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Biomedical subjects

M L Mills

Publications and source records attributed to M L Mills.

12 recordsLinked to original sources

Use of a type-III trilateral external skeletal fixation device in three deer with comminuted fractures.

A type-III trilateral external skeletal fixation device was used to repair comminuted fractures of metacarpal and tibial bones in 3 deer. Mean weight of the deer was 25 kg, and mean age was 4 months. Mean interval from application until removal of the device was 6.5 weeks. All deer had complete function of their previously fractured limbs and had minimal complications during healing. Several factors should be considered when choosing a method of repair for wildlife with fractured limbs. Economic constraints and demeanor of the animal may limit the number of options. Analysis of results of our findings indicated that type-III trilateral external skeletal fixation devices can be used for the repair of comminuted fractures in young deer.

Animals↗

An analysis of the emergency medicine literature: 1982 through 1985.

This study analyzed the subject matter and type of articles published by the three peer-reviewed journals of emergency medicine from 1982 through 1985. Subject matter was classified by the author according to the Emergency Medicine Core Content. Articles were classified by type (research, case reports, reviews, editorials, etc). The data were cross-tabulated to determine how each of the subject areas was covered. The analysis included 1,573 contributions to the three journals over the four-year period. Results are reported for each journal. The small proportion of articles published on administration and education were mostly anecdotal information and only 14% to 15% were based on objective studies. A very small proportion of articles in general emergency medicine, 2% to 4%, were based on basic research. More than one-half of the basic research published in two of the three journals related to resuscitation. Two-thirds of the articles pertaining to toxicology were anecdotal. Articles pertaining to emergency medical services and trauma achieved a balanced distribution of type of articles. Major subject areas not covered over the four-year period are also reported and discussed.

Emergency Medicine↗

High-yield criteria for urgent cranial computed tomography scans.

We conducted a study to establish high-yield criteria for urgent cranial computed tomography (CT) scanning in both medical and surgical conditions. Patients were scanned on an emergency basis and were entered in the study if they met preestablished criteria. The clinical findings of the 407 patients in this study were correlated with CT findings. The majority were scanned on an emergency basis for the following reasons: trauma, seizures, altered mental status, hemiparesis, headache, and coma. The yield for CT scans that altered patient management was moderate to high for each of the following categories: coma, 46%; trauma, 30%; seizures, 23%; hemiparesis, 22%; and headache, 21%. The yield for altered mental status and reasons outside the established criteria were fairly low, 8% and 7%, respectively. The specific clinical correlation with CT results in each category is discussed.

Brain Diseases↗

Lumbar spine x-rays: a multihospital study.

To define the usefulness of the lumbar spine x-ray series in the emergency department and to generate clinical criteria for optimizing its application, we retrospectively studied 552 consecutive emergency department patients for whom lumbar spine x-rays were ordered. Patients were divided into traumatic (47.6%) and nontraumatic (52.4%) groups. Three subgroups were created based on radiological findings: 1) "negative" (55.8%), 2) "possibly significant" (37%), and 3) "positive" (7.2%). The "positive" subgroup was compared with the other two subgroups in an attempt to define physical markers that correlated with positive radiological findings. Four clinical findings were present in significantly different frequencies between the positive group and others: an abnormal physical examination (90% vs 61.5%, respectively) (P less than .0001), tenderness (72.5% vs 41.2%) (P less than .0005), multiple positive findings (42.5% vs 20.7%) (P less than .005), and contusion or abrasion (15% vs 2.7%) (P less than .0005).

Adolescent↗

Determination of synovial fluid and serum concentrations, and morphologic effects of intraarticular ceftiofur sodium in horses.

OBJECTIVES: To determine the serum and synovial fluid concentrations of ceftiofur sodium after intraarticular (IA) and intravenous (IV) administration and to evaluate the morphologic changes after intraarticular ceftiofur sodium administration. STUDY DESIGN: Strip plot design for the ceftiofur sodium serum and synovial fluid concentrations and a split plot design for the cytologic and histopathologic evaluation. ANIMALS: Six healthy adult horses without lameness. METHODS: Stage 1: Ceftiofur sodium (2.2 mg/kg) was administered IV. Stage 2: 150 mg (3 mL) of ceftiofur sodium (pHavg 6.57) was administered IA into 1 antebrachiocarpal joint. The ceftiofur sodium was reconstituted with sterile sodium chloride solution (pH 6.35). The contralateral joint was injected with 3 mL of 0.9% sterile sodium chloride solution (pH 6.35). Serum and synovial fluid samples were obtained from each horse during each stage. For a given stage, each type of sample (serum or synovial fluid) was collected once before injection and 12 times after injection over a 24-hour period. All horses were killed at 24 hours, and microscopic evaluation of the cartilage and synovium was performed. Serum and synovial fluid concentrations of ceftiofur sodium were measured by using a microbiologic assay, and pharmacokinetic variables were calculated. Synovial fluid was collected from the active joints treated during stage 2 at preinjection and postinjection hours (PIH) 0 (taken immediately after injection of either the ceftiofur sodium or sodium chloride), 12, and 24, and evaluated for differential cellular counts, pH, total protein concentration, and mucin precipitate quality. RESULTS: Concentrations of ceftiofur in synovial fluid after IA administration were significantly higher (P = .0001) than synovial fluid concentrations obtained after IV administration. Mean peak synovial fluid concentrations of ceftiofur after IA and IV administration were 5825.08 microg/mL at PIH .25 and 7.31 microg/mL at PIH 4, respectively. Mean synovial fluid ceftiofur concentrations at PIH 24 after IA and IV administration were 4.94 microg/mL and .12 microg/mL, respectively. Cytologic characteristics of synovial fluid after IA administration did not differ from cytologic characteristics after IA saline solution administration. White blood cell counts after IA ceftiofur administration were < or =3,400 cells/ML. The mean synovial pH of ceftiofur treated and control joints was 7.32 (range, 7.08-7.5) and 7.37 (range, 7.31-7.42), respectively. Grossly, there were minimal changes in synovium or cartilage, and no microscopic differences were detected (P = .5147) between ceftiofur-treated joints and saline-treated joints. The synovial half-life of ceftiofur sodium after IA administration joint was 5.1 hours. CONCLUSIONS: Synovial concentrations after intraarticular administration of 150 mg of ceftiofur sodium remained elevated above minimal inhibitory concentration (MIC90) over 24 hours. After 2.2 mg/kg IV, the synovial fluid ceftiofur concentration remained above MIC no longer than 8 hours. CLINICAL RELEVANCE: Ceftiofur sodium may be an acceptable broad spectrum antimicrobial to administer IA in septic arthritic equine joints.

Animals↗