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Biomedical subjects

D Bar-Or

Publications and source records attributed to D Bar-Or.

34 records · Page 2Linked to original sources

Peritoneal lavage in penetrating injuries of the small bowel and colon: value of enzyme determinations.

The value of lavage alkaline phosphatase determinations following hollow visceral injury was studied. Twenty-nine mongrel dogs were subjected to partial transection of the small intestine or colon, or underwent sham laparotomy. Sequential diagnostic peritoneal lavage was performed. At one hour post injury the lavage red cell count, white cell count, and amylase levels were within normal limits in each group. The lavage alkaline phosphatase, however, was markedly elevated in both bowel-injured groups compared with the sham group. In the five-hour lavage, red cell counts and amylase levels remained normal. White cell counts were now elevated in all three groups, but the results did not distinguish the intestinal injury from the sham model. Lavage alkaline phosphatase was again significantly increased in the injured groups versus the sham model. Serum alkaline phosphatase and amylase levels were normal in all study groups at baseline and one and five hours post injury. This canine study demonstrates the utility of peritoneal lavage alkaline phosphatase levels in identifying isolated small intestine and colon injuries that were otherwise undetected by red cell, white cell, and amylase determinations.

Alkaline Phosphatase↗

Diagnosis of iron deficiency anemia in a rural population of children. Relative usefulness of serum ferritin, red cell protoporphyrin, red cell indices, and transferrin saturation determinations.

The diagnostic usefulness in iron deficiency anemia of serum ferritin, red cell protoporphyrin (Epp), mean corpuscular volume, mean corpuscular hemoglobin (MCH), and transferrin saturation measurements has been studied in a population of 294 children aged 1 to 6 yr. Of the children studied 19% had hemoglobin below 11 g/dl. Iron deficiency, diagnosed by at least two abnormal independent laboratory parameters, was the cause of anemia in all except two cases. The Pearson correlation coefficient for hemoglobin was highest with MCH, followed in decreasing order of magnitude by MCV, Epp, transferrin saturation, and finally by ferritin. Sensitivity and specificity were highest for MCH and lowest for ferritin. Of anemic, iron deficient individuals 97 to 100% could be identified by low MCH, 88 to 100% by transferrin saturation, 66 to 83% by ferritin, and 61 to 74% by Epp. In contrast, only 0 to 6% of normal, nonanemic individuals had low MCH, 0 to 4% had high Epp, but 21 to 39% had low transferrin saturation and 25 to 39% had low ferritin. Although reduced serum ferritin in anemic individuals is good evidence of iron deficiency, a significant proportion of anemic iron-deficient patients is missed by this procedure rendering it less useful than other, less expensive laboratory methods.

Age Factors↗

Anemia among Druze children in the Golan Heights.

The prevalence and causes of anemia were studied in 294 Druze children aged 10 months to six years. The hemoglobin level was less than 11.0 g/dl in 19%; none of these anemic children had folate deficiency. Iron deficiency, diagnosed on the basis of abnormal values for at least two independent laboratory parameters, was the cause of anemia in all but two cases. The Pearson correlation coefficient for hemoglobin was highest with mean corpuscular volume, erythrocyte protoporphyrin, serum iron, transferrin saturation, total-iron-binding capacity, and serum ferritin. Mean corpuscular hemoglobin and transferrin saturation were abnormal in greater than 90% of anemic children, whereas serum ferritin and total-iron-binding capacity were abnormal in only 70%. In view of its limited sensitivity, serum ferritin appears to be a less useful diagnostic aid in iron-deficiency anemia than other, less expensive laboratory methods.

Anemia, Hypochromic↗

Protracted metabolic acidosis: the impact of acute ethanol in hemorrhagic shock.

The effects of acute ethanol administration on acid-base balance and hemodynamic parameters were studied in a canine model. Ten mongrel dogs, anesthetized and maintained on a volume ventilator, underwent splenic artery ligation 30 minutes prior to study. Group A (N = 5) served as controls. Thirty minutes after drug administration, the animals underwent a 20-cc/kg hemorrhage over 15 minutes. Thirty minutes postphlebotomy, resuscitation was performed with the same volume of homologous blood. Acid-base and hemodynamic parameters were monitored over 3.5 hours. Ethanol levels peaked 60 minutes following administration at 207 +/- 13 mg%. During the entire study, no differences were observed in heart rate, pulmonary capillary wedge pressure, systemic vascular resistance index, pO2, or pCO2, between the two groups. Following hemorrhage, statistically significant decreases in pH, mean arterial pressure (MAP), cardiac index (CI), and left ventricular stroke work index (LVSWI) developed in group A compared to controls. Maximal disparity developed in pH (7.21 +/- 0.05 to 7.33 +/- 0.02, P < 0.01), MAP (67 +/- 11 v 110 +/- 9 torr, P < 0.01), CI (1.69 +/- 0.24 compared to 2.72 +/- 0.19 L/min/M2, and LVSWI (18.7 +/- 1.2 compared to 44.9 +/- 4.8 gr-meter/M2/beat, P < 0.01) at 60, 45, 30, and 75 minutes postphlebotomy. In this study, ethanol directly or indirectly caused an increased metabolic acidosis and myocardial depression in the post-hemorrhage period.

Acidosis, Lactic↗