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Biomedical subjects

R Spencer

Publications and source records attributed to R Spencer.

At least 73 records · Page 4Linked to original sources
PubMed1988

Major congenital anomalies in infants and glycosylated hemoglobin levels in insulin-requiring diabetic mothers.

Glycosylated hemoglobin levels were obtained in 133 diabetic pregnancies. Nongestational diabetic mothers delivered of infants with major congenital anomalies had significantly higher glycosylated hemoglobin levels than the remaining nongestational diabetic mothers (P less than .001). The higher a mother's glycosylated hemoglobin level, the higher her risk of having a severely affected infant was. The positive predictive value for a nongestational diabetic mother having an infant with severe congenital anomalies was 26% if the glycosylated hemoglobin level was greater than or equal to 11%, 40% if the level was greater than or equal to 12%, and 56% if the level greater than or equal to 13%. However, high glycosylated hemoglobin levels in insulin-requiring gestational diabetic mothers were not predictive of major congenital anomalies.

Congenital Abnormalities↗
PubMed1987

Severe uterine hemorrhage from blastomycosis of the endometrium. A case report.

A 32-year-old black woman presented in the emergency room with vaginal bleeding. Physical examination revealed a granulomatous lesion on the thigh and a breast abscess. Histopathologic examination and culture of an endometrial biopsy revealed Blastomyces dermatitidis. The breast abscess and thigh lesion were found to contain B. dermatitidis as well.

Abscess↗
PubMed1986

Perinatal events and cerebral palsy.

This review highlights recent studies that refute the following hypothesis on the genesis of cerebral palsy: The risk factors that cause death are also risk factors for brain damage resulting in cerebral palsy, if they occur at lower intensity, less frequently, or for a shorter duration. Untested, unproved, and invalid theories that emerged in the 1950s stimulated the assembly of much data that are at odds with the notion that the pathways of causation for cerebral palsy and perinatal mortality are identical.

Acidosis↗
PubMed1986

Silastic interposition arthroplasty of the shoulder.

We report a series of 12 Silastic interposition arthroplasties of the shoulder. There was a very high incidence of dislocation or fragmentation (50%) leading to early failure of the device in seven patients. Our analysis suggests that the operation should be restricted to rheumatoid arthritic shoulders in which there is no loss of bone or distortion of the humeral head.

Adult↗
PubMed1986

Interventional genitourinary radiology in children: a review of 61 procedures.

Forty-nine children underwent 61 interventional uroradiologic procedures. These included percutaneous nephrostomy, internal ureteral stenting, ureteral stricture dilatation, perirenal abscess drainage, and percutaneous removal of renal calculi. Of the 61 procedures, 60 (98%) were technically successful. Of the 60 successful procedures, 24 (40%) were considered "definitive," 33 (55%) favorably "altered the course," and 3 (5%) "failed" to have any beneficial effect. Technical success at minimal risk can be achieved in even the smallest patients by modifying equipment and by attending to the special needs of the pediatric patient.

Adolescent↗
PubMed1984

Gastric emptying and drug absorption before surgery.

The rate of paracetamol absorption following oral administration has been used as a model of drug absorption and as an indirect estimate of the rate of gastric emptying before and after elective or emergency surgery in 13 adult patients. The rates of paracetamol absorption before and after surgery were not significantly different and compared well with results obtained previously in normal volunteers. This suggests that preoperative anxiety and pain did not delay gastric emptying in this group of patients.

Acetaminophen↗
PubMed1984

Nature of the renal injury following total renal ischemia in man.

The effects of total renal ischemia (TRI) of 15-87 min duration due to suprarenal clamping of the aorta were studied in 15 mannitol-treated patients undergoing abdominal aortic surgery. 15 patients undergoing similar surgery but requiring only infrarenal clamping served as controls. 1-2 h following TRI, GFR was reduced to only 39% of that in controls, 23 +/- 5 vs. 59 +/- 7 ml/min (P less than 0.001). This could not be ascribed to impaired renal plasma flow (RPF), which was mildly reduced to 331 +/- 71 and was not different from the value in controls, 407 +/- 66 ml/min. However, impaired PAH extraction (43 +/- 7%) and isosthenuria, not present in controls, suggest a primary role for tubular injury in lowering GFR at this time. 24 h following TRI, the GFR remained depressed below controls, 45 +/- 8 vs. 84 +/- 8 ml/min (P less than 0.005), while the transglomerular sieving of neutral dextrans was significantly enhanced (radius interval, 24-40 A). A theoretical analysis of transcapillary solute exchange revealed that these findings could be largely explained by a selective reduction of either RPF (-61%) or of transmembrane hydraulic pressure difference (-18%) below control values. Alternately, a combination of these two factors with changes of smaller magnitude could explain the findings. In contrast, a selective increase in oncotic pressure or decrease of the glomerular ultrafiltration coefficient could be excluded as a cause of hypofiltration 24 h after TRI. These observations lead us to suggest that the transient azotemia observed following TRI is due to a self-limited injury to the nephron that is identical to that seen in overt and sustained forms of acute renal failure.

Aged↗
PubMed1983

Analysis of licking responses in rats: effects of cholecystokinin and bombesin.

A detailed analysis of the licking response of rats to milk was made. The effects of cholecystokinin (CCK) and bombesin (BBS) on the consummatory response were compared. The normal licking response pattern was found not to change as the meal progressed; no predictor was found to indicate when the meal would terminate. Licks normally occurred at about six per second, but there were a few licks that occurred at about three per second, with no licking occurring in the intermediate range; thus a distinctive bimodal frequency distribution of the interlick interval was formed. Cholecystokinin was found to reduce the intake of milk and the related licking indexes as expected, but it also induced an unusual licking pattern: The contact duration was shortened, the interlick interval was lengthened, and there was an increase in the proportion of licks with long interlick intervals, the effects that accentuated the bimodality of the distribution of interlick intervals. Bombesin reduced the intake and the related licking indexes as expected; however, it did not induce any unusual licking characteristics as seen with CCK at comparable effective doses. The CCK effect may be mediated partially by a change in the motor aspect of the consummatory response; however, BBS reduced intake by simply decreasing the number of licks and shortening the intake duration.

Animals↗
PubMed1981

Visual outcome in moderate and severe proliferative diabetic retinopathy.

Four hundred eyes with moderate or severe proliferative diabetic retinopathy, initial good vision, and an average follow-up of 44.3 months were studied. Final visual acuity was 20/40 or better in 33% of these eyes, 20/50 to 5/200 in 32%, and 5/200 or worse in 35%. A poor visual prognosis was correlated with a traction detachment or relatively poor visual acuity at initial examination. No correlation was found between the length of follow-up and final visual prognosis. General guide-lines are available for the management of these patients' conditions.

Diabetic Retinopathy↗