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Biomedical subjects

P Tomich

Publications and source records attributed to P Tomich.

10 recordsLinked to original sources
PubMed1991

Pain control after cesarean birth. Efficacy of patient-controlled analgesia vs traditional therapy (IM morphine).

A clinical trial compared the efficacy of a mechanical device to deliver patient-controlled analgesia (PCA) (n = 25) with intramuscularly administered morphine (n = 17) for postcesarean pain management. Hypotheses were: (1) patient-controlled administration of narcotics will be superior (increased satisfaction, reduced pain, decreased sedation, increased ambulation, decreased length of stay), and (2) functional vital capacity will increase post-operatively with PCA. No differences in demographic variables were identified (P = less than or equal to .001). Differences in satisfaction (greater in PCA group, P = less than or equal to .05), ambulation (greater in PCA group, P = less than or equal to .001), amount of medication used (greater in PCA group, P = less than or equal to .001), and sedation level (less in PCA group, P = less than or equal to .05) were identified. No differences in vital capacity were identified. The hypothesis related to the superiority of PCA was accepted, while the association between PCA and increased vital capacity was not supported. The use of mechanical PCA devices provides an effective and safe means of managing postcesarean pain.

Analgesics↗
PubMed1985

Gallbladder wall thickening in preeclampsia.

Sonographic examination of the gallbladder in two patients with preeclampsia and right upper quadrant pain demonstrated notable thickening of the gallbladder wall. The sonographic abnormality and clinical symptoms completely resolved after delivery and/or medical management of the preeclampsia. This finding is probably secondary to the hypoalbuminemia characteristic of preeclampsia and should not be mistaken for intrinsic gallbladder disease.

Adult↗
PubMed1983

Rapid diagnosis of amniotic fluid embolism.

Acute respiratory failure developed in a 19-year-old primigravida 7 hours after undergoing cesarean section. The diagnosis of amniotic fluid embolism was established by viewing fragments of vernix caseosa in a pulmonary artery blood sample. Forty-eight hours after the cytologic diagnosis had been made, amniotic fluid material was no longer present in pulmonary arterial blood. The patient underwent supportive care in an intensive care setting and recovered completely.

Adolescent↗
PubMed1982

Etiology and outcome of low birth weight and preterm infants.

A population of 489 low birth weight infants was studied to identify specific subgroups with high neonatal morbidity and mortality. It was found that 134 (27.4%) of these infants were born at term but were small for gestational age. The other 355 were preterm and contributed most of the mortality and morbidity of the overall population. There was no significant difference in morbidity and mortality between preterm small and appropriate for gestational age infants. The etiologic analyses show that premature rupture of the fetal membranes and maternal-fetal problems are more frequent causes of low birth weight than preterm labor and that they cause significantly more severe neonatal morbidity. It is concluded that only by developing means to improve the outcome of patients with premature rupture of the membranes and maternal-fetal problems will it be possible to decrease significantly the unacceptably high mortality and morbidity of low birth weight infants.

Cesarean Section↗
PubMed1981

lambda altSF: a phage variant that acquired the ability to substitute specific sets of genes at high frequency.

We report the isolation of lambda altSF, a variant of Escherichia coli phage lambda that substitutes sets of genes at high frequency. Two forms of the variant phage have been studied: lambda altSF lambda, which exhibits the immunity (repressor recognition) of phage lambda, and lambda altSF22, which exhibits the immunity of Salmonella phage P22. Lysates made from single plaques of lambda altSF lambda contain 10-30% phage of the P22 form. Similarly, lysates from single plaques of lambda altSF22 contain as much as 1% phage of the lambda form. Heteroduplex analyses reveal the following features of the lambda altSF chromosomes: (i) each form has the immunity genes appropriate to its immune phenotype, (ii) the substituted segments include genes involved in regulation and replication, and (iii) the alt phages have unusual additions and substitutions of DNA not normally found associated with either immunity region. In the case of lambda altSF lambda, there is a small insertion in the region of the cI gene. Because revertants that lose this inserted DNA concomitantly lose the ability to substitute, we conclude that the insertion plays a role in the substitution process. In the case of change from lambda altSF lambda to lambda altSF22, the substituting P22 genes are derived from the E. coli host. We have identified a set of Salmonella phage P22 genes in a standard nonlysogenic strain of E. coli K-12 that is apparently carried in a silent form. The reason for this lack of expression is not obvious, because this P22 material includes structural genes and associated promoters and is potentially active. When this set of genes substitutes for the analogous set of genetic material on the genome of lambda altSF lambda, the P22 genes are expressed in a normal manner.

Bacteriophage lambda↗
PubMedDate not supplied

Gender differences in the outcomes of participants in home programs compared to those in structured cardiac rehabilitation programs.

This study compared gender differences in outcomes of patients who had had coronary bypass surgery and either attended structured cardiac rehabilitation programs or participated in home programs. The principal advantages related to patients' attending a structured hospital-based outpatient rehabilitation program, compared to a home program, included increased exercise adherence for males and females, increased knowledge about the condition for males, and increased stress control for females. Return to work, self-efficacy, and aspects of self-care such as adherence to a medication regimen and smoking cessation were not significantly different, regardless of type of program, for either sex. In general, females at home fared the worst regarding lifestyle changes, showing decreased exercise adherence, decreased ability to control stress, and no significant increase in knowledge about their medical condition.

Aged↗
PubMedDate not supplied

The ethics of caring for conjoined twins. The Lakeberg twins.

In June 1993, conjoined twin Amy and Angela Lakeberg became the focus of national attention. They shared a complex six-chambered heart and one liver; only one could survive separation surgery; and even her chances were slim. The medical challenge was great and the ethical challenges were even greater.

Chicago↗