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Biomedical subjects

S A Martinez

Publications and source records attributed to S A Martinez.

At least 19 recordsLinked to original sources
PubMed1998

Intraoperative endoscopy during colorectal surgery.

In cases where preoperative studies may have been inadequate or could not be performed, intraoperative endoscopy (IOE) becomes an essential investigative tool for identification of synchronous lesions, of nonpalpable lesions, of sources of bleeding, and localization of lesions during laparoscopic colonic surgery. We report our experience with IOE, and describe our techniques of transabdominal colonoscopy. A review of the IOE performed in hospitals affiliated with the University of Miami was done. Fifty-eight patients received IOE from July 1994 to August 1996. There were 47 colonoscopies (38 transanal and 9 transabdominal), and 11 flexible sigmoidoscopies. Colorectal cancer, diverticulitis, inflammatory bowel disease, and lower gastrointestinal bleeding represented 83% of cases. In 10% of cases IOE changed the extent of the surgical procedure. There were no complications related to IOE. We conclude that in selected patients undergoing colorectal procedures, IOE is an essential tool. It can be performed safely, effectively, and rapidly.

Adult↗
PubMed1997

Congenital conditions that lead to osteoarthritis in the dog.

Several congenital arthropathies exist in the canine that can lead to the development of degenerative joint disease. Nevertheless, early diagnosis and treatment generally will afford the patient a favorable prognosis for limb function. There is still a great need to develop controlled studies to evaluate the long-term efficacy of many of the surgical and medical treatment modalities that are currently available and will be made available in the future to treat the patient with a congenital arthropathy.

Animals↗
PubMed1997

Acquired conditions that lead to osteoarthritis in the dog.

There are many acquired arthopathies that will result in some degree of osteoarthritis, even after proper management. Once the articular cartilage is damaged, it is unlikely that the architecture of the original cartilage surface will return to the normal conditions that existed prior to injury. The purpose of timely and meticulous management of traumatic joint events is to stop the progression of osteoarthritic development. When dealing with articular fractures or other forms of trauma to articular cartilage, three important principles to remember are anatomic reduction of the articular surfaces, stable fixation, and limited weight bearing on the affected limb as soon as possible after surgery. Even after strict adherence to these principles, the pet owner should always be warned that the animal will develop some degree of osteoarthritis in the affected joint at some future time; at that time, chronic medical management may be indicated.

Animals↗
PubMed1996

Effect of volume variations on osteogenic capabilities of autogenous cancellous bone graft in dogs.

OBJECTIVE: To evaluate the osteogenic effect of differing volumes of autogenous cancellous bone graft (ACBG) placed into partial cortical defects of the ulna. ANIMALS: 15 healthy, mature Beagles. PROCEDURE: Weekly radiographic views of defects were obtained over 8 weeks and were analyzed for bone density by use of radiographic optical densitometry. Histologic sections were obtained 8 weeks after surgery and were planimetrically evaluated for area of total, lamellar, and woven bone. RESULTS: Defects receiving 0.3 and 0.75 g of ACBG had rapid initial bone production, and dogs receiving 0.3 g of ACBG had faster bone ingrowth than did those receiving 0.1 g of ACBG or controls. Defects receiving 0.75 g of ACBG had a rate of bony ingrowth equal to 0.3 g of ACBG. There was no difference in the histomorphometric area fractions of total, lamellar, or woven bone between defects treated with 0.1 or 0.75 g of ACBG, and between grafted or control defects, 8 weeks after surgery. CONCLUSIONS: Overfilling a cortical defect with ACBG does not enhance early osteogenesis within the defect, and underfilling will delay the onset of osteogenesis within the defect. CLINICAL RELEVANCE: A volume of ACBG sufficient only to fill a cortical defect is required to obtain a clinical osteogenic effect from the graft.

Animals↗
PubMed1993

Pantarsal arthrodesis in dogs and a cat: 11 cases (1983-1991).

Bone plates applied to the cranial surfaces of the tibia, the tarsus, and the metatarsus were used in 10 dogs and 1 cat that underwent pantarsal arthrodesis. Lengthening plates were used in 7 dogs, and 2.7- and 3.5-mm dynamic compression plates were used in the remaining dogs and the cat. Radiography was used to determine whether bone plates became loose or broke, and whether the joint fused completely. Bone plates became loose in 5 dogs; mean time between surgery and development of radiographic evidence of plate loosening was 19.4 months. The bone plate used in the cat broke 4 months after surgery. Overall, 9 of 11 animals had evidence of complete bony fusion of the tarsus at the time of the last radiographic evaluation. One dog had incomplete healing of the talocalcaneocentral joint and another dog had incomplete healing of the tarsometatarsal joint.

Animals↗
PubMed1993

HIV wasting syndrome in the United States.

OBJECTIVE: To describe the characteristics of individuals > or = 13 years of age with HIV wasting syndrome in the United States and US territories. DESIGN: Retrospective review of national AIDS case surveillance data. METHODS: Data for the 147,225 individuals with AIDS reported to the Centers for Disease Control from 1 September 1987 to 31 August 1991 were reviewed. The frequency of HIV wasting syndrome and its association with demographic and exposure category variables and with other AIDS-indicator diseases were assessed. RESULTS: A total of 10,525 (7.1%) had wasting syndrome as the only AIDS-indicator condition, and 15,726 (10.7%) had wasting syndrome plus at least one other AIDS-indicator condition. Patients with wasting syndrome as the only AIDS diagnosis were more likely to be female, to be black or Hispanic, and to have a mode of HIV exposure reported as injecting drug use, heterosexual contact, or transfusion/hemophilia. The proportion of AIDS patients reported with wasting syndrome varied by geographic distribution, ranging from 11% in the northeastern United States to 47% in Puerto Rico. The association between HIV wasting syndrome and Hispanic ethnicity was due to the much higher prevalence of wasting syndrome reported in Puerto Rican AIDS patients. The other AIDS-indicator conditions most strongly associated with wasting syndrome were isosporiasis, pulmonary candidiasis, esophageal candidiasis, HIV encephalopathy, chronic mucocutaneous herpes simplex, and coccidioidomycosis. CONCLUSIONS: The association between HIV wasting syndrome and injecting drug use, and the significant racial/ethnic and geographic differences in prevalence of this AIDS diagnosis may reflect differences in diagnostic and reporting practices and/or access to medical care.

AIDS-Related Opportunistic Infections↗
PubMed1993

Eustachian tube dysfunction and its sequelae in patients with cleft palate.

The incidence of middle ear disorders in patients with cleft palate deformities was determined in a retrospective review of 110 children with palate or palate and lip involvement. Ages ranged from 2 months to 18 years and included patients with associated abnormalities such as Pierre Robin syndrome and Treacher Collins syndrome. Clinical manifestations of eustachian tube dysfunction were found in 79% in the form of effusions, retraction pockets, adhesions, and ossicular erosion. Only two patients had confirmed cholesteatoma formation. Despite the low incidence of acquired cholesteatoma in these patients, the frequent occurrence of other disorders that affect hearing warrants early and aggressive otologic management to prevent long-term sequelae.

Adolescent↗
PubMed1992

Effects of a fixed compression load on the osteogenic effect of autogenous cancellous bone grafts in dogs.

A standardized cortical defect was created on the caudal cortex of the proximal portion of each ulna in 5 adult mixed-breed dogs. One gram of autogenous cancellous bone graft (ACBG) was obtained from the greater tubercle of the ipsilateral humerus. The cortical defect in the ulna of 1 limb was filled with 1 g of ACBG that had been compressed with 2-MPa pressure for 30 seconds. One gram of noncompressed ACBG was placed into the contralateral ulnar cortical defect. The compressed and noncompressed ACBG recipient sites were radiographed at weekly intervals. Dogs were euthanatized 8 weeks after surgery, and the ACBG recipient sites were harvested for histomorphometric analysis. Optical densitometry was performed on all radiographs. There was no significant difference between compressed and noncompressed ACBG with optical densitometry or histomorphometric analysis for total bone area. We concluded that there was no difference in osteogenic capability between compressed and noncompressed ACBG of equal mass.

Analysis of Variance↗
PubMed1990

The resident selection process in otolaryngology-head and neck surgery.

This study was undertaken to characterize the objective information available about applicants to otolaryngology-head and neck surgery residency positions, and to determine the influence of these factors on obtaining a residency position. Applicants to the otolaryngology-head and neck surgery programs at University of Utah, Salt Lake City, University of Texas Medical Branch, Galveston, and University of Louisville (Ky) were studied. Thirty-one variables were examined, representing demographic and academic factors. Excellent academic performance in medical school (as represented by medical school grade-point average greater than 3.4, National Board part I score greater than 650, class percentile rank greater than 85th percentile, honors grades in both junior medicine and surgery clinical clerkships, or [5] election to Alpha Omega Alpha) was significantly correlated with success in obtaining an otolaryngology-head and neck surgery residency position.

Adult↗
PubMed1990

Impact of diagnosis-related groups on the quality of postoperative care of patients with neck dissections.

Two hundred eighty patients underwent neck dissection over a 10-year period: 138 during the 5-year period before the institution of Diagnosis-Related Group (DRG) reimbursement and 142 during the 5 years after DRG regulations. A comparison of these two groups by site of tumor, stage of disease, histopathology, previous treatment, type of neck dissection, whether neck dissection was carried out alone or in combination with another procedure, presence of preexisting disease, postoperative complications, and mortality revealed no significant differences. A 35% reduction in the length of hospital stay from 16 to 10 days was identified in the post-DRG group with no detrimental effects on patient care. The variables found to have the greatest impact on length of hospital stay were the extent of operation and postoperative complications.

Diagnosis-Related Groups↗
PubMed1990

Epidermal growth factor binding and action on tympanic membranes.

A significant percentage of tympanic membrane (TM) perforations require some form of therapy to heal. Topical application of epidermal growth factor (EGF), a potent mitogen for epidermal and mesodermal cells, promotes healing of injuries in tissues histologically similar to TM, such as cornea and skin. We evaluated TM as a target tissue for EGF action. Specific, high affinity receptors for EGF were detected in TM (Kd = 3.1 nM, 150 fmol receptor/mg protein). Autoradiography of iodine 125-EGF binding to intact TMs revealed that EGF receptors were present on cells in the stratified squamous epithelial layer and in the stromal/mucoepithelial layer. Repetitive treatment of perforated cat TMs with 20 micrograms of EGF formulated in saline induced substantial hyperplasia of epithelial and stromal layers compared to paired TMs treated with saline. A single treatment of perforated cat TMs with 50 micrograms of EGF formulated in a hydrogel or in shredded Gelfoam produced significantly (p less than .05) smaller perforations at 6 days following the operation compared to paired TMs treated with vehicles. These results demonstrate that TM is a target tissue for EGF and that topical treatment with EGF stimulates healing of TM perforations.

Animals↗
PubMed1990

Surgical and nonsurgical complications associated with cochlear prosthesis implantation.

Relatively few complications have been reported for cochlear implant surgery in spite of a recent report detailing a complication rate of 11.8 percent. This report highlights both the surgical and nonsurgical complications we have encountered that have resulted in either replacement of the implanted prosthesis or compromise of the sound processing strategy employed by the external unit. These complications make a strong argument for the use of preoperative, intraoperative, and postoperative radiologic examinations. Since the complications reported herein have not been attributed to the implant device proper, we feel cochlear implantation remains a safe and effective procedure for those patients who are untreatable by traditional methods.

Aged↗
PubMed1989

Are we teaching medical students what they need to know?

If our broad goal for undergraduate education is to prepare students for residency and the eventual practice of medicine, the specific knowledge and skills we teach should reflect those that will be required of them to perform well as residents and practicing physicians. To determine and compare priority goals and objectives, we surveyed otolaryngology educators, a representative group of physicians in practice, and a representative group of residents. Participants were asked to evaluate the level of knowledge and skills necessary for students to attain in various areas of otolaryngology by ranking each item by a score of 0 to 3 according to its required depth of knowledge or skill. A rank "order of importance" was developed based on mean scores. The highest-ranking areas of knowledge were otitis media, airway obstruction, tonsillitis, and croup/epiglottitis, whereas the highest-ranking skills were history and physical examination of the head and neck, throat cultures, and use of the otoscope and pneumatoscope. The lowest-ranking areas of knowledge were voice disorders and ear deformities, whereas the lowest-ranking skills were interpreting electronystagmograms and stapedial reflex testing. We review the findings of our survey and comment on their role in undergraduate curriculum planning for otolaryngology.

Curriculum↗
PubMed1989

Magnetically evoked facial nerve potential.

Facial nerve stimulation by electrical current is painful and tends to discourage serial studies. Transcutaneous magnetic stimulation of the facial nerve is painless, easily reproducible, and elicits facial muscle responses identical to electrical stimulation.

Electromyography↗
PubMed1987

Nasal fractures. What to do for a successful outcome.

Nasal trauma is common in both children and adults. Most nasal fractures are easily reduced and do not result in long-term discomfort or disfigurement. However, care must be taken to avoid delay of treatment, especially in children, and to identify any associated cervical, paranasal, or intracranial injuries. Septal hematomas are not uncommon following nasal fracture and should be treated as soon as detected. The most common long-term sequela of nasal trauma is septal deviation with partial obstruction of the airway.

Humans↗