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Biomedical subjects

J H Seashore

Publications and source records attributed to J H Seashore.

51 records · Page 3Linked to original sources
PubMed1978

Excision of pulmonary and renal aspergillomas. Its use in treating chronic granulomatous disease of childhood.

Renal and pulmonary Aspergillus granulomas in two 6-year-old boys with chronic granulomatous disease were treated by nephrectomy and lobectomy as well as intravenous amphotericin B and granulocyte transfusion. After lobectomy two smaller pulmonary aspergillomas resolved with medical therapy. The second child's condition improved after nephrectomy, but he died with disseminated Aspergillus infection. This experience suggests that surgical excision of localized Aspergillus granulomas in conjunction with specific antimicrobial therapy provides temporary clinical improvement and may prevent further blood-borne dissemination of the fungus.

Aspergillosis↗
PubMed1978

Radiographic aspects of total parenteral nutrition during infancy.

In a retrospective radiographic study the authors reviewed the position of 82 central venous catheters in 57 consecutive infants receiving total parenteral nutrition between 1972 and 1976. Sixteen of the 82 catheters (19%) were initially not positioned within the superior vena cava and 11 (14%) migrated from a satisfactory position during therapy; peripheral edema, pleural effusion, and vascular thrombosis occurred more frequently in this group than in those infants with the catheter remaining in the superior vena cava. Unusual complications of intersititial pulmonary edema, hydrocephalus, and cardiac arrhythmia were noted in three different patients. An increased incidence of clinical complications is associated with catheter malposition or migration during total parenteral nutritional therapy. Radiographic monitoring with repositioning or removal of a malpositioned catheter may reduce the number of clinical complications.

Catheterization↗
PubMed1975

Hepatic secretory obstruction with total parenteral nutrition in the infant.

Transient hepatic secretory obstruction manifested primarily by chemical evidence of cholestasis with a conjugated bilirubin above 2.0 mg/100 ml occurred in eight of 19 neonates and infants receiving total parenteral nutrition. The incidence of cholestasis was greater in the premature than full-term infant. Prospective determinations of conjugated bilirubin and 5' nucleotidase are essential to detecting cholestasis before jaundice becomes obvious. These tests are more sensitive than serum alkaline phosphatase which normally rises after birth and during periods of accelerated osteoblastic activity. Preliminary data indicate that the 5' nucleotidase is the most sensitive indicator of secretory obstruction and may become elevated in patients with a normal direct bilirubin. The etiology of hepatic cholestasis during total parenteral nutrition is unknown but is presumed to be caused by interference with hepatocellular enzymes controlling bile secretion; immaturity of these enzyme systems increases the risk of secretory obstruction.

Alkaline Phosphatase↗
PubMed1975

Treatment of gastroschisis and omphalocele with biological dressings.

Porcine skin grafts and human amniotic membranes have been used as biological dressings for the treatment of gastroschisis or omphalocele in 16 newborn infants. Eleven infants with gastroschisis were managed initially by the Silastic pouch technique but delayed healing resulted in separation of the Silastic sheeting from the wound margins and required use of biologic dressings to achieve complete closure. Biological dressings were used in five patients with intact omphaloceles for all or part of their course. Average time to achieve complete closure was 55 days. Three patients died of associated anomalies. One patient developed an enteric fistula. Biologic dressings appear to be useful adjuncts in the management of some patients with gastroschisis or omphalocele.

Abdominal Muscles↗
PubMedDate not supplied

Femoral nerve injury following inguinal hernia repair.

Insidious leg pain and weakness followed inguinal hernia repair. Despite the temporal relationship of the surgery and the symptoms, the diagnosis proved elusive, in part, because of the rarity of the complication.

Child↗
PubMedDate not supplied

Hyperammonemia during total parenteral nutrition in children.

Serial blood ammonia (NH3) determinations in 19 low birth weight (LBW) infants, 14 term neonates and 12 children receiving total parenteral nutrition (TPN) have shown that 73% of patients had one or more elevated NH3 values (greater than 150 micrograms/dl). The mean blood NH3 was 220 +/- 13 micrograms/dl in LBW infants, 180 +/- 9 micrograms/dl in 10 infants, and 140 +/- 7 micrograms/dl in children. All of these values are significantly higher than normal (p less than 0.001). There was no difference in incidence or mean blood ammonia concentration between patients receiving casein hydrolysate and those receiving a crystalline amino acid solution. Only four patients were symptomatic and several infants remained fully alert despite blood NH3 concentration in excess of 400 micrograms/dl. One infant who had sustained hyperammonemia was given another amino acid source (Travasol) containing 1.2 mmol/dl of arginine; blood NH3 promptly fell to the normal range. However, six of seven additional infants had hyperammonemia while receiving Travasol (mean = 184 micrograms/dl). Hyperammonemia is common during TPN in children, often is not recognized clinically, and occurs with equal frequency in infants and older children. The high levels observed in LBW infants may be due to hepatic immaturity. Blood NH3 concentration should be monitored frequently during TPN. Persistent hyperammonemia should be treated by decreasing protein content of the infusate. The role of supplemental arginine is unclear.

Adolescent↗
PubMedDate not supplied

Nutritional support of children in the intensive care unit.

Nutritional support is an integral and essential part of the management of 5-10 percent of hospitalized children. Children in the intensive care unit are particularly likely to develop malnutrition because of the nature and duration of their illness, and their inability to eat by mouth. This article reviews the physiology of starvation and the development of malnutrition in children. A method of estimating the nutritional requirements of children is presented. The techniques of nutritional support, including enteral, peripheral, and central parenteral nutrition are discussed in detail. Appropriate formulas are given for different age groups. Electrolyte, vitamin, and mineral supplements are discussed. Guidelines are provided for choosing between peripheral and central total parenteral nutrition. A monitoring protocol is suggested and complications of nutritional therapy are reviewed. Safe and effective nutritional support requires considerable investment of time and effort by members of the nutrition team.

Adolescent↗