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Biomedical subjects

M Mars

Publications and source records attributed to M Mars.

At least 73 records · Page 4Linked to original sources
PubMed1991

Direct intracompartmental pressure measurement in the management of snakebites in children.

Snakebite remains a source of considerable morbidity in Natal. Despite the availability of specific and polyvalent antivenins, the regional effects of envenomation and inappropriate first-aid result in significant, potentially avoidable, disability--particularly in children. Direct measurement of intracompartmental pressure has been used as an adjunct to clinical assessment of the child with a swollen limb following snakebite in order to diagnose compartment syndrome. Initial encouraging results in 9 patients suggest that, in this difficult clinical situation, such measurements may have an important role in patient assessment.

Adult↗
PubMed1991

Alterations in the morphology of skeletal myofibres after 90 minutes of ischaemia and 3 hours of reperfusion.

Morphometric, light and electron microscopic methods were employed to determine whether skeletal myofibres were damaged by 90 minutes of tourniquet-mediated ischaemia. Open biceps muscle biopsies were obtained before 90 minutes of upper limb tourniquet ischaemia in 5 Chacma baboons. Further biopsies were obtained just before tourniquet release in 2 animals and after 3 hours' reperfusion in the remaining 3 animals. Other than a slight reduction in myofibre diameter and the anaerobic depletion of intermyofibrillar glycogen, no pathological changes were noted in skeletal myofibres after ischaemia. However, after reperfusion there was myofibre enlargement, intermyofibrillar oedema, internalisation of nuclei, myofibrillar and mitochondrial disorganisation and dissolution, and Z-band streaming. These results show that reperfusion injury affects skeletal myofibres after 90 minutes of tourniquet-mediated ischaemia.

Animals↗
PubMed1991

Gastric carcinoma in Durban's Indian population.

Histologically proven gastric carcinoma was studied to establish the incidence and pattern of the disease in the Indian population of Durban. The incidence in this population was found to be low, 6.9/100,000/year. Over a 7-year period (1980-1986) 115 patients were treated for gastric carcinoma at R. K. Khan Hospital. There was a male preponderance, and the average age at presentation was 56 years. The commonest presenting symptoms were dyspepsia and vomiting, and the majority of patients presented with advanced disease. Only a third underwent resection, a third had no treatment, and a third underwent palliative bypass or laparotomy only. The majority of patients who had a palliative bypass or no treatment died within 9 months. The 5-year survival rate for patients undergoing curative resection was 38% and for palliative resection 9%. To improve survival, emphasis must be on early diagnosis and it is recommended that any patient with dyspepsia who is over the age of 30 years should have an endoscopic investigation.

Adenocarcinoma↗
PubMed1991

A histometric analysis of skeletal myofibers following 90 min of tourniquet ischemia and reperfusion.

Routine tourniquet use causes sublethal hypoxic cellular injury and results in edema formation. Using a histochemical morphometric technique, edema caused by 90 min of tourniquet-induced ischemia and 3 hr of reperfusion is measured in the different muscle fibers of a primate model. The degree of cellular swelling is shown to be related to the fiber's metabolic dependence upon oxygen. After reperfusion, predominantly oxidative type 1 fibers show a 29% increase in diameter, P less than 0.0005, type 2a fibers which are both oxidative and glycolytic increase by 7%, P less than 0.005, and the glycolytic type 2b fibers increase by 5%, P less than 0.01. A 48% increase in interfiber distance occurs with reperfusion, P less than 0.01. By quantifying the different fibers' responses to ischemic injury, this method may be of use in investigating the pathophysiology and prevention of reperfusion injury and the post-tourniquet syndrome.

Animals↗
PubMed1991

The effect of tourniquet release on intra-compartmental pressure in the bandaged and unbandaged limb.

Changes in intra-compartmental pressure in bandaged and unbandaged limbs following 90 minutes of tourniquet-induced ischaemia and subsequent tourniquet release are examined in a primate model. Bandaging raises intra-compartmental pressure. Release of the tourniquet is shown to cause a transient increase in intra-compartmental pressure of less than 30 minutes duration. This is followed by a fall in intra-compartmental pressure for up to three hours. Tourniquet release and the ensuing hyperaemia does not appear to put the limb at risk of developing a compartment syndrome.

Animals↗
PubMed1990

The Sri Lankan Cleft Lip and Palate Project: the unoperated cleft lip and palate.

Since 1984, the Sri Lankan Cleft Lip and Palate Project has developed a large surgical and research program collecting records on over 500 subjects with unrepaired cleft lip and palate. In addition, 410 operations were performed by Project and will be followed by individual reports on facial growth and morphology, speech, surgical and anesthetic aspects, and the otologic significance of cleft palate in this issue and subsequent ones.

Adolescent↗
PubMed1990

A preliminary study of facial growth and morphology in unoperated male unilateral cleft lip and palate subjects over 13 years of age.

This paper investigates the effects of surgery on facial growth and morphology in Sri Lankan males with unilateral cleft lip and palate who were over 13 years of age at the time of study with cephalometry and dental study models. Three separate subgroups were analyzed: those who had totally unrepaired cleft lip and palate, those who received lip repair in infancy but not palatal repair, and those who had lip and palate repair in infancy. Twenty-three healthy noncleft Sri Lankan males over 13 years formed a control group from the same racial background. The results show that subjects who had no surgery had a potential for normal maxillary growth. Subjects who have had lip repair in early infancy show relatively normal maxillary growth, but maxillary hypoplasia is common when the palate has also been repaired early.

Adolescent↗
PubMed1990

A study model analysis of adult unoperated Sri Lankans with unilateral cleft lip and palate.

The maxillary arch-form of 41 Sri Lankan adults with unoperated complete unilateral cleft lip and palate (8 female and 33 male) were compared to a control group of 100 normal Sri Lankan adults (45 female and 55 male). The teeth in the cleft group were smaller than their equivalents in the control group, the most marked difference being found in the central and lateral incisors. Arch widths of the cleft groups were reduced, more anteriorly than posteriorly, resulting in more V-shaped arches. No differences were found in the arch length or chord lengths between the groups. Crossbites occurred in 19.5 percent of the cleft group as compared to none of the controls. The overjet was greater in the cleft group than in the controls. A higher percentage of missing teeth was recorded in the cleft group.

Adolescent↗
PubMed1990

Training assistants in cleft palate speech therapy in the developing world: a report.

This paper describes the training, which took place in Sri Lanka, of five speech therapy assistants in cleft palate speech therapy. The context in which this training occurred is described. The original aims of the training and the criteria drawn up for the selection of the assistants are contrasted with the modifications required to these, once the British therapists started working in Sri Lanka. Information is given on the training objectives, syllabus, curriculum, and methods of evaluation of the assistants' progress. The achievements of the assistants are described. Factors relating to the difficulties and ease with which the assistants were trained are highlighted. The paper concludes with a discussion of the cultural, political, and clinical problems encountered in this type of training, and highlights the special difficulties encountered in the training of assistants in the field of speech therapy in developing countries.

Allied Health Personnel↗
PubMed1990

Congenital heart anomalies in patients with clefts of the lip and/or palate.

The nature and severity of congenital heart disease in 78 patients who presented with clefts of the lip and/or palate is reported. The prevalence of bilateral cleft lip and palate in patients with heart lesions was much higher than in cleft patients with normal hearts. Cardiac defects were predominantly conotruncal. Tetralogy of Fallot was present in 24 percent of patients; the prevalence of transposition, atrioventricular septal defect, and truncus arteriosus was also disproportionately high. Patients with conotruncal defects had a greater prevalence of either unilateral or bilateral cleft lip and palate. Most patients with congenital heart disease and clefting had additional abnormalities. Anomalies of other systems were found to be present in 87 percent of patients.

Abnormalities, Multiple↗
PubMed1990

Training counterparts in cleft palate speech therapy in the less developed world: an extended report.

This paper describes the training of five counterparts in cleft palate speech therapy which took place in Sri Lanka. The context in which this training occurred is described. The original aims of the training, and criteria drawn up for the selection of the counterparts, are contrasted with the modifications required to these once the British therapists started working in Sri Lanka. Information is given on the training objectives, syllabus, curriculum and methods of evaluation of the counterparts' progress. The achievements of the counterparts are described, and factors relating to the difficulties and ease with which the counterparts were trained are discussed. The paper concludes with a discussion of the cultural, political and clinical problems encountered in this type of training, and highlights the special difficulties encountered in the training of counterparts in the field of speech therapy in less developed countries.

Allied Health Personnel↗
PubMed1990

Do pre-operative antibiotics reach the operative field in amputation surgery for peripheral vascular disease? A pilot study.

Amputation surgery in patients with peripheral vascular disease is associated with high revision and mortality rates. A prospective pilot study examined the intra-operative delivery of cefoxitin sodium to the amputation site, and used pre-operative transcutaneous oxygen pressure measurement to try to predict the tissue antibiotic levels at the amputation site. Antibiotic concentrations were measured in plasma and muscle from the amputation site at the time of amputation, and a significant difference in antibiotic distribution was found between healed and failed amputations. Transcutaneous oxygen pressures correlated with the antibiotic distribution.

Adult↗
PubMed1988

Hands up? A preliminary study on the effect of post-operative hand elevation.

Intra-compartmental pressures of up to 30 mmHg may be generated by compression bandaging following upper limb surgery. Compression bandaging and hand elevation are both shown to diminish skin blood-flow as measured by transcutaneous oxygen pressures. Hand elevation following post-operative compression bandaging is potentially hazardous.

Hand↗