PubMed Health⌕ Search

Biomedical subjects

M J Henderson

Publications and source records attributed to M J Henderson.

At least 37 records · Page 2Linked to original sources
PubMed1999

Plasma creatinine rises dramatically in the first 48 hours of life in preterm infants.

OBJECTIVE: Published data show that plasma creatinine falls steadily during the first 28 days of life and that creatinine levels in the neonatal period are higher in more premature infants. However, the best reference data commence on day 2 of life. The objective of this study was to document how plasma creatinine changes in the first 48 hours of life and to examine the reason for the apparently high levels of creatinine in preterm infants, compared with maternal levels. DESIGN: A prospective observational study on a regional neonatal intensive care unit. PATIENTS: A total of 42 preterm infants, mean gestational age of 29.4 weeks (range: 23-35), mean birth weight of 1.42 kg (.55-2.77), divided into 4 gestation groups: 23 to 26 weeks (n = 9), 27 to 29 weeks (n = 13), 30 to 32 weeks (n = 12), and 33 to 35 weeks (n = 8). INTERVENTIONS: Measurement of plasma creatinine and urea concentration in cord blood and in serial samples taken for routine arterial blood gas analysis. OUTCOME MEASUREMENTS: Changes in creatinine concentration with time and relationship to gestational age, birth weight, and illness severity. RESULTS: Mean creatinine at birth was 73 micromol/L (95% confidence interval [CI]: 68-79 micromol/L). Plasma creatinine rose significantly over the first 48 hours. Mean peak creatinine in the most preterm infants (23-26 weeks) was 221 micromol/L (CI: 195-247 micromol/L). Peak plasma creatinine was inversely related to gestation (Spearman's coefficient: -.73) and birth weight (Spearman's coefficient: -.76). Significant differences in creatinine concentration were seen among different gestational groups at 24 and 48 hours of life. Peak creatinine correlated with a high Clinical Risk Index for Babies score (Spearman's coefficient:. 64). The fall in creatinine began later in more premature infants. All 38 surviving infants had normal renal function; their mean plasma creatinine at discharge was 52 micromol/L (CI: 46-58 micromol/L). CONCLUSIONS: Rather than falling steadily from birth, creatinine rises dramatically in the first 48 hours of life, especially in infants of <30 weeks' gestation. Even large rises in creatinine in the first 48 hours may be expected and should not be used in isolation to diagnose renal failure.

Birth Weight↗
PubMed1997

Extracorporeal circuit design considerations for giant intracranial aneurysm repair.

Clinical perfusionists must be able to modify the existing extracorporeal circuit in order to accommodate a specific surgical pathology. The clipping of a giant intracranial middle cerebral artery aneurysm, unapproachable with conventional neurosurgical techniques, required the use of a modified closed cardiopulmonary bypass circuit combined with deep hypothermia and total circulatory arrest. In-hospital discussions with anaesthesia, cardiac surgery, neurosurgery, and cardiology enabled an informed team approach directed towards the successful treatment of this complex neurosurgical lesion.

Catheterization, Peripheral↗
PubMed1996

Amino acid profile in Down's syndrome.

Fasting plasma and urinary amino acid concentrations were studied under carefully controlled conditions in 22 children with Down's syndrome and in age matched controls. The only significant difference between the groups was a higher mean plasma lysine concentration in Down's syndrome patients compared to controls.

Amino Acids↗
PubMed1995

Carbon dioxide: an alternative to iodinated contrast media.

OBJECTIVES: To study the use of carbon dioxide as a contrast medium for arteriography. METHODS: Carbon dioxide was used as a contrast medium for intra-arterial digital subtraction lower limb angiography in 12 examinations on 11 patients. RESULTS: No complication was encountered and no significant changes occurred in the arterial pH, PaCO2 and PaO2. The quality of images as assessed by an independent observer was adequate for the majority of the vessels (77%). CONCLUSIONS: Carbon dioxide is a safe alternative in patients at an increased risk of adverse reaction to iodinated ionic or non-ionic contrast medium and is very cheap.

Aged↗
PubMed1995

Trends in the inpatient care of persons with schizophrenia.

This report analyzes nationally representative data to examine inpatient services provided to persons with schizophrenia. The data are for patients admitted to general hospitals, private psychiatric hospitals, and State and county mental hospitals between 1970 and 1986 (weighted n = 860,637). The proportion of admissions diagnosed as having schizophrenia decreased from 21 percent in 1970 to 16 percent in 1986; this proportion decreased in public general hospitals and increased in private general hospitals. The rate of admissions for schizophrenia decreased in public general hospitals and State and county mental hospitals and increased in private general hospitals. The overall admissions rate decreased for whites with schizophrenia and increased for African-Americans, owing entirely to increased admissions of African-American males. Private general hospitals and State and county mental hospitals relied less over time on private insurance; the use of Medicare increased in both public and private general hospitals; and Medicaid use increased in private general hospitals. Further research on services for this population is necessary as a baseline for health care reform.

Adolescent↗
PubMed1994

Healing of incisions in the tongue: a comparison of results with milliwatt carbon dioxide laser tissue welding versus suture repair.

The healing of carbon dioxide laser weld closures produced by two commercial instruments of differing design were compared. Healing after laser welding was also compared to healing following conventional suture closure. Healing was evaluated histologically and by measurement of tensile strength over time. No histologic differences were found between closures produced by different lasers; however, in all cases suture closure resulted in slower healing times consistent with a foreign body reaction prolonging the healing process. Tensile strength measurements were performed at intervals over the first 21 days after the operation. Laser repair was found to be equivalent to or stronger than suture repair at every interval measured. The clinical use of the carbon dioxide laser for tissue welding of oral injuries should be investigated further, since it appears to be a good alternative to suture repair.

Analysis of Variance↗
PubMed1994

Covariance structure models of expectancy.

Antecedent variables under the broad categories of genetic, environmental and cultural influences have been linked to the risk for alcohol abuse. Such risk factors have not been shown to result in high correlations with alcohol consumption and leave unclear an understanding of the mechanism by which these variables lead to increased risk. This study employed covariance structure modeling to examine the mediational influence of stored information in memory about alcohol, alcohol expectancies in relation to two biologically and environmentally driven antecedent variables, family history of alcohol abuse and a sensation-seeking temperament in a college population. We also examined the effect of criterion contamination on the relationship between sensation-seeking and alcohol consumption. Results indicated that alcohol expectancy acts as a significant, partial mediator of the relationship between sensation-seeking and consumption, that family history of alcohol abuse is not related to drinking outcome and that overlap in items on sensation-seeking and alcohol consumption measures may falsely inflate their relationship.

Adaptation, Psychological↗
PubMed1994

Surveillance policy for early detection of failing arteriovenous fistulae for haemodialysis.

We have developed a programme of surveillance for arteriovenous fistulae. Indications for investigation were a reduction of thrill or pulsation on the fistula, decreasing flow (< 200 ml/min) and/or increased venous return pressure (> 150 mmHg.) when on haemodialysis. Between March 1992 and February 1993 we performed intravenous digital subtraction fistulograms in 17 patients. These investigations demonstrated vein stenosis in 11 patients, nine with primary arteriovenous fistulae and in two with secondary access. There was disease of the arterial inflow in one, and no evidence of anatomical problems in the remaining five. As a result revision surgery was performed in 10 cases and percutaneous transluminal angioplasty in the remaining two cases. Five patients underwent dialysis the following day on the same site, avoiding temporary access. Sixteen patients (94%) are still using the same site for haemodialysis at mean follow-up time of 6.1 months (range 2-12 months) and one failed subsequently. Close surveillance of arteriovenous fistulae leads to detection of stenosis prior to occlusion and intervention increases patency, preserves alternative access sites, and prevents central venous cannulation for temporary access.

Adult↗
PubMed1993

Sternocostoclavicular hyperostosis.

Sternocostoclavicular hyperostosis is a chronic arthro-osteitis affecting mostly juxtasternal structures. It is characterized clinically by painful swelling of the upper anterior chest wall and occasionally is associated with pustulosis palmaris and plantaris. Pathologically there is osteitis, periostitis, and new bone formation of periarticular structures. Two patients are described, and the clinical, laboratory, and radiological findings of 251 reported cases in the English literature are reviewed.

Adult↗
PubMed1993

Projections of inpatient admissions to specialty mental health organizations: 1990 to 2010.

OBJECTIVE: To help predict changes in patterns of service delivery, the total number of inpatient admissions to specialty mental health organizations and the number of elderly persons (over age 65) admitted were projected in five-year intervals between 1990 and 2010. METHODS: One set of projections is based on 1986 rates of use and their coefficients of variation. A second, more accurate, set is based on 1990 rates derived from logarithmic projections of trends from 1980 to 1986 and the coefficients of variation for the 1986 rates. RESULTS: Projections based on 1990 rates show an increase of more than 25 percent in the total number of inpatient admissions to all specialty mental health organizations between 1986 and 2010 and an increase of more than 40 percent in elderly admissions. Nonfederal general hospitals are expected to have the largest increases in the number of total admissions, and state and county mental hospitals the smallest. The greatest percentage growth in total admissions will occur in private psychiatric hospitals. For elderly persons, inpatient admissions to Veterans Affairs medical centers will show the largest percentage increase, and admissions to state and county mental hospitals the smallest. By 2010 the majority of elderly admissions (67.6 percent) will be to nonfederal general hospitals. CONCLUSIONS: Plans to cope with increased demand for inpatient services should take into account the potential economic consequences of the forecasted changes as well as their effects on allocation of and access to services.

Aged↗