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Biomedical subjects

G Healy

Publications and source records attributed to G Healy.

14 recordsLinked to original sources
PubMed2005

Fluid restriction for term infants with hypoxic-ischaemic encephalopathy following perinatal asphyxia.

BACKGROUND: Current recommendations to control the consequences of hypoxic-ischaemic encephalopathy following perinatal asphyxia include the careful management of fluids, with avoidance of fluid overload and thus avoidance of cerebral oedema. Recommendations for fluid restriction in a neonate are based on the experience of restricting fluid intake in adults or older children. The extrapolation from studies in adults, older children and animals to the human neonate is fraught with hazard due to the different physiology and mechanisms of injury. OBJECTIVES: The objective of this review was to determine the effects of fluid restriction on short-term (mortality within the first 28 days of life, grade of hypoxic ischaemic encephalopathy, electrolyte disturbances, renal function, seizure activity) and long-term outcomes (death during the first year of life, CT or MRI changes, or severe neurodevelopmental disability at or equal to 12 months of age or more) in term infants following perinatal asphyxia. Subgroup analyses were planned on the basis of the severity of the resulting hypoxic-ischaemic encephalopathy, degree of fluid restriction, and length of fluid restriction. SEARCH STRATEGY: Searches were undertaken of MEDLINE October 2004 back to 1966, CINAHL back to 1966, the Oxford Database of Perinatal Trials and the Cochrane Central Register of Controlled Trial (CENTRAL, The Cochrane Library, Issue 3, 2004). Searches were made of previous reviews including cross-references and abstracts. The search was not limited to the English language; reports in foreign languages were translated. SELECTION CRITERIA: Randomised or quasi-randomised trials of fluid restriction in term newborn infants with perinatal asphyxia. DATA COLLECTION AND ANALYSIS: No studies were found meeting the criteria for inclusion in this review. MAIN RESULTS: No studies were found meeting the criteria for inclusion in this review. AUTHORS' CONCLUSIONS: Given that fluid restriction for the treatment of hypoxic ischaemic encephalopathy following perinatal asphyxia is recommended in standard textbooks, there is a need for randomised, controlled trials to establish if this practice affects mortality and morbidity. As it may not be ethical to include neonates with acute renal failure in a randomised trial, these babies will have to be excluded from the trial. These studies should investigate the effects of fluid management on outcomes such as mortality, seizure activity, evidence of cerebral damage on histology, and effects on renal function and electrolytes.

Asphyxia Neonatorum↗
PubMed1994

The use of prefabricated fascial flaps for lining of the oral and nasal cavities.

Twelve temporoparietal fascial flaps were prefabricated to line the oral and/or nasal cavities in 10 patients. Bilateral flaps were used both in a patient suffering from lye ingestion and in a patient undergoing bilateral lip reconstruction. All reconstructions were performed in two stages separated by 3 to 4 weeks. The first stage involved creation of an epithelial lining by placing a non-hair-bearing skin graft over the temporoparietal fascia. The second stage raised the fascial flaps as vascular islands and transferred them as either pedicled or free flaps. All 12 flaps survived and improved function for the patients involved. Although all possible applications for this flap have not been explored fully, there appears to be great potential for the use of this procedure in refined reconstructions of moderately sized intraoral and nasal defects.

Adult↗
PubMed1989

The impact of cultural and environmental changes on the epidemiology and control of human babesiosis.

The infection of humans with Babesia spp. has provided a well studied example of how cultural and environmental factors have contributed to the spread of an infection. Individuals developing babesiosis have been those engaging in life styles which put them at risk of tick bites. Farmers, hunters and other outdoor types are most frequently infected. The forms of human babesiosis which occur in the north-eastern United States are directly related to the spread of deer and the deer tick, which is the vector of the Babesia responsible for human infection. The spread of deer in the region was a direct result of cultural changes resulting in altered human behaviour which permitted deer to exist close to human settlement areas.

Agricultural Workers' Diseases↗
PubMed1989

Antigenic stability and immunodominance of the Gal/GalNAc adherence lectin of Entamoeba histolytica.

Immunoprecipitation of Entamoeba histolytica proteins was performed with the sera of patients recovered from amebic liver abscess and colitis. The patients' amebic infection had been acquired in diverse areas of the world. The amebic galactose and N-acetyl-D-galactosamine-inhibitable adherence lectin was the major amebic antigen immunoprecipitated. The adherence lectin was recognized by all of the patients' sera tested regardless of the site (liver abscess vs. colitis) or geographic region that the amebic infection had occurred.

Animals↗
PubMed1976

Orphan airlift. Enteric pathogens isolated from Vietnamese children immigrating to the United States.

Isolation studies for bacterial and parasitic agents were carried out on stool specimens from Vietnamese infants at the time of their mass airlift to the United States. One or more bacterial pathogens were found in 49% of the 367 stool specimens cultured. The isolates included enteropathogenic Escherichia coli (161), Shigella (16), Salmonella (15), but no Salmonella typhi or Vibrio cholerae. Parasites identified in 88 stool specimens included Giardia lamblia (10), Ascaris lumbricoides (7), and Entamoeba histolytica (1). Transmission of agents to volunteers probably occurred, because 48% of 272 adults questioned had diarrhea shortly after caring for the children, and stool cultures from these adults resulted in the isolation of E coli (105), Salmonella (1), and Shigella (3).

Adult↗
PubMedDate not supplied

Fibrosarcoma of the infratemporal fossa in an 8-year-old girl.

The consultants agree that an open biopsy is generally necessary to establish the histology of a pediatric head and neck neoplasm. Although a frozen section may be useful to ascertain whether tumor tissue has been sampled, definitive therapy should be based only on the histopathologic interpretation of the permanent specimen. The consultants also agree that certain studies should be obtained prior to a biopsy. Dr. Grundfast recommends a chest x-ray, liver function tests, complete blood count, and an magnetic resonance scan. Dr. Healy would obtain additional CT cuts and an MRI scan. Dr. Richardson prefers coronal cuts on the CT scan and an MRI. The skull base is regarded as the area that might pose the greatest difficulty in obtaining a surgical margin. In addition, Dr. Healy states that eustachian tube involvement would compromise the resection. Although all consultants agree that the facial nerve should be sacrificed, they disagree as to how to reconstruct this defect. Dr. Grundfast would restore the mandibular profile with a prosthesis and reconstruct the soft tissue defect with a myocutaneous flap. Dr. Healy would use an iliac bone graft for the skull base defect and would replace soft tissue with a rectus free flap or a myocutaneous flap. Dr. Richardson favors a latissimus dorsi free flap. Because the survival rates for poorly differentiated fibrosarcomas of the head and neck are so low, the experts recommend adjunctive chemotherapy. Drs. Grundfast and Richardson would also advise radiotherapy. Dr. Healy feels that the morbidity of radiotherapy is too high and would use it only in cases of positive margins, parameningeal involvement, or perineural invasion.

Biopsy↗
PubMedDate not supplied

CT-guided percutaneous insertion of interstitial radiotherapy catheters in head and neck tumors.

We describe a new method of placing interstitial radiation therapy catheters in patients with head and neck tumors. In three patients with recurrent inoperable head and neck tumors CT guidance was utilized to insert interstitial radiation therapy catheters percutaneously. This method enabled palliative radiation therapy to be administered without the need for surgical placement of seeds or catheters. The detailed anatomical localization of tumor and vascular structures provided by CT enabled precise percutaneous placement of afterloading catheters while ensuring safety. Pain was reduced and tumor size was decreased in all three patients. The CT-guided percutaneous insertion of afterloading catheters is a simple yet effective method of providing interstitial radiation therapy for head and neck tumors.

Aged↗
PubMedDate not supplied

Carbon dioxide laser in subglottic hemangioma. An update.

Congenital subglottic hemangioma is a potentially life-threatening lesion which frequently presents before the age of 6 months. Many forms of therapy have been advocated for the treatment of this difficult lesion. The use of the carbon dioxide laser has been advocated in the past and this report represents an update in treating 31 patients from 1975 to 1983. The success rate was 94% and the complication rate was 6.5%. This form of therapy is an effective and valuable addition to those already available for this troublesome lesion.

Carbon Dioxide↗