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Biomedical subjects

L Moore

Publications and source records attributed to L Moore.

At least 19 recordsLinked to original sources
PubMed1992

Late direct angioplasty in patients with myocardial infarction and fluctuating chest pain.

Myocardial infarctions may be associated with reduced but persistent blood flow to the infarct zone. We developed clinical criteria to select patients likely to have persistent perfusion to the infarct zone in the setting of acute myocardial infarction. Twenty-four consecutive patients with fluctuating pain and/or ST segment elevation who presented within 24 hours of the onset of infarction were studied with coronary angiography followed by direct percutaneous transluminal coronary angioplasty. Sixty-seven percent of patients had residual flow to the infarct territory. Eighteen patients had repeat angiography on day 9.4 +/- 4.1, and all arteries were patent (21% +/- 12% stenosis). Ejection fraction had risen from 50.0% +/- 15% to 54.0% +/- 14% (p less than 0.05). At follow-up (9.1 +/- 4.6 months), one patient died of noncardiac causes, and five redeveloped angina and underwent repeat procedures. Patients with fluctuating symptoms and/or ST segments are likely to have residual flow to the infarct zone, and late angioplasty may improve ventricular function in this group.

Angina Pectoris↗
PubMed1992

Clostridium botulinum and sudden infant death syndrome: a 10 year prospective study.

It has been proposed that sudden and unexpected death in infants due to intestinal infection with Clostridium botulinum may mimic the clinicopathological features of sudden infant death syndrome. Between 3.3 and 3.8% of infants in some series have had this neurotoxin-producing bacterium isolated on faecal culture. Prospective screening of 248 infants presenting with the sudden infant death syndrome to the Adelaide Children's Hospital over a 10 year period from 1981 to 1990 was conducted. Faecal samples were obtained from both small and large intestines and cultured specifically for C. botulinum. No samples were positive. The results of this study suggest that routine post-mortem culture of faeces for C. botulinum has been of limited use within the South Australian infant population over the last decade, and that occult botulism has not been a significant factor in the causation of sudden death.

Botulism↗
PubMed1992

Demographic characteristics and health behaviours of consenters to medical examination. Results from the Welsh Heart Health Survey.

STUDY OBJECTIVE: The aim was to compare the demographic characteristics and health related behaviours of people who consented to a medical examination as part of a population survey with those who did not. STUDY DESIGN: The study formed part of the (1985) Welsh Heart Health Survey, which comprised a three stage design involving household interview, self completion questionnaire, and medical examination. Subjects for medical examination were selected from responders to the questionnaire survey (67%). Sixty six per cent of this group consented to medical examination (n = 11,637). Odds ratio analysis techniques were used to compare consenters and non-consenters. MEASUREMENTS AND MAIN RESULTS: The analysis was based on self reported information available from previously completed questionnaires, and from personal interviews. The study supported the findings of previous research indicating that consenters to medical examination are more likely to be from non-manual social groups, to be aged 25-44 years, to be educated beyond school age, and to be married. Individuals with healthy lifestyle characteristics (diet, physical activity) were overrepresented among consenters. The only exception to this finding was in relation to excessive alcohol consumption. CONCLUSIONS: These findings emphasise the importance of maximising response rates in all forms of social research including surveys with a clinical component. They also have methodological and analytical implications for the Welsh Heart Health Survey.

Adolescent↗
PubMed1992

White sponge nevus presenting in the esophagus--case report and literature review.

White sponge nevus (WSN) is a rare inherited disorder which usually presents as non-painful white plaques primarily involving the buccal mucosa, gingiva and palate. Extra-oral lesions most often occur in the esophagus or anogenital area but almost invariably follow the development of typical buccal lesions. We present a non-familial case in which the first manifestation of the disease was in the esophagus in the absence of oral lesions. This sequence of events has not previously been reported in the literature. The cytohistological and electron microscopical appearances which allow the recognition and differentiation of WSN from other conditions presenting as esophageal white lesions are discussed.

Biopsy↗
PubMed1992

Sudden death in early infancy due to delayed cardiac tamponade complicating central venous line insertion and cardiac catheterization.

Cardiac tamponade is an unusual cause of sudden death in the first weeks of life. We present two cases of cardiac tamponade in the neonatal period that caused death 5 to 6 days following the insertion of intracardiac lines, to draw attention to the possibility of a "delay phenomenon" between the time of the initial procedure and the occurrence of sudden and unexpected death. The presence of blood or clear fluid within the pericardial sac should prompt careful examination of the myocardium for small foci of traumatic damage, particularly when the fluid is under pressure or of large volume. Although the development of circulatory impairment or shock in the days following central line insertion or catheterization raises the possibility of tamponade, it should be noted that sudden death may occur in the absence of any significant antemortem symptoms or signs.

Cardiac Catheterization↗
PubMed1991

Potentiation of the toxicity of model hepatotoxicants by acetaminophen.

A 24-hr oral pretreatment of rats with 1.6 g/kg acetaminophen potentiated hepatotoxicity of allyl alcohol, bromobenzene, carbon tetrachloride, 1,1-dichloroethylene, and thioacetamide, as assessed by elevation of serum alanine aminotransferase activity and histopathological examination. Doses, of these hepatotoxicants, which did not cause hepatocellular necrosis, became necrogenic after acetaminophen pretreatment with all toxicants except thioacetamide. Acetaminophen pretreatment did not decrease the threshold dose of toxicity for thioacetamide but did accentuate hepatotoxic doses. Acetaminophen pretreatment potentiated lethality of allyl alcohol and 1,1-dichloroethylene. Upon necropsy, these rats had congested livers and appeared to suffer from hypovolemic shock. We conclude that while acetaminophen was not necrogenic at the doses used in this study, it produced alterations that make hepatocytes much more susceptible to hepatotoxic insult.

1-Propanol↗
PubMed1991

Cocaine and the use of alcohol and other drugs during pregnancy.

Recent reports of adverse pregnancy outcomes associated with prenatal cocaine exposure have raised questions about the actual numbers of infants who are exposed to cocaine in utero. Whereas toxicologic urine screens obtained at delivery can detect cocaine use in the preceding few days, they fail to yield a comprehensive picture of use during and immediately before pregnancy. According to postpartum self-report, 15% of a teaching hospital sample and 3% of a private hospital sample of mothers had used cocaine during pregnancy or in the previous month (total = 876). Rates at the teaching hospital reflect a fifteenfold increase over the past 12-year period, when compared with previously obtained data. Cocaine users were significantly more likely to report that they drank alcohol, smoked cigarettes, and took other illicit drugs during pregnancy than women who denied using cocaine. Mothers at highest risk for cocaine use were those who were black (20%), were single-separated-divorced (24% to 33%), and had less than a high school education (21%).

Adolescent↗
PubMed1991

The relationship of tonsil bacterial concentration to surface and core cultures in chronic tonsillar disease in children.

Fifty-five tonsils removed for chronic tonsillar disease (chronic tonsillitis and obstructive tonsillar hyperplasia) underwent surface swab and quantitative core cultures in order to identify the relationship between core bacterial concentration and the presence of aerobic bacteria on the tonsil surface. The accuracy of a single core culture was further established by quantitative cultures of 9 sections per tonsil in an additional 19 tonsils. The results indicate that many (61.5%) but not all aerobic bacteria which were found in the tonsil core were cultured from the surface of the tonsil. Conversely, the tonsil core bacteria with the highest bacterial concentrations are more likely to be present on the tonsillar surface and the greater the bacterial concentration, the more likely the bacteria are to be found in most if not all areas of the tonsil core. Therefore, the core bacterial concentration appears to be related to the presence of aerobic bacteria on the tonsillar surface. Surface bacteria may not, however, be truly representative of the core bacterial environment. Implications for the management of chronic tonsillar disease will be discussed.

Bacteria↗
PubMed1991

Total anomalous pulmonary venous drainage and sudden death in infancy.

The clinicopathologic features of four infants with undiagnosed total anomalous pulmonary venous return who died suddenly and unexpectedly are presented. Two infants were found dead in their beds and two collapsed following very non-specific episodes of mild tachypnoea and tachycardia, respectively. Pulmonary venous blood drained via a common channel to the left innominate vein, the superior vena cava, the inferior vena cava at the junction of the hepatic vein and the supradiaphragmatic portion of the inferior vena cava. All cases demonstrated right atrial and ventricular hypertrophy and in one case there was associated hypoplastic left heart syndrome. Although those mechanisms responsible for sudden infant death syndrome could not definitely be excluded in two cases, the presence of anomalous pulmonary drainage with significant right-sided cardiac cardiac hypertrophy in each patient strongly suggests a contributing role for the vascular malformation in the aetiology of sudden unexpected death. The importance of careful in situ dissection of the major vessels in all cases of paediatric sudden death is emphasised, particularly in the presence of other congenital cardiac anomalies.

Cardiomegaly↗
PubMed1991

Effects of a smoker's hotline: results of a 10-county self-help trial.

The effect of a smokers' hotline as an adjunct to self-help manuals was examined. Subjects were 1,813 smokers recruited from a 10-county rural and small urban area. Counties were matched on demographic characteristics and assigned to a manual only or manual plus hotline condition. Subjects were followed over an 18-month period. Hotline services included taped messages and access to paraprofessional counselors. Results show a consistent, significant hotline effect across outcome measures and follow-up periods. This effect emerged either as a main effect for the hotline or as an interaction with enrollment method such that a significant hotline effect emerged for subjects who enrolled through face-to-face methods. These findings indicate the effectiveness of the hotline in enhancing self-help quit rates.

Adult↗
PubMed1991

Adrenal cortical tumors in childhood--clinicopathological features of six cases.

Six cases of adrenal cortical tumors are presented with a discussion of the clinical features and histological findings. Five of the 6 children, aged between 6 mths and 6 yrs, presented with symptoms of hyperadrenalism, 4 with virilization and 1 with Cushingoid features. The remaining infant presented with an asymptomatic abdominal mass. In each case there was a unilateral tumor separated from the residual adrenal gland by a thin fibrous capsule. Surgical resection was the treatment employed and, in the 5 cases with functional tumors, perioperative hydrocortisone was given. None of the children received post-operative chemotherapy or radiotherapy. Bizarre cellular morphology, a high mitotic count and extensive necrosis were all seen in clinically benign disease, demonstrating not only the efficacy of local resection but also the difficulty in applying the usual histological criteria of malignancy to these pediatric adrenal tumors. At follow-up, 5 of the 6 patients are alive with no evidence of recurrent disease. The only death resulted from measles pneumonitis in the 1 child who presented with Cushing's syndrome.

Adrenal Cortex Neoplasms↗
PubMed1991

Cyclosporine and the renin-angiotensin system.

Much is known about the renin-angiotensin system during cyclosporine treatment: plasma renin or prorenin activity seems to be raised in man and animals; hyperplasia of the juxtaglomerular apparatus has been reported in man and animals; renin concentration is known to be increased in animal kidneys; renin-angiotensin-like alterations in vascular contractility have been identified in animal vessels. Since the major functional side effects of cyclosporine are systemic vasoconstriction and renal vasoconstriction, the renin-angiotensin system could be involved. Also, an infrequent complication in man, vasculopathy, develops only in the afferent arteriole, where renin production is most abundant. Hence, this information is now reviewed and incorporated into a single pathophysiological concept, with the implication that renin activation plays a central role in the pathogenesis of cyclosporine-induced functional and structural lesions, merits further attention.

Animals↗
PubMed1991

Heart healthy education. Effectiveness of teaching methods in the workplace.

One fourth to one third of employed workers in this country have at least one of three major risk factors for coronary heart disease. This pilot study examined differences between educational methods used in an occupational setting. The specific aims of the quasi-experimental study were: to determine differences between two groups of subjects who received either group support and instruction or only written instruction; and to determine the association between the practice of heart healthy behaviors and decreased blood cholesterol levels. No significant differences were found between the two groups in cholesterol and behavior changes. However, there was a significant difference between pre- and post-instruction for all subjects. The study documented significant changes in cholesterol levels, cholesterol and fat intake, and weight reduction.

Adult↗
PubMed1990

Prostate specific antigen and local recurrence after radical prostatectomy.

We evaluated the location of recurrent disease in 63 patients with carcinoma of the prostate who had abnormal levels of prostate specific antigen (greater than 0.4 ng./ml., Tandem-R assay) 6 to 240 months after radical prostatectomy but who were otherwise considered to be without evidence of disease. The evaluation involved physical examination including digital rectal examinations by 3 urologists, isotopic bone scans, computerized tomography scans of the abdomen and pelvis, cystoscopy, and random needle biopsies of the urethrovesical anastomotic area. In 6 patients metastatic disease to the bone and/or lymph nodes was found and local prostate cancer was discovered in 5. Among 57 patients without evidence of disease by the usual methods of evaluation needle biopsies of the anastomosis revealed local disease in 42%. No local disease was discovered in 30 post-radical prostatectomy patients with normal prostate specific antigen levels. There was a wide range of transrectally palpable contours after radical prostatectomy in patients with and without elevated prostate specific antigen levels. We conclude that prostate specific antigen but not digital rectal examination is an excellent early indicator of possible local recurrence after radical prostatectomy. Whether the prevalence of local disease after radical prostatectomy using prostate specific antigen levels and needle biopsies of the anastomosis is greater than heretofore has been appreciated will require further study.

Aged↗