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Biomedical subjects

G Conrad

Publications and source records attributed to G Conrad.

17 recordsLinked to original sources

Prehospital ultrasound imaging improves management of abdominal trauma.

BACKGROUND: Blunt abdominal trauma with intra-abdominal bleeding is often underdiagnosed or even overlooked at trauma scenes. The purpose of this prospective, multicentre study was to compare the accuracy of physical examination and prehospital focused abdominal sonography for trauma (PFAST) to detect abdominal bleeding. METHODS: Six rescue centres took part in the study from December 2002 to December 2003, including 230 patients with suspected abdominal injury. The accuracy of physical examination at the scene and PFAST were compared. Later examinations in the emergency department (ultrasonography and/or computed tomography) were used as the reference standard. RESULTS: The complete protocol and follow-up was obtained in 202 patients. The sensitivity, specificity and accuracy of PFAST were 93 per cent, 99 per cent and 99 per cent, respectively, compared with 93 per cent, 52 per cent and 57 per cent for physical examination at the scene. Scanning with PFAST occurred a mean(s.d.) 35(13) min earlier than ultrasound in the emergency department. Abdominal bleeding was detected in 14 per cent of patients. Using PFAST led to a change in either prehospital therapy or management in 30 per cent of patients, and a change to admitting hospital in 22 per cent. CONCLUSION: In this study, PFAST was a useful and reliable diagnostic tool when used as part of surgical triage at the trauma scene.

Abdominal Injuries↗

Systemic sarcoidosis and electrocardiographic conduction abnormalities. Electrophysiologic evaluation of two patients.

Two patients with long histories of sarcoidosis had progression of conduction abnormalities to heart block and severe bradycardia. Conduction system involvement was trifascicular in both patients, though evidence for left ventricular functional impairment was otherwise lacking. Sudden death is seen more commonly in patients with sarcoidosis who have diffuse myocardial involvement, while conduction abnormalities can occur with relatively localized disease.

Arrhythmias, Cardiac↗

Cephalothin plus an aminoglycoside is more nephrotoxic than methicillin plus an aminoglycoside.

In a prospective, randomised, double-blind trial to determine if cephalothin plus an aminoglycoside is more nephrotoxic than methicillin plus an aminoglycoside, patients were assigned to one of four treatment groups: cephalothin and gentamicin (C.G.), cephalothin and tobramycin (C.T.), methicillin and gentamicin (M.G.), or methicillin and tobramycin (M.T.). The incidence of definite nephrotoxicity was: C.G., 7/23 (30.4%); C.T., 5/24 (20.8%); M.G., 2/20 (10%); and M.T., 1/23 (4.3%). There was no statistically significant difference in nephrotoxicity between the combined gentamicin groups (C.G. and M.G.) and the combined tobramycin groups (C.T. and M.T.). Definite nephrotoxicity developed in 12/47 (25.5%) of the combined cephalothin groups (C.G. and C.T.) and in only 3/43 (7%) of the combined methicilllin groups (M.G. and M.T.). The combination of cephalothin plus an aminoglycoside is therefore more nephrotoxic than the combination of methicillin plus an aminoglycoside.

Acute Kidney Injury↗

Partial trisomy for short and long arm of chromosome no. 5: Two cases of two possible syndromes.

We report 2 patients from different families with malformation-retardation syndromes caused by a partial trisomy of the long and of the short arm of chromosome 5, respectively (case 1: 46,XX,der(3),t(3;5)(p27;p13)mat; case 2: 46,XY,der(22),t(5;22)(q33;q13)pat). Several members of these families were balanced translocation carriers. Our cases are compared with those cited in the literature. The possibility of delineating a 5p- and a 5q-partial-trisomy syndrome is discussed.

Abnormalities, Multiple↗

[Comparative examinations of stomach and duodenum with the use of Buscolysin and Cerucal].

The administration of buscolysin and cerucal in the pharmacoradiography of the stomach and the region of the small intestine was tested on every 50 patients. In these cases the differentiated range of action of the two preparations was shown. Buscolysin can be regarded as remedy of choice for the hypotonic duodenography, whereas cerucal is conspicuously suited for the functional diagnostics especially of the regions of antrum and bulb. By the aimed administration of the two preparations a complex functional diagnostics of stomach and duodenum is possible.

Ampulla of Vater↗

Counselling the adolescent girl in a time of changing values.

The position of the adolescent girl has always been somewhat ambiguous in western culture. No more a little girl and not yet a woman, she remained in limbo waiting for the time when she would marry and no longer be the responsibility of her family. Counsellors who work with adolescent girls have been expected to reinforce a value system which prized 'innocence' in young women, emphasized the romantic view of love and looked upon marriage as an eternal bond. Developing trends in the Women's Liberation Movement, the ability of contraceptive information and easy abortion, experiments by young people with varied forms of interpersonal relationships anf family structures, all indicate that the traditional value system is changing. There is a new reality; women are now free to follow more than one way of life. For the counsellor this presents the same dilemma which faces the adolescent girl: how to leave the security of the known and prepare for the potential choices which are inherent in the unknown.

Adolescent↗

Cartilage cell differentiation: review.

Differentiation of cartilage cells from embryonic precursor cells is characterized by the onset of biosynthesis of at least two cartilage-specific gene products, type II collagen and cartilage-specific chondroitin sulfate proteoglycan (CSPG). Biochemical and immunological assays for these compounds now allow rapid, quantitative, and specific determination of the onset of cartilage differentiation, and present several advantages over assays that use histochemical stains or [35S]-sulfate incorporation into glycosaminoglycans. Chondrogenic differentiation also is associated with the formation of extracellular, high MW proteoglycan (CSPG) aggregates containing hyaluronic acid and the loss of fibronectin, or LETS protein, a cell surface glycoprotein found on presumptive chondroblasts, fibroblasts, and several other cell types. Comparatively little insight has been gained recently regarding the mechanism of cartilage cell differentiation. A number of factors or "inducers" of cartilage differentiation, such as chondroitin sulfate proteoglycan, notochord, spinal cord, low oxygen tension, and collagen substrates, increase the amount of glycosaminoglycan synthesis per cell, but the question remains open as to whether these factors also selectively increase the number of cells differentiating from precursor cells into chondroblasts, or whether they only increase cell viability. Other factors, such as conditioned medium from chondrocyte cultures, increase significantly the number of chondrocyte colonies arising in mass cultures of limb bud mesenchyme, but differentiation of nonchondrogenic cells is stimulated as well. Similarly, many inhibitors of cartilage differentiation, such as BrdUrd and 6-amino nicotinamide, also inhibit myogenic differentiation. It is possible that a unique and specific inducer or regulating factor of cartilage cell differentiation may not exist, for cartilage differentiation of normal embryonic mesenchyme can be triggered by a variety of environmental conditions, such as cell density, pH, potassium ion concentration, and fetal calf serum. These results imply that the temporal and spatial controls of cartilage differentiation are governed by environmental influences that are each of rather low specificity, but which together synergistically generate a morphogenetic control of high specificity. Signals which appear able to mimic those controlling normal cartilage differentiation seem to be exchanged during formation of ectopic cartilage. Muscle tissue and periosteum can be triggered to form cartilage by demineralized bone matrix. Chick limb bud epithelium induces type II collagen synthesis in embryonic mouse tooth germ, whereas homologous, oral epithelium induces the formation of dentin (type I collagen). Thus, the type of response elicited from mesenchyme cells can be determined by nearby epithelia, and that response frequently can be the formation of cartilage.

Animals↗