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Biomedical subjects

R J Bower

Publications and source records attributed to R J Bower.

At least 37 records · Page 2Linked to original sources
PubMed1981

Diagnostic value of the white blood count and neutrophil percentage in the evaluation of abdominal pain in children.

Only 15 of 382 patients with appendicitis had a normal white blood count and neutrophil percentage. Abnormal counts are nonspecific and are elevated in other inflammatory conditions, such as those which are observed in the patients of group 2. A much higher number of patients with negative laparotomy findings had both a normal white blood count and neutrophil percentage. The real value of the white blood count and neutrophil percentage is in selecting patients who can be observed safely rather than undergoing operation. This may decrease the incidence of negative exploratory findings. It is essential to give priority to the physical findings and to use the white blood count and neutrophil percentage only as part of the over-all clinical evaluation.

Abdomen↗
PubMed1980

The microbial flora and antimicrobial therapy of neonatal peritonitis.

Data from 31 infants with gastrointestinal perforation were analyzed to determine the microorganisms usually present in the peritoneum and blood, and the antibiotic susceptibility of those organisms. Multimicrobial contamination of the peritoneal cavity was present in over one-half of the patients and 23% were found to have mixed aerobic-anaerobic peritoneal flora. Most common organisms were E. coli and Bacteroides species. Blood cultures were positive in 32% of patients, most frequently growing E. coli. Among numerous antibiotics tested, only gentamicin was effective against all Enterobacteriaceae isolated. Clindamycin was 99% effective against Bacteroides species isolated and 90% against other anaerobes. Group D streptococcus was the most frequently isolated gram positive aerobe. Based on these findings, empiric therapy with ampicillin, gentamicin and clindamycin is recommended for neonates with gastrointestinal perforation. Adjustments in therapy for individual patients should be based upon culture and sensitivity data.

Anti-Bacterial Agents↗
PubMed1980

Ondine's curse and neurocristopathy.

A newborn with congenital neuroblastomas, Ondine's curse (central hypoventilation) and Hirschsprung's disease is presented. All lesions may be related embryologically and might fall under the general heading of neurocristopathy.

Abdominal Neoplasms↗
PubMed1980

Low velocity vehicular injuries in children--"run-over" accidents.

Fourteen children, mostly in the toddler to preschool age group, were treated for injuries resultant from low velocity vehicular accidents in which the child was literally run over. Multiple system injury and visceral injury to brain, lungs, liver, and kidneys were noted. One death and several permanent disabilities resulted in this small group. Most of the accidents could have been prevented by closer supervision of the children. Devices such as childproof door handles, which are currently available, and audible backing signals, currently available on industrial vehicles, might further reduce the incidence of this type of accident.

Accidents, Traffic↗
PubMed1979

Nectotizing enterocolitis: is there a place for resection and primary anatomosis?

While most situations of peritonitis, perforation and compromised blood flow in necrotizing enterocolitis are best handled by resection and stoma formation, primary resection and anastomosis should be considered in selected cases. Nine premature infants with NEC underwent bowel resection with primary anastomosis in the face of localized perforation and peritonitis. Eight survived and had no problems when oral alimentation was started. One patient with small bowel involvement underwent two anastomoses rather than a high jejunostomy; the proximal anastomosis leaked and led to the death of the patient.

Enterocolitis, Pseudomembranous↗
PubMed1979

Stapled cystograstrotomy. A method of treatment for pediatric pancreatic pseudocyst.

An uncommon complication of pancreatic inflammatory disease or pancreatic trauma in children is the development of a pseudocyst. The English literature records less than 100 cases in children and emphasizes that surgical intervention is the indicated form of treatment. The authors have had experience with nine pediatric patients suffering from pseudocysts in a seven year period. All except one were successfully treated by internal drainage; the other spontaneously resolved. Four had cystogastrostomy using a stapler. This method is discussed as far as indications, technique, advantages and complications.

Child↗
PubMed1978

Alimentary tract duplications in children.

This report reviews the experience with 78 alimentary tract duplications found in 64 patients over a 40 year period at the Children's Hospital of Pittsburgh. Ten patients had the duplication discovered at autopsy. Multiple duplications were found in 15% of patients. The symptoms and physical findings of a duplication varied with location, size and mucosal pattern. About one-fifth of the duplications contained ectopic mucosa, usually gastric. Two-thirds of the patients were diagnosed prior to one year of age. Vertebral anomalies, as a clue to the presence of the lesion, were present in 15% of the patients. The most common indications for surgery included a mediastinal or abdominal mass, intestinal obstruction, and gastrointestinal bleeding. The results of surgery were favorable, with a mortality of 20%. Surgical complications accounted for six deaths, while four children died of severe associated anomalies. Three others died without surgical treatment, but with symptoms from the duplication.

Digestive System Abnormalities↗
PubMed1977

Mediastinal masses in infants and children.

In a group of 93 pediatric patients with mediastinal masses, three quarters of them were diagnosed because they were symptomatic. Approximately one half of the masses were malignant, and of neurogenic or lymphomatous origin. Neurogenic tumors predominated before the age of 4 years, while lymphomas were most common beyond age 4. Two thirds of the malignancies were potentially curable by surgery, irradiation, and chemotherapy; 54% of the patients were salvaged. Enteric duplications, ganglioneuromas, bronchogenic cysts, hemangiolymphangiomas, thymic cyst, and teratomas were the most frequently occurring benign masses. Simple excision was uniformly effective in these lesions.

Adolescent↗