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Biomedical subjects

L Malis

Publications and source records attributed to L Malis.

16 recordsLinked to original sources
PubMed1999

Ethical issues in the history of prophylactic antibiotic use in neurosurgery.

There has always been controversy about the indications for prescribing antibiotics to prevent postoperative sepsis in patients undergoing cranial and spinal surgery. The earlier specialists in infectious diseases warned that the effectiveness of antimicrobial drugs was leading to indiscriminate administration for the prevention of wound infection. Three clinical researchers present a review of the history of prophylactic antibiotic use in neurosurgery, including their own work, and raise a number of ethical issues not previously discussed in the literature about: (1) scientific methodology; (2) random selection; (3) prospective study; (4) blinded control; (5) placebo medication; (6) professional equipoise; (7) statistical analysis; (8) informed consent; (9) utilitarian philosophy; and (10) managed care. Also discussed are the dual role of physician and investigator and the ethical dilemma of depending upon meticulous technique versus adopting regimens of prophylactic antibiotics.

Antibiotic Prophylaxis↗
PubMed1984

A quantitative assessment of the brain stem auditory evoked response during intraoperative monitoring.

The brain stem auditory evoked response (BAER) was monitored intraoperatively in 11 patients with tumors of the posterior fossa. A technique for the objective quantitative assessment of the BAER based on the variance of the phase angle between small group averages is described. The resulting component synchrony measure corroborated standard peak latency and amplitude changes of the BAER during operative manipulation. A discussion of the replication and use of the objective measure is presented.

Brain Stem↗
PubMed1984

Application of phase spectral analysis for brain stem auditory evoked potential detection in normal subjects and patients with posterior fossa tumors.

A statistical test of the brain stem auditory-evoked potential (BAEP) detection is presented. The data were collected by averaging groups of 200 sweeps in order to obtain a set of group averages. The synchrony measure (SM), which represents the degree of reproducibility for group averages, is used as a statistical measure and is calculated from the phase variance for selected Fourier components of the group averages. The sensitivity of the test was demonstrated on 375 normal BAEPs with different stimulus intensities (45, 60, 75 dB SL) from both the ipsilateral and contralateral recordings, and on 82 BAEP recordings in the absence of stimulus. In all 375 cases of normal BAEPs the SM exceeds the threshold level while in the absence of stimulation the SM was below the threshold level. The clinical usefulness of the test was demonstrated on 22 patients with tumors of the posterior fossa. The absence of the BAEP was detected in 21 patients. In 12 out of 13 patients with lateralized tumors (acoustic neuromas), absence of the BAEP was noted for stimulation of the affected ear.

Adolescent↗
PubMed1980

Laboratory diagnosis of scabies.

All the above listed reasons as well as the experience we have obtained with this method, justify our recommendation of the introduction of the laboratory diagnosis of scabies through the method of lye scraping of the skin into routine practice. A single parasite element is enough for determining the diagnosis while, for the above mentioned reasons, a negative microscope finding does not exclude the parasitic etiology of the given disease. We therefore recommend in the diagnosis of scabies that the following criteria are parallely used: 1. an objective skin finding 2. laboratory proof of the causative agent of infestation 3. subjective feelings of the patient (itching at the typical time) 4. positive epidemiological anamnesis, primarily the occurrence of clinical symptoms in several members of a family or a group 5. diminishing of clinical symptoms after specific treatment with an anti-scabies medicament.

Adult↗