Search PubMed⌕ Search

Biomedical subjects

T R Martin

Publications and source records attributed to T R Martin.

179 records · Page 10Linked to original sources

Overt diabetes in pregnancy.

Of 45 diabetic pregnancies, 80% were Class C, D, or R. The perinatal mortality rate was 4.4% (corrected 2.2%); however, neonatal morbidity was high. Of the infants, 28% developed respiratory distress syndrome (RDS); 18%, asphyxia; and 42%, hypoglycemia. Thus, the woman with overt diabetes needs delivery in an institution where neonatal expertise and modern neonatal facilities exist. Of the mother 28% had a family history that was negative for diabetes mellitus. Four neonates developed RDS despite mature lecithin/sphingomyelin ratios.

Abortion, Induced↗

The management of severe toxemia in patients at less than 36 weeks' gestation.

Fifty-five patients at less than 36 weeks' gestation with severe toxemia were treated conservatively. The pregnancies were continued for a mean duration of 19.2 days and the mean gestation at delivery was 35.2 weeks. Fifty-three percent of the deliveries were by cesarean section. Of the neonates, 56.5% showed severe intrauterine growth retardation (IUGR), 17% had asphyxia neonatorum, and 13.2% developed respiratory distress syndrome (RDS). There were 3 stillbirths and 2 neonatal deaths for a mortality rate of 8.9% and a corrected rate of 7.1%.

Female↗

Failure of cyanoacrylate tissue glue (Flucrylate, MBR4197) to stop bleeding from experimental canine gastric ulcers.

A plastic tissue adhesive, trifluoroisopropyl 2-cyanoacrylate (Flucrylate (TM), MBR4197), was tested for hemostatic efficacy in acute laparotomy experiments using a canine model of acute bleeding gastric ulcer. An improved delivery system suitable for endoscopic use was developed. Hemostatic efficacy of the adhesive was tested in both briskly bleeding ulcers and in oozing ulcers after partial treatment with a heater probe. In pilot studies at laparotomy, primary and adjunctive cyanoacrylate therapy of 81 bleeding ulcers were evaluated in seven unheparinized foxhounds. Hemostasis was produced in 11% of ulcers treated with cyanoacrylate alone and in 31% of ulcers treated with cyanoacylate as an adjunctive after partial heater-probe treatment; no sham-treated control ulcers stopped bleeding under the conditions of the experiment. To evaluate Flucrylate (TM) using out standard heparinized ulcer model, a randomized study was performed in six heparinized foxhounds at laparotomy. Ulcers were randomized to treatment with cyanoacrylate alone, adjuctive cyanoacrylate, heater probe alone or untreated control. Sham-treated control ulcers or ulcers treated with cyanoacrylate alone did not stop bleeding; 42% of ulcers treated with cyanoacrylate as an adjunctive stopped bleeding; all ulcers treated with a heater probe stopped bleeding. In this experimental model of acute bleeding gastric ulcer, trifluoroisopropyl 2-cyanoacrylate (Flucrylate(TM),MBR4197) did not stop severe bleeding and was unpredictable as an adjunctive treatment.

Animals↗

Group B beta haemolytic streptococci in the female genital tract: a study of four clinic populations.

The carrier rate of group B beta-haemolytic streptococci (GBS) was assessed in pregnant and non-pregnant women attending four clinics. Multiple sites were sampled and standard methods were used to isolate GBS. Colonization rates were highest in patients attending a venereal disease clinic but were not associated with other sexually transmitted diseases. Higher colonization rates were detected when multiple sites were sampled. Serotypes II and III occurred most frequently.

Adolescent↗

Sinusoidal fetal heart rate pattern associated with alphaprodine administration.

Sinusoidal fetal heart rate patterns were observed in 42.5% of a group of 40 women who had received alphaprodine (Nisentil) for relief of labor pain. Analysis showed that the pattern appeared approximately 19 minutes following alphaprodine administration and persisted for approximately 60 minutes. In a control group of 18 patients who did not receive narcotic analgesia, and intermittent sinusoidal pattern was observed in one patient. All babies with sinusoidal heart rate during labor had 1-minute Apgar scores of 7 or greater except two in the study group. Both these neonates had low Apgar scores directly associated with complications at delivery. All 5-minute Apgar scores were 7 or greater, and there were no perinatal deaths.

Alphaprodine↗

Evaluation of the posterior flow study in brain scintigraphy.

To evaluate the usefulness of the posterior cerebral flow study, a prospective study was instituted. Of 32 adult patients examined for presumed posterior disease, 17 were found to have a positive posterior flow study that yielded information not available from the anterior study. Indications for posterior flow studies include posterior parietal, occipital, and posterior fossa tumors, posteriorly located arteriovenous malformations, Paget's disease involving occipital bone, posterior cerebral infarcts, and sagittal sinus occlusions. Our experience indicates that the posterior flow study is a valuable adjunct in those patients carefully screened for suspected posterior cerebral disease.

Adult↗

Heparin treatment in abruptio placentae.

Two cases of abruptio placentae with disseminated intravascular coagulation (DIC) were treated with heparin, and coagulation was monitored by thromboelastography as well as the usual hematology tests. The cases demonstrated the vagaries of DIC and both showed decreased overt hemorrhage after heparin treatment was started. Heparin may be indicated for the management of abruptio placentae where delivery is not imminent, where significant disseminated intravascular coagulation exists, and when adequate serial coagulation studies are available.

Abruptio Placentae↗

Mortality after esophagectomy: risk factor analysis.

Esophageal resection is associated with a high incidence of operative mortality, suggesting the need for predictors of operative risk. A retrospective analysis was performed for esophagectomy patients using univariate and multivariate analyses; relative risks (RR) were calculated. Of the 269 patients, 35 (13%) died. The optimal model for the preoperative prediction of risk of mortality was defined by age (p = 0.001; RR = 2.6) and performance status (p = 0.04; RR = 1.9). Delimiting the data pool using a calculated risk of 0.2 accurately identified outcomes in 79% of patients and predicted 41% of deaths. The optimal model for the overall prediction of risk of mortality was defined by age (p = 0.001; RR = 3.9), intraoperative blood loss (p < 0.001; RR = 1.7), pulmonary complications (p = 0.002; RR = 6.6), and the need for inotropic support (p = 0.003; RR = 10.2). The individual risk of mortality after esophagectomy can be predicted preoperatively with a model based on patient age and performance status. The findings underscore the importance of preoperative evaluation of cardiopulmonary function, meticulous operative technique, and aggressive respiratory care in the management of the esophagectomy patient.

Adolescent↗

Prospective assessment of the aorto-iliac segment by visual interpretation of frequency analysed Doppler waveforms--a comparison with arteriography.

In a group of 83 patients the prospective Doppler assessment of disease in the aorto-iliac segment, obtained from visual interpretation of the frequency analysed Doppler waveforms, is compared with subsequent arteriographic findings. The Doppler technique proved to be particularly accurate in the severely diseased vessels (sensitivity 87%, specificity 88%) but tended to underestimate the extent of the minimal/moderate disease.

Angiography↗

Use of death certificates for mesothelioma surveillance.

Data from the Massachusetts Cancer Registry and death certificates were linked for mesothelioma cases reported to the registry from 1982 through 1987 to determine the extent to which the cause of death information that is given on the death certificate is useful in identifying mesothelioma cases for disease surveillance. Only 12 percent of all persons reported with mesothelioma who had died were detected using underlying cause of death codes for cancers of the peritoneum and pleura, which are commonly used to identify mesothelioma cases. The rate increased to 83 percent when death certificates were reviewed manually for any mention of mesothelioma. Surveillance using only the coded cause of death data currently available will result in a large underascertainment of mesothelioma cases.

Death Certificates↗