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Biomedical subjects

K Reilly

Publications and source records attributed to K Reilly.

At least 37 records · Page 2Linked to original sources
PubMed1992

Midazolam versus fentanyl as premedication for painful procedures in children with cancer.

Premedication for painful procedures in children with cancer is not routinely used. Many medications used are only intermittently effective or require special equipment or anesthesia support. In a randomized, double-blind, crossover study, the safety and efficacy of midazolam, a short-acting benzodiazepine, were compared with the safety and efficacy of fentanyl, a short-acting narcotic analgesic. In 25 children studied, 100% of children and their parents preferred study drugs to any previous premedication. Seventy-two percent preferred midazolam to fentanyl. Preprocedural anxiety, adverse behavioral symptoms, and visual analog scales all improved and side effects were minimal. It is concluded that premedication for painful procedures should be used routinely in children with cancer. With proper monitoring, fentanyl and midazolam can be used safely in the outpatient clinic setting. Midazolam was found to be the drug of preference for the majority of patients.

Adolescent↗
PubMed1991

The rational ordering of blood cultures in the emergency department.

A large number of patients with febrile illness are evaluated in emergency departments. Blood cultures are often obtained on such patients without reference to established guidelines. As a result of such practice, unnecessary blood cultures are being ordered with negative financial impact on both hospitals and patients. Generally speaking, as the number of blood cultures obtained increases so does the number of false positive results. Follow-up on these results directly impacts on patient care as these patients are often subjected to call backs, additional work up, and admission to the hospital. This study reviews the manner in which blood cultures were ordered before and after the introduction of general guidelines for their use. It outlines a process whereby excessive ordering of blood cultures can be eliminated and suggests that this approach may be effective in limiting inappropriate use of other laboratory and diagnostic studies.

Blood Specimen Collection↗
PubMed1990

The role of the aortic aneurysm diameter aortic diameter ratio in predicting the risk of rupture.

This study was performed to examine the ratio between the size of an infrarenal aortic aneurysm and the normal aorta proximal to it, in the hope of identifying a high-risk group of patients. All patients underwent a computed tomography scan of the abdomen, at which time the diameters of the largest aneurysm and of the normal proximal aorta were measured. The ratio was calculated by dividing the diameter of the normal aorta (in centimetres) into the diameter of the aneurysm. One hundred and thirty patients were assessed. One hundred asymptomatic patients had a mean ratio of 2.0. The 30 symptomatic patients were subdivided into 2 groups; 17 were symptomatic but had no evidence of rupture (mean ratio 2.7), and the remaining 13 had a contained rupture (mean ratio 3.4). There was a significant difference between the asymptomatic patients and the two symptomatic groups (P less than 0.001). The results suggest that the aneurysm/aorta ratio may be helpful in identifying the high-risk aneurysm. Patients with a ratio of 2.7 or greater are likely to become symptomatic, whereas those with a ratio of 3.4 or greater are at risk of rupture.

Aorta, Abdominal↗
PubMed1990

Atypical presentation of pulmonary embolism.

Today we have discussed an interesting patient with an atypical presentation of pulmonary embolism. We have outlined a suggested algorithm to aid in the diagnosis and management of this disease. References 8 through 24 in the reference section are suggested readings that offer further insight into the diagnosis and management of this entity.

Aged↗
PubMed1989

Differences between a supervised and independent strength and conditioning program with chronic low back syndromes.

The purpose of this study was to evaluate changes in physiologic parameters seen in a group of patients with chronic low back syndrome assigned to supervised and independent strength and conditioning programs. Forty patients with chronic low back syndrome were assigned either to a control group (independent exercise) or to an experimental group (supervised exercise). All subjects underwent pre-testing for aerobic fitness, strength and responses to visual analog pain rating scales. Twenty control subjects were given predesigned exercise programs and told to exercise four times per week for 6 months. Twenty experimental subjects were given predesigned exercise programs but were monitored by a strength and conditioning specialist for the same period. Statistically significant results were seen for increases in aerobic fitness and strength, decreases in reported pain, and percent body fat in the experimental group. Since the experimental group completed 90.75 sessions out of 96, compared with 31.95 for the control group, it could be concluded that supervision increases chances for compliance and success as measured by these parameters.

Back Pain↗
PubMed1988

Linguistic status subsequent to childhood immersion injury.

The linguistic abilities of two groups of children who had been involved in immersion incidents are reported--one group at 12 months after the immersion incident (n = 25), and the second group at five years after the immersion incident (n = 9). The performances of the two experimental groups on standardized language tests were compared with the performances of appropriate control groups that were matched for age, sex and socioeconomic status. The speech and language skills of the 12-months post-immersion group and the matched control group were assessed by means of the sequenced inventory of communication development. Subjects who were assessed 12 months after the immersion injury scored significantly lower results than did control subjects on receptive and expressive language ages that were calculated as percentages of the chronological age. No differences in language scores were evident between the subjects who were at five years after the immersion incident and their control subjects as assessed by the test of language development--primary. The language abilities of the victims of an immersion incident were correlated with their neurological status at presentation to hospital. The results suggest a need to monitor the linguistic development of all children who present initially in a coma after an immersion incident. The need for a longitudinal study of the linguistic abilities of these children is indicated.

Child, Preschool↗
PubMed1987

Leukocyte depletion enhances cultured endothelial retention on vascular prostheses.

Approximately 90% of endothelial cells that are seeded or cultured onto vascular prostheses are lost from the flow surface within 24 hours of implantation. To determine the contribution of leukocytes to endothelial cell loss, 111In-labeled, cultured canine jugular venous endothelial cells were grown to confluence on fibronectin-coated polyester elastomer tubes measuring 4 mm inner diameter and 30 mm in length. Autogenous cell-lined tubes were implanted as bilateral carotid replacement grafts in six dogs made leukopenic by cyclophosphamide. Similar unilateral grafts were placed in 12 control dogs. Grafts were removed and perfusion-fixed from six control animals after 2 hours of in vivo arterial perfusion and from the other six animals after 6 hours of perfusion. One graft was removed and perfusion-fixed from each leukopenic animal after 2 hours of implantation and the other after 6 hours. Attachment of endothelial cells to the grafts was measured by indium-labeling technique. Retention of endothelium on grafts removed after 2 hours was measured by planimetric counting with scanning electron microscopy and on those removed after 6 hours by radioisotope quantification. Endothelial cell retention after 2 hours was 37.6% +/- 27.0% in control dogs and 97.0% +/- 3.4% in leukopenic animals (p less than 0.0007). After 6 hours retention was 35.9% +/- 23.2% in control animals and 86.5% +/- 6.0% in leukopenic animals (p less than 0.0009). Leukocyte surface activity was present in less than 1% of the leukopenic dogs compared with 8.5% of the other in vivo midgrafts after 2 hours. These results suggest that leukocytes play a significant role in the loss of seeded endothelium from vascular prostheses.

Animals↗
PubMed1985

The presence in blood of both glycosaminoglycan and mucosal mast cell protease following systemic anaphylaxis in the rat.

The appearance in blood of rat mast cell protease II (RMCPII) and glycosaminoglycan (GAG) was examined in normal and Nippostrongylus brasiliensis-primed rats challenged intravenously with worm antigen. Systemic release of these two products occurred only in immune recipients of antigen; substantial levels of RMCPII were also present in the intestinal perfusates of these same rats and there was depletion of both RMCPII and mucosal mast cells (MMC) from the intestinal mucosa. Depletion of MMC was evident after staining for proteoglycan or for serine esterase and the mast cell counts with both histochemical techniques were highly correlated. Taken together, the results suggest that MMC are likely to be the principal source of secreted GAG and RMCPII.

Anaphylaxis↗
PubMed1983

The role of cephalexin in the treatment of skin and soft-tissue infections.

Cephalexin remains an effective and highly useful antibiotic for the treatment of streptococcal and staphylococcal skin infections. Twelve years of experience have not diminished its efficacy, and cure rates of 90% or higher continue to be achieved. Its resistance to degradation by gastric acid and its uniform absorption ensure its bioavailability, and its efficacy in twice-daily dosages enhances medication compliance. The suspension formulation is well accepted by young children, and side effects have generally been mild and infrequent. Cephalexin is comparable to erythromycin, clindamycin, dicloxacillin, cloxacillin, and other cephalosporins in the treatment of streptococcal and staphylococcal infections. Because many of these antibiotics are similar in their efficacy, palatability, and adverse reactions, cost factors may play an important role in choosing one over the other. Penicillin remains the drug of choice for streptococcal skin infections. If the cure rates of the mixed streptococcal-staphylococcal lesions continue to decrease with penicillin, cephalexin and the other alternative antibiotics may assume a more important role in the primary treatment of these infections in the future.

Adolescent↗
PubMed1982

The production of varicella Zoster virus antiserum in laboratory animals. Brief report.

Hyperimmune anti-varicella zoster virus (VZV) antisera were prepared in BALB/c mice, Lewis rats and New Zealand rabbits by subcutaneous inoculations of purified VZ virions suspended in Freund's adjuvant. VZV antibodies were demonstrated both by an enzyme-linked immunosorbent assay (ELISA) and by indirect immunofluorescence (IF). VZV could not be detected in organs of any inoculated animals by IF or by cocultivation of tissue fragments from infected animals with human diploid fibroblasts.

Animals↗
PubMed1977

Comparative evaluation of different types of blood culture media for isolation of aerobes.

The possible advantage of hypertonic sucrose medium over isotonic medium for isolating aerobic organisms from blood was studied. Approximately 50 ml of medium and 5 ml of blood inoculum were present in each culture bottle. In the first phase of the study, supplemented peptone broth (SPB) was compared with brucella broth containing 10% sucrose (BB-10S). There were 194 significant clinical isolates in at least one of the two bottles in each set during a 7-month period; 160 (82%) of the isolates grew in SPB, whereas 191 (98%) grew in BB-10S (P less than 0.01). Of the 158 isolates that grew in both media, 13 (8%) appeared earlier in BB-10S, whereas none did so in SPB. In the second phase of the study, SPB with 10% sucrose (SPB-10S) was compared with BB-10S. There were 187 isolates during a 9-month period; 173 (93%) grew in SPB-10S compared with 179 (96%) for BB-10S. In this comparison there was no apparent difference in the time interval required for recovery of organisms. The two hypertonic sucrose media (SPB-10S and BB-10S) were comparable for isolating organisms under aerobic conditions and superior to the nonhypertonic medium (SPB).

Aerobiosis↗