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Biomedical subjects

E H Miller

Publications and source records attributed to E H Miller.

At least 37 records · Page 2Linked to original sources
PubMed1987

Motivation in health behavior: measurement, antecedents, and correlates.

Additional reliability, validity, and information on health behavior correlates for a recently developed measure of intrinsic motivation in health behavior are reported. A randomly selected sample of 379 elders responded to a structured interview containing the Health Self-determinism Index (HSDI) and other relevant variables. The overall reliability of the HSDI was supported with an alpha coefficient of 0.78. The multidimensionality of the instrument was reconfirmed through principal components analysis, and factor invariance across study samples was established. The total HSDI and subscale scores were associated with the practice of selected life-style behaviors. The homogeneity of the sample raises significant considerations relative to contextual item sensitivity and sample-induced response tendencies.

Aged↗
PubMed1986

Self-bearing, uncemented, ceramic total hip replacement arthroplasty.

The results for young patients in three diagnostic groups--osteoarthritis, posttraumatic arthritis, and osteonecrosis--show clearly that the uncemented procedure requires longer a recovery time than the cemented procedure. A more aggressive physical therapy program has resulted in an earlier return to function, as shown in these graphs. In conclusion, our experience with this operative procedure includes excellent patient acceptance, a failure rate comparable to that in Europe, a longer period of recovery than that for cemented arthroplasty, excellent results in revision of failed cemented arthroplasty, and an encouraging facility in the difficult case.

Adolescent↗
PubMed1984

Nosocomial Hemophilus pneumonia in patients with severe trauma.

In recent years, there have been increasing reports of Hemophilus pneumonia in adults. With few exceptions, these reports described Hemophilus as a cause of community acquired pneumonia. In the past three years, however, we have seen 15 instances of nosocomial Hemophilus pneumonia in patients with trauma who are intubated. This represented 11 per cent of the incidences of pneumonia that we diagnosed in this time period. The average age of the patient was 36 years and most patients had been in motor vehicle accidents. Six had received antibiotics and nine, steroids prior to their infection. Of note is that all incidences of Hemophilus pneumonia occurred within 11 days of hospitalization. This suggested to us that although the infections were clearly nosocomial, the organisms were probably not hospital acquired. Nevertheless, Hemophilus should be considered a potential cause of early pneumonia in the patients with trauma who are intubated.

Adolescent↗
PubMed1982

A prospective randomized controlled trial of cefoxitin versus clindamycin-aminoglycoside in mixed anaerobic-aerobic infections.

Ninety patients infected with presumed penicillin resistant anaerobes were randomized to cefoxitin or clindamycin-aminoglycoside. Cefoxitin was comparable to clindamycin-aminoglycoside in cures of intestinal associated, 16 of 26 versus 11 of 21, and pelvic infections, 20 of 20 versus 22 of 23. Cefoxitin-resistant facultative-aerobic gram-negative rods were found in 16 of 45 patients with intestine associated infection. Probable antibiotic associated nephrotoxicity was less frequent in the patients in the cefoxitin group, zero of 46 versus seven of 44, p less than 0.05, although a false creatinine elevation was noted more frequent, seven of 46 versus one of 44, p less than 0.05. Infections causing failure in patients in the cefoxitin group more frequently contained cefoxitin resistant gram-negative rods at the time of failure than did infections causing failure in those in the clindamycin-aminoglycoside group that contained gentamicin-resistant gram-negative rods, eight of eight versus zero of eight, p less than 0.001. Cefoxitin may be adequate therapy for many patients with mixed anaerobic/aerobic infections; however, the addition of an aminoglycoside may be prudent in those with known, or suspected, cefoxitin resistant gram-negative rods.

Adolescent↗
PubMed1981

Extra-anatomical vascular bypass and external skeletal fixation in limb replantation.

The scientific background for limb replantation began 75 yr ago with the work of Hopfner and of Carrel and Guthrie. Thirty-five years ago, Hall indicated that the techniques were available, but it was not until 17 yr ago that Malt and McKhann performed the first successful replantation of a limb in man. Since then, the techniques have become more sophisticated and guidelines have been formulated. Many successful replantations have been reported. We present two children with partial amputation of a lower limb. Both had severe soft tissue and bone damage sufficient to contraindicate replantation by conventional criteria. Wound sepsis resulted in failure of replantation of the first child's limb replanted by conventional methods. The second child's limb was salvaged. Extra-anatomical vascular bypass graft separated the critical vascular anastomoses from the open contaminated wound. External skeletal fixation allowed aggressive open wound treatment. In selected cases, these two techniques would appear to increase the chances for successful limb replantation.

Amputation, Surgical↗
PubMed1981

Infection of bone by Mycobacterium fortuitum masquerading as Nocardia asteroides.

A case of traumatic osteomyelitis of the leg yielded on culture a branching partially acid-fast organism that failed to respond to therapy directed at Nocardia asteroides. Subsequent laboratory investigation revealed the organism to be Mycobacterium fortuitum. N. asteroides and M. fortuitum can demonstrate similar staining and morphologic patterns microscopically, as well as common colonial and cultural characteristics. Separation can be aided by careful examination of the branching pattern, and can be established by thin-layer chromatography of lipid extracts of the organism. Correct identification of these species in the laboratory is important because of some overlap in their clinical syndromes and because of differences in their susceptibilities to antibiotics.

Aged↗
PubMed1981

Evaluation of A/Alaska/6/77 (H3N2) cold-adapted recombinant viruses derived from A/Ann Arbor/6/60 cold-adapted donor virus in adult seronegative volunteers.

The influenza A/Ann Arbor/6/60 (H2N2) cold-adapted (ca) virus was evaluated as a donor of attenuating genes to new variants of influenza A virus. This ca donor virus was mated with the A/Alaska/6/77 (H3N2) wild-type virus, and three A/Alaska/6/77 (H3N2) ca recombinant viruses were produced. The parental origin of the genes in the three ca recombinants had been determined previously (2), and their virulence for adult seronegative volunteers was assessed in the present study to identify the genes present in the ca donor virus that confer attenuation. Each of the recombinants received the hemagglutinin and neuraminidase genes from the A/Alaska/6/77 (H3N2) wild-type parent. One ca recombinant (CR-29) received all six transferable genes from the ca parent and was found to be satisfactorily attenuated in the volunteers. The two other ca recombinants received five of the six transferable genes with a wild-type gene at the M or NS locus. The pattern of infection in humans with these latter two ca recombinants was similar to the CR-29 ca recombinant. These findings demonstrate that inheritance of a gene in ca recombinants at the M or NS locus segregates independently of attenuation and suggest that the M and NS genes present in the ca donor virus are not the major determinants of attenuation conferred by this virus.

Antibodies, Viral↗
PubMed1975

A new consideration in athletic injuries. The classical ballet dancer.

The professional ballet dancer presents all of the problems of any vigorous athlete. The problems include osteochondral fractures, fatigue fractures, sprains, chronic ligamentous instability of the knee, meniscal tears, impingement syndrome, degenerative arthritis of multiple joints and low back pain. Attention to minor problems with sound conservative therapy can avoid many major developments and lost hours. Observations included the extraordinary external rotation of at the hip without demonstrable alteration in the hip version angle and hypertrophy of the femur, tibia and particularly the second metatarsal (in female dancers). Careful evaluation of the range of motion of the extremities, serial roentgenographic examination, and systematic review of previous injuries, training programs and rehearsal techniques have been evaluated in a series of cases to provide the basis for advice to directors and teachers of the ballet.

Achilles Tendon↗
PubMed1975

Gram-negative osteomyelitis following puncture wounds of the foot.

Seven cases of gram-negative osteomyelitis following puncture wounds of the foot are presented. Regardless of age (range, five to thirty-two years) all patients had a similar, typical clinical picture of one to two weeks of improvement after the initial post-traumatic inflammation followed by worsening of the local signs. Two patients were successfully treated with antibiotics alone and five, with antibiotics in combination with curettage.

Adolescent↗