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Biomedical subjects

M L Weber

Publications and source records attributed to M L Weber.

42 records · Page 3Linked to original sources

Acute epiglottitis in children: management of 27 consecutive cases with nasotracheal intubation, with special emphasis on anaesthetic considerations.

Twenty-seven consecutive cases of acute epiglottitis in children were treated by nasotracheal intubation during a 25-month period. The duration of intubation averaged 44.2 hours. No mortality or morbidity occurred. Mean hospitalization was 4.5 days. Anaesthetic techniques are discussed. Ketamine is a somewhat controversial choice for these patients as it can enhance excitement, restlessness, and accidental extubation. This study reconfirms the ease of maintaining an assured airway by nasotracheal intubation in cases of acute epiglottitis.

Age Factors↗

Diminution of bone mass in childhood diabetes.

Photon absorption measurements of forearm bone density in 196 insulin-dependent patients, age 6--26 years, were compared with findings in 124 controls. Expected density, gm. Ca/cm.2 bone width (M/W), was calculated from regressions of M/W on ulnar length for white and black male and female controls. There were no significant correlations between M/W differences from expected and serum Ca, Mg, P, or alkaline phosphatase levels, estimated physical activity level, insulin dosage, or the presence of joint contracture. White females averaged 8.2 per cent (+/- 1 S.E.M.) loss of M/W, as against white male average loss of 4.7 per cent +/- 1 and black female loss of 2 per cent +/- 2 (p less than 0.001); the black male population was too small for separate analysis. M/W loss greater than 10 per cent was seen in 29 per cent of white males, 19 per cent of blacks, and 48 per cent of white females (p less than 0.02). When the groups were further divided into those with duration of diabetes less than or equal to five years and those with duration greater than five years, significant reduction in M/W average loss over time was seen with white females (10.6 per cent +/- 1.2 to 3.7 per cent+/- 1.5, p less than 0.0001). Expression of this defect in bone mineralization is controlled by race and sex acting independently of each other.

Adolescent↗

The bacteriology and cytology of chronic otitis media with effusion.

The bacteriology and cytology of middle ear effusion from 729 children with persistent otitis media with effusion were studied. Thirty-five percent of these chronic effusions were culture-positive. Type b and non-type b Haemophilus influenzae, Streptococcus pneumoniae, Neisseria sp. and Staphylococcus epidermidis were the predominant isolates. Serous and mucoid effusion cultures yielded bacteria more often in younger than in older children. In addition bacteria were seen in 17% of the Gram-stained smears of the sterile effusions; Gram-positive cocci predominated in these effusions. Disparate effusion culture results were obtained in 32% of bilateral otitis media cases. Effusions which yielded H. influenzae and S. pneumoniae on culture had more polymorphonuclear leukocytes than did effusions which yielded S. epidermidis or Neisseria or were sterile. Phagocytic cells were equally prevalent in sterile effusions with or without bacteria on Gram stain. Phagocytic cells were seen less often in mucoid effusions from antibiotic-treated patients than in mucoid effusions from untreated patients. The results suggest that certain bacteria in chronic middle ear effusion contribute to the pathogenesis of this condition by eliciting a local inflammatory cell response.

Age Factors↗