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Biomedical subjects

R B Anderson

Publications and source records attributed to R B Anderson.

At least 19 recordsLinked to original sources
PubMed1992

The influence of diabetes on free flap transfer: I. Flap survival and microvascular healing.

Although recent clinical case presentations suggest that diabetes does not predispose free tissue transfers to increased risk of failure, this remains an open question. The present study used a syngeneic rat strain (Lewis) for free groin flap transplantations between normal rats and streptozotocin-induced diabetic rats (2 months' duration of symptoms), to investigate the influence of diabetes on flap transfer. Flap survival at 1 week, vascular patency, flap histology and ultrastructure, and scanning electron microscopy of anastomotic sites and of corrosion casts of flap vasculature were used as bases for comparison. No differences were found in comparisons of flap survival between any groups of transfer combinations (normal flap onto normal recipient, diabetic flap onto normal recipient, normal flap onto diabetic recipient, and diabetic flap onto diabetic recipient); 100% success was achieved in each group. No differences were found in histology or corrosion casts. Transmission electron microscopy revealed a thickening of the capillary basement membrane in rat diabetic skin after only 8 weeks of symptoms. This ultrastructural finding is consistent with similar capillary basement membrane thickening seen in many other tissues of short- and long-term diabetic animals and humans. Re-endothelialization across the arterial anastomosis at 2 weeks postoperatively was significantly faster in normal versus diabetic animals (p less than 0.05). The predominantly negative findings of this study support the application of free flap transfers in diabetic patients. It is concluded that reconstructive efforts involving free tissue transfer may not be contraindicated in diabetic patients.

Animals↗
PubMed1991

Assessment of quality of life by patient and spouse during antihypertensive therapy with atenolol and nifedipine gastrointestinal therapeutic system.

To evaluate differences in efficacy, safety, and quality of life, 394 male patients with mild-to-moderate hypertension were randomized to receive 20 weeks of either atenolol or nifedipine gastrointestinal therapeutic system (GITS) in a multicenter double-blind trial. A four-week placebo washout was followed by 8 weeks of titration and 12 weeks of maintenance therapy. Quality-of-life evaluation included clinical assessments by the patient and parallel take-home assessments by patient and spouse. Blood pressure was controlled equally in both groups. The total incidence of adverse reactions was similar in both groups, but a greater percentage of nifedipine GITS patients withdrew due to peripheral edema. Patients completing 20 weeks of therapy demonstrated a more favorable quality-of-life profile (P less than .05) for nifedipine GITS over atenolol in psychosocial (P less than .01), well-being (P less than .05), general affect (P less than .05), emotional ties (P less than .01), emotional control (P less than .05), vitality (P less than .05), and leisure (P less than .05) scores. Treatment differences were particularly pronounced for patients over 50 years of age and were not fully detectable until after 14 weeks of therapy. Deterioration in quality of life was associated with withdrawal. Spouses of younger patients receiving atenolol reported deterioration in sexual satisfaction as compared to spouses of patients taking nifedipine GITS (P less than .02). Thus age, length of trial, and third-party observation are important factors in quality-of-life assessment. Comparison of adverse reactions provides an incomplete measure of how well a drug is tolerated. In contrast, findings indicate that even subtle CNS-mediated effects on mood and well-being can be detected by quality-of-life evaluation.

Adult↗
PubMed1991

The use of open phenol blocks to the motor branches of the tibial nerve in adult acquired spasticity.

Spasticity of the posterior calf muscles often occurs following head injury or spinal cord injury. If left untreated, equinovarus contractures of the foot and ankle may occur in a relatively short time period. This paper retrospectively reviews nine patients with either closed head injury (six patients) or spinal cord injury (three patients) who underwent open phenol injections into the motor branches of the tibial nerve in 16 limbs. Spasticity was decreased in all patients. No significant equinus contractures had occurred at final follow-up. Five of the patients were subsequently able to ambulate. One patient had recurrence of spasticity requiring a second surgical procedure (split anterior tibial tendon transfer), and two patients had significant toe clawing at final follow-up. Open phenol injections to the motor branches of the tibial nerve safely and effectively prevent foot and ankle contractures following spinal cord injury or head injury.

Adult↗
PubMed1990

Free tissue transfer and calcanectomy as treatment of chronic osteomyelitis of the os calcis: a case report.

Chronic osteomyelitis of the os calcis presents a formidable management dilemma. Successful treatment requires aggressive surgical debridement of devitalized bone and soft tissue and appropriate antibiotic therapy. Difficulties arise, however, when radical debridement results in significant loss of weight-bearing bone. Recalcitrant osteomyelitis of the os calcis or major loss of bone secondary to debridement has been treated by amputation. Advances in microsurgical reconstruction now provide the opportunity for limb salvage in this situation.

Adult↗
PubMed1990

The effects of fixation and restricted visual field on vection-induced motion sickness.

Approximately 60% of healthy human subjects experience motion sickness when exposed to a rotating optokinetic drum. The purpose of the present study was to determine the effects of certain visual factors on susceptibility to motion sickness. Vection data (illusory self-motion), horizontal eye movement recordings, subjective motion sickness report, and a measure of gastric myoelectric activity (electrogastrogram, EGG) were obtained from 45 subjects, who were randomly divided into the following three groups: a control group that observed the entire visual field with no fixation, a group that fixated on a central target, and a third group that had a visual field restricted to 15 degrees. The experimental session was divided into the following three 12-min periods: baseline, drum rotation, and recovery. The results showed that fixation greatly reduced nystagmus and slightly reduced vection. The restricted visual field slightly reduced nystagmus and greatly reduced vection. Both of these manipulations significantly reduced symptoms of motion sickness and tachyarrhythmia, the abnormal gastric myoelectric activity that usually accompanies nausea.

Electromyography↗
PubMed1988

Sesamoid foot problems in the athlete.

Problems of the sesamoid bones of the metatarsophalangeal joint of the great toe are critical in maintaining full ability to compete or to engage in recreation--in athletes of any age. The sesamoids are subject to the same post-traumatic, acute, and chronic changes as any other bone. These unique and deceptively important injuries demand a high index of suspicion, a thorough diagnostic effort, and a guided long-range treatment program, including follow-up to normalized athletics, particularly in the running-based sports.

Athletic Injuries↗
PubMed1988

Patient outcome following inpatient vs outpatient treatment of rheumatoid arthritis.

To assess the short and longterm efficacy of intensive inpatient treatment of active rheumatoid arthritis (RA), 16 patients, the test group, admitted to a hospital based rheumatic disease unit (mean length of stay 12.4 days) were studied, using clinical and laboratory variables. The comparison group was similarly evaluated, using 10 outpatients with active RA to whom hospitalization was recommended, but refused by the patients. Both groups were studied intensively over a 12-week period. In addition, a 2-year followup was performed on 12 test group inpatients and 8 comparison group outpatients, using the same variables plus a functional status questionnaire. Health care costs were determined for both groups and corrected for a 1985 dollar value. The test group showed significant improvement in morning stiffness, pain, and joint score, whereas the comparison group improved only in pain score during the initial 12-week period. At 2 years, the test group and the comparison group showed significant improvement in morning stiffness, pain, grip strength, and joint score. The comparison group initially had a somewhat lower index of disease activity. The test group maintained their initial improvement and none required rehospitalization. Functional status scores were similar for both groups. Health care costs were initially higher for the test group ($5,065); followup care cost for the test group was $99 less/year than the comparison group over 2 years. Hospitalization on a rheumatic disease unit brought about prompt, sustained improvement in 2 weeks which required nearly 2 years to achieve in the comparison group. Such hospitalization of uncomplicated RA seems warranted to decrease disability and increase the quality of life.

Adrenal Cortex Hormones↗
PubMed1987

A model for the evaluation of statewide substance abuse prevention programs.

A recently completed study of the existing substance abuse prevention programs in Iowa is discussed. Content analyses were made of three sets of material: the prevention grants made to (1) community agencies and (2) community/parents' groups which were funded by the Iowa Department Substance Abuse, and (3) state agency documents. The findings revealed that there were articulation problems between the agencies and that the projects were vaguely conceived and evaluated.

Financing, Government↗
PubMed1984

Hip pain in patient with Crohn's disease. Occult retroperitoneal abscess as cause.

A 20-year-old man with Crohn's disease was seen as an outpatient for pain in the left hip and gait disturbance. Initially, arthritis of the hip was suspected, because of the absence of fever or abdominal abnormalities. Two weeks later, fever, malaise, and pneumaturia developed and urine culture grew Escherichia coli. Laparotomy revealed a large occult retroperitoneal abscess on the left side, which had been irritating the psoas muscle. Surgical drainage effected complete recovery of hip function. The abscess in this patient had a very unusual presentation and was diagnosed chiefly through a high index of suspicion after a careful physical examination.

Abscess↗