Biomedical subjects

C Jelenko

Publications and source records attributed to C Jelenko.

27 records · Page 2Linked to original sources

PubMed1976

Postburn respiratory injury.

A common and frequently overlooked concommitant of burn injury is postburn pulmonary damage. The lesion may be secondary to inhalation or mechanical obstructive or toxic problems; or it may be associated with indirect damage from hypovolemia, shock, central nervous system disturbances or drugs. Therapy comprises establishing a clear airway; administration of sufficient humidity and oxygen to maintain adquate arterial pO2; sequential pO2 monitoring; surface decompression of the thorax; systemic antibiotics and sequentially increasing--and later decreasing--airway support. The diagnosis of postburn pulmonary injury is clinical. Aggressive, sequential management of the patient, supported vigorously by laboratory evaluation, is essential.

Burns↗

PubMed1976

The elusive artery: found by sound.

The Doppler flow probe can be used to locate blood vessels in patients with shock or severe burns. The technique, which uses an ultrasonic signal, is described.

Arteries↗

PubMed1976

Studies in burns: XV. Use of a topical lipid in treating human burns.

Sixty patients were selected from the 24-month burn population admitted to the Medical College of Georgia. Selection was on the basis of age, size of burn, and survival beyond 120 hours. Thirty-one of these patients were treated with ethyl linoleate agent (hELate) in addition to the modalities we routinely use for burn care. hELate was applied in a dose of 25 mg/kg only once in the period after burn. Significant pain relief and enhancement of wound healing (with return of hair and pigment) occurred in the hELate-treated patient. Less narcotic was needed, fewer grafts and reconstructive procedures were required, and hospital stay was reduced significantly. It is suggested that hELate is a safe and useful adjunctive to burn care.

Administration, Topical↗

PubMed1975

Respiratory problems complicating burn injury: recognition, assessment, and treatment.

Postburn pulmonary injury is a common and frequently overlooked concomitant of burn injury. The lesion may be secondary to direct damage to the respiratory apparatus from the inhalation of smoke or of toxic or superheated chemicals or from mechanical mechanisms or it may be secondary to indirect damage from hypovolemia, shock, central nervous system disturbances, or drug usage. Therapy comprises establishment of a clear airway and administration of humidity and oxygen in amounts appropriate to maintain adequate blood oxygen tension and pH. Sequential monitoring of oxygen and pH status is required. The diagnosis of postburn pulmonary injury is made on clinical grounds, and sequential management of the patient, closely supported by laboratory studies, is essential. Surface decompression of the thorax, antibiotics given systemically, and sequentially increasing respiratory support (with later de-escalation) may be needed.

Airway Obstruction↗

PubMed1975

Studies in burns: XIV, Heling in burn wounds treated with Ethyl Linoleate alone or in combination with selected topical antibacterial agents.

Studies of the efficacy, in terms of burned wound healing, of a mixture of Ethyl Linoleate (ethyl 9-12 (cis, cis) octadecadienoate) with alpha-1-histidine, alpha-tocopherol, and TBHQ (hELate) was undertaken in 12 swine. The species was selected so as to study an animal with skin anatomy similar to the human. Statistically significantly greater healing occurred in 730 C/7sec contact burns (20% BSA) treated with hELate than in untreated burns in pigs. Further, there was no contracture noted in the hELate treated lesions, while marked contracture occurred in the untreated burns. Additionally, we noted that there was a proportional increase in weight gain amongst swine studied as their burn lesions epithelialized. In order to evaluate the compatibility of hELate with selected, currently-used topical antibacterial agents, 154 rabbits with 20% 730 C/7 sec contact burns were studied. The lipid was applied (0.01 ml/cm2 burn) at 1 hour postburning; the topical agent was applied at 2 hours post-burn and every 24-hours. All animals were washed once daily. hELate was applied only once. We found no statistical difference in the number of subjects healed or in the mortality between animals treated with hELate alone and those treated with the agent plus Gentamycin cream, Neosporin cream, and silver sulfadiazine 1% in Unibase USP (compounded at Medical College of Georgia specifically and only for this study.) We suggest that Ethyl Linoleate agent (hELate) may be used safely in combination with selected antibacterial substances. Further, these selected combinations seem to be non-toxic and appear to allow the calorie-saving and healing effects of the lipid to proceed unimpeded.

Administration, Topical↗

PubMed1975

Sexual function after abdominoperineal resection.

A survey of the sexual changes in patients having abdominoperineal resection for ulcerative colitis was made at the Medical College of Georgia. The incidence of impotence in our series is zero. Only one of our female patients had a successful pregnancy. The other women seemed to be hampered by anatomic derangements relating to strictures, adhesions, or dislocation of the uterus, although the precise causes of infertility have not been elucidated. We suggest that in young men, fear of infertility have not been elucidated. We suggest that in young men, fear of injuring sexuality should not impede selection of appropriate surgical modality. However, we also suggest that the woman's risk of post-operative impairment of sexual function is greater than the man's.

Adolescent↗

PubMed1975

Primary hyperparathyroidism in a referral hospital.

A series of 46 patients had a tissue diagnosis of primary hyperparthyrodism. Forty (88%) had a single adenoma, one had multiple adenomas; four exhibited parathyroid hyperplasia and one had carcinoma of the parathyroid. The incidence establishing the diagnosis has increased in recent years because of routine multichemistry screening for calcium. The most reliable "diagnostic" laboratory finding was an elevated serum calcium: 96 per cent of our patients had serum calcium above the upper limit of normal. Forty-one patients had lesions removed; parathyroid carcinoma (1), hyperplasia (3), and adenomas (37). Only two patients have presistent disease postoperatively: one with hyperplasia who apparently had an inadequate resection of her involved glands and one who had biopsy of an adenoma without further surgical management.

Adolescent↗

PubMed1975

Studies in burns. XIII. Effects of a topical lipid on burned subjects and their wounds.

We evaluated ethyl linoleate (ethyl, (9, 12)-cic, cis-octadecadienoate), a naturally occurring cutaneous water-holding lipid, for its water-holding metabolic, healing and toxic properties in groups of unburned and burned rabbits and its toxic potentials in this species and mice. The lipid appears to reduce evaporative water loss in full-thickness burned rabbits. Associated with this effect is a proportional and related lowering of metabolic heat production. The topical application of the lipid at any time after burn appears to be associated with a significant healing in lesions that, histologically at least, would be interpreted as fullthickness. The material is highly toxic if applied daily to mice or rabbits. The details of the toxic effect (s) are being studied. The commerical-grade material (75 percent pure) contains a derivative of ricinoleci acid and chronic exposure of the EL to air may result in the formation of peroxides and epoxides. These materials exert well-defined toxicity. The obvious potential uses of this agent in treating human burn lesions need not be emphasized, but it does need to be stated categorically that, at present, (Feb 1974), the toxicity has not been defined enough for use except in experiments.

Administration, Topical↗

PubMed1975

Fluid shifts after burn injury.

Following significant burn injury, severe translocations occur in the distribution of water and solute. These result in major deficits in functional extracellular fluid and circulating water volume which may result in shock. The weight of evidence suggests that resuscitational regimens must contain large quantities of water which should be at least isotonic with respect at sodium; and some evidence suggests that current resuscitational regimens may not provide sufficient potassium to maintain the normal relationship between intracellular and extracellular solute and to prevent sodium sequestration. It is clear, however, that most of the currently used resuscitational "formulas" are effective in restoring and maintaining water balance, renal function, cardiac output, and in preventing or correcting shock.

Burns↗