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Biomedical subjects

B Bennett

Publications and source records attributed to B Bennett.

At least 199 records · Page 11Linked to original sources
PubMed1983

Endotracheal intubation in the prehospital phase of emergency medical care.

One hundred seventy-eight endotracheal intubations by paramedics were reviewed prospectively during a nine-month period; 149 patients (83.7%) had medical conditions, and 29 (16.2%) had trauma. The endotracheal tube was successfully placed in 172 (96.6%); in four patients (2.2%), attempts were unsuccessful, and in two patients (1.1%), the attempt was aborted. There were no incidences of reported complications. We conclude that endotracheal intubation can be accomplished successfully outside the hospital by paramedical personnel. Comprehensive training and continuous medical control of paramedics' activities seem to be essential requirements for its success.

Adolescent↗
PubMed1983

Cis-platin based combination chemotherapy for advanced ovarian cancer. High overall response rate with curative potential only in women with small tumor burdens.

Thirty-eight women with advanced ovarian cancer were given monthly cycles of intravenous cyclophosphamide, Adriamycin (doxorubicin) and cis-platin, and oral hexamethylmelamine. Of 26 with tumor which would be evaluated for response, 42% had complete remission and 50% partial remission. Median time to disease progression from entry for all 38 patients was 13 months, and median survival 23.5 months. The bulk of tumor at the time chemotherapy was begun was the only significant prognostic factor for time to disease progression and survival. Of the seven women surviving free of disease a median of three years later, five had no mass greater than 2 centimeters in diameter at entry. Toxicity was predominantly myelosuppression and vomiting, with mild peripheral neuropathy in 27% and no significant renal or cardiac toxicity. The response rate of 92% is much higher than that previously reported with melphalan, and the survival considerably longer. The toxicity is acceptable, given the substantial improvement in results.

Adult↗
PubMed1983

Splenectomy and infection in Hodgkin's disease.

The incidence of infection in 56 patients with Hodgkin's disease who had undergone staging laparotomy with splenectomy was compared with that of 28 non-splenectomized patients with Hodgkin's disease treated concurrently. The results suggest that splenectomy does not result in a major change in the incidence of infection experienced by such patients with stage II or stage III disease. Aggressive therapy may be of greater importance in increasing the susceptibility to infection in Hodgkin's disease.

Adolescent↗
PubMed1983

Preoperative antithrombin III activities and lipoprotein concentrations as predictors of venous thrombosis in patients with fracture of neck of femur.

The presence or absence of venous thrombosis was determined by the technique of autologous 111indium-labelled platelets in 64 patients following reduction and fixation of fractures of the neck of femur. Venous thrombosis was found in 41 (64%) of these patients. Compared to the thrombosis-negative group, the thrombosis-positive group had a significantly lower mean serum antithrombin, and higher mean antithrombin consumption during clotting in the immediate preoperative period. No significant differences were seen between the two groups in plasma ATIII activities, fibrinogen, alpha-2-macroglobulin, serum lipoproteins or age. Significant correlations were seen between ATIII activities and lipoprotein fractions; these are discussed.

Adult↗
PubMed1983

Frequency of venous thrombosis in patients with an exacerbation of chronic obstructive lung disease.

The presence or absence of venous thrombosis was determined in 29 patients with an acute exacerbation of chronic obstructive lung disease by the technique of autologous platelet labelling with indium-111. Deep venous thrombosis was diagnosed in 13 patients and in nine of these patients thrombosis was located proximal to the knee--that is, in areas associated with an appreciable risk of pulmonary embolism. One patient died; pulmonary emboli were found at postmortem examination. The incidence of venous thrombosis seen in this study is high enough to suggest that these patients may benefit from prophylactic antithrombotic treatment.

Aged↗
PubMed1983

Emergency medical personnel training: II. Components of training.

Nationwide Emergency Medical Technician (EMT) training programs at both basic and advanced levels are in flux, confronting similar challenges in design and implementation. There currently exist the 81-hour Department of Transportation course of instruction as the basis for EMT-Ambulance (EMT-A) certification and the National Standard Training Curriculum (NSTC) 15-module course for training the EMT-Paramedic (EMT-P). The National Registry of EMTs has established examination and recertification guidelines as well as requirements for both levels of training. The two national training courses reflect a difference in disease focus (ie, trauma vs cardiac) and thus a difference in care rendered by the two EMT levels. Variations in both EMT-A and EMT-P training programs at the state level in areas such as length of training and requirements for certification point out a need for greater consistency in training of emergency medical personnel. Evaluation of current training programs based on the NSTC has resulted in updating the EMT-P curriculum. The proposed curriculum includes new course material with behavioral and performance objectives. An ongoing system of training, evaluation, and incorporation of new techniques found clinically relevant is recommended.

Allied Health Personnel↗
PubMed1983

A new life-long hemorrhagic disorder due to excess plasminogen activator.

A life-long bleeding disorder is described, characterized by hemorrhage occurring after surgery, injury, or dental extraction, and finally by spontaneous intracerebral bleeding. No abnormality of platelet function or plasma coagulation was demonstrable, but grossly enhanced overall fibrinolytic activity was present. The patient had, additionally, a hyperlipidemia with gross arterial atheroma and a family history of myocardial infarction but not of any hemorrhagic disorder. Laboratory studies led to the conclusion that the enhanced fibrinolysis was due to consistently greatly raised levels of a plasma plasminogen activator physically and immunologically related to that in human tissues and blood vessel endothelium. No deficiency of any known inhibitor of fibrinolysis was detected. Free plasmin was not detectable in functional assays but continuous intravascular plasmin generation clearly occurred as evidenced by presence of plasmin-alpha 2-antiplasmin complexes and of fibrin/fibrinogen-related antigens. Excessive production of plasminogen activator appeared to have occurred throughout life and to be independent of the hyperlipidemia. The pathologically increased fibrinolytic activity may have accounted for the complete absence of detectable thrombotic vascular occlusion at autopsy despite extensive arterial disease with severe narrowing of coronary and cerebral arteries.

Blood Coagulation Tests↗
PubMed1982

Lipoprotein fractions and antithrombin III consumption during clotting.

Plasma and serum antithrombin levels were measured in functional (initial rate measurement) and immunological assays together with serum lipid levels in normal subjects and patients with coronary artery disease. Specific antithrombin activity in plasma showed a negative correlation with triglyceride levels. The consumption of antithrombin activity during blood clotting was negatively correlated with both serum total triglyceride and heparin precipitable lipoprotein and positively correlated with serum high density lipoprotein cholesterol. Different blood lipoprotein fractions may influence the activity of the antithrombin III molecule.

Adult↗
PubMed1982

Shunt nephritis progressing to chronic renal failure.

Shunt nephritis is an immune-complex mediated glomerular disease associated with chronically infected ventriculo-jugular shunts for hydrocephalus. In general, early diagnosis and appropriate antibiotic therapy result in marked improvement or disappearance of the concomitant urinary and renal functional abnormalities. We describe, a child in whom the diagnosis and treatment were delayed until she presented with irreversible renal insufficiency. We conclude that shunt nephritis is not an innocuous condition and that a high level of suspicion must be maintained by those caring for children with ventriculo-jugular shunts.

Adolescent↗
PubMed1982

Plasmin--alpha 2-antiplasmin complex as an indicator of in vivo fibrinolysis.

alpha 2-Antiplasmin is the principal plasma inhibitor of plasmin, with which it rapidly and irreversibly forms a complex. The simple technique of crossed immunoelectrophoresis against antiserum to alpha 2-antiplasmin has been applied to detect plasmin-alpha 2-antiplasmin complex in plasma. The presence of this complex is demonstrated in patients in whom overactive fibrinolysis was the only or major contributor to severe haemorrhagic disorders arising spontaneously.

Adult↗
PubMed1982

Dupuytren's contracture in manual workers.

The incidence of Dupuytren's contracture in a polyvinyl chloride (PVC) manufacturing plant, where a great deal of bagging and packing took place by hand, was higher than in another plant in which there was no bagging or packing. The incidence in the packing plant was double that found in an earlier survey by Early at Crewe Locomotive Works of 4801 individuals, most of whom were manual workers. The implication is that the nature of the work of bagging and packing in our PVC compounding plant may have triggered Dupuytren's contracture.

Adolescent↗
PubMed1982

Chronic renal failure due to Takayasu's arteritis: recovery of renal function after nine months of dialysis.

A twelve year old boy presented with sudden onset of severe hypertension and oligo-anuria. A diagnosis of Takayasu's Arteritis was made by aortography which demonstrated irregular narrowing of the lumbar aorta and renal arteries. Severe renal insufficiency necessitated maintenance hemodialysis. Hyperreninemic hypertension was intractable despite aggressive dialysis and multiple drug therapy. Renal biopsy after eight months of dialysis showed preservation of glomerular architecture. After nine months GFR improved spontaneously to 32 ml/min/1.73 m2 despite no improvement in his hypertension. This case report emphasizes the remarkable ability of renal parenchyma to recover function after sustained ischemia.

Aortic Arch Syndromes↗