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Biomedical subjects

D Becker

Publications and source records attributed to D Becker.

At least 289 records · Page 16Linked to original sources
PubMed1986

Comparison of nonwoven and woven gown and drape fabric to prevent intraoperative wound contamination and postoperative infection.

In a prospective, controlled clinical trial, nonwoven, disposable gown and drape fabrics were no better barriers to intraoperative wound contamination or postoperative wound infection than reusable cotton poplin. We observed no difference between the two study groups in either the frequency or level of intraoperative wound contamination as judged by cultures of specimens collected at the time of wound closure. Of procedures in which reusable fabrics were used, 13.1 percent had positive cultures compared with 15.5 percent of those in which disposable fabrics were used (difference not statistically significant). We recovered coagulase-negative Staphylococci from more than 95 percent of contaminated wounds. Rates of postoperative wound infection were virtually identical in the two groups. Our data suggest that either both fabrics were similar in their ability to block bacteria that were shed from skin surfaces from entering the wound, or that bacteria which contaminate the wound in clean surgical procedures are derived from sources other than skin.

Clinical Trials as Topic↗
PubMed1986

Postcholecystectomy wound infection. The impact of prophylactic antibiotics on the epidemiology of infections.

The clinical courses of 347 patients undergoing gallbladder surgeries were monitored to study the epidemiology of postcholecystectomy wound infection in a hospital in which high-risk patients received prophylactic antibiotics. Overall, 3.8% of patients had wound infections. Patients who had positive bile cultures taken during surgery or positive intraoperative wound cultures had higher rates of infection than patients with negative cultures. However, there was a poor correlation among the bacterial isolates that were recovered from the bile or the wound surface during surgery and from postoperative infections. Antibiotic-sensitive enteric bacteria were recovered from bile samples at surgery, gram-positive organisms and enteric gram-negative bacteria were isolated from intraoperative cultures of the wound surface, and antibiotic-resistant gram-negative bacteria or enterococci were recovered from wounds that developed postoperative infections. There was a strong association between the prior receipt of prophylactic antibiotics and infections with antibiotic-resistant bacteria. Data suggest that bactibilia is still an important epidemiologic marker that identifies patients at high risk for subsequent wound infection. However, in patients who have received prophylactic antibiotics, intraoperative cultures cannot be relied on to guide the choice of empiric therapeutic antibiotics for postoperative infections. Bacteria responsible for these infections are not identified by cultures taken at the time of surgery and are often resistant to the class of antibiotics used for prophylaxis.

Adolescent↗
PubMed1986

Why do children with diabetes die?

While the treatment of children with Type I diabetes mellitus has dramatically improved since the introduction of insulin in 1922, significant acute mortality still remains. To better ascertain the causes of death in younger children and adolescents with diabetes mellitus, a retrospective review was undertaken of diabetes associated mortality in the patient population followed at the Children's Hospital of Pittsburgh between the years 1950 and 1985. Fifty-five deaths were identified of which 20 occurred during the initial presentation of diabetes and 35 occurred between 2 months and 11 years following the diagnosis of diabetes mellitus. Diabetic ketoacidosis (DKA) was associated with 64% of the total mortality with 85% of the early onset and 54% of the late onset deaths being ketoacidosis related. Of these ketoacidosis associated deaths, cerebral edema was documented in 31%, or 20% of the total group mortality. Non ketoacidosis deaths in both early and late onset groups were caused by heterogeneous events. There were no deaths associated with the traditional late vascular complications of diabetes mellitus. Since diabetic ketoacidosis is a potentially preventable acute complication of diabetes mellitus and represented a predominant cause of mortality in these children, early recognition and prompt treatment might substantially reduce childhood mortality in patients with Type I diabetes mellitus.

Adolescent↗
PubMed1986

Activity in the spinal cord-injured patient: an epidemiologic analysis of metabolic parameters.

Individuals with traumatic spinal cord injury (SCI) represent a population with extreme inactivity. The purpose of the current research was to investigate the metabolic differences between extremely inactive disabled individuals (SCI sedentary group), active disabled individuals (SCI athletes), and able-bodied individuals. Fasting morning blood samples were obtained for the determination of high density lipoprotein cholesterol (HDLc) subfractions, glucose, and insulin. The sedentary SCI group was comprised of 77 consecutive male admissions to a rehabilitation center. The 17 SCI athletes were recruited prior to competition at the annual National Wheelchair Games. Total HDLc and both its subfractions were significantly lower (P less than 0.01) in the male SCI sedentary population than in the SCI athletes or able-bodied controls. HDL2 was significantly elevated (P less than 0.01) in the SCI athlete compared to the SCI sedentary group (42.7 vs 34.1 mg X dl-1) and was similar to the control population (46.1 mg X dl-1). Glucose levels were similar in the two SCI groups but were both significantly lower (P less than 0.05) than in the able-bodied controls. These data suggest that the extreme inactivity observed in disabled populations is associated with lower HDLc concentrations and presumably an increase in coronary heart disease risk if these values were to persist over time. Additionally, it appears that physical activity is associated with increases in total HDLc, primarily through the HDL2 subfraction. Glucose and insulin were similar for both SCI groups despite the marked difference in activity levels, suggesting that these parameters may not be associated with activity.

Adult↗
PubMed1986

Intraarticular methylprednisolone acetate in knee arthrotomy.

Ninety-eight arthrotomy patients undergoing meniscectomy were given intraoperative intraarticular methylprednisolone (40 mg) or placebo using double-blind technique and were evaluated clinically at three days, two weeks, four weeks, eight weeks, and twelve weeks after operation. Patients who received methylprednisolone showed small but statistically significant accelerated rehabilitation time with respect to subjectively evaluated pain and range of motion, through two weeks after operation. After two weeks, there was no further advantage over placebo through 12 weeks of rehabilitation.

Double-Blind Method↗
PubMed1984

The association between long-term diabetic control and early retinopathy.

A study was performed to determine the relationship between level of long-term antecedent diabetic control and early diabetic retinopathy changes. Fifty-eight insulin dependent diabetics aged 14 to 17 1/2 years, with duration of diabetes of at least 8 years, were studied. Glycosylated hemoglobins were assessed a mean of 8.5 times per patient, over a mean period of 3.1 years, representing 28% of the mean duration of diabetes in this patient population. Fluorescein angiography, obtained according to a standardized technique, was assessed in masked fashion for number of microaneurysms, presence of abnormal areas of capillary nonperfusion, and presence of intraretinal dye leakage. Sixty-four percent of the study population showed some evidence of retinopathy. There was a high correlation found between degree of metabolic control as measured by glycosylated hemoglobin level, and presence of early retinopathy changes as defined by angiography.

Adolescent↗
PubMed1984

Transformation of NIH 3T3 cells by DNA of the MCF-7 human mammary carcinoma cell line induces expression of an endogenous murine leukemia provirus.

Previous studies identified two glycoproteins of 86 (gp86) and 72 (gp72) kilodaltons and two nonglycosylated proteins of 70 (p70) and 19 (p19) kilodaltons which were specifically expressed in NIH cells transformed by DNA of the MCF-7 human mammary carcinoma cell line. Pulse-chase experiments and the use of tunicamycin to inhibit glycosylation suggested that gp86, gp72, and p19 were related as precursor products. Characteristics of the four transformation-associated proteins resembled those of murine leukemia virus (MuLV) proteins. Sera raised against disrupted MuLV immunoprecipitated the same four proteins in extracts of NIH(MCF-7) cells and MuLV-infected NIH 3T3 cells. In addition, a monoclonal antibody against MuLV gp70 immunoprecipitated proteins gp86 and gp72, whereas a monoclonal antibody against MuLV p15(E) immunoprecipitated gp86 and p19. These results indicate that proteins gp86, gp72, and p19 expressed in NIH(MCF-7) transformants correspond to MuLV envelope proteins gp80env, gp70, and p15(E), respectively. The transformation-associated protein p70 appears to be a non-envelope MuLV protein, most likely p65gag. Northern blot analysis confirmed that transformation of NIH cells by MCF-7 mammary carcinoma DNA led to the induction of an endogenous MuLV provirus.

Animals↗
PubMed1983

Parent--child obesity and cardiovascular risk factors.

Blood pressure, cholesterol, high density lipoprotein cholesterol, and triglycerides were studied in obese children and obese parents selected to participate in a weight treatment program. The relationships between parent and child risk levels, as well as the relationship between child and parent weight and risk factors, were established. Results showed that children's cholesterol and triglycerides were related to parental lipid levels, independent of weight. Children's blood pressure readings were strongly related to their weight, but not to parental blood pressure. High density lipoprotein cholesterol levels were negatively related to weight in both child and parent female populations, and weakly positively related to weight for male children. Implications of these risk factor patterns for intervention are discussed.

Blood Pressure↗
PubMed1983

Clinical and roentgenographic evaluation of nonunion of the forearm in relation to treatment with D.C. electrical stimulation.

A total of 50 nonunions of the forearm bones in 42 patients were reviewed. The mean age was 35.6 years, with the majority secondary to motor vehicle accidents. Five of the nine identified infections were due to primary closure of the initial open fracture. The middle third of the forearm was the most common site of the nonunion. The majority (96%) had significant displacement on the original roentgenograms. Open fractures were more apt to develop nonunions. A gap produced a significant therapeutic challenge and we conclude such are best managed with a bone graft. If a compression plate is applied in the presence of comminution, a bone graft is indicated. The overall success rate with 3 months of D.C. electrical stimulation in the absence of a gap or infection was 80.0%. This compares favorably with time-honored bone graft surgery for nonunion.

Adult↗