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Biomedical subjects

R L Holliday

Publications and source records attributed to R L Holliday.

47 records · Page 3Linked to original sources
PubMed1976

Perforated peptic ulcer in pregnancy with survival of mother and child: case report and review of the literature.

Peptic ulcer in pregnancy and its complications, though rare, can be life-threatening to mother and fetus. Perforated peptic ulcer in pregnancy is extremely rare; when this occurs survival of both mother and child is unusual. Only five cases of maternal survival following perforation of a peptic ulcer have previously been recorded and, of these, only three were associated with survival of both mother and infant. The authors report an additional case of perforated ulcer in pregnancy with survival of mother and infant, and review the relevant literature. Early surgical diagnosis and treatment followed by vaginal delivery of the fetus offers the best hope for survival of mother and child.

Adult↗
PubMed1975

Pulmonary edema in patients with sepsis.

Fifteen critically ill patients with sepsis, 12 of whom had significant pulmonary dysfunction develop, were investigated with regard to changes in pulmonary capillary pressure, in serum oncotic pressure and on roentgenograms of the chest. It could not be shown that the pulmonary edema, which is a major characteristic of the septic lung lesion, was due to changes only in oncotic and hydrostatic pressures. Nor was there evidence that increased capillary permeability was the sole explanation of the edema. A significant relationship was found which consisted of increasing severity of the lung lesion, decreasing serum oncotic pressure and increasing pulmonary pressure. When patients with sepsis require resuscitation with fluids, the administration of moderate amounts of albumin along with monitoring of pulmonary capillary pressure appears to be a rational approach to therapy.

Bacterial Infections↗
PubMed1975

Capillary muscle blood flow in human sepsis.

Tissue perfusion was determined by cardiac index (Cl) and skeletal muscle capillary blood flow (MBF), and arteriovenous oxygen difference (AVD) and oxygen uptake were compared in seven patients with severe spesis and eight nonseptic patients. Skeletal capillary muscle blood flow also was measured before and after a 2 day fast in 14 normal volunteers. In both septic and nonseptic patients, MBF varied directly with Cl. The average muscle blood flow was greater in septic than in nonseptic patients and, in addition, was greater per unit Cl. AVD in septic patients was narrower than in nonseptic patients. Septic patients with an AVD of less than 4 ml. of O2 had markedly higher MBF and Cl than did septic patients with an AVD greater than 4 ml. of O2. Fasting normal volunteers who, like the septic patients, would be catabolic had a significant increase in MBF during the fast. Although peripheral shunts are not ruled out ans an explanation of the hyperdynamic circulation in sepsis, the evidence is against their existence, at least in skeletal muscle, since capillary flow increases in direct proportion to cardiac output. If capillary flow is increased in fact in sepsis, then flow like blood pressure becomes less of a critical factor in explaining the demise of the septic patient. It might be postulated that the increased capillary flow seen in sepsis is secondary to the mobilization of amino acids from the body cell mass for gluconeogenesis and energy.

Adult↗
PubMedDate not supplied

Peritonitis--old and new thoughts.

A review of the etiology, pathogenesis, pathophysiology, and clinical picture of peritonitis is presented. A regimen for treatment is outlined. Complications and newer methods of adjuvant therapy are discussed.

Bacterial Infections↗
PubMedDate not supplied

Intra-abdominal sepsis.

Intra-abdominal sepsis remains one of the major challenges to the surgeon. With a proper appreciation of the bacteriology and pathophysiology involved and an awareness of new diagnostic and therapeutic modalities, hopefully, mortality and morbidity rates can be reduced.

Abscess↗