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At least 1,315 records · Page 73Linked to original sources
PubMed1990

Dermal absorption of the phenoxy herbicides 2,4-D, 2,4-D amine, 2,4-D isooctyl, and 2,4,5-T in rabbits, rats, rhesus monkeys, and humans: a cross-species comparison.

Dermal absorption of the 14C-ring-labeled phenoxy herbicides 2,4-D [(2,4-dichlorophenoxy)acetic acid], 2,4-D amine (2,4-dichlorophenoxyacetic acid dimethylamine), 2,4-D isooctyl (2,4-dichlorophenoxyacetic acid isooctyl ester), and 2,4,5-T amine (2,4,5-trichlorophenoxyacetic acid trimethylamine) was examined following topical applications of the herbicides to the back of rabbits, the back and tail of rats, the forearm and forehead of rhesus monkeys, and the forehead of human volunteers. The effect of three pesticide vehicles (water, acetone, and Esteron LV96) was also investigated. The total percent dermal absorption was calculated from the mean percent urinary recoveries from the animal tests and corrected for nonurinary excretion of the radiolabel using data from intramuscular (im) injections. The human data are reported without im correction. The reliability of animal data for modelling human dermal absorption of pesticides is highlighted.

2,4,5-Trichlorophenoxyacetic Acid↗
PubMed1994

Ethnic differences in the myocardial and vascular reactivity to stress in normotensive girls.

Cardiovascular reactivity to stress has been proposed as a mechanism partially responsible for the increased prevalence of essential hypertension in African-Americans compared with whites. However, few studies have examined ethnic differences in cardiovascular reactivity among women. The present study evaluated potential ethnic differences in the cardiovascular reactivity to three laboratory stressors (postural change, video game challenge, forehead cold stimulation). The sample consisted of 171 normotensive girls (74 whites, 97 African-Americans) with a mean age of 11.1 +/- 2.7 years, all with positive family histories of essential hypertension. African-American girls showed higher resting diastolic blood pressures and higher resting total peripheral resistance compared with white girls. African-American girls also exhibited higher peak responses in systolic and diastolic blood pressure and total peripheral resistance and lower cardiac index responses during video game challenge and forehead cold stressor. The findings extend previous observations of ethnic differences in blood pressure reactivity to stress and indicate that concomitant increases in total peripheral resistance appear to account for the greater blood pressure reactivity in African-American girls.

Adolescent↗
PubMed2004

Occupational dermal exposure to cyclophosphamide in Dutch hospitals: a pilot study.

INTRODUCTION: Several studies have shown that exposure to antineoplastic drugs can cause reproductive toxic effects as well as carcinogenic effects. Presence of these drugs in the urine of hospital personnel has been widely studied and some work has been done on exposure by inhalation. So far, assessment of dermal exposure to antineoplastic drugs has not been extensively studied. In this pilot study we assessed potential and actual dermal exposure for several common hospital tasks. Results were used to derive an optimal measurement strategy for a currently ongoing exposure survey. METHODS: Dermal exposure to cyclophosphamide was determined in three Dutch hospitals during five tasks (preparation, decanting urine, washing the patient, removing bed sheets and cleaning the toilet) using pad samples on 10 body locations. In addition, protective medical gloves (worn during the performance of these activities) were collected to estimate potential exposure of the hands. Subsequently, hands were washed to measure actual exposure of the hands. Bulk samples (i.e. application and body fluids) were collected and possible contact surfaces were monitored to assess the amount of cyclophosphamide potentially available for exposure. RESULTS: The results show that hospital personnel (i.e. pharmacy technicians and oncology nurses) are dermally exposed to cyclophosphamide during performance of their daily duties. Exposure occurred predominantly on the hands and sporadically on other body locations (i.e. forehead and forearms). Gloves used during preparation of cyclophosphamide were more contaminated than gloves used in other tasks, however, actual exposure of the hands (underneath the gloves) was highest during decanting of urine of treated patients. Glove samples correlated significantly with handwash samples (r = 0.57, P = 0.03, n = 15). The level of protection from gloves varied between tasks, being highest for gloves used during preparation (median = 98%) and lowest for gloves used during decanting urine (median = 19%). CONCLUSION: This pilot study demonstrated that dermal exposure to cyclophosphamide is common among hospital personnel. The results showed that hands, forearms and forehead accounted for 87% of the cyclophosphamide total body exposure. Glove samples together with handwash samples enabled estimation of glove efficiency, which appeared to vary strongly between tasks observed.

Antineoplastic Agents, Alkylating↗
PubMed1980

Experimental comparison of extradural and i.m. morphine.

Morphine sulphate 3 or 4 mg was administered to the extradural space in five volunteers. Morphine 10 or 15 mg i.m. was given as control. Extradural administration resulted in an increase of pain threshold in the legs but not in the forehead. There was no significant depression of carbon dioxide response or deterioration of co-ordination or short-term memory. I.m. morphine caused an increase in forehead pain threshold, depression of the carbon dioxide response and some deterioration of cerebral function. Extradural morphine caused urinary retention in four and inability to ejaculate in three of the subjects. The principal site of action of extradural morphine appears to be regional, at spinal cord level, but it appears that autonomic function as well as pain perception can be affected.

Adult↗
PubMed1991

Influence of hypertonic volume replacement on the microcirculation in cardiac surgery.

We have studied the effects of two types of volume replacement on the microcirculation in an open, controlled study in 45 patients undergoing aorto-coronary bypass grafting whose pulmonary capillary wedge pressure (PCWP) was less than 5 mm Hg. Hypertonic saline prepared in hydroxyethylstarch solution (HS-HES, n = 15) and 6% HES 200/0.5 solution (6% HES; n = 15) were infused randomly before operation in order to double the PCWP. Patients not given an infusion served as controls (n = 15). Skin microcirculatory blood flow was investigated by laser Doppler flow (LDF) measured simultaneously at the forearm and forehead before and after cardiopulmonary bypass (CPB). Less HS-HES (3.8 (SD 0.3) ml kg-1) than 6% HES-solution (9.7 (1.5) ml kg-1) was necessary to double baseline PCWP. There were no differences in heart rate and mean arterial pressure (MAP) between the groups. Cardiac index (CI) increased significantly in both volume groups (HS-HES max. +54%; 6% HES max. +30%). Systemic vascular resistance (SVR) decreased after infusion of HS-HES (-30%) and after 6% HES(-19%) and remained almost unchanged in the control group. Plasma viscosity decreased after infusion of HS-HES and increased slightly in control patients (+4%). In comparison with the 6% HES and particularly with the control group, LDF was significantly greater after infusion of HS-HES (forearm +80%; forehead +28%). LDF during CPB and thereafter was always greater than baseline values in the HS-HES group, whereas after bypass LDF was reduced in the 6% HES (-5%) and particularly in the control patients (-30%).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

Does correction of acidosis influence microcirculatory blood flow during cardiopulmonary bypass?

We studied 15 patients undergoing cardiopulmonary bypass (CPB) to examine the effect of response to correction of acidosis on microcirculatory blood flow. Acidosis was defined when base excess was less than -10.0 mmol litre-1 while carbon dioxide partial pressure was within the normal range. CPB was carried out at almost normothermic temperature (smallest rectal temperature 35.2 (SD) 0.4 degrees C). Sodium bicarbonate (NaHCO3) was given to correct acidosis during steady state CPB. Skin microcirculatory blood flow was assessed using a double-channel laser Doppler flow (LDF) monitor. LDF was measured on the patient's forehead and forearm before infusion of NaHCO3 (baseline) and 30 s, 1, 3, 5, 7, 10 and 15 min later. Skin, blood, rectal and nasopharyngeal temperatures did not change during the investigation. Plasma viscosity, haemoglobin and carbon dioxide partial pressure also remained unchanged. Mean arterial pressure (MAP) and systemic vascular resistance (SVR) decreased slightly after infusion of NaHCO3 (MAP -29%; SVR -32%). A total of NaHCO3 99.4 (4.4) mmol litre-1 was given for correction of acidosis. pH and HCO3- were within the normal range shortly after the infusion of NaHCO3. LDF measured on both the forehead (+49%) and the forearm (+29%) increased significantly after infusion of NaHCO3. Changes in pH correlated positively with changes in LDF (analyses of co-variance, P < 0.02), but haemodynamic and other laboratory values did not correlate with LDF. We conclude that the microcirculatory response to correction of acidosis with NaHCO3 during CPB can be monitored using skin laser Doppler flowmetry. Infusion of NaHCO3 resulted in a significant improvement in skin microcirculatory perfusion.

Acidosis↗
PubMed1986

Head position trainer application for research and clinical use.

The head position trainer (HPT) is a frequently used biofeedback device for improving the head control of cerebral palsied children. When the HPT is used as a training or evaluative device, questions may arise regarding the consistency and accuracy of positioning it on the head and the position of the trainee's head. This article describes a technique for positioning and orienting the head and the HPT to one another and to common axes. With the subject in a supine position on a specially designed platform, the long axes of the zygomatic arch and the control box of the HPT were oriented vertically. The headband of the HPT then was tightened about the midforehead and the occipital areas. Reference marks were made on the forehead and the HPT was removed. After the subject assumed the sitting position, the HPT was reapplied using the forehead reference marks and the occipital areas as guides. Test-retest procedures were conducted using different therapists to apply the HPT to healthy and to handicapped subjects. The criterion score was the degrees difference between the long axes of the HPT control box and the zygomatic arch, an angle that would be 0 degree if the two long axes were parallel. No significant differences were observed between Trials 1 and 2, and the correlation coefficient between the two trials was statistically significant (p less than .02) in all situations. The HPT referencing platform can be constructed at minimal expense, and the technique of HPT application is relatively quick and reliable, and it produces minimal stress in handicapped subjects.

Adult↗
PubMed1996

Thermal response in acute porcine malignant hyperthermia.

This study was designed to evaluate how vital organ and skin-surface temperatures correlate with other clinical signs of a malignant hyperthermia (MH) episode. Six susceptible swine were anesthetized with thiopental and nitrous oxide and kept normothermic (approximately equal to 38 degrees C). After a 30-min control period, halothane (1 minimum alveolar anesthetic concentration) was administered, followed in 5 min by a bolus of succinylcholine (2 mg/kg intravenously). Monitoring included: 1) ETCO2; 2)PaO2, PaCO2, pHa; 3) cardiovascular function; 4) core temperatures (esophagus, pulmonary artery, and rectum); 5) organ temperatures (brain, kidney, liver, and four skeletal muscles); and 6) skin temperatures (forehead, neck, and axilla). Within 10 min after exposure to halothane and succinylcholine, all animals developed fulminant MH. Kidney, liver, and brain temperatures increased more rapidly than pulmonary artery temperature with the onset of MH. Temperatures significantly increased in the visceral organs prior to the detection of contractures within skeletal muscles. The masseter, longissimus dorsi, quadriceps, deltoid, and extensor digiti II intramuscular temperatures were 1-2 degrees C less than pulmonary artery and esophageal temperatures during the episodes, whereas those of the kidney, liver, and brain were the same or slightly greater. When it occurs, core hyperthermia during acute MH results largely from heat produced in central organs, not in skeletal muscle per se. In these swine, changes in axilla skin surface temperatures correlated well with core temperature trends, whereas those of the neck and forehead did not. Unless a skin-surface probe can be placed in close proximity to a major vessel, cutaneous temperatures should not be substituted for measurements at an appropriate core site.

Acute Disease↗
PubMed2000

The accuracy and precision of body temperature monitoring methods during regional and general anesthesia.

UNLABELLED: We tested the hypotheses that accuracy and precision of available temperature monitoring methods are different between spinal anesthesia (SA) and general anesthesia (GA), and that patients receiving SA are at equal risk for hypothermia as those receiving GA. Patients scheduled for radical retropubic prostatectomy were enrolled. Either GA (n = 16) or SA (n = 16) was given according to patient and clinician preference. Temperatures were monitored with thermocouple probes at the tympanic membrane, axilla, rectum, and forehead skin surface. Tympanic temperatures were also measured with an infrared device, and forehead skin temperatures were monitored with two brands of liquid crystal thermometer strips. Accuracy and precision of these monitoring methods were determined by using tympanic membrane temperature, measured by thermocouple, as the reference core temperature (T(c)). At the end of surgery, T(c) was similar between SA (35.0 +/- 0.1 degrees C) and GA (35.2 +/- 0.1 degrees C) (P = 0.44). Accuracy and precision of each temperature monitoring method were similar between SA and GA. Rectal temperature monitoring offered the greatest combination of accuracy and precision. All other methods underestimated T(c). These findings suggest that patients receiving SA or GA are at equal and significant risk for hypothermia, and should have their temperatures carefully monitored, recognizing that most monitoring methods underestimate T(c). IMPLICATIONS: Body temperature should be monitored during spinal anesthesia because patients are at significant risk for hypothermia. Rectal temperature is a valid method of measuring core temperature, whereas other methods tend to underestimate true core temperature.

Anesthesia, General↗
PubMed2002

Insufficiency in a new temporal-artery thermometer for adult and pediatric patients.

UNLABELLED: SensorTouch is a new noninvasive temperature monitor and consists of an infrared scanner that detects the highest temperature on the skin of the forehead, presumably over the temporal artery. The device estimates core temperature (T(core)). We tested the hypothesis that the SensorTouch is sufficiently precise and accurate for routine clinical use. We studied adults (n = 15) and children (n = 16) who developed mild fever, a core temperature of at least 37.8 degrees C, after cardiopulmonary bypass. Temperature was recorded at 15-min intervals throughout recovery with the SensorTouch thermometer and from the pulmonary artery (adults) or bladder (children). Pulmonary artery (T(core)) and SensorTouch (T(st)) temperatures correlated poorly in adults: T(core) = 0.7. T(st) + 13, r(2) = 0.3. Infrared and pulmonary artery temperatures differed by 1.3 +/- 0.6 degrees C; 89% of the adult temperatures thus differed by more than 0.5 degrees C. Bladder and infrared temperatures correlated somewhat better in pediatric patients: T(core) = 0.9. T(st) + 12, r(2) = 0.6. Infrared and bladder temperatures in children differed by only 0.3 degrees C, but the SD of the difference was 0.5 degrees C. Thus, 31% of the values in the infants and children differed by more than 0.5 degrees C. IMPLICATIONS: We evaluated a noninvasive infrared forehead thermometer (SensorTouch) in adult and pediatric cardiac patients. Accuracy was poor in the adults and suboptimal in infants and children.

Adult↗
PubMed1998

Experimental determination of heat flow parameters during induction of general anesthesia.

BACKGROUND: Alterations in body temperature result from changes in tissue heat content. Heat flow is a complex function of vasomotor status and core, peripheral, and ambient temperatures. Consequently it is difficult to quantify specific mechanisms responsible for observed changes in body heat distribution. Therefore the authors developed two mathematical models that independently express regional tissue heat production and the motion of heat through tissues in terms of measurable quantities. METHODS: The equilibrium model expresses the effective regional heat transfer coefficient in terms of cutaneous heat flux, skin temperature, and temperature at the center of the extremity. It applies at steady states and provides a ratio of the heat transfer coefficients before and after an intervention. In contrast, the heat flow model provides a time-dependent estimate of the heat transfer coefficient in terms of ambient temperature, skin temperature, and temperature at the center of the extremity. RESULTS: Each model was applied to data acquired in a previous evaluation of heat balance during anesthesia induction. The relation between the ratio of steady state regional heat transfer coefficients calculated using each model was linear. The effective heat transfer coefficient for the forehead (a core site) decreased approximately 20% after induction of anesthesia. In contrast, heat transfer coefficients in the six tested extremity sites more than doubled. CONCLUSIONS: Effective heat transfer coefficients can be used to evaluate the thermal effects of various clinical interventions, such as induction of regional anesthesia or administration of vasodilating drugs. The heat transfer coefficient for the forehead presumably decreased because general anesthesia reduces brain perfusion. In contrast, increased heat transfer coefficients in the extremity sites indicate that thermoregulatory and anesthetic-induced vasodilation more than doubles the core-to-peripheral flow of heat. This flow of heat causes redistribution hypothermia, which is usually the major cause of core hypothermia during anesthesia.

Anesthesia, General↗
PubMed1985

Craniofacial surgery for craniosynostosis improves facial growth: a personal case review.

An evaluation of 220 cases of frontocranial remodeling for craniosynostosis is reported. The follow-up period was 10 years for children, 7 years for infants. The principles of the craniofacial techniques described in 1974 [4] and 1978 [3] were not modified; only variations were added. The floating forehead [5] concept has also remained basically unchanged. Intracranial pressure recordings have been used continually to help evaluate borderline indications and to assess results [9]. Our results show that 14% of cases of craniosynostosis affecting only one suture, usually considered as merely aesthetic problems, in fact were accompanied by increased intracranial pressure. The postoperative recordings have shown a return to normal pressures. Growth has not deteriorated the initially satisfactory results at the level of the forehead. At the midface level, improvement has been observed after surgery, especially for plagiocephalics. Their orbitonasal asymmetry has nearly completely disappeared. Patients with bilateral faciocraniosynostosis show an improvement of midface development compared with non-operated patients, but in severe cases an inverted bite still develops and further facial osteotomies remain necessary. The Apert's patients remain the most difficult to improve.

Child↗
PubMed1990

Port wine stain: distribution patterns on the face and neck.

One hundred and three port wine stains, maximum length 5.0 cm or more in adults, and the length of the patient's thumb or more in children, on the unilateral side, were selected to be part of an analysis of port wine stain distribution patterns. Port wine stain lesions were evaluated, and similar lesion patterns were grouped together and outlined on a face map. Six major patterns were found: forehead (F), temporal (T), angular (A), labio-infraorbito-(angular) (L-O and L-O-A), labio-infraorbito-angulo-(forehead)-temporal (L-O-A-[F]-T) and jaw-neck (J-N). A wide-ranging, unilateral, or even bilateral port wine stain may be evaluated as a mixed form, which is composed of several standard patterns of port wine stains. The cause of port wine stains is also briefly discussed.

Adolescent↗
PubMed1992

Comprehensive correction of the craniofacial deformity in achondroplastic dwarfism.

The treatment of this patient serves to demonstrate a craniofacial team approach to a unique and moderately severe problem. By the modification and careful combination of standard techniques, i.e., frontofacial advancement, and Le Fort I and vertical mandibular osteotomy, a good correction has been obtained. Analysis of the problem clearly indicated the need for moving multiple components of the facial skeleton into new positions to provide correction. The upper and lower midface required simultaneous movements in exactly opposite directions to normalize the skeletal deformity. To address the excess forehead height and projection, a modification of the usual frontofacial advancement was necessary. Rotation of the frontofacial segment forward inferiorly allowed correction of the orbital deficiency while also allowing shortening of the vertical forehead dimension. This is a deviation from the straight linear advancement usually dissected. Simultaneous retroposition and rotation of the maxilla allowed correction of the plane of occlusion while lengthening the midface. The unique combination and application of standard techniques of craniofacial surgery in this patient allowed a very good result.

Achondroplasia↗
PubMed1993

Facial injuries from falling: age-dependent characteristics.

A retrospective analysis was undertaken of 108 patients with facial injuries from falling who presented at the Plastic Surgery Unit of the Toyo-oka Public Hospital from 1988 to 1990. Facial injuries from falling were common in little children, in those < 6 years of age comprising 45.4% of injuries. Age-dependent characteristic injury sites were found (i.e., in those < 2 years old, the forehead; in small children, the chin; in students, the lip; and in older persons, the cheek); this disparity can be explained by the mechanism of injury. The injury pattern also depended on age, varying activities, and tissue strength. In children of < 6 years of age, small lacerations on the forehead or chin were most common, but even conservative treatment could achieve good results. On the other hand, inadequate suturing by emergency room physicians brought on poor results. In adults, abrasions and traumatic tattoos occurring with late-night inebriation tended to develop some sequelae.

Accidental Falls↗
PubMed1994

The radial forearm flap as a pedicled flap for resurfacing a scarred nose.

The radial forearm flap, applied as a free flap, has been shown to be very versatile, if covering a defect with a thin, flexible flap is of predominant importance. The advantage of this technique compensates for any disadvantages in the donor area. Under certain circumstances it is a better solution to design the radial forearm flap as a distant, vascular pedicled flap than to perform it as a free flap with microvascular anastomoses. In treatment of this patient we used a distally pedicled radial forearm flap to resurface a burned nose and to reconstruct the tip of the nose. In this case a scarred forehead prevented us from using an expanded forehead flap. The increased morbidity of a distant, pedicled flap was well accepted as the price for preventing additional scarring in the face, as would have occurred in the case of a free flap, through the exposure of vessels for the vascular anastomoses.

Adolescent↗
PubMed1997

Laser resurfacing as an adjunct to endoforehead lift, endofacelift, and biplanar facelift.

Laser resurfacing is a wonderful technological advance at improving the quality of aged skin. Physicians have been reluctant to perform full facial resurfacing at the time of rhytidectomy due to risk of flap slough. Newer endoscopic-assisted subperiosteal techniques allow hardy flaps without significant blood supply interruption. Since September 1995 we have performed 26 full facial resurfacings at the time of rhytidectomy or brow lift using the Coherent 5000C carbon dioxide laser. Standard settings and densities were used. Twelve patients underwent full endoscopic facelift; 5 patients, extended endoforehead lift; 8 patients, biplanar rhytidectomy; and 1 patient, standard rhytidectomy prior to immediate laser resurfacing. An additional 2 patients underwent endoscopic forehead lift and forehead resurfacing. There were three herpes infections, one in the endoscopic group, one in the biplanar group, and one in the standard rhytidectomy patient. There were 2 patients with minor skin slough in our early experience with the biplanar group. Full facial resurfacing at the time of rhytidectomy provides a one-stage rejuvenation of skin and deeper layers, and can be performed safely. However, only experienced laser practitioners should attempt resurfacing over undermined flaps.

Adult↗
PubMed1999

Modifications in endoscopic facelifts.

Since 1996, 72 patients (66 women and 6 men) have undergone endoscopic upper and midface rejuvenation. Sixteen of these patients had concomitant lower face rejuvenation at the same time. The patients were operated using a personal endoscopic technique, including biplanar endoscopic dissection (subgaleal and subcutaneous) at the forehead and temporal regions, excision of a galeal strip approximately 1 cm in thickness (to achieve a stable forehead lift), and a lower blepharoplasty incision for midface lifting and fixation of the malar fat pad. This approach helps to prevent midface widening-a concern of most surgeons. Regarding patient satisfaction, 51 patients had excellent results, 16 patients had good results, and 5 patients had an improved appearance of the mid and upper face. Complications included 11 incidences of temporary numbness in different regions of the upper and mid face, three incidences of temporary lower lid retraction (which did not require additional revision), three relapses of eyebrow elevation (which were reoperated), and unbalanced eyebrows in 2 patients (which were corrected during secondary revisional procedures).

Adult↗