PubMed Health⌕ Search

Biomedical subjects

B Short

Publications and source records attributed to B Short.

At least 37 records · Page 2Linked to original sources
PubMed1990

Extracorporeal membrane oxygenation and congenital diaphragmatic hernia: should any infant be excluded?

Mortality in infants with congenital diaphragmatic hernia (CDH) remains high despite improvements in neonatal and surgical care because many infants develop persistent pulmonary hypertension of the newborn (PPHN) following repair. Since 1984, extracorporeal membrane oxygenation (ECMO) has been used as rescue therapy in all infants (n = 25) with PPHN following CDH repair when conventional management failed, with an overall survival of 60%. Repair was performed in this hospital on 12 infants and in other hospitals in 13 infants transferred for consideration of ECMO after repair. Mortality was the same in the group repaired here and those transferred for ECMO. Although complications were frequent in the surviving group, they were successfully managed with nonoperative or operative therapy. Selective use of ECMO has been advocated in CDH patients based on various predictors of high mortality such as "best" PO2 postrepair less than 100 mm Hg, oxygenation index greater than 40, and ventilation index greater than 1,000 with PCO2 greater than 40. Seven surviving infants following ECMO would have been classified as unsalvageable by at least one parameter if selection criteria based on these parameters had been used. We conclude from this series that current predictors of high mortality in CDH patients are unreliable when ECMO is used. Surgeons caring for infants with CDH should consider the use of ECMO in all infants.

Extracorporeal Membrane Oxygenation↗
PubMed1990

Beneficial effects of long-term treatment with SK&F 105685 in murine lupus nephritis.

MRL/Mp-lpr/lpr (MRL/lpr) mice were studied from 6 to 19 weeks of age. Proteinuria began to increase at 15 weeks, and continued to increase until the animals were sacrificed at 19 weeks. This proteinuria was associated with lymphadenopathy and splenomegaly, as well as changes in lymph node cell phenotype and histologic changes in the glomeruli. Oral administration of SK&F 105685 starting at 12 weeks of age prevented the increased urinary protein loss, inhibited the histologic changes in the glomeruli, reduced the increase in spleen and lymph node weight and modified the phenotypic profile of the lymphoid cells. SK&F 105685 appears to act by increasing the number/activity of nonspecific suppressor cells in MRL/lpr mice. On the basis of this evidence, we conclude that SK&F 105685 can attenuate the progression of renal damage in MRL/lpr mice by exerting a unique effect on cells which may be involved in the autoimmune process.

Animals↗
PubMed1989

The comparative pathobiology of alpha 2u-globulin nephropathy.

alpha 2u-Globulin nephropathy is an important toxicologic syndrome that occurs in male rats following exposure to a number of important industrial and environmental chemicals. A low, but significant incidence of renal neoplasia develops in male rats as a chronic sequela to the disease. Studies on the pathogenesis of alpha 2u-globulin nephropathy have demonstrated that this protein is produced in large amounts in the male rat, that reversible binding occurs between chemicals and/or their metabolites and alpha 2u-globulin, and that this complex is resistant to proteolytic hydrolysis, leading to accumulation in renal lysosomes and subsequent cytotoxicity and cell death. This results in marked exposure-related increases in cell proliferation that persist for at least one year, providing exposure continues. This sustained increase in renal cell proliferation can promote initiated cells to form preneoplastic foci and renal neoplasia in male rats. Since this syndrome is highly species and sex specific, it is important to determine the relevance of these data for human risk assessment. The scientific considerations involved in high to low dose and species to species extrapolation are discussed.

Alpha-Globulins↗
PubMed1989

Morbidity for survivors of extracorporeal membrane oxygenation: neurodevelopmental outcome at 1 year of age.

Extracorporeal membrane oxygenation is an important technology in the treatment of high-risk infants whose long-term outcome is being followed prospectively at our institution. The extracorporeal membrane oxygenation procedure allows temporary cardiopulmonary support for critically ill full-term neonates who are refractory to maximum ventilatory and medical management as a consequence of severe persistent pulmonary hypertension. The technique necessitates both the permanent ligation of the right common carotid artery and jugular vein and systemic heparinization. The survivors constitute a unique group of high-risk infants, from the standpoint of the hypoxic-ischemic insults preceding extracorporeal membrane oxygenation and the risks associated with the procedure. Our results indicate that most of our survivors are developing normally at 1 year. Major morbidity, in terms of either significant developmental delay (Bayley mental and motor indices less than 70) or significant neuromotor abnormality, occurred in only 10% of these infants. Poor outcome was associated with major intracranial hemorrhage and chronic lung disease. Ligation of the right carotid artery and jugular vein was not associated with a consistent lateralizing lesion. Long-term follow-up through school age is essential.

Asphyxia Neonatorum↗
PubMed1987

Medical school performance of initially rejected students.

At the University of Texas Medical School at Houston we had a unique opportunity to examine performance through the medical curriculum and one year of postgraduate training of 50 students initially rejected for medical school. Each had been interviewed by the same Admissions Committee, which earlier had selected 150 students through the traditional process. In contrasting the initially accepted and initially rejected groups, academic and demographic variables accounted for only 28% of group difference. The 72% of group difference not accounted for by the variables examined was presumed to relate to Admissions Committee preference. In attrition and in both preclinical and clinical performance through medical school and one year of postgraduate training, there were no meaningful differences between the groups. The observations suggest that the traditional interview process probably does not enhance the ability to predict performance of medical school applicants.

Achievement↗
PubMed1987

Term abdominal pregnancy, meconium aspiration, and extracorporeal membrane oxygenation.

This report describes a term gestation abdominal pregnancy resulting in meconium aspiration syndrome (MAS) complicated by pulmonary hypertension. These cases occur infrequently. In this instance, extracorporeal membrane oxygenation (ECMO) was successfully utilized to support the infant after conventional neonatal medical support failed to yield sufficient oxygenation.

Adult↗
PubMedDate not supplied

Measurement of alcohol and tobacco availability to underage students.

Communities Mobilizing for Change on Alcohol (CMCA) and Tobacco Policy Options for Prevention (TPOP) are randomized multicommunity trials designed to reduce the availability of alcohol (CMCA) and tobacco (TPOP) products to underage youth. We assessed the test-retest reliability and internal consistency of perceived availability measures developed for surveys of middle and high school students. Two questionnaires were administered twice, each to separate student populations (CMCA: 9th graders; TPOP; 8th graders) 21 to 26 days apart. A total of 111 (CMCA) and 70 (TPOP) subjects participated at both times (participation rate of 93.3% and 84.3%, respectively). There were no statistically significant differences in the distribution of demographic variables, alcohol or tobacco use variables, or availability variables across administrations. The scales assessing perceived access to alcohol or tobacco had high internal consistency (Cronbach's alpha of 0.84 for alcohol and 0.77 for tobacco), but moderate to low test-retest correlations (0.58 and 0.13, respectively). Single-item measures of sources of alcohol and tobacco and reported buy attempts also had moderate to low test-retest correlates (0.10-0.65). We recommend that items assessing tobacco and alcohol availability to underage youth be further developed.

Adolescent↗
PubMedDate not supplied

Anger of African American women in the south.

In this existential-phenomenological investigation middle-class African American women (n = 9) in the Southern United States were interviewed about their experience of anger in daily life. The purpose of the study was to examine what African American women's anger is about, what it means, and how it is experienced. Transcribed interviews were analyzed using a hermeneutic process. The thematic structure of African American women's anger comprises three main elements that stand out as figural: power, control, and respect. These figural elements can be understood only when seen against the ground of a racist Southern culture that produces pervasive mistrust. These findings are of importance to clinicians, who cannot deliver culturally competent interventions to African American female clients without a clear understanding of the complexity and meaning of their anger experience.

Adult↗