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Biomedical subjects

J McAloon

Publications and source records attributed to J McAloon.

11 recordsLinked to original sources

Infantile chest hamartoma--case outcome aged 11.

Chest wall hamartoma of infancy is a rare lesion, usually presenting in the first year of life. Recent literature has recommended conservative management of asymptomatic children, yet most continue to undergo surgical resection irrespective of their symptom status. We report a case of spontaneous regression of a chest wall hamartoma of infancy, supporting recommendations for conservative management in asymptomatic children.

Child↗

Sustained inflations improve respiratory compliance during high-frequency oscillatory ventilation but not during large tidal volume positive-pressure ventilation in rabbits.

OBJECTIVE: To determine whether volume recruitment maneuvers that induce significant lung reexpansion during high-frequency oscillatory ventilation are also of value during conventional positive-pressure ventilation. DESIGN: Crossover comparison of volume recruitment maneuvers administered during high-frequency oscillatory ventilation and positive-pressure ventilation in normal and surfactant-deficient adult rabbits. SETTING: Laboratory. SUBJECTS: Nineteen adult New Zealand white rabbits (weight 2.3 to 3.3 kg). METHODS: Respiratory system compliance was measured plethysmographically before and after sustained inflations in six normal and five saline-lavaged anesthetized rabbits, using both ventilators over a range of mean and end-expiratory pressures. RESULTS: Under conditions where sustained inflations during high-frequency oscillatory ventilation at 15 Hz increased respiratory system compliance 50 +/- 28%, sustained inflations during conventional positive-pressure ventilation at a rate of 30 to 40 breaths/min and tidal volumes of 14 to 17 mL/kg did not change respiratory system compliance (mean change 3 +/- 9%). Sustained inflations during conventional positive-pressure ventilation could not be made effective by increasing the positive end-expiratory pressure level to equal the mean pressure during high-frequency oscillatory ventilation. Sustained inflations on conventional positive-pressure ventilation remained ineffective up to positive end-expiratory pressure levels of 17.5 cm H2O. In lavaged rabbits, sustained inflations increased respiratory system compliance 49 +/- 14% during high-frequency oscillatory ventilation and 0 +/- 3% during conventional positive-pressure ventilation. Sustained inflations increased compliance significantly during conventional positive-pressure ventilation only when ventilating with tidal volumes of 7 mL/kg and low end-expiratory pressure. CONCLUSIONS: Active recruitment of lung volume during high-frequency oscillatory ventilation appears necessary, because small pressure/volume cycles adequate to support high-frequency gas transport are not able to reexpand atelectatic lung units without the aid of a sustained inflation. We conclude that volume recruitment maneuvers improve respiratory system compliance substantially during high-frequency oscillatory ventilation at 15 Hz, but these maneuvers offer potential risk and no benefit during conventional positive-pressure ventilation with large tidal volumes or when using smaller tidal volumes and high levels of positive end-expiratory pressure.

Airway Resistance↗

Study of gypsum-bonded casting investments. Part 2.

The simultaneous differential thermal analysis--thermogravimetry (DTA-TG) method used in Part 1 of this two-part study was extended to analyse two gypsum-bonded dental casting investments, Kerr Cristobalite Inlay and GC Cristobalite Micro. Both investments had a similar cristobalite content of about 70 per cent. The remaining 30 per cent was dental stone in GCM, and a mixture of plaster and dental stone in KCl. Inclusion of plaster in KCl appeared responsible for the greater amount of water required for mixing this investment. The DTA-TG method used in the present study can be applied to identify the type and amount of hemihydrate, and the type of silica, in currently available gypsum-bonded investments.

Calcium Sulfate↗

Evaluation of paediatric intensive care in a regional centre.

All 162 consecutive admissions to a multidisciplinary paediatric intensive care unit in the UK have been prospectively evaluated in terms of therapeutic intention, sickness levels, age, utilisation of resources, and outcome. For 101 (62.3%) of the children admitted the aim of treatment was to cure the condition but for 30 (18.5%) ultimately only a palliative option was available. Five children were admitted to avail of specialised monitoring facilities. One half of the children admitted were physiologically unstable. The majority (102, 62.9%) were age 12 months or less. Resource utilisation, which was not affected by therapeutic intention, was greatest for the sickest patients, those age 1 month or less and non-survivors. Mortality rate overall was 17.9%. Mortality was unaffected by age and therapeutic intention and was inversely related to level of sickness. The information provided by this study forms a basis for medical audit within the unit and is essential for meaningful comparisons of standards of care and outcome with other units.

Adolescent↗

Cerebral oedema complicating diabetic ketoacidosis.

Signs of raised intracranial pressure (ICP) developed during treatment of diabetic ketoacidosis in a young child. A CT scan revealed cerebral oedema and direct measurement confirmed elevated ICP. Aggressive treatment was successful in maintaining cerebral perfusion pressure. The child survived with mild handicap in contrast to the poor outcome of previous reports.

Brain Edema↗

Management of childhood urinary tract infection.

Experience with childhood urinary tract infection is reviewed in conjunction with recent information on the management of the problem by family practitioners in the same health board. The need for bacteriological confirmation of the diagnosis in every case is confirmed and the importance of radiological investigation of the urinary tract after a first infection irrespective of age or sex is emphasised, as 17% of intravenous pyelograms and 31% of micturating cystogram examinations showed significant abnormality.

Child↗

Management of childhood urinary tract infection in family practice.

To find out to what extent doctors appreciate the potential damage that bacteriuria may cause, we sent questionnaires to 195 family practitioners and trainees in one health board in Northern Ireland. The results of the survey showed that, though doctors seemed to be aware of the risk of renal disease, this was not reflected in practice.

Bacteriuria↗