical complex of history, physical examination, and laboratory data which prompted suspicion of small-bowel disease. Thirty indications of possible small-bowel disease were divided into groups carrying (a) a high suspicion and (b) a low suspicion of disease. Pertinent abnormalities were revealed by 14.2% of examinations in the high-suspicion group, compared with 4.9% in the low-suspicion group. The individual indications covered a spectrum of 0-34% abnormality. Overall, 9.7% of examinations (99/1,020) revealed abnormalities, but only 6.6% (67/1,020) were pertinent to the clinical problems. The authors conclude that the efficacy of the small-bowel series is directly dependent upon the reason(s) for which it is performed.

Adolescent↗
PubMed1981

Behavioral predictors of amitriptyline response in depression.

In this study of 18 female depressed patients and 18 age- and sex-matched control subjects, the authors examined the relationship between nonverbal behavior and treatment outcome with amitriptyline. A behavioral analysis indicated that amitriptyline responders could be differentiated from nonresponders before drug treatment on the basis of discrete nonverbal behaviors. Nonresponders showed a high frequency of body-focused self-adaptors, posture shifts, and pauses and a low frequency of smiles, while responders displayed long speech pauses and long durations of head aversion.

Adolescent↗