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Biomedical subjects

R Lambert

Publications and source records attributed to R Lambert.

At least 379 records · Page 21Linked to original sources

Temporary ovarian inactivity in elephants: relationship to status and time outside.

The captive elephant population in North America is in reproductive decline and, without importation from the wild, may cease to be viable within the next several decades. The estrous cycle of three captive, reproductive-age African elephants was monitored for 3 years by measuring serum progesterone concentrations. Each elephant experienced one or more episodes of extended low progesterone (>12 weeks), analogous to supposed terminal cessation of estrous cyclicity or 'flatlining' that has been described in some captive Asian and African elephants. Other studies have reported lengthy non-luteal (follicular) phases that indicate extended episodes of ovarian inactivity; however, this phenomenon has not been examined in detail. In this study, total duration of temporary ovarian inactivity or acyclicity followed a social rank pattern, with the most subordinate female having the longest and the dominant female the shortest duration. During periods of acyclicity, the number of hours the elephants spent outside was significantly less than during non-luteal or luteal phases of the cycle. Except in one instance, behavioral data recorded by elephant keepers during their interactions with the elephants showed no change in handling during periods of ovarian inactivity. Further study is necessary to distinguish the causative agent for temporary cessation of estrous cyclicity. Understanding this phenomenon is imperative for the future reproductive viability of captive elephant populations.

Animals↗

Comparison between dipyridamole and adenosine as pharmacologic coronary vasodilators in detection of coronary artery disease with thallium 201 imaging.

BACKGROUND: Both dipyridamole and adenosine are widely used as pharmacologic stressors with 201Tl imaging for detection of coronary artery disease. The purpose of this study was to compare dipyridamole and adenosine 201Tl imaging directly in patients with angiographically proved coronary artery disease. METHODS AND RESULTS: Fifty-four patients were submitted to two planar 201Tl studies: one with dipyridamole and the other with adenosine. The interval between the two studies varied from 2 to 7 days and the order was assigned randomly. Three standard planar views were obtained 10 minutes and 4 hours after the injection of 3.0 mCi 201Tl. Administration of dipyridamole was as follows: 0.142 mg/kg/min during 4 minutes, followed by a slight exercise and 201Tl injection. The infusion of adenosine was as follows: 0.140 mg/kg/min during 6 minutes with injection of 201Tl after the third minute of infusion. Patients were asked to give their preference considering the number, type, severity, and duration of side effects on a scale from 0 (worst) to 5 (best). Reading was done by two experienced observers. The heart was divided into three segments per view. The change in systolic blood pressure was -12 +/- 11 mm Hg for adenosine and -5 +/- 10 mm Hg for dipyridamole (p < 0.001), and the change in heart rate was 18 +/- 10 beats/min for adenosine and 8 +/- 7 beats/min for dipyridamole (p < 0.001). With regions of interest, ischemic/normal wall ratios were determined: 0.78 +/- 0.06 for adenosine and 0.83 +/- 0.08 for dipyridamole (p < 0.001). Adenosine detected 295 normal, 170 ischemic, and 21 scar segments, whereas dipyridamole detected 326, 135, and 25 segments, respectively. Patients preferred adenosine (4.3 +/- 1.0 for adenosine vs 3.8 +/- 1.5 for dipyridamole; p < 0.04) mainly because of the short duration of side effects. CONCLUSION: This study shows that the use of adenosine with 201Tl imaging may have some advantages over dipyridamole.

Adenosine↗

Localized hypertrophic osteoarthropathy due to arterial graft sepsis from an enteroprosthetic fistula.

The case of a 73-year-old man with localized left-lower-limb hypertrophic osteoarthropathy in association with aortic left-iliac-artery bypass and enteroprosthetic fistula was studied. The patient presented first with massive gastrointestinal bleeding and with pain and swelling of his left leg. He was hospitalized on numerous occasions for recurrent episodes of bacteremia involving enteric flora; hypertrophic osteoarthropathy and aortoduodenal fistula were documented before surgery. Symptoms and signs of hypertrophic osteoarthropathy were markedly alleviated after removal of the infected prosthesis. A review of the literature revealed seven additional patients with a similar presentation. The diagnosis of infected arterial graft with enteroprosthetic fistula may be extremely difficult, and a delay in this diagnosis may be lethal. Awareness of this uncommon association may lead to prompt diagnosis and early surgical therapy.

Aged↗

Neurocognitive functioning and magnetic resonance imaging in children with sickle cell disease.

OBJECTIVE: To examine neurocognitive functioning in children classified with overt cerebral vascular accidents (CVAs), silent infarcts, or without central nervous system (CNS) pathology on magnetic resonance imaging. METHODS: Participants were 63 children and adolescents with sickle cell disease (SCD). RESULTS: Children with overt CVAs and silent infarcts differed from their peers without CNS pathology on measures of attention and executive functioning. CONCLUSIONS: We consider these deficits the result of the high frequency of frontal lobe deficits incurred by children with SCD. Recommendations include the use of tests designed to measure attention and executive functioning as a way of screening children with SCD for possible CNS pathology. We also suggest that future research examine the mechanism underlying frontal lobe involvement for individuals with SCD.

Adolescent↗

Imaging of renovascular hypertension: respective values of renal scintigraphy, renal Doppler US, and MR angiography.

Renovascular hypertension affects 15%-30% of patients who have clinical criteria suggestive of renovascular disease. Noninvasive screening is crucial for patient selection prior to conventional angiography and renal revascularization. Renal scintigraphy has been reported to be sensitive for detection of renovascular hypertension, but some of its limitations (eg, in the setting of bilateral renal artery stenosis and renal failure) should be considered. Doppler ultrasonography (US) allows direct evaluation of the renal arteries as well as transrenal Doppler waveform analysis, but it remains operator dependent. Gadolinium-enhanced magnetic resonance (MR) angiography is becoming an excellent alternative to conventional angiography. The main limiting factors of this technique are inadequate visualization of segmental and accessory renal arteries as well as a tendency toward overestimation of stenoses. Given the high cost and low availability of MR angiography, scintigraphy and Doppler US should be considered the primary studies in screening for renovascular hypertension. MR angiography could be reserved for patients with inconclusive scintigraphic and Doppler US results, patients with high clinical suspicion of renovascular hypertension, and patients with a contraindication to conventional angiography.

Evaluation Studies as Topic↗

Return to work after rehabilitation following traumatic brain injury.

The relationship of medical variables and discharge functional status to vocational and educational outcomes was examined in 79 closed head-injured patients who were consecutively admitted to an inpatient rehabilitation hospital during a two-year period. A follow-up study, conducted after hospital discharge (median, 16.5 months), found that 66% (n = 52) of the patients had returned to work or school, while 34% (n = 27) did not. Patients were divided into return and non-return to work groups. Traditional variables included age, severity of brain-damage as characterized by CT head scan, duration of post-traumatic amnesia, duration of coma, length of stay and acute inpatient rehabilitation program. Discharge functional scores were analysed by t-tests and chi-square analysis. Results suggest that traditional factors of younger age, shorter length of coma, minimal CT head scan findings and shorter length of stay were significant contributors to educational/vocational outcome. Their significance was enhanced by discharge functional profile measurement of medical, physical and psychological/neuropsychological integrity. Those functional measures not significant were in social, vocational, recreational and communication areas. These factors may continue to improve over a longer period of time and should be tracked in the post-acute rehabilitation phase for their significance in return to work/school.

Activities of Daily Living↗

The management of patients with colorectal adenomas.

The management of a patient with a colorectal adenoma aims at removal of adenomas that are missed initially or develop subsequently. Classification of adenomas permits the separation of patients into those at minimal and high risk of developing recurrent or new adenomas. Follow-up schedules for these two groups are based on currently available clinical and pathologic data.

Adenoma↗

[Comparison between myocardial perfusion scintigraphy with thallium-201 and technetium-99m-Sestamibi (methoxy isobutyl isonitrile) for the detection of coronary atherosclerotic disease].

99mTc-SESTAMIBI is a new myocardial perfusion agent used in the detection of atherosclerotic coronary artery disease. In the present study, myocardial scintiscanning (on treadmill) with 99mTc-SESTAMIBI and 201-Thallium were compared, and both were compared with coronary angiography. Some 130 consecutive patients were evaluated within an interval of a few weeks with scintiscans of both 99mTc-SESTAMIBI and 201-Thallium: 82 of them were also examined by coronary angiography. Segmental analysis of the two series of scans revealed some correlation in 89.2% of the segments, while correlation of the final diagnosis showed agreement in 92% of cases. Compared to coronary angiography, sensitivity in the detection of CAD was found to be 75.8% for 201-Thallium and 72.5% for 99mTc-SESTAMIBI. The authors conclude that 99mTc-SESTAMIBI is a promising myocardial perfusion agent which displays an excellent correlation with 201-Thallium.

Adult↗

[Immuno-reactive somatostatin in acetic extracts of duodenal, antral and fundic biopsies (author's transl)].

The concentration of immunoreactive somatostatin in acetic extracts of duodenal, antral and fundic biopsies was estimated in 11 subjects with no gastric or duodenal abnormality and 21 duodenal ulcer patients by using a specific and reproducible radioimmunoassay. Somatostatin was detected in the duodenal, antral and fundic mucosa in normal subjects. As compared to the values in the control group, the concentrations in the duodenal ulcer patients were comparable in the antrum and duodenal bulb, and significantly higher in the fundus.

Adult↗