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Biomedical subjects

R E Bell

Publications and source records attributed to R E Bell.

33 records · Page 2Linked to original sources
PubMed1985

Survival and short-term morbidity of the premature neonate.

Obstetric decisions regarding premature (23 to 32 weeks' gestation) infants must be based on gestational age. However, most reports of the survival of premature infants are based on birth weight. The present report relates the perinatal survival and morbidity of 105 newborns to the obstetric gestational dating criteria between 23 and 32 weeks' gestation. Gestational age was determined from at least four obstetric criteria including the first day of the last menstrual period, early pelvic examination, the earliest auscultation of fetal heart tones with a fetoscope, fundal height measurements in centimeters between 20 and 30 weeks' gestation, and sonographic gestational age measurements. At 23 to 26 weeks' gestational age, nine (39%) of 23 neonates survived. Five of nine survivors had moderate to severe intracranial hemorrhage, three had moderate to severe bronchopulmonary dysplasia, and three had moderate to severe retrolental fibroplasia. At 27 to 29 weeks' gestational age, 25 (93%) of 27 neonates survived. Of the 25 survivors, three had moderate to severe intracranial hemorrhage, one had moderate to severe bronchopulmonary dysplasia, and one had severe retrolental fibroplasia. At 30 to 32 weeks' gestational age, 52 (95%) of 55 neonates survived. Three of the 52 (6%) survivors had serious neonatal morbidity consisting of moderate to severe intracranial hemorrhage (three neonates) and moderate to severe bronchopulmonary dysplasia (one neonate). Thus, ten of 34 (29%) survivors between gestational ages of 24 to 29 weeks had a serious morbidity versus only three of 52 (6%) survivors between 30 to 32 weeks' gestation (P less than .01).

Bronchopulmonary Dysplasia↗
PubMed1984

High-frequency ventilation compared to conventional positive-pressure ventilation in the treatment of hyaline membrane disease in primates.

High-frequency ventilation (HFV) has been suggested as an alternative to conventional positive-pressure ventilation (PPV) in the treatment of infants with hyaline membrane disease (HMD). Using a previously validated primate model of HMD, 15 baboon fetuses were delivered at 75% of gestation and randomly assigned to 1 of 3 ventilator treatment groups: PPV, HFV delivered by an oscillator (HFO), or HFV delivered by a flow interrupter (HFFI). All animals had clinical and radiographic evidence of HMD. At 96 h of life, all animals were sacrificed and clinical and pathologic findings were analyzed. During the first 10 h of the experiment, the HFO animals required higher mean proximal airway pressures than either the HFFI or PPV groups. However, both the HFFI and HFO animals had higher PaO2/PAO2 ratios than the PPV controls, suggesting earlier saccular recruitment. Thus, HFV is as effective as PPV in the treatment of HMD in baboons. Whether it will decrease the risk of bronchopulmonary dysplasia is not known.

Animals↗
PubMed1982

Differential pulmonary auscultation in neonates.

Auscultation of neonates by means of conventional techniques is subject to many errors. Consequently, pediatricians rely on radiographs for much of their information regarding ventilation abnormalities. We report a method of simultaneous differential auscultation, using a double-headed stethoscope, which allows better auscultatory evaluation of neonates. The technique is simple and easily learned. The equipment used is inexpensive and easily constructed. The technique is most useful in emergency and transport situations when radiographs are not readily available.

Auscultation↗
PubMed1966

Three cases of hemolytic anemia with erythrocyte pyruvate kinase deficiency in Alberta.

Erythrocyte pyruvate kinase (PK) activity was determined by the lactate dehydrogenase-coupled spectrophotometric assay. The effects of modifications in the buffer and in substrate concentrations were studied. Three patients with congenital non-spherocytic hemolytic anemia were deficient in erythrocyte PK, and were evidently homozygous for this deficiency. The daughter of one patient and the parents of another had intermediate PK levels and were probably heterozygous. The erythrocyte adenosine triphosphate (ATP) level was low in one patient, high in another. Adenosine triphosphatase activity of the erythrocyte membranes of one patient was normal.

Adenosine Triphosphate↗
PubMedDate not supplied

Is the endogenous antipyretic neuropeptide alpha-MSH responsible for reduced fever in aged rabbits?

The reduced febrile response in aged man has been noted since the beginning of clinical thermometry. Our previous research on aged rabbits and squirrel monkeys disclosed a similar reduced fever, presumably due to a decrease in central receptors for endogenous pyrogen. However, because central alpha-melanocyte stimulating hormone (MSH) appears to have a potent role in physiological control of fever, it may be that increased release of the peptide is responsible for the reduced febrile response in aged animals. To test this idea, antiserum specific to MSH was administered intracerebroventricularly to rabbits of known age. The antiserum given according to three schedules of treatment augmented fever caused by IV injections of interleukin-1 (IL-1) in young (less than 2 years) male and female rabbits. Aged female rabbits (3-5+ years) and females aged 2-3 years showed significant augmentation of fever only after pretreatment plus acute injection of antiserum. A single ICV injection of MSH (200 ng) reduced fever in all groups with the greatest antipyretic effect in the aged females. The results indicate that while aged rabbits have an increased antipyretic response to central MSH, binding of the endogenous peptide does not result in marked increases in fever in these animals. Thus, whereas a change in central MSH sensitivity may contribute to reduced fever in aged homeotherms, a reduction in central pyrogen receptors appears to be the most parsimonious explanation.

Aging↗
PubMedDate not supplied

Combined carotid and coronary artery disease.

Stroke is a devastating complication of coronary artery bypass surgery. It increases the mortality and morbidity of the operation, and prolongs the length of hospital stay. Functional disability from the stroke may dramatically reduce the quality of life post-operatively, and some patients will require permanent institutional care. Although there are many causes of stroke extra-cerebral carotid stenosis is the most important predictor of stroke for patients undergoing coronary artery bypass grafting (CABG). If patients are identified before coronary intervention, they may benefit from treatment of their carotid disease. Carotid endarterectomy can be performed before or simultaneously with coronary artery bypass. However, carotid angioplasty with stenting and cerebral protection may offer a superior method to conventional surgery in this high-risk group of patients.

Angioplasty, Balloon↗