Search PubMed⌕ Search

Biomedical subjects

S Tanner

Publications and source records attributed to S Tanner.

32 records · Page 2Linked to original sources
PubMed1993

Management of traumatic liver injuries.

Liver injuries in Europe are usually caused by blunt trauma and a high mortality rate is generally reported. The severity of liver injury in 175 patients was graded from I to V and the Injury Severity Score assessed. Seventy-five patients in a prospective study (1987-1990) were treated according to a defined protocol. Non-operative management was used for those who were haemodynamically stable on admission. In unstable patients who proceeded to surgery, liberal use of packing was made and a low threshold for relaparotomy employed. Increasing experience resulted in fewer indications for resection and a 40 per cent rate of non-operative treatment in the prospectively managed group. The overall mortality rate was 12 per cent (15 per cent in the retrospective and 8 per cent in the prospective group). Death in patients with multiple injuries should only rarely result from liver trauma.

Adolescent↗
PubMed1993

[The significance of computerized tomography for conservative treatment of liver trauma].

Increasing experience with early radiological evaluation by ultrasound (US) and computed tomography (CT) of patients with abdominal trauma is leading to more frequent use of conservative treatment in patients with severe liver injuries. In a retrospective study with predominant use of peritoneal lavage only 3 out of 100 patients with liver injuries were treated non-surgically. In a consecutive prospectively evaluated series of 75 patients with early use of US and CT, 30 patients in stable circulatory conditions were treated non-surgically. With increasing experience a higher percentage of patients, even with severe liver injuries, could be treated non-operatively. 17 patients with minor injuries (grade I and II, modified according to Moore) and 13 patients with severe injuries (grade III and IV) could be treated non-surgically. 2 patients with grade IV injury developed an arterial/portal-venous fistula and an arterial aneurysm which necessitated radiological embolizations. All conservatively treated patients have been followed up for a mean period of 18 months without complications. Although a precise anatomical classification of the liver injury degree seems difficult, the predictive value of computed tomography for non-surgical treatment was good. Use of iv-contrast is mandatory. We conclude that in experienced hands computed tomography allows precise evaluation of liver injuries for adequate treatment, provided careful follow-up (intensive care unit, CT, angiography) ensues to avoid complications.

Abdominal Injuries↗
PubMed1992

[Experimental atrophy/hypertrophy complex of the liver after portal and/or biliary ligation in the rat].

Patients with lobar or segmental, benign or malignant strictures of the biliary tree (with or without impairment of the portal blood flow) show a considerable atrophy of the involved area of the liver with a compensatory hypertrophy/hyperplasia of the remaining non affected liver. To investigate the importance of the biliary and portal obstruction for the development of this process, we used a rat model, with selective biliary and/or portal ligation of the anterior liver lobes (two thirds of the liver mass). Weight measurements, morphometry, functional scintigraphy (Hepatoiodida-scan) and blood enzyme analyses were done immediately postoperatively, at 30 hours and 4, 8 and 28 days after the operation. The major findings were: 1. 28 days after biliary and/or portal ligation there was no difference between the body weight of the four groups, all ligated animals having compensated for an initial greater percentage body-weight loss. 2. Total liver weight remained constant, while atrophy and hypertrophy/hyperplasia occurred although a progressive derangement of liver morphology was observed during that time. 3. A severe atrophy-hypertrophy-complex (AHC) developed after selective portal ligation, which in our experiment did not appear after selective biliary ligation. 4. Morphometrical changes after selective biliary ligation were reversible, whereas in liver lobes with selective portal ligation a progressive parenchymal destruction and involution with subsequent impairment of hepatic function of the concerned lobe was observed.

Animals↗
PubMed1991

Low back pain in young athletes. A practical approach.

Lumbar spine pain accounts for 5 to 8% of athletic injuries. Although back pain is not the most common injury, it is one of the most challenging for the sports physician to diagnose and treat. Factors predisposing the young athlete to back injury include the growth spurt, abrupt increases in training intensity or frequency, improper technique, unsuitable sports equipment, and leg-length inequality. Poor strength of the back extensor and abdominal musculature, and inflexibility of the lumbar spine, hamstrings and hip flexor muscles may contribute to chronic low back pain. Excessive lifting and twisting may produce sprains and strains, the most common cause of low back pain in adolescents. Blows to the spine may create contusions or fractures. Fractures in adolescents from severe trauma include compression fracture, comminuted fracture, fracture of the growth plate at the vertebral end plate, lumbar transverse process fracture, and a fracture of the spinous process. Athletes who participate in sports involving repeated and forceful hyperextension of the spine may suffer from lumbar facet syndrome, spondylolysis, or spondylolisthesis. The large sacroiliac joint is also prone to irritation. The signs and symptoms of disc herniation in adolescents may be more subtle than in adults. Disorders simulating athletic injury include tumours and inflammatory connective tissue disease. Often, however, a specific diagnosis cannot be made in the young athlete with a low back injury due to the lack of pain localisation and the anatomic complexity of the lumbar spine. A thorough history and physical examination are usually more productive in determining a diagnosis and guiding treatment than imaging techniques. Diagnostic tests may be considered, though, for the adolescent athlete whose back pain is severe, was caused by acute trauma, or fails to improve with conservative therapy after several weeks. Radiographs, bone scanning, computed tomography, and magnetic resonance imaging may help identify, or exclude serious pathology. Fortunately, the majority of cases of low back pain in adolescents respond to conservative therapy. Immediate treatment of an acute injury, such as a sprain or strain, includes cryotherapy, electrogalvanic stimulation, anti-inflammatory medications and gentle exercises. Prolonged bed rest should be avoided since atrophy may occur rapidly. Strong analgesics are also usually contraindicated, except for sleep, since they mask pain and may allow overvigorous activity. Early strengthening exercises include the Williams flexion exercises and/or McKenzie extension exercises. Both exercise motions may often be prescribed. Athletes with an acute disc herniation, however, should only perform extension exercises initially. Athletes with spondylolysis, spondylolisthesis and facet joint irritation should initially be limited to flexion exercises.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1989

[Diagnosis and therapy of liver injuries in the polytraumatized patient].

We examined 120 patients with liver trauma, 100 retrospectively (1973-1986 group I) and 20 prospectively (1986-1987 group II). The severity of the liver injury was categorized in 5 grades (modified after Moore) and the degree of multiple trauma was assessed by the injury severity score (ISS). Patients in the liver injury groups were equally distributed among grades I to IV; there was one patient with a grade V injury in both the retrospective and prospective group. The overall mortality was 14%, 15% for the retrospective and 10% for the prospective group. Mortality was mainly due to concomitant injuries (head injuries, ARDS, multiple organ failure, pneumonia) and only 3 patients in the whole group died as a result of continuous bleeding or because of prolonged hemorrhagic shock due to the liver injury. The defined protocol for the prospective group included early efficient resuscitation and blood/fresh frozen plasma transfusion, systematic and rapid assessment of injuries and determination of priorities of treatment. Immediate ultrasonography or peritoneal lavage was used for assessment and diagnosis of a liver injury and early selection of treatment according to the grade of the liver injury: Conservative management for stable cases consisted of close supervision and repeated investigations (CT, angiography). Immediate operation was undertaken for continuing hemorrhage. Postoperative care in an intensive care unit with a low threshold for reoperation in cases of suspected sepsis, ongoing hemorrhage or necrosis of liver tissue was an important part of the treatment. Our results suggest that death in multiple trauma patients should almost never be due to liver injury alone. Conservative treatment may be justified in some patients, but early resuscitation and operation directed at definitive or provisional control of hemorrhage with removal of all devitalized tissue and liberal use of early reoperation are essential in the management of severe liver injury.

Adolescent↗
PubMed1982

Stuttering: the results of 5 days treatment with an airflow technique.

Brief treatments for stuttering would be available if they could produce long term benefits. Six clients were given training in a variant of an airflow technique. Treatment required eight hours of clinician time per client. Significant improvement occurred after four days of treatment, but relapse was considerable and by the end of the year speech was unimproved in respect to pretreatment scores. Presently, proven effective treatments require 30 hours of clinician time per client and shorter treatments do not appear to produce comparable results.

Adult↗
PubMed1981

Short- and long-term outcome in an intensive treatment program for adult stutterers.

A three week intensive treatment program for adult stutterers is described. This treatment has evolved from an original program developed by Ingham and Andrews (1973) using speech prolongation techniques, gradual shaping of speech rate to normal, and systematic transfer of skills acquired in the clinic to real life situations. Immediately after intensive treatment, stuttering was virtually eliminated and speech rate and attitudes toward communication were normalized. There was no substantial deterioration in these treatment effects when clients were evaluated in the clinic after two months in the Maintenance Phase of treatment. Speech and attitude measures collected outside the clinic 12--18 months after intensive treatment showed lasting overall improvement in most clients, although some deterioration in fluency from immediate post-intensive treatment levels had occurred in 40% of clients. Covertly collected data supported this finding. Possible causes of relapse and likely solutions are discussed.

Adult↗
PubMed1972

A christmas angel.

Explore the source record for details and available documents.

Delivery, Obstetric↗
PubMedDate not supplied

Steroids: a breakfast of young champions.

Anabolic-androgenic steroids (AAS) may, unfortunately, be the breakfast of some youngsters aspiring to become champions. Awareness of this problem by health care providers is important so youngsters tempted to take, or taking, AAS may be identified and counseled.

Adolescent↗
PubMedDate not supplied

Variability of deoxynivalenol measurements in barley.

Deoxynivalenol (DON), a toxin produced by Fusarium fungi, can occur in many cereal grains. If wet climatic conditions coincide with the flowering period of plant development, circumstances are favorable for the fungi infection. Because the presence of DON in barley can have significant economic consequences to barley producers, commercially available test kits are used to measure DON in shipments throughout marketing channels. The quantity of barley sampled from a lot and used to measure DON can vary widely, depending on where the test is conducted. The Grain Inspection, Packers and Stockyards Administration of the U.S. Department of Agriculture specifies that a minimum of 100 g of grain must be processed to measure DON. Other laboratories may use more or less grain. A study undertaken to measure the variability among measurements of different sample sizes found no detectable differences in variability attributable to sample size. It was concluded that the variability among DON concentrations in samples from the lot was small relative to that introduced by the measurement process (combined sample preparation and analysis). A separate experiment investigated variation among samples taken from a lot, variation among subsamples taken from ground samples, and variation among multiple replicated measurements of an extract. On 10 lots, all 3 sources were significant contributors to variation. Stratification of DON within lots was hypothesized as a source of variation of DON measurements. Tests indicated that some stratification may exist.

Hordeum↗
PubMedDate not supplied

Acceptance and perceptions of NORPLANT among users in San Francisco, USA.

Two hundred and five women participating in a five-year clinical trial of NORPLANT and NORPLANT-2 were interviewed about their contraceptive and reproductive history, sources of information and knowledge of NORPLANT, experiences using the method, and the impressions of friends and family about the method. The most common reasons for trying the implants were dissatisfaction with other methods and perceptions about NORPLANT's ease of use. Forty-one percent of acceptors had anxiety prior to insertion; 49 percent of these feared pain, but only 5 percent said that they actually experienced significant pain. Women also feared implant removal, but their fear did not influence their decision to continue or discontinue use, and 74 percent reported little or no pain at removal. Most of the women were pleased with NORPLANT, although 95 percent reported side effects, with 82 percent reporting changes in menstruation. More than one-half of those women who discontinued reported that they would use the implants again. Seventy-four percent of the current users interviewed said they would like to use the implants in the future. For the women enrolled in the clinical trial, NORPLANT appeared to be a highly acceptable method of contraception, despite the frequent occurrence of bothersome side effects.

Adult↗