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Biomedical subjects

M T Shannon

Publications and source records attributed to M T Shannon.

8 recordsLinked to original sources
PubMed1998

An intravenous fluid bolus is not necessary before administration of intrathecal fentanyl for labor analgesia.

STUDY OBJECTIVE: To determine if an intravenous (i.v.) fluid bolus is necessary to prevent any possible hemodynamic sequelae after administration of intrathecal fentanyl in laboring parturients. DESIGN: Prospective, randomized study. SETTING: Labor suite of a women's tertiary care hospital. PATIENTS: 30 ASA physical status I and II parturients in active labor requesting labor analgesia. INTERVENTIONS: Patients were randomly divided into two groups of 15. One group received no i.v. fluid prior to the administration of 25 micrograms of intrathecal fentanyl, and the other group received 500 ml of lactated Ringer's solution before the block. MEASUREMENTS AND MAIN RESULTS: Blood pressures [systolic (SBP), diastolic (DBP), mean (MAP)], heart rate (HR), cardiac index (CI; using impedance cardiography), and visual analog scores were measured before the block, after fluids, and then every 5 minutes for 45 minutes after the block. Prenatal baseline blood pressures before the onset of labor were obtained from the obstetrician's office records. Results were analyzed using analysis of variance. All patients reported good pain relief. No patient from either group required treatment for hypotension. In the no fluid group, SBP and MAP decreased 10% and 14%, respectively (p = 0.05), following intrathecal fentanyl administration compared with preblock values obtained during labor but not when compared with prelabor prenatal values. In the fluid group, no significant changes occurred in SBP after intrathecal fentanyl but MAP decreased approximately 12% only in comparison to preblock values. No significant changes were noted in CI in either group. Fluid infusion itself caused an increase in HR and CI of approximately 12% and 9.4%, respectively. CONCLUSION: Intrathecal fentanyl produces only minimal hemodynamic changes with or without prior fluid administration.

Adult↗
PubMed1991

Lymph node metastasis in spindle cell carcinoma arising in odontogenic cyst. Report of a case.

The majority of primary intraosseous carcinomas of the jaws develop in preexisting odontogenic cysts. These tumors are usually well-differentiated keratinizing carcinomas with relatively good prognosis. Only two of 41 previously reported acceptable cases of primary intraosseous carcinomas from ex-odontogenic cysts were associated with cervical lymph node metastasis. Spindle cell carcinoma is an anaplastic dimorphic neoplasm with poor prognosis. It has a special predilection for the upper aerodigestive tract. This is to our knowledge the first report of spindle cell carcinoma developing in an odontogenic cyst. Cervical lymph node metastasis showing typical histologic features of spindle cell carcinoma was detected 8 months postoperatively. The prognostic implications of this finding are discussed in light of previously reported cases of intraosseous carcinoma arising in odontogenic cysts and of spindle cell carcinoma of the oral cavity.

Carcinoma↗
PubMed1990

Invasive aspergillosis of the maxilla in an immunocompromised patient.

Patients who are immunocompromised have a high susceptibility to infection, which can be fatal. Studies have shown that patients receiving chemotherapeutic and adjunctive medications have inhibited inflammatory response to microbes, particularly those increasing the potential for the development of invasive infection. Aspergillus is a fungus often found in the atmosphere. Colonization of Aspergillus in the upper respiratory tract is common. In the immunocompromised patient, Aspergillus flavus is found to be the most frequent fungus cultured in the maxillary sinus. Because of the depressed immunologic state of the patient, A. flavus can differentiate into hyphal forms producing toxins that destroy epithelial tissues. Penetration of Aspergillus into connective and vascular tissue produces thrombosis and ultimately necrosis of hard and soft tissue.

Aged↗
PubMed1989

Health promotion and illness prevention: a biopsychosocial perspective.

The biomedical model of disease, in which health is viewed as the absence of disease, is becoming obsolete. Burgeoning health care costs coupled with an increased focus on health promotion and illness prevention have created new demands on the health care delivery system. A biopsychosocial model of health care--in which disease is seen as an interplay between environmental, physical, behavioral, psychological, and social factors--can integrate mental health services into the primary care sector. Social workers, as primary providers of psychosocial care, can close the gap between physical health and mental health services. Strategies for implementing the biopsychosocial model, methods to evaluate its effectiveness, potential problems, and recommendations for future research are discussed.

Health Promotion↗