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Biomedical subjects

J Ansley

Publications and source records attributed to J Ansley.

14 recordsLinked to original sources
PubMed2001

Lack of utility of postoperative chest radiograph in pediatric tracheotomy.

OBJECTIVE: To assess the incidence of pulmonary complications after nonemergent pediatric tracheotomy and to determine whether obtaining a routine postoperative chest radiograph is warranted. STUDY DESIGN: Retrospective review of the records of 107 consecutive patients (age 1 month to 18 years) who underwent tracheotomy from October 1994 to June 2000. Main outcome measures included frequency of pulmonary complications and use of information obtained from postoperative chest radiograph for intervention. SETTING: Tertiary care university children's hospital. RESULTS: No pneumothoraces or significant pulmonary complications were detected in the immediate postoperative period. No management changes were undertaken as a result of information obtained from any chest radiograph in this period. CONCLUSIONS: The incidence of significant pulmonary complications after pediatric tracheotomy is low. Little information is obtained from chest radiograph after tracheotomy, and this information does not change management. SIGNIFICANCE: Routine postoperative chest radiograph after pediatric tracheotomy is not indicated in all patients.

Adolescent↗
PubMed2000

Apoptosis in the developing human cricoid cartilage: a pilot study.

Apoptosis is widely recognized as a major phenomenon in normal development. Deficiencies in this process may lead to developmental abnormalities such as congenital subglottic stenosis. We studied apoptosis using in situ end labeling of the 3'-OH ends of fragmented DNA in 5 progressively older, normal, human cricoid cartilage specimens. Results show that apoptosis is a very active process in fetal and neonatal tissue. The process gradually slows with advancing age. In the 4- and 13-year-old specimens, minimal to no apoptosis was seen. We conclude that apoptosis plays a critical role in the intraluminal and extraluminal expansion of the cricoid cartilage.

Adolescent↗
PubMed1994

Emotional correlates of fluency test and maze performance.

This study tested the hypothesis that depression, anxiety, and bizarre thought content, as measured by MMPI-2 scales, would show a negative relationship with performance on widely used measures of executive functioning. Subjects were 70 male psychiatric patients who were ostensibly free of any neurologic disease or history of substance abuse. Correlational analyses were performed between age and education-corrected scores on the Controlled Oral Word Association Test (FAS), Design Fluency, and WISC-R Mazes, and scores on MMPI-2 scales D, PT, Anxiety, Fears, Obsessional Thinking, Depression, and Bizarre Mentation. The findings suggest that fluency and maze performance is (1) largely independent of measures of depression (D, DEP) and bizarre mentation (BIZ); (2) mildly associated with a measure of generalized anxiety (ANX); and (3) strongly related to an MMPI-2 measure of fearfulness (FRS).

Adult↗
PubMed1994

MMPI correlates of poststroke neurobehavioral deficits.

MMPI profiles of 130 male veterans with cerebrovascular accidents were examined in relation to type and degree of neuropsychological deficit, hemispheric location of lesion, and time poststroke. Three neurobehavioral factors (Verbal, Visuospatial, Sensorimotor) were extracted from the Halstead-Reitan Battery and Wechsler Memory Scale. Canonical analyses revealed verbal impairment to be associated with greater openness in reporting emotional difficulties (Scale F) and limited social facility (Scale Hy). Sensorimotor deficits were associated with anxiety and distress (Pt) in patients with left hemisphere (LHD) but not right hemisphere damage (RHD). Although RHD and LHD patients had similar composite MMPI profiles, neuropsychological deficits in RHD were unrelated to MMPI scores. Time poststroke was independent of MMPI findings in both LHD and RHD samples.

Journal Article↗
PubMed1981

Hyperalimentation of the cancer patient with protein-calorie undernutrition.

Because protein-calorie undernutrition is common in patients with neoplastic disease, nutritional support is often recommended. It is uncertain, however, that methods of supplemental alimentation successful in noncancerous subjects are suitable in cancer patients. We measured elemental balances, serum proteins, anthropometrics (triceps skinfold and mid-arm muscle area), and creatinine/height ratio in 15 undernourished patients with advanced cancer and in 10 noncancer undernourished controls during central venous or enteral hyperalimentation and found the following. (a) During central venous hyperalimentation, cancer patients showed significantly less improvement than the noncancerous controls in body weight (median increment, 5 kg in cancer patients and 8.5 kg in noncancerous), albumin (0.1 g/dl in cancer patients and 0.5 g/dl in noncancerous patients), creatinine/height ratio (4% of standard in cancer and 10% of standard in noncancer), and mid-arm muscle area (4% of standard in cancer and 11% of standard in noncancer). During enteral hyperalimentation, gains in body weight and albumin by cancer patients were significantly inferior to those in noncancerous subjects. Triceps skinfold increments, in contrast, were similar during both central venous and enteral hyperalimentation for cancer and noncancerous patients. (b) While nitrogen retention was similar in cancer and noncancer patients, the cancer group retained significantly less magnesium and phosphorus (delta Mg in cancer patients, 3.2 mEq/day central, -2.7 mEq/day enteral; delta Mg in noncancer patients, 11.9 mEq/day central, 10.1 mEq/day enteral; delta P in cancer patients, 0.13 g/day central, 0.07 g/day enteral; delta P in noncancer patients, 0.27 g/day central, 0.33 g/day enteral). The poorer balances of cancer patients were caused by increased urinary, not fecal, loss. These findings indicate a partial block in repletion of lean body mass or abnormal composition of newly deposited lean body mass when undernourished patients with advanced cancer receive hyperalimentation.

Adult↗
PubMed1981

Hypotyrosinemia, hypocystinemia, and failure to retain nitrogen during total parenteral nutrition of cirrhotic patients.

Six patients with gastrointestinal malabsorption and 12 with alcoholic cirrhosis received total parenteral nutrition for 4 wk. Freamine II, the source of the amino acids, is nearly devoid of cystine and tyrosine. We monitored daily nitrogen balance and other nutritional parameters and 22 plasma amino acids. Malabsorbers had a strongly positive nitrogen balance and improvements in nutritional parameters. Plasma amino acids were maintained within or above their normal fasting ranges. Eight of 12 cirrhotics resembled malabsorbing patients in terms of positive nitrogen balance, improved nutritional parameters, and plasma amino acids. In 4 cirrhotics, nitrogen balance remained negative and nutritional repletion failed to occur. Plasma cystine and tyrosine fell to below 30% of their normal fasting means. In 2 of these patients, oral supplements of cystine and tyrosine were given during the fifth week of parenteral nutrition. Plasma cystine and tyrosine were normalized, nitrogen balance became positive, and other repletion indicators demonstrated recovery. We conclude that in 4 cirrhotics, repletion was blocked by deficiencies of cystine and tyrosine, resulting from hepatic inability to synthesize cystine from methionine and tyrosine from phenylalanine.

Amino Acids↗
PubMed1981

Enteral versus parenteral nutritional support in cancer patients.

There are many theoretical and practical advantages to enteral rather than parenteral administration of nutrients. However, it is unlikely that enteral supplementation of nutritional intake as presently practiced will be successful as a primary therapy for most patients with the cancer cachexia syndrome. The most likely role of enteral nutritional support (ENS) is in conjunction with other therapies. This modality deserves evaluation in surgery with curative intent. Changes in diet are effective in reducing the gastrointestinal symptoms of abdominopelvic irradiation, but the effect of ENS on the hematologic toxicity of radiation therapy and on response rates and survival is unclear. Elemental diets can reduce the gastrointestinal toxicity of conventional doses of 5-FU, but they worsen the mortality and hematologic toxicity of higher doses. Factors such as protein, fat, and carbohydrate sources, degree of hydrolysis of protein, lactose content, and timing of dietary manipulations are important in evaluating the response to ENS.

Animals↗
PubMed1981

Total parenteral nutrition as an adjunct to chemotherapy of metastatic colorectal cancer.

A randomized study was performed in advanced cancer to test the effectiveness of total parenteral nutrition (TPN) in maintaining and improving nutrition, to examine the effects of TPN on tumor growth, and to determine if TPN altered chemotherapy response rates, treatment tolerance, and survival. Forty-five patients on identical chemotherapy were randomized to TPN versus ad libitum feeding. TPN was well tolerated. No clinical or tumor marker evidence suggesting neoplastic growth stimulation was obtained. Chemotherapy-related complications and chemotherapy responses did not differ between the two groups. TPN had little effect on performance status. TPN patients gained an average of 2.8 kg before chemotherapy, but triceps skinfold and mid-arm muscle area did not change significantly during TPN. Survival did not improve with TPN. We conclude that current techniques of TPN are of limited benefit in advanced colon cancer. A small subset of patients with short-gut malabsorption may be helped. Further study is needed to determine the mechanisms of cancer undernutrition and to refine nutritional supplementation techniques on the basis of these mechanisms.

Adenocarcinoma↗
PubMed1981

Effect of total parenteral nutrition on survival in advanced colon cancer.

To determine if total parenteral nutrition (TPN) with constant infusion of hypertonic glucose and amino acids by central vein (35 kcal/kg/day) would influence survival in advanced colorectal carcinoma, 50 patients were randomized to receive either chemotherapy alone or the same drugs plus TPN for 14 days before treatment and a variable period thereafter. Overall median survival was significantly decreased in the TPN patients (79 vs 305 days, P = 0.03). Survival was significantly decreased in the TPN patients who had lost the least percentage of premorbid weight (0-6%) (66 vs 398 days, P = 0.02), and in all TPN males (61 vs 209 days, P = 0.03), when compared to similar controls. TPN did not increase survival in any patient subcategory. Catheter-related and metabolic complications were uncommon. We conclude that TPN as used in this study did not prolong median survival in the group as a whole, and may have shortened survival in males and in patients with little or no prior weight loss.

Adolescent↗