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Biomedical subjects

T Moore

Publications and source records attributed to T Moore.

At least 163 records · Page 9Linked to original sources
PubMed1988

Predictors of survival in patients undergoing dialysis.

Survival and risk analyses were performed on all 532 patients in whom long-term dialysis was started from 1970 through 1985. During this 16-year period, starting age increased from 47 to 60 years (p less than 0.001), and the incidence of diabetes mellitus and renal vascular disease increased. Survival analysis showed age, renal diagnosis, type of dialysis, and year starting dialysis to be important predictors of survival. There was a fourfold rise in the risk ratio as starting age increased from 25 to 65 years. The risk was 1.5 times higher for those patients who did not start dialysis in 1978 through 1981 than for those who did. Risk decreased fivefold for patients choosing home hemodialysis. Home hemodialysis patients survived longer compared with patients utilizing other dialysis modalities, possibly because of a younger average age and a lower incidence of diabetes mellitus and renal vascular disease. There was greater than a threefold rise in risk ratio with the diagnosis of diabetes mellitus compared with either chronic glomerulonephritis or polycystic kidney disease. Older patients and those with diabetes mellitus formed the high-risk group; these two characteristics have been increasing during the last eight years of the study. It is concluded that although patients with high risk have an increased and a high mortality, overall survival has improved.

Actuarial Analysis↗
PubMed1988

Closure of defects from pressure sores requiring proximal femoral resection.

Proximal femoral resection (i.e., modified Girdlestone procedure) is often required in the paraplegic with an infection or dislocation of the hip joint. A philosophy and technique for dealing with this difficult problem are presented. The technique involves using an external osseous fixator to stabilize the femur and allow healing of the flap used to fill the defect.

Adult↗
PubMed1988

Sepsis of the hip in paraplegic patients.

For the treatment of chronic sepsis of the hip in paraplegic patients, we adopted three measures: (1) a Girdlestone procedure, (2) transposition of the vastus lateralis muscle into the void that was left by the removal of the femoral head and neck and the acetabular wall, and (3) external fixation to prevent unrestrained motion of the femoral shaft, which might damage the transposed muscle. The hip joint was spanned by a posterior pelvic-femoral skeletal external fixator. Nine patients, all of whom had thoracic-level paraplegia, were treated in this manner. The fixator was kept in place for three to six weeks while the patients were cared for in the prone position. All of the infections were fully healed by twelve weeks postoperatively. In two patients, the wound drained at the edge of the flap for a short time.

Adult↗
PubMed1987

Human-immunodeficiency-virus infections in infants negative for anti-HIV by enzyme-linked immunoassay.

Of 85 children with human-immuno-deficiency-virus (HIV) infection based on clinical (opportunistic infection), epidemiological (mother a drug addict or known to be HIV infected), and immunological (helper-T-cell deficiency and impaired proliferative response to pokeweed mitogen) features, 9 were found to lack antibody to HIV as measured by a commercial enzyme-linked immunoassay (ELISA). All 9 children had detectable levels of HIV antigen in simultaneous plasma specimens, measured by a sensitive antigen-capture ELISA. The use of the western blot assay and an ELISA with recombinant HIV antigens was able to identify HIV infection in 4 of the 9 children.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Reflectance photoplethysmography as an adjunct to assessment of gravitational acceleration tolerance: preliminary findings.

We have examined the feasibility of using reflectance photoplethysmography to assess Gz acceleration tolerance. Reflectance plethysmograms recorded using a sensor placed on the region of the superficial temporal artery were analysed along with the mean value and the pulsatile component of the Doppler velocity recorded from the opposite temporal artery. The photoplethysmogram signal and pulsatile and mean Doppler velocities were examined as predictors of impending peripheral light loss (PLL) during the experiments. Photoplethysmography correctly predicted a large percentage of the PLL runs (80.5%) and non-PLL runs (98.3%). Mean Doppler velocity predicted a higher percentage of PLL runs (88.1%), but with an unacceptably low rate of non-PLL runs (77.2%). The pulsatile Doppler velocity yielded only 50.7% correct prediction of PLL runs. The results of this preliminary study indicate that, with an improved design of the sensor and the electronics, it may be possible to use reflectance photoplethysmography in acceleration tolerance experiments as a reliable predictor of impending peripheral light loss.

Acceleration↗
PubMed1987

Bipolar prosthetic replacement for the management of unstable intertrochanteric hip fractures in the elderly.

To promote early full weight-bearing and rapid rehabilitation, 20 elderly patients (average age, 82.2 years) with unstable intertrochanteric hip fractures were treated with a bipolar head-neck replacement. Seventeen patients had the prosthesis inserted as primary fracture management, and three, for salvage of failed internal fixation. The patients were ambulating with unrestricted weight-bearing at an average of 5.5 days after the operation. The bipolar design may permit conversion to a total hip arthroplasty without removal of the femoral component, and may reduce the risk of acetabular cartilage damage. By using the greater trochanter as a landmark for precise placement of the femoral head, correct limb length was restored.

Aged↗
PubMed1986

Abnormal renal sodium handling in essential hypertension. Relation to failure of renal and adrenal modulation of responses to angiotensin II.

This study assessed renal sodium handling in a group of patients with essential hypertension in whom control of the renal blood supply and aldosterone release by angiotensin II is abnormal ("non-modulating") because of recent evidence that these patients have sodium-sensitive hypertension. Sixty-one patients were studied, 25 as balance was achieved with a daily sodium intake of 10 meq and 36 after a shift from a 10 meq to 200 meq sodium intake for five days. Renal and adrenal responsiveness to angiotensin II was assessed by measurement of para-aminohippurate clearance and plasma aldosterone prior to and during the infusion of 3 ng/kg per minute of angiotensin II, to identify the non-modulator group (n = 32). The half-time of the exponential function relating sodium excretion to time during the three to five days when external balance was being achieved with a 10 meq sodium intake was 23.9 +/- 0.3 hours in 60 normal subjects, 24.5 +/- 1.8 hours in the patients with essential hypertension in whom renal responsiveness to angiotensin II was normal, and prolonged (p less than 0.001) to 36.6 +/- 2.1 hours in the non-modulating patients. A prolonged half-time suggests that, with a shift to a high sodium intake, more time will be required to achieve external sodium balance and at the expense of more retained sodium. During the shift from a 10 to 200 meq sodium intake, the non-modulator group showed a delayed rate at which external sodium balance was achieved, greater cumulative positive sodium balance, more weight gain, and a greater frequency of blood pressure rise. The abnormality in the rate at which external sodium balance is achieved in non-modulation results in a difference in total body sodium that varies with sodium intake and that may well contribute to, or cause, sodium-sensitive hypertension.

Adrenal Glands↗
PubMed1986

A comparative assessment of home versus hospital comprehensive treatment for advanced cancer patients.

A prospective comparative analysis of home and hospital comprehensive treatment for advanced non-ambulatory cancer patients was conducted. Patients were assigned to hospital (group A) and home (group B) treatment groups based on geographic location. Home treatment was provided by the Don Monti Home Oncology Medical Extension (HOME) program. A multidisciplinary health team, including an oncologist, oncology nurse, social worker, dietitian, and medical technologist, was transported to the home in a medically equipped van. Services included physical examinations, pain control, psychosocial interventions, chemotherapy and blood transfusions, nutrition consultation, and bereavement counseling. One hundred seventy-four patients were treated at home and 44 in the hospital. Pretreatment characteristics were similar for both groups, with the exception that age under 50 years was more frequent in the hospital group, and home patients were more likely to have gastrointestinal (GI) cancer. Medical benefits for home treatment included decreased narcotic analgesic requirements, decreased hospitalization and length of stay, and improved measurements of fat stores for female patients. Improved survival for home patients was related to Karnofsky performance status, since there was no difference in survival for sicker patients with lower performance status whether they received home or hospital treatment. Patient and family acceptance of home treatment was excellent. Comprehensive home treatment provided by a multispecialty oncology team is an effective alternative to hospitalization for terminal cancer patients.

Analgesics↗