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Biomedical subjects

R Feinstein

Publications and source records attributed to R Feinstein.

At least 37 records · Page 2Linked to original sources
PubMed1992

Anesthesia for laparoscopic cholecystectomy. Is nitrous oxide contraindicated?

Since it has been suggested that the use of nitrous oxide (N2O) may contribute to bowel distention, we evaluated the effects of N2O on operating conditions during laparoscopic cholecystectomy in 50 healthy patients using a double-blind protocol design. All patients received the same preanesthetic medication (midazolam, 2 mg intravenously) and induction of anesthesia consisted of intravenously administered fentanyl 1.5 micrograms.kg-1, thiopental 4-6 mg.kg-1, and a nondepolarizing muscle relaxant. For maintenance of anesthesia, patients were randomly assigned to one of two treatment groups: group 1 (n = 26) received isoflurane with 70% N2O in oxygen (O2), whereas group 2 (n = 24) received isoflurane in an air/O2 mixture. The surgeon (blinded to the anesthetic technique) estimated the degree of technical difficulty before beginning the operation using a five-point scale. At 15-min intervals throughout the operation, the surgeon was asked to evaluate both "overall operating conditions" and degree of "bowel distension" using independent five-point scales. At the end of the operation, the surgeon was asked whether or not N2O had been used as part of the anesthetic technique. There were no significant intraoperative differences between the two groups with respect to operating conditions or bowel distension. More importantly, there was no time-related change in either variable during the course of the operation. Finally, the incidence of postoperative nausea and vomiting was similar in both treatment groups. The surgeon was able to correctly determine that N2O had been administered only 44% of the time. Thus, N2O had no clinically apparent deleterious effects during laparoscopic cholecystectomy.

Adult↗
PubMed1991

A simple height-specific and rate-specific step test for children.

Recently an anatomic model was reported for adults that standardized the platform height for step tests using an individual's stature and a specified hip angle. In order to determine if the model could be used to predict the platform height for children, platform heights were calculated and hip angles were measured in 146 boys and 140 girls ages 6 to 18 years who were divided into four age groups (6 to 8, 9 to 11, 12 to 15, and 16 to 18 years old). There were no statistical differences between measured and calculated hip angles in any of the age groups. In order to determine the validity for predicting maximal oxygen consumption from stepping using a calculated platform height, three step tests were employed using one platform height and stepping frequencies of 22, 26, or 30 ascents/min. Each of the tests was administered to 93 6- to 18-year-olds. Correlation coefficients between the 15-second recovery heart rate after stepping and maximal oxygen consumption measured on a treadmill were .80 at 30 ascents/min, .79 at 26 ascents/min, and .81 at 22 ascents/min. Each of the correlation coefficients was significant at the P less than .01 level. It can be concluded that the model is valid for standardizing the platform height for children for use with a single stage step test for estimating maximal oxygen consumption.

Adolescent↗
PubMed1991

Heat illness in football players in Alabama.

Fall football practice in Alabama generally begins during the later months of summer during some of the hottest periods of the year. Exercise during these periods significantly exposes young athletes to risks of heat illness and possible death and is made even more dangerous while training in full football uniform. In order to delineate specific guidelines to reduce the risk of heat illness, optimal practice times and fluid replacement schedules were studied for the state of Alabama. A review of five-year climatological data (1984-1988) for the months of August and September were conducted for four geographic regions of the state. A study of the data revealed that there were no environmental combinations at any time periods during the month of August for any locale in the state that would be considered safe for outdoors practice in full uniform. Similar results were recorded for September for cities in the south-central portion of the state. There were only two time periods during which players could practice outdoor with extreme caution. The periods were at 0900 and 1800 hrs in the north-central and northern portions of the state. If practice is conducted outdoors in Alabama during August and September, copious amounts of water should be consumed prior to practice; frequent water breaks should be scheduled throughout practice at which time each player should consume 150 - 200 ml; and the player should be carefully monitored for signs of heat illness.

Football↗
PubMed1989

Occurrence of intracytoplasmic inclusion bodies in the digestive epithelium of fallow deer (Dama dama L).

Intracytoplasmic inclusion bodies were observed in the digestive epithelium of fallow deer (Dama dama L) suffering from bovine virus diarrhea/mucosal disease. Similar inclusion bodies were also found in the ruminal epithelium of fallow deer subjected to overfeeding by supplementary food. Inclusion bodies were not found in the upper alimentary mucosa of clinically healthy deer but were frequently found when these tissues were subjected to autolysis. At electron microscopical studies the inclusion bodies were found to consist of granular protein-like material encircled by a single membrane. Such inclusion bodies may constitute a non-specific degenerative cell response which could be elicited by diverse factors including autolysis.

Animals↗
PubMed1988

[Characteristics of hereditary colorectal carcinoma without pre-existing polyposis].

The report presents two families with inherited predisposition to colorectal carcinoma without preexisting polyposis coli. In these families the disease is characterized by early onset and tumor localization in the right side colon. Screening colonoscopy should be started early. Families of this kind are of greatest value for genetic marker studies.

Adenocarcinoma↗
PubMed1984

Desmoid tumors in Gardner syndrome: use of computed tomography.

Desmoid tumors are known to be associated with Gardner syndrome and, when located in the mesentery, can contribute to morbidity and mortality. Computed tomography (CT) was used to evaluate six patients with Gardner syndrome who, after colectomy, complained either of abdominal pain or of palpable masses. In five patients, desmoids of the mesentery, abdominal wall, and paraspinous muscles were diagnosed; four of these were later proven surgically. The sixth case, with both CT and subsequent surgery negative for desmoid lesions, is included to illustrate the ability of CT to replace exploratory surgery in certain instances. CT provides a relatively noninvasive means of assessing and following patients with Gardner syndrome after colectomy and delaying or preventing further surgery or, if necessary, providing a surgical "road map" to optimize unavoidable procedures.

Adult↗
PubMed1983

Unilateral scapulohumeral muscular atrophy.

A peculiar form of chronic spinal muscular atrophy is described, 5 unrelated young males developed muscle wasting of the left shoulder and upper arm region, mainly in the distribution of myotomes C5 and C6. This muscle atrophy remained confined to the primary site for 13-18 years, being followed in 4 cases by a mild muscle atrophy of the right upper arm or or the left forearm and hand and in 1 case by atrophy of the legs and the facial muscles. On EMG examination, muscle involvement was always found to be more widespread than on clinical examination. The repeated and extensive EMG examinations gave results typical of an anterior horn cell disease. Pyramidal signs were absent. During the observation period of 21-40 years the course was benign and at least partial working capacity was retained until retiring age.

Aged↗
PubMed1982

The teen-tot clinic: an alternative to traditional care for infants of teenaged mothers.

A comprehensive interdisciplinary clinic was established to provide health care for teenaged mothers less than 16 years old and their infants. Thirty-five mother-infants pairs using this clinic were matched with 70 mother-infant pairs who used "traditional" health care facilities. Significant differences in infant outcomes of immunization status at 6 months (91% versus 46% completed), and weight (97% versus 83% within "normal" range) and maternal outcomes of contraceptive use (91% versus 63%), enrollment in educational programs (86% versus 66%), and repeat pregnancy rate (16% versus 38%) were found between Teen-Tot Clinic participants and the control group. Coordination and consolidation of services for teenaged mothers and their infants appears to favorably influence their short-term outcomes.

Adolescent↗
PubMed1981

An objective method for early diagnosis of gram-negative septicemia in burned children.

The present investigation was undertaken to standardize the early diagnosis of Gram-negative septicemia in burned children. Data were collected by means of a matrix which encompassed eight clinical variables routinely monitored by nursing personnel. These variables were evaluated according to their severity using a numerical scale of 0 to 3. A sepsis score was thus calculated for each of 243 burned patients, three times a day throughout their entire hospitalization. Eighty patients with suspiciously high scores (controls) were subjected to a battery of ten laboratory tests aimed at confirming the presence or absence of septicemia. During the 26 months of the study 16 patients (22 episodes) had clinical and laboratory evidence of Gram-negative septicemia. Multiple regression and discriminant analysis techniques were then used to develop statistical models for early diagnosis of septicemia. The two most practical and reliable of these are reported herein. Model I and II would have predicted the diagnosis of sepsis, 83% and 86% of the time, respectively, 1 day before the diagnosis was made using conventional methods. The false positive rates of Models I and II were 7% and 3%, respectively. On the basis of this information it seems possible and rewarding to utilize decision-making charts for monitoring and diagnosis of septicemia.

Adolescent↗
PubMed1979

Monitoring of cortical excitability during induced hypotension in aneurysm operations.

The electrical excitability of the cortex was monitored during craniotomy in 10 patients with ruptured aneurysms, to test their ability to tolerate hypotensive anesthesia. Excitability was assessed by measuring the direct cortical response, a response evoked and recorded from the surface of the brain. Previous animal experiments had shown that this response can be used as an index of cerebral blood flow. In the 10 patients the response progressively declined as the blood pressure was lowered and increased when the pressure was restored. Observation of the direct cortical response during aneurysm operations is a practical method for evaluating the electrophysiological responsiveness of the cortex during hypotension, and the authors suggest that decreases in the amplitude of the response are related to decreased in local cerebral blood flow.

Adult↗