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Biomedical subjects

R Marshall

Publications and source records attributed to R Marshall.

At least 145 records · Page 8Linked to original sources
PubMed1984

Biobrane--a useful adjunct in the therapy of outpatient burns.

Fifty-five patients with partial thickness burns ranging from 1% to 10% of their body surfaces have been treated with Biobrane (Woodroof Laboratories, Santa Ana, CA) dressings on an outpatient basis. This material is a biosynthetic skin prosthesis that was introduced commercially in 1979. Advantages of Biobrane over other conventional dressings in outpatient burn care have been the significant pain relief, reduced number of dressing changes, decreased patient visits, and satisfactory epithelization in 7 to 14 days, ease of application and removal, and cost effectiveness. The dressing must be placed on clean wounds judged to be partial thickness in depth. Topical antibiotics are unnecessary in the care of these patients.

Burns↗
PubMed1984

In vitro susceptibility of anaerobic bacteria to ciprofloxacin (Bay o 9867).

About 80% of 70 clinical isolates of Bacteroides fragilis were inhibited by 4 micrograms of ciprofloxacin (Bay o 9867) per ml. The 90% MIC of ciprofloxacin was 8 micrograms/ml for other Bacteroides species, 2 micrograms/ml for Peptococcus species, 8 micrograms/ml for Peptostreptococcus species, and 16 micrograms/ml for Clostridium and Eubacterium species.

Animals↗
PubMed1983

Reduction in mortality from upper gastrointestinal haemorrhage.

A study of 2377 cases of haemorrhage from the upper gastrointestinal tract shows a significant fall in mortality rate--from 15.5% in the period of retrospective study from 1961 to 1970 to 7% in the prospective study from 1972 to 1982. The fall in mortality rate from non-variceal bleeding was from 12.8% to 5%. In the second five years of the prospective study, the total mortality rate was 5.8%, with 4.5% for non-variceal haemorrhage. This improvement occurred despite a significant rise in the proportion of patients of 60 years of age and over, and was particularly evident in patients with bleeding chronic gastric ulcers. There was also a significant reduction in mortality in the 60 years and over age group in the latter five years of the prospective study. The data suggest that there were three aspects of management which were important in the reduction of mortality. These were early fibreoptic endoscopic diagnosis, improved resuscitation and postoperative care, and early control of bleeding from oesophageal varices by balloon tamponade and surgery in selected cases. These complicated procedural aspects of management are best applied in a special unit for the treatment of patients with haemorrhage from the upper gastrointestinal tract. It is concluded that there has been significant progress in the treatment of this problem during the last decade.

Age Factors↗
PubMed1982

Modification of the Smeloff mitral prosthesis.

The simplicity of the ball valve with its random seating capabilities coupled with its durability, reliability, and predictability has made it the attractive choice of many surgeons. A low incidence of embolic phenomena with the Smeloff full-orifice, double-caged, bare-strutted ball valve has made us reluctant to alter the design over 17 years. Recent evaluation of the reasons for reoperation on the Smeloff mitral valve implantation in 376 cases revealed 16 cases in which development of fibrous subvalvular pannus with signs and symptoms of mitral stenosis occurred. The mean occurrence time was 7.5 years for adults and 4.6 years for children under age 8 years. No such problem has been encountered with the valve in the aortic position. Many of these patients are maintained on aspirin and Persantine alone. Valve design was explored as a possible cause of mitral subvalvular stenosis. Alterations of the design were examined in the engineering laboratory and in dog implantations by catheterization, electrophysiologic evaluation, and echocardiography. The results were encouraging.

Adult↗
PubMed1982

Absolute quantitation of radiotracer uptake in the lungs using a gamma camera.

A transmission-emission method for the absolute quantitation of Tc-99m in the lungs with a computerized gamma camera is described. The method requires no measurements of the linear attenuation coefficients of the lung and chest wall, or of their thickness. It yields results of acceptable accuracy for everyday clinical use and offers the great advantage of avoiding the use of a phantom. The method could be extended for the absolute quantification of Tc-99m agents in soft tissue and bone with errors of less than 10%.

Humans↗
PubMed1981

Pediatric-based assessment: children with school problems.

Twenty-one children with school problems underwent pediatric assessment within a university hospital primary care clinic. Assessment included history-taking facilitated by parent and teacher questionnaires, physical examinations, vision and hearing screening and neurodevelopmental examination. For 11 of the children, psychoeducational assessment was also obtained. Parent and school personnel were interviewed 2 to 6 months following assessment to determine implementation rates for recommendations. Overall, 66% of parent recommendations were implemented, including 72% of medical, 58% of mental health and 64% of educational recommendations. Seventy-two percent of school recommendations were implemented. Interdisciplinary evaluation as compared to pediatric-based assessment alone resulted in a greater number of recommendations generated (p less than .05) and a higher percentage of school recommendations implemented (p less than .01). Implementation rates for school recommendations were greater for young children (p less than .01). This study supports the usefulness of pediatric-based assessments for school problems and documents the advantages of an interdisciplinary approach to such children.

Child↗
PubMed1981

Growth of Peptococcus and Peptostreptococcus: effect of variations of culture media on efficiency of recovery.

Reference strains and clinical isolates of Peptococcus and Peptostreptococcus spp. were evaluated for their growth response in supplemented thioglycolate-yeast extract media. Supplements used included various combinations of hemin, menadione, sodium bicarbonate, and Tween 80. Parallel studies were done to compare the efficiency of recovery of viable cells grown in thioglycolate-based media and Wilkins-Chalgren broth and agar. In addition, the effects of age of the medium and medium storage on viable cell yields for reference strains were determined. Reference strains grown in freshly prepared thioglycolate-yeast extract medium supplemented with sodium bicarbonate produced a 10-fold greater increase in the number of viable cells recovered after 24 h of incubation than did the same organisms cultivated in Wilkins-Chalgren medium. The efficiency of recovery of organisms when either mid-logarithmic- or mid-stationary-phase cells were used to prepare standardized inocula was similar. The results suggest that thioglycolate-yeast extract medium supplemented with sodium bicarbonate is more productive than Wilkins-Chalgren medium for the cultivation of anaerobic gram-positive cocci and may represent a suitable alternative for antimicrobial susceptibility testing of these organisms.

Bicarbonates↗
PubMed1981

Production of deoxyribonuclease, ribonuclease, coagulase, and hemolysins by anaerobic gram-positive cocci.

Clinical isolates of Peptococcus and Peptostreptococcus species and Streptococcus intermedius strains were obtained from local hospitals. After confirmed identification, each isolate was tested for the in vitro production of deoxyribonuclease, ribonuclease, coagulase, and hemolysins. Of the 60 strains studied, 18 had enzymatic activity. The variability of enzyme production suggests that such assays are not suitable as an aid to identification of these organisms.

Anaerobiosis↗
PubMed1981

Protective value of dust respirators in extrinsic allergic alveolitis: clinical assessment using inhalation provocation tests.

Six subjects with budgerigar fancier's lung, pigeon breeder's lung, or mushroom worker's lung underwent identical paired inhalation provocation tests of 20 minutes to five hours duration (mean 2.3 hours) using a natural method of antigen exposure. For one test of each pair, the subjects were protected by the use of industrial dust respirators that incorporate electrostatically charged, resin-impregnated merino wool filters. The unprotected challenges provoked late responses of mild to moderate severity, that were characteristic of extrinsic allergic alveolitis. These were monitored by methods described previously, using four subjective and six objective monitoring tests. A score of 1 was allowed for each monitoring test showing a significant change. A combined monitoring score of 32/57 was associated with the unprotected challenges-that is, 56% of the maximum score possible. The respirators successfully protected four of the subjects from any suspicion of a positive response. The remaining two subjects reported symptoms of minimal severity, but there was no independent confirmatory evidence of positive reactions. The combined monitoring score associated with all six protected challenges was 2/60 (3%), while that associated with corresponding control challenges was 3/73 (4%). We conclude that respirators of this type can offer substantial, and in most cases complete, protection against single exposures to environmental dusts that may provoke extrinsic allergic alveolitis.

Adult↗
PubMed1981

Subsequent physical and mental development in infants with positive contraction stress tests.

Little knowledge exists concerning long-term sequelae in children born of pregnancies complicated by chronic uteroplacental insufficiency. This follow-up study evaluates 12 children with positive contraction stress tests (CSTs) 5.5 months to 4.75 years following birth. Subsequent physical growth was uniformly normal in the four infants classified as appropriate for gestational age at birth; however, continued postnatal growth deficiency was present in 50% of the eight infants who suffered from intrauterine growth retardation. No major neurologic abnormalities were detected, and 10 of the 12 displayed normal mental and motor function, as determined by the Denver Developmental Screening Test, Bayley Scales of Infant Development and Wechsler Preschool and Primary Scale of Intelligence. Two of the 12 infants were depressed at birth and had serious neonatal complications. These were the only two children who scored poorly on the Bayley test. Although no conclusions regarding minimal brain dysfunction can be made, the majority of infants with positive CSTs demonstrate grossly normal neurologic and psychologic development.

Apgar Score↗
PubMed1980

Detection of the action of salicylic acid on the normal stratum corneum.

The undoubted clinical usefulness of salicylic acid contrasts markedly with its barely detectable action on normal skin. In this study we have attempted to extend our understanding of the action of salicylic acid by monitoring its effect on the stratum corneum using newly developed techniques for assessing desquamation, as well as using conventional methods for measuring other aspects of epidermal activity. Our findings have succeeded in demonstrating that salicylic acid enhances the shedding of corneocytes and we suggest that this compound in some way decreases corneocyte to corneocyte cohesion. We have confirmed that salicylic acid has no effect on the mitotic activity of the normal epidermis.

Cell Count↗
PubMed1980

Positive "alveolar" responses to antigen inhalation provocation tests: their validity and recognition.

The validity of inhalation tests in the investigation of extrinsic allergic alveolitis was assessed from the results of 144 antigen and control tests in 31 subjects. A definitive pattern of positive late responses was observed. Reactions to nebulised bird serum and droppings in subjects with bird fancier's lung were identical to reactions after "natural" exposures in aviaries or lofts, and to reactions after "occupational" challenges in subjects with farmer's lung and mushroom worker's lung. In general, positive tests were easily recognised subjectively from symptoms and signs appropriate to an influenza-like illness and undue respiratory effort on exercise. They were associated with significant changes in six readily available objective monitoring measurements--exercise minute ventilation (greater than or equal to +15%), body temperature (> 37.2 degrees C), circulating neutrophils (greater than or equal to +2500/mm3), exercise respiratory frequency (greater than or equal to +25%), circulating lymphocytes (greater than ore equal to -500/mm3 with lymphopenia), and forced vital capacity (greater than or equal to -15%). These confirmatory monitoring tests had specificities of approximately 95% and sensitivities of 85-48%. Measurement of diffusing capacity, lung volume subdivisions, or resting minute ventilation/respiratory frequency proved to be too insensitive to be useful, as did auscultation and chest radiography. We conclude that responses that do provoke significant changes in these less sensitive tests are unnecessarily distressing and, presumable, unnecessarily hazardous.

Alveolitis, Extrinsic Allergic↗