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Biomedical subjects

C Jordan

Publications and source records attributed to C Jordan.

At least 37 records · Page 2Linked to original sources
PubMed1988

Group A streptococcal infection in children younger than three years of age.

We evaluated 758 sick children younger than 3 years of age for Group A beta-hemolytic streptococcal (GABHS) upper respiratory infection (URI) to determine the usual clinical presentation of the disease in this age group, indications for culture and the optimal site(s) from which to isolate the organism. GABHS infection was documented in 35 subjects (4.6%). The classic presentation (as proposed in the 1940s) of GABHS URI in children younger than 3 years of age was not confirmed by this study. In 32 of the GABHS cases there were pharyngitis, common cold symptoms or both, and these were associated with acute otitis media 10 times and with otitis media with effusion 3 times. Clinical impetigo was associated with GABHS URI (4 of 32 cases). GABHS URI would not have been documented in 6 of 32 cases if cultures of the anterior nares had not been performed. Children between 18 and 36 months of age were more likely to have GABHS disease than were younger children. Hoarseness and vomiting occurred less frequently in children younger than 36 months with GABHS infection than in those of that age who had non-beta-hemolytic streptococcal illnesses. A history of two or more siblings at home or a family member with a recent streptococcal infection and the presence of irritability, a reddened throat or palate or uvular edema were each associated with GABHS URI. We concluded that sick children between 18 and 36 months of age with a reddened throat should have cultures taken of the throat and anterior nares for GABHS.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacteriological Techniques↗
PubMed1988

Hamstring release for knee flexion contracture in spastic adults.

Thirty adults (17 male and 13 female patients) with spastic disorders were treated by hamstring releases of 46 extremities. The diagnoses were stroke, traumatic brain injury, spinal cord injury, multiple sclerosis, and anoxia. The mean age at surgery was 38.6 years. Three extremities had partial release of the hamstring tendons behind the knee; the remaining 43 extremities had a complete release. The average position of the knee was 61.4 degrees of flexion preoperatively and 6 degrees postoperatively. The follow-up period averaged 21.3 months. Preoperatively, 87% of patients were nonambulatory. Following hamstring release 43% became ambulatory and 17% had gained the ability to transfer. Complications included two stroke patients with severe peripheral vascular disease; one developed a large nonhealing sore of the ankle and the other developed gangrene of the foot. Both patients required amputation. Three other patients developed recurrent flexion contractures that have since been rereleased with good results.

Adult↗
PubMed1988

Approaches to senior care #2. Orthopaedic management of the stroke patient. Part I. Pathophysiology, limb deformity, and patient evaluation.

Cerebrovascular accidents remain one of the most serious medical problems in the United States. They are responsible for 200,000 deaths per year and are the leading cause of hemiplegia in the adult. The purpose of these reports is to review the orthopaedic aspects of stroke rehabilitation, with emphasis on functional defects, evaluation of the patient, and methods of treatment. Part I will discuss the pathophysiologic changes and patient evaluation. Part II will discuss the surgical and nonsurgical management of extremity deformities.

Aged↗
PubMed1987

Nondetectable levels of interferon gamma is a critical host defense during the first day of herpes simplex virus infection.

Previous studies have demonstrated the importance of IFN alpha/beta in resistance to primary viral infections. However, the role of IFN gamma in primary infections is unclear. The present studies were undertaken to determine whether IFN gamma induction was an important early host defense against primary HSV infection. The approach was to block the IFN gamma response with antibodies to IFN gamma prior to infection and at various times post-infection (p.i.). The data indicates that treatment of mice with anti-IFN gamma prior to infection enhanced mortality (89% vs 37%). Anti-IFNs given at various times post HSV challenge proved most effective within the first 24 h of infection. The above results suggest for the first time that IFN gamma mediates important host defense(s) early during primary HSV infection. Similar results were obtained using antibody to IFN alpha/beta.

Animals↗
PubMed1987

Prophylactic effect of aminophylline and salbutamol on histamine-induced bronchoconstriction.

The effect of salbutamol 200 micrograms aerosol, i.v. high-dose aminophylline 670 mg or placebo (aerosol and infusion) on bronchomotor tone were compared in normal volunteers before and after bronchial provocation with histamine aerosol 500 micrograms. The study was a double-blind cross-over design. Specific airways conductance of the lower airway (s. Glaw) was measured using a forced airflow oscillation technique. All subjects receiving aminophylline had tremor and irritability, whereas after salbutamol there were no noticeable systemic or psychological effects. Before the administration of histamine, salbutamol caused significant bronchodilatation compared with control: aminophylline did not induce a significant change in airway conductance. The effect of histamine administration on s. Glaw was only partially blocked by the high dose of aminophylline, but was completely blocked by salbutamol.

Albuterol↗
PubMed1987

Effect of halothane, enflurane and isoflurane on bronchomotor tone in anaesthetized ponies.

The effects of halothane, enflurane and isoflurane on bronchial calibre were investigated in five anaesthetized ponies using a computer-aided forced airflow oscillation technique to derive specific lower airways conductance (s.Glaw) and expiratory reserve volume (ERV). All the agents tended to increase s.Glaw (indicating bronchodilatation), but ERV was reduced by halothane and enflurane, and increased by isoflurane. It was concluded that the effects of these agents on bronchomotor tone were similar to those which occur in man. However, the reasons for the differences in their effects on ERV compared with those found in man remain to be determined.

Anesthesia, Inhalation↗
PubMed1986

Prospective study of perinatal transmission of Chlamydia trachomatis.

During a five-year period, 262 (4.7%) of 5,531 pregnant women had positive cervical cultures for Chlamydia trachomatis, and 131 of their infants were followed up prospectively to ascertain the outcome of chlamydial exposure during the birth process. Culture-confirmed inclusion conjunctivitis of the newborn was seen in 23 (18%) of the infants. Chlamydial pneumonia was diagnosed in 21 (16%) of the infants at risk. Chlamydia trachomatis was recovered from 47 of the infants (36%), while 79 (60%) showed serologic evidence of infection. Subclinical rectal and vaginal infections were detected in 14% of infants at risk. In our population, 2.8% of newborn infants show serologic evidence of perinatal chlamydial infection and 1.4% develop either chlamydial pneumonia or conjunctivitis. Incidence rates of this magnitude indicate the need for programs aimed at preventing perinatal transmission of C trachomatis.

Antibodies, Bacterial↗
PubMed1986

Effect of isoflurane on bronchomotor tone in man.

Twenty patients were anaesthetized with thiopentone, the trachea intubated and the lungs ventilated with 70% nitrous oxide and oxygen. Normocapnia was maintained and, following control measurements of the specific conductance of the lower airways (s.Glaw), either 1.7% isoflurane or 1.3% halothane was added to the inspired gas mixture, 10 patients receiving each drug. s.Glaw was measured repeatedly during the next 30 min. There was a tendency for s.Glaw to increase--indicating a reduction in bronchomotor tone--during the administration of isoflurane, the effect approaching statistical significance. The administration of halothane was associated with a significant increase in s.Glaw. There was a statistically significant increase in the expiratory reserve volume, and a decrease in mean respiratory resistance over the tidal range in both groups. These results indicate that isoflurane does not cause an increase in bronchomotor tone, and may have a tendency to decrease it. This suggests that the previously reported increase of respiratory resistance during isoflurane anaesthesia resulted from a reduction in lung volume, rather than a change in bronchomotor tone.

Adolescent↗
PubMed1985

Pronounced, episodic oxygen desaturation in the postoperative period: its association with ventilatory pattern and analgesic regimen.

The respiratory effects of two postoperative analgesic regimens were compared in two groups of 16 patients each, recovering from general anesthesia and major surgery. One group received a pain-relieving dose of iv morphine (mean, 18.1 mg), with the same dose repeated as a continuous intravenous infusion over the subsequent 24 h. The other group received regional anesthesia using bupivacaine. The patients were monitored for 16 h after surgery. The two analgesic regimens provided patients with comparable analgesia throughout the study period, but there were quite different respiratory effects in the two groups. Ten patients receiving morphine infusions had a total of 456 episodes of pronounced oxygen desaturation (SaO2 less than 80%). These occurred only while the patients were asleep, and all were associated with disturbances in ventilatory pattern, namely, obstructive apnea (144 episodes in eight patients), paradoxic breathing (275 episodes in six patients), and period of slow ventilatory rate (37 episodes in one patient). In contrast, in patients receiving regional anesthesia, oxygen saturation never decreased below 87%. Central apnea, obstructive apnea, and paradoxic breathing occurred more frequently in patients in the morphine group (12, 10, and 10 patients, respectively) than patients in the regional anesthesia group (4, 3, and 5 patients, respectively). The interaction of sleep and morphine analgesia produced disturbances in ventilatory pattern, causing profound oxygen destruction. These results suggest that postoperative pain relief using regional anaesthesia has a greater margin of safety in terms of respiratory side effects than does the continuous administration of opiates.

Adult↗
PubMed1985

Episodic postoperative oxygen desaturation: the value of added oxygen.

Six patients were studied following general anaesthesia for cholecystectomy or hip replacement. Intravenous morphine was given for postoperative pain relief. Continuous measurements were made of breathing pattern and arterial oxygen saturation for a 12-hour period postoperatively. The effect of breathing either air or 28% oxygen for alternate 2-hour periods was examined. There was no significant effect of oxygen on the number of periods of central apnoea, obstructive apnoea or partial upper airways obstruction. The number of episodes of decreases in oxygen saturation to below 80%, associated with these breathing disturbances, was reduced from 59 to zero by the administration of oxygen. There was a gradual improvement in oxygenation whilst breathing air during the 12-hour postoperative period. The administration of oxygen had a beneficial effect on average arterial oxygen saturation.

Airway Obstruction↗
PubMed1985

Histochemical and morphometric changes in muscles of stroke patients.

There is little information on the muscle fiber changes or the fiber type affected in supraspinal hemiplegia. Muscle biopsy specimens from 20 patients with stroke, obtained during orthopedic reconstruction, were examined by modern histochemistry. Atrophy was present in all of the muscles, affecting Type 1 fibers in 100% and Type 2 fibers in 95% of the patients. Type 2 atrophy was more severe than Type 1 atrophy. Group atrophy and fiber type grouping, present in 40%, seemed related to peripheral nerve or root damage. Hypertrophy of Type 1 fibers was present in 45%, associated with Type 2 hypertrophy in 15%. Although diffuse morphometric atrophic seemed not to correlate with the level of motor activity in this group of 20 patients, hypertrophy appeared related to activity. Hence, efforts to mobilize and rehabilitate stroke patients cannot prevent atrophy of some fibers, they seem to stimulate a hypertrophy not seen in inactive patients.

Adult↗
PubMed1984

Measurement of systolic time intervals during exercise using inductive plethysmography.

Measurement of systolic time intervals (STI) provides a noninvasive assessment of cardiac function in resting subjects. However, large motion artifacts often limit their application during exercise. To improve such measurements, we employed a new lightweight carotid arterial pulse transducer and minimized the artifacts by computerized signal averaging. The carotid pulse was recorded with an inductive plethysmographic transducer band (CIP) wrapped around the neck. STI derived from these measurements were compared to standard measurements from a funnel-shaped cup attached to the neck and connected to a pressure transducer (CUP) in 12 normal subjects at rest and with graded bicycle ergometry. To compare the techniques, CIP and CUP signals, together with the EKG and phonocardiogram, were connected separately to two microcomputer systems. The systems were triggered from the EKG and averaged the signals over 16 or 32 heart beats. Semi-automatic analysis of the averaged signals provided estimates of left ventricular ejection time (LVET), pre-ejection period (PEP) and electromechanical systole (QS2). Motion artifact levels of the unprocessed signals were similar with both CIP and CUP methods but were greatly reduced by signal averaging. All LVET values using CIP fell within 10% of CUP values. 85% of PEP values using CIP were within 20% of CUP values. Increasing exercise loads produced appropriate decreases in QS2, LVET, PEP and PEP/LVET consistent with increased myocardial contractility. The CIP proved comfortable to wear and did not require critical positioning as did the CUP. Measurement of STI complements exercise pulmonary testing with useful information of cardiac function.

Adult↗
PubMed1984

Infections in the alcoholic.

Serious infections appear to occur more frequently in alcoholic patients. However, whether this is due to the effects of alcohol per se or to the other frequent complications of alcoholism--nutritional deficiencies, cirrhosis, and poor hygiene--has not been determined. The host factors that may underlie an increased frequency of infection in alcoholics and the clinical infectious syndromes associated with alcoholism are described.

Adult↗
PubMed1984

Evidence for altered vascular reactivity in sodium-sensitive young subjects with borderline hypertension.

To assess mechanisms associated with the pressor effects of a high sodium diet in susceptible individuals, the hemodynamic and hormonal effects of sodium depletion and repletion were studied in 33 normal subjects and 30 subjects with borderline hypertension. The hypertensive group had significantly higher mean arterial pressure, weight, hematocrit, and upright plasma renin activity. Forearm hemodynamics were measured during periods of ad lib diet, 10 mEq, and 200 mEq sodium diet. The fall in forearm resistance during reactive hyperemia was inversely related to mean arterial pressure at rest (R = .400, p less than .005) and rose significantly in hypertensive subjects during salt depletion, 39 +/- 3.6 to 61 +/- 6.1 mmHg/ml/min/100 g (p less than .05). Sodium sensitivity in either normotensive or borderline hypertensive subjects was defined as an increase in mean blood pressure of more than 5% when sodium repleted. The individuals who were sodium sensitive had a higher forearm vascular resistance during sodium depletion than those who were sodium resistant, 67 +/- 10.5 versus 45 +/- 4.1 mm/ml/min/100 g (p less than .03). We conclude that young individuals with borderline hypertension already have alterations in vascular reactivity. This trait is shared by normotensive individuals whose blood pressure rises in response to sodium.

Adult↗