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Biomedical subjects

C W Clinton

Publications and source records attributed to C W Clinton.

At least 19 recordsLinked to original sources
PubMed2001

Use of intravesical temperature as a monitor of core temperature during and following general anaesthesia.

OBJECTIVE: The value of thermistor-bearing urinary catheters has not been extensively investigated in the postoperative period. This study compared thermistor-bearing urinary catheters with pulmonary artery catheters as a means of measuring core temperature during and following general anaesthesia in patients undergoing aortic aneurysmectomy. METHODS: Information was obtained from 16 patients divided into two equal groups; one group provided intra-operative data, and the other group postoperative data. Simultaneous temperature measurements were obtained from each of the catheters at specific time intervals--every 10 minutes for the duration of anaesthesia and every 30 minutes for 10 hours during the postoperative period. RESULTS: Agreement between the two catheters and the accuracy and precision of the intravesical catheter with regard to the pulmonary artery catheter were determined. Clinically acceptable limits of agreement between the two methods of measurement were noted, although the limits of agreement were somewhat better for the postoperative period. During the early intra-operative period the intravesical catheter tended to over-read the pulmonary artery catheter, the largest mean difference being +0.3 degree C. During the postoperative period the intravesical catheter either under-read or over-read the pulmonary artery catheter, depending on whether core temperature was rising or falling. Mean differences varied from +0.2 degree C to -0.1 degree C. However, neither during the intra-operative nor the postoperative periods were statistically significant differences noted between the two measurement methods. CONCLUSION: The study indicates that in patients undergoing aortic aneurysmectomy, the thermistor-bearing urinary catheter is a clinically acceptable measure of core temperature during and following general anaesthesia.

Anesthesia, General↗
PubMed1997

Postoperative management of hypothermia of intra-operative origin--experience with a forced-air convective warming device.

Hypothermia develops during the intra-operative period partly as a result of disordered thermoregulation induced by anaesthesia, and partly because of the nature of the operation or injury and the surgical environment. Both the hypothermic state and the consequences of physiological attempts to return the core temperature to normal, which take place during the postoperative period, are associated with non-beneficial effects. Attempts to prevent an intra-operative decline in core temperature are a part of anaesthesia management. However, most of the traditional options available are inefficient or ineffective, especially if used as a single intervention and particularly in adults. This study evaluates the performance of a new device, the forced-air convective warmer, in the management of the postoperative hypothermic state. Results show that the device made a significant difference to the thermal state of a group of hypothermic postoperative patients when compared with a hypothermic control group, but only if used for at least 2 hours after the operation.

Adolescent↗
PubMed1994

Prevalence of cystine and urate uroliths in bulldogs and urate uroliths in dalmatians.

Data were evaluated from all dogs admitted to the University of Minnesota Veterinary Teaching Hospital (UMVTH) between June 1, 1981 and Dec 31, 1991. During this period, uroliths were retrieved and analyzed from 452 of 37,574 dogs admitted. The odds that uroliths from Bulldogs were composed of cystine were 32.3 times greater than for other breeds evaluated. The odds that a Bulldog admitted was affected with cystine uroliths were 154.1 times greater than for other breeds. Cystine uroliths were retrieved only from male Bulldogs. The odds that uroliths from Bulldogs were composed of urate were 7.9 times greater than for other breeds. The odds that a Bulldog admitted was affected with urate uroliths were 43.0 times greater than for other breeds. Male Bulldogs were 14.3 times more likely to be affected with urate uroliths than were females. The odds that uroliths from Dalmatians were composed of urate were 228.9 times greater than for other breeds. The odds that a Dalmation admitted was affected with urate uroliths were 122.4 times greater than for other breeds. Male Dalmatians were 16.4 times more likely to be affected with urate uroliths than were females. Data also were evaluated from files of canine uroliths submitted to the Minnesota Urolith Center for quantitative mineral analysis between June 1, 1981 and Dec 31, 1991. During this period, 94 of 11,188 uroliths analyzed were obtained from Bulldogs and 387 were obtained from Dalmatians. The odds that uroliths retrieved from Bulldogs were composed of cystine were 40.7 times greater than for other breeds. Cystine uroliths were retrieved only from male Bulldogs.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Distribution↗
PubMed1992

Postoperative intensive care and the South African Society of Anaesthetists' patient category.

A group of 412 postoperative patients admitted to an intensive care unit of an academic hospital were evaluated in terms of their need for intensive care. The Acute Physiology and Chronic Health Evaluation score, the Therapeutic Intervention Scoring System (TISS) and the South African Society of Anaesthetists' (SASA) patient category were utilised to determine the level of care required by each patient. A further objective of the study was to determine if the SASA patient category, on its own, adequately described the need for intensive care in postoperative patients. Evaluation of the data indicated that, in terms of TISS, 66% of the patients required intensive care. These patients were distributed throughout all three SASA categories. Of the 137 patients who, according to TISS, did not require intensive care, 122 were SASA category 3 patients. However, of the total number of category 3 patients, just less than half required intensive care. In order to identify better those patients within a specific SASA category who require intensive care we suggest further subdivision of each category into groups A, B and C, according to the number of TISS points scored at 24 hours postoperation. In this way a retrospective audit using SASA categories would clearly identify those postoperative patients who required intensive care.

Anesthesiology↗
PubMed1992

Postoperative hypoxaemia--its causes and prevention.

Postoperative hypoxaemia presents with varying degrees of severity. Aetiology of the condition is diverse and may originate in the pre-, intra- or postoperative periods. However, induction of anaesthesia and the type of operation are important initiating factors over which there is little control. The impact of postoperative hypoxaemia, especially when detected early, can be alleviated. This article attempts to explain the pathophysiology and provide suggestions as to detection and management of postoperative hypoxaemia.

Age Factors↗
PubMed1992

The value of the ejection fraction as a predictor of postoperative cardiac mortality in patients undergoing peripheral vascular surgery.

Retrospective evaluation was undertaken in 131 patients who underwent peripheral vascular operations before which a multigated scan had been obtained. The patients were assigned to one of three groups according to their pre-operatively determined ejection fraction; 82 patients had an ejection fraction greater than 55%, in 38 patients the ejection fraction was between 36% and 54% and in 11 patients it was 35% or less. Two cardiac deaths occurred in each of the three groups. Although mortality in the three groups just failed to achieve statistical significance, metanalysis of published reports indicates that significant mortality exists for patients with an ejection fraction of less than 35% compared with those with an ejection fraction of over 55%. In this series, if the ejection fraction was used as the sole indicator, it was not an accurate predictor of peri-operative cardiac mortality. However, when used in conjunction with patient factors, such as cardiac history and status of the resting ECG, it did define a group of patients in whom there was a significant clinical risk of peri-operative cardiac mortality.

Adult↗
PubMed1992

Effect of two different syringes on syringe driver function.

A laboratory investigation into the effect of two different syringes on the performance of a syringe driver was undertaken in order to assess accuracy of delivery, occlusion-alarm delay time and the effect of incorrectly coding the device for the syringe in use. Results indicated that accuracy of delivery was of the order of -1%/h for both syringe types at an infusion rate of 5 ml/h. Clinically and statistically significant differences in the occlusion-to-alarm time were found between syringes and between infusion rates. At 99.9 ml/h lag time was about 30 seconds for both syringes, whereas at 5 ml/h this was 667 seconds for one syringe and 903 seconds for the other. Incorrect coding of the driver for the syringe in use, resulted in a significant change in the accuracy of delivery at an infusion rate of 5 ml/h. Similarly, incorrect coding resulted in changes in the occlusion-alarm time. These results carry significant pharmacological implications for the clinical situation.

Humans↗
PubMed1991

Prevalence of calcium oxalate uroliths in miniature schnauzers.

Epidemiologic data were evaluated from all dogs admitted to the University of Minnesota, Veterinary Teaching Hospital (UMVTH) between June 1981 and November 1989. Of 69,890 admissions, 2,077 were Miniature Schnauzers. Uroliths were retrieved from 63 of the 2,077 Miniature Schnauzers admitted. In 20 of the 63 urolith episodes, calcium oxalate was the predominant mineral identified. By comparison, calcium oxalate uroliths were identified in only 56 of the remaining 67,813 non-Miniature Schnauzer canine admissions. The odds that uroliths from Miniature Schnauzers were composed of calcium oxalate was 11.8 times greater than for other canine breeds evaluated at the UMVTH (95% confidence interval = 6.8 to 20.1). Data also were evaluated from files of uroliths retrieved from dogs and submitted to the Minnesota Urolith Center for quantitative mineral analysis, between June 1981 and November 1989. Of 3,930 uroliths analyzed, 615 (15.6%) uroliths were obtained from Miniature Schnauzers. of the 615 uroliths, 175 (28.4%) were calcium oxalate. By comparison, only 550 (16.6%) of the remaining 3,315 from dogs of breeds other than Miniature Schnauzers were calcium oxalate. The odds that uroliths submitted for analysis were composed of calcium oxalate was 2 times greater for Miniature Schnauzers than for dogs of other breeds (95% confidence interval = 1.6 to 2.4). Calcium oxalate uroliths were retrieved more frequently in males than females. The risk for males developing calcium oxalate uroliths was greater than 3 times the risk for females in both groups of data evaluated. The mean age of all Miniature Schnauzers admitted to the UMVTH with calcium oxalate uroliths was 9 years. Calcium oxalate uroliths were not detected in Miniature Schnauzers younger than 1.7 years.

Age Factors↗
PubMed1990

Fulminant adult respiratory distress syndrome after suction lipectomy. A case report.

The adult respiratory distress syndrome developing within 24 hours in a patient who underwent suction lipectomy for body contouring under general anaesthesia is reported. During surgery, in which a total of 1.3 l of suction matter was removed, the patient became haemodynamically unstable and mildly hyperthermic. Subsequently, clinical signs and symptoms of the fat embolism syndrome developed. Aggressive haemodynamic and respiratory support over an 8-day period resulted in patient survival. Malignant hyperthermia was excluded as cause for the clinical presentation on muscle biopsy and in vitro caffeine contracture studies. Although usually complication-free, suction lipectomy may be associated with life-threatening incidents. Even suction volumes as low as 1.3 l have potential hazards, therefore the procedure merits regular postoperative observation and re-assessment.

Adult↗
PubMed1989

Pre-operative prophylactic transvenous cardiac pacing for bifascicular heart block.

Some authorities consider that the combination of right bundle-branch block with left axis deviation (bifascicular block) is not an indication for prophylactic insertion of a pacing generator in patients undergoing non-cardiac surgery. Five patients who developed peri-operative progression of bifascicular block to complete heart block are described. Bifascicular block, together with any other cardiovascular condition, advanced age or surgery in regions that promote vagal stimulation, merit consideration for prophylactic pacing. A cardiological opinion is an essential aspect of the pre-operative preparation of patients with this abnormality.

Aged↗
PubMed1986

Urolithiasis. Terms and concepts.

Urolithiasis is a general term that encompasses formulation of urinary tract stones as a sequela of one or more underlying abnormalities. A variety of terms have been used to describe the characteristics of uroliths based on mineral composition, location, and/or shape. Knowledge of the origins and meanings of these terms will facilitate understanding of the cause, detection, treatment, and prevention of uroliths.

Animals↗
PubMed1986

Prevalence of canine uroliths. Minnesota Urolith Center.

Uroliths obtained from 839 dogs were evaluated by quantitative methods. Struvite was the most prevalent mineral detected; newberyite, calcium oxalate, calcium phosphate, uric acid, sodium and ammonium urate, cystine, and silica were detected much less frequently. Seven per cent of the uroliths had an identifiable nucleus and one or more surrounding layers of different mineral types. Although uroliths were found in all parts of the urinary tract, the urinary bladder was most common. Uroliths of different composition were encountered in a variety of breeds of both sexes and different ages.

Animals↗
PubMed1986

Comparison of qualitative and quantitative analyses of canine uroliths.

A study was performed to compare qualitative test results of canine uroliths with quantitative test results. Qualitative test results were in agreement with quantitative test results in only 96 of 223 specimens (43 per cent). Lack of agreement was caused by false-negative qualitative test results (85 of 223), false-positive qualitative test results (15 of 233), and a combination of false-negative and false-positive qualitative test results (27 of 233). This study indicates that the veterinary profession should abandon exclusive use of qualitative chemical test kits for uroliths.

Animals↗
PubMed1985

Painful muscle spasm reversed by magnesium sulphate. A case report.

A 25-year-old paraplegic man who had sustained a T3/T4 vertebral compression fracture 3 years previously presented with severe, painful spasm of the left hamstring muscle group of 2 hours' duration. This spasm produced extreme knee flexion of a degree which held the left foot posterior to the right buttock. An intravenous injection of 2 g magnesium sulphate produced immediate relief. Possible mechanisms of action of magnesium are discussed.

Adult↗