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S Sherman

Publications and source records attributed to S Sherman.

At least 181 records · Page 10Linked to original sources
PubMed1989

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Education, Nursing, Associate↗
PubMed1989

Routine chest radiographs in exacerbations of chronic obstructive pulmonary disease. Diagnostic value.

Routine admission chest radiographs were abnormal in 35 (14%) of 242 patients hospitalized with an exacerbation of chronic obstructive pulmonary disease and resulted in management changes that were appropriate and clinically significant in only 11 cases (4.5%). Based on our analysis of clinical variables predictive of significant radiographic abnormalities and our assessment of clinically important findings, we propose the following indications for admission chest radiographs in patients with an acute exacerbation of chronic obstructive pulmonary disease: white blood cell count above 15 x 10(9)/L and polymorphonuclear leukocyte count above 8 x 10(9)/L, history of congestive heart failure, history of coronary artery disease, chest pain, or edema. In view of the low yield of clinically significant abnormalities, we believe that routine chest radiographs need not be performed in this patient population. The use of selective criteria could eliminate unnecessary studies while assuring recognition of important new radiographic abnormalities.

Acute Disease↗
PubMed1988

Optimum anesthesia with intrapleural lidocaine during chemical pleurodesis with tetracycline.

Chemical pleurodesis with tetracycline is frequently complicated by pleuritic chest pain. The most promising approach to control pain is to optimize the use of intrapleural lidocaine. While administering amounts of intrapleural lidocaine larger than commonly reported, we attempted to determine a safe and more effective dose, by using a subjective and objective assessment of pain, by measuring serum concentrations of lidocaine, and by observing patients for possible toxic effects of lidocaine. Chemical pleurodesis with tetracycline was performed on ten patients receiving an intrapleural dose of 200 mg of lidocaine (group 1) and on ten patients receiving a 250-mg dose (group 2). A significantly greater number of patients in group 2 were free of pain following pleurodesis (7/10 vs 1/10; p = 0.006). Of the 80 serum lidocaine levels obtained, only one value (6.1 micrograms/ml), in an asymptomatic patient in group 1, exceeded the therapeutic range (1.5 micrograms/ml to 5.5 micrograms/ml). One patient in group 2 experienced transient numbness of the right hand, a possible side effect of lidocaine. We conclude that to achieve optimum anesthesia during chemical pleurodesis with tetracycline, it is necessary to use doses of intrapleural lidocaine large than previously reported. Until the feasibility of a further escalation is demonstrated, 250 mg should be considered the standard dose.

Anesthesia, Local↗
PubMed1987

The feasibility of thoracotomy for lung cancer in the elderly.

We reviewed 139 cases of thoracotomy for lung cancer, performed during a 7 1/2-year period. Patients were divided into two groups based on age: a younger group (less than 70 years old) and an elderly group (greater than or equal to 70 years old). Among all cases of lung cancer diagnosed during the study period, the percentage of patients undergoing thoracotomy in both groups was comparable. Comparison of baseline features of the two groups revealed no statistical difference in the distribution of sex, smoking history, arterial blood gas values, degree of airflow obstruction, cell type, stage of cancer, or subsequent therapy. Potentially serious medical problems were more frequent in the elderly group, whereas the younger group had significantly higher values for several pulmonary function parameters and underwent a significantly higher proportion of pneumonectomies. Although operative mortality in the elderly group was greater (9.4% vs 4.0%; 95% confidence intervals, 3.5%, 19.3% vs 0.8%, 11.2%), [corrected] further analysis of outcomes revealed no statistically significant difference in the postoperative complications, postoperative hospital stay, or actuarial survival. We conclude that advanced age does not adversely affect prognosis following thoracotomy for lung cancer. Therefore, elderly patients with reasonable cardiopulmonary function should not be denied potentially curative pulmonary resection because of concern for age-related complications.

Age Factors↗
PubMed1987

Prolonged spinal analgesia in the rat with the alpha-adrenoceptor agonist oxymetazoline.

The acute intrathecal (i.t.) injection of 50, 100, 200, 250 and 300 nmol of oxymetazoline produced dose-dependent antinociception in rats assessed by tail flick and paw pressure tests. Significant antinociception was observed with all doses of oxymetazoline except 50 nmol in the paw pressure test. The ED50 values for i.t. oxymetazoline in the tail flick and paw pressure tests were 120 nmol (95% CI: 76-178 nmol) and 148 nmol (95% CI: 120-186 nmol), respectively. Oxymetazoline had a long duration of action; a single i.t. dose of 100 nmol significantly elevated tail flick latency and paw pressure threshold for 8 h. The alpha-adrenoceptor antagonist phentolamine, given i.t. 1 h after oxymetazoline, attenuated the antinociceptive effect in a dose-dependent manner. Phentolamine (50 micrograms i.t.) produced almost complete antagonism in the tail flick and paw pressure tests. These data indicate that oxymetazoline produces long lasting antinociception in the rat following i.t. injection, and that the effect is mediated by alpha-adrenoceptors in the spinal cord.

Anesthesia, Spinal↗
PubMed1987

Smith-Lemli-Opitz syndrome-type II: multiple congenital anomalies with male pseudohermaphroditism and frequent early lethality.

In 1964, Smith et al described a syndrome of microcephaly, growth and mental retardation, unusual facial appearance, syndactyly of toes 2 and 3, and genital abnormalities. Major structural malformations and early death have been uncommon in the many subsequent literature reports. We report on 19 infants with a phenotype we propose to call Smith-Lemli-Opitz syndrome (SLOS)-Type II, in which major structural abnormalities, male pseudohermaphroditism, and early lethality are common. Of these 19 patients, 18 had postaxial hexadactyly, 16 had congenital heart defect, 13 had cleft palate, and 10 had cataracts. Unusual findings seen in these patients at autopsy included Hirschsprung "disease" in five patients, unilobated lungs in six, large adrenals in four, and pancreatic islet cell hyperplasia in three. Comparison of our cases to 19 similar literature cases suggests the existence of a distinct phenotype that may be separate from SLOS as originally described. It is also inherited as an autosomal recessive, as documented by occurrence in one pair of sibs in this study and recurrence in three reported families.

Abnormalities, Multiple↗
PubMed1987

Clinical experience with tetracycline pleurodesis of malignant pleural effusions.

Because many patients with malignant pleural effusions could survive for months to years beyond its onset, definitive management must be safe and effective. Chemical pleurodesis with tetracycline has gained general acceptance as the therapy of choice, even though no large series confirming this viewpoint has appeared in the literature. We reviewed 108 procedures involving tube thoracostomy and tetracycline pleurodesis, and report a success rate of 94.4% without serious complications. Considering all patients, 49% were symptom-free at three months, and 13% were alive one year later. Several potentially important changes in technique have emerged since the initial description of this procedure. With adherence to meticulous technique, tetracycline pleurodesis provides rapid, effective, and safe palliation of malignant pleural effusions.

Adult↗
PubMed1987

Gunshot wounds of the orbit.

Five cases of ocular firearm injuries are presented. A physical analysis of the gunshot wound characteristics, with representative examples, is highlighted. The important early and late complications are completely discussed. Appropriate management sequence, including complete evaluation, diagnostic testing, and surgical intervention, is outlined and discussed.

Adolescent↗
PubMed1986

Tight linkage of apolipoprotein C2 to myotonic dystrophy on chromosome 19.

The cDNA and genomic probes for apolipoprotein C2 detect two restriction fragment length polymorphisms on chromosome 19. The combined estimated percentage of heterozygosity, assuming equilibrium, is approximately 75%, ie, apolipoprotein C2 is informative in 75% of matings. We have analyzed over 350 individuals in large multigenerational families for linkage of apolipoprotein C2 to myotonic muscular dystrophy. The maximum lod score was 16.29 with the maximum recombination fraction (theta) of 0.02, with 95% confidence limits for theta of 0.001 to 0.065. Thus, apolipoprotein C2 is useful in carrier detection and prenatal diagnosis with an accuracy of about 98%.

Apolipoproteins↗
PubMed1982

Corneal endothelial changes after argon-laser iridotomy and panretinal photocoagulation.

We performed argon-laser peripheral iridotomies on the right eyes of eight cynomolgus monkeys and administered panretinal scatter photocoagulation to the left eyes of the same monkeys. Both eyes of each monkey were photographed and studied with a slit lamp, pachymetry, and direct and indirect specular microscopy. After follow-up periods of 0 to 31 days, the monkeys were killed and the enucleated eyes studied by light and scanning electron microscopy. Scanning microscopy were deposits showed that the changes observed by specular microscopy were deposits on the endothelium. Only minimal damage occurred and there were no significant changes in endothelial cell density after either treatment.

Animals↗