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Biomedical subjects

S F Miller

Publications and source records attributed to S F Miller.

At least 55 records · Page 3Linked to original sources
PubMed1981

Repair of a subvalvular left ventricular aneurysm following mitral valve replacement.

Left ventricular aneurysms are a frequent complication of myocardial infarction. Some aneurysms occur secondary to trauma, previous operation, or infection. This report presents the case of a patient with a posterior submitral left ventricular aneurysm, which occurred following mitral valve replacement. The complete obliteration of the pericardial sac due to previous cardiac operation and the posterior location made external dissection of the aneurysmal wall technically impossible. Closure of the defect through the valve orifice by placing a patch over the neck of the aneurysm was found to be a relatively simple and safe technique combined with replacement of the prosthetic valve. The possibility of injury to the circumflex coronary artery was reduced using this surgical approach.

Female↗
PubMed1981

Comparison of derived and actual transferrin: a potential source of error in clinical nutritional assessment.

A prospective study was undertaken to evaluate the utility of calculating transferrin from total iron-binding capacity in the nutritional assessment of burned patients. Regression analysis was used to compare total iron-binding capacity with radial immunodiffusion transferrin determinations. The method used for calculating transferrin (0.8 TIBC - 43) is a frequently published conversion formula for deriving transferrin. One hundred twenty-five data sets were obtained from 45 burned patients. Values for derived transferrin ranged from 39 to 235 mg/dl, averaging 121 mg/dl. Actual transferrin averaged 162 mg/dl, ranging from 41 to 320 mg/dl. Forty-eight actual serum transferrin samples were normal (greater than 172 mg/dl) whereas only 17 derived transferrin values were normal. While there is a correlation between total iron-binding capacity and serum transferrin (r = 0.85), to calculate transferrin according to the formula above would have resulted in significant error in the clinical assessment of the patients' nutritional status (p less than 0.001). From our studies, the formula for conversion of total iron-binding capacity to transferrin was found to be (0.68 TIBC + 21). These results suggest that the development of a universal conversion factor is not feasible. Modification of the formula may be necessary at each institution for clinically useful evaluations of serum transferrins are to be derived from iron-binding capacity for use in nutritional assessment.

Adolescent↗
PubMed1979

Vascular complications as a result of intra-aortic balloon pumping.

Intra-aortic balloon conterpulsation (IABP) was used to assist 109 patients with extensive myocardial infarcts, unstable angina, cardiogenic shock, and unstable cardiodynamic states after cardiopulmonary bypass over a six year period. Severe vascular occlusion occurred in three patients (3%) which required an above the knee amputation. Each patient had a long history of smoking. Obesity, atherosclerotic disease of the femoral vessels, and extensive coronary artery disease were additional contributing factors. Two of the three patients survived, but both survivors had extensive postoperative myocardial infarctions. A low flow cardiac state and the presence of atherosclerotic changes in the legs must be precipitating factors for the vascular complications. Several possible methods to minimize complications of this nature include 1) angiographic examination of the lower aorta and femoral arteries at the time of cardiac catheterization, 2) frequent monitoring with ultrasound equipment, and 3) use of anticoagulation during and after the period of counterpulsation.

Amputation, Surgical↗
PubMed1978

Immediate excision of burn wounds.

Early excision and grafting of body burns is a safe and efficient means of treatment. It reduces hospital stay and probably reduces septic complications. A group of 41 patients were so treated at Miami Valley Hospital Burn Therapy Program. Their hospital stay was less than that of patients treated and reported to the National Institute of Burn Medicine.

Burns↗
PubMed1978

The detection of asymptomatic colorectal cancer.

The classic symptoms and signs of colorectal cancer (change in bowel habits, weight loss, melena or a palpable abdominal mass) signify advanced disease. Improvements in survival rates have not occurred in the last 15 years because the majority of patients have metastases at the time of surgery. Asymptomatic patients are detected by routinely screening stools for occult blood. If practiced routinely, this technique will improve survival statistics by identifying patients and instituting treatment at an earlier stage of disease.

Colonic Neoplasms↗
PubMed1977

The early detection of colorectal cancer.

A review of the American Cancer Society's statistics for colorectal cancer indicates that there has been little improvements in the survival rate for this disease in the past 25 years. Although there have been advances in surgical techniques, radiation therapy, and chemotherapy, the key to improved survival rates is earlier diagnosis. A significant percentage of patients continues to present with regional or distal metastasis at the time of their initial diagnosis. Both proctosigmoidoscopy and guaiac impregnated filter slide paper methods have been productive in diagnosing this disease at an earlier stage. The "Hemoccult" test, however, is inexpensive, can be used on a routine basis, is easier for patients to perform themselves, and is aesthetically pleasing. It represents a significant cost savings compared to proctosigmoidoscopy and should be advocated for routine use in all patients over 40 years of age. Although there continues to be a role for local and regional mass screening programs, significant improvements in colorectal survival rates cannot be expected until routine application of this type of screening is practiced.

Adult↗
PubMed1977

Outpatient management of minor burns.

The overwhelming majority of burns are minor and can be treated on an ambulatory basis if hospitalization is not indicated. Recommended are topical antimicrobial agents in the acute phase and pressure garments after wound healing. Sound principles of burn wound management determine the ultimate outcome of treatment, the degree of function and the cosmetic appearance of the healed wound.

Administration, Topical↗
PubMedDate not supplied

CT diagnosis of right hemothorax secondary to ruptured thoracoabdominal aneurysm: case report.

The development of a right hemothorax as the result of a ruptured thoracoabdominal aneurysm is an uncommon and usually fatal event. Survival depends upon an accurate diagnosis and prompt surgical intervention. We present a case of a ruptured thoracoabdominal aneurysm into the right chest that presented as opacification of the right hemithorax and hypotension. An early CT scan provided the correct preoperative diagnosis, although the patient did not survive.

Aged↗