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Biomedical subjects

J Connell

Publications and source records attributed to J Connell.

At least 37 records · Page 2Linked to original sources

Predictive value of early continuous electroencephalogram monitoring in ventilated preterm infants with intraventricular hemorrhage.

The contribution of early continuous four-channel EEG monitoring to the evaluation of intraventricular hemorrhage in acutely ill preterm infants mechanically ventilated for acute respiratory distress was assessed in a prospective study of 54 infants of less than 34 weeks' gestation. Early abnormal EEG results correlated significantly with later outcome. They often preceded ultrasound evidence of hemorrhage and provided prognostically significant functional correlation with the grade of hemorrhage. Continuous EEG monitoring allows collection of significant data with minimal interference and could contribute to clinical management of high-risk preterm infants.

Cerebral Hemorrhage

Mortality in Niue, 1978-82.

This report is an analysis of mortality in the population of Niue Island over the years 1978-82. The overall level of mortality in Niue is low. Life expectancy at birth is correspondingly high (66.5 years). Because of the extensive migration of Niueans during the period of study the death rate may be underestimated and the life expectancy correspondingly overestimated. Infant mortality has dropped from over 200 deaths per 1000 live births during the 1940s to around 10 per 1000 during the period under study. The major causes of premature mortality in Niuean males were injury/poisoning followed by cardiovascular disease. In females infection, injury/poisoning and neoplasia were the major causes of mortality. The 1980 epidemic of dengue fever had an appreciable effect on mortality in this small population. Except for dengue fever, the pattern of mortality in Niue is similar to that in many developed countries. Preventive efforts against metabolic and cardiovascular disease (including hypertension and diabetes) should continue in order to control mortality from these causes, Mosquito programmes, and emergency measures if epidemics threaten, are required so that deaths from haemorrhagic dengue are prevented.

Adolescent

Continuous four-channel EEG monitoring in the evaluation of echodense ultrasound lesions and cystic leucomalacia.

Continuous monitoring by electroencephalography (EEG) was performed in 31 preterm infants with echodense ultrasound lesions using the Oxford Medilog four channel recorder. In 12 infants these densities preceded cyst formation, eight in the periventricular and four in the subcortical region. In the 19 other infants the densities resolved. The most severe EEG depression occurred in the four infants with subcortical cysts, who also had the poorest outcome. Six of eight infants with periventricular lesions had lesser degrees of abnormality though all infants had moderate to severe handicap at follow up. Similar abnormalities were seen on EEG recording in three infants in whom the densities resolved without cyst formation and these infants also had an abnormal outcome. An abnormal EEG recording provides a sensitive early guide to the severity and prognosis of these lesions, even before they can be seen on ultrasonography.

Brain Ischemia

A case of pancreatitis associated with gastrinoma.

A case is presented of a 56 year old man with a history of idiopathic pancreatitis and multiple admissions for Klebsiella sepsis from an intra-abdominal focus, who in February 1980, developed spontaneous jejunal perforations on two occasions due to multiple ulcers in the small intestine associated with multiple hepatic metastases from a gastrin-secreting islet-cell tumor (gastrinoma) of the pancreas. On searching the literature, no other record could be found of an association between pancreatitis and a gastrinoma, although in this patient the two disease processes appear to be inextricably related.

Acute Disease

Localized tick bite reaction.

A woman presented with a localized tick bite reaction. The tick (Amblyomma americanum, the "lone star" tick) was still attached to the erythematous, indurated skin of the upper back. After several unsuccessful attempts at removal, a punch biopsy was performed, and the resultant histologic sections incorporated both tick and involved skin. The various systemic and localized tick bite reactions are discussed, as are the diagnostic dilemmas which may arise when the organism is no longer present. Punch biopsy is suggested as an effective means of removing the organism.

Aged

Popliteal vein entrapment.

A case of popliteal vein entrapment by an abnormal 'third' head of the gastrocnemius muscle is reported. Complete relief of disabling symptoms was obtained by dividing the abnormal muscle band.

Adult

Carotid body tumours.

Carotid body tumours are rare, but important. Their reputation for slow growth and virtual non-malignancy has had, in the light of experience, to be revised. Sudden spurts of growth are well known, and the tumour may become irremovable in a relatively short time. Aggressive local invasion and widespread metastasis are now well recognized. Histological features are no guide to malignancy. These tumors can nearly all be removed with an acceptable mortality and morbidity, without damage to the internal carotid artery. Ideally the diagnosis should be made by clinical acumen and confirmatory X-ray examination. Biopsy makes subsequent removal of the tumour much more difficult, and should be avoided if at all possible. Eleven personal cases of carotid body tumours are reported, and the technique of surgical excision is discussed in detail.

Adult

Magnesium bullets.

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Animal Nutritional Physiological Phenomena