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Biomedical subjects

R L Bass

Publications and source records attributed to R L Bass.

12 recordsLinked to original sources
PubMed1996

High implant fracture incidence with Sutter silicone metacarpophalangeal joint arthroplasty.

We performed a retrospective review of Sutter silicone metacarpophalangeal (MP) joint arthroplasties in 34 patients (42 hands, 168 implants) with rheumatoid arthritis. Patients were evaluated at an average of 27 months (minimum follow-up period, 12 months). Twenty percent of the implants were shown to be definitely fractured on final follow-up examination, and 45% followed for more than 3 years were definitely fractured. At the final follow-up examination, the average ulnar drift in intact implants was 11 degrees and in the fractured implants, 23 degrees. However, there was no correlation between implant fracture and patient satisfaction. Eighty percent of patients said they would undergo the procedure again. Because of a significantly higher implant fracture incidence at a relatively shorter follow-up period than that of most studies of silicone MP implants of the Swanson design, we have abandoned the use of the Sutter implant.

Arthritis, Rheumatoid↗
PubMed1995

Results of combined internal and external fixation for the treatment of severe AO-C3 fractures of the distal radius.

Combined internal and external fixation for distal radius fractures has been previously reported, but the indications, technique, and results are not defined. This study reviews an experience with a specific surgical strategy for the treatment of a homogeneous population of AO-C3 fractures of the distal radius. The technique is composed of combined palmar and dorsal surgical approaches for open reduction and internal fixation of fracture fragments after neutralizing the wrist with a rigid external fixator. Thirteen fractures in 12 patients were followed an average of 27 months. Wrist motion averaged 60 degrees of flexion and 45 degrees of extension. The injured extremities had a mean grip strength that was 83% of the uninjured side. Follow-up x-ray films showed a dorsal tilt of 1 degree, radial inclination of 18 degrees, and radial length of 12 mm. Using the rating system of Green and O'Brien, the results were excellent or good in 10 wrists. The results indicate that this surgical strategy, though technically demanding, can be successfully used in this specific subset of difficult to treat distal radius fractures.

Adult↗
PubMed1994

Tracheal aspirate correlates with protected specimen brush in long-term ventilated patients who have clinical pneumonia.

STUDY OBJECTIVE: This study was undertaken to determine whether tracheal aspirate cultures correlate with protected specimen brush (PSB) cultures in the diagnosis of probable ventilator-associated pneumonia (VAP). DESIGN: Retrospective evaluation of 52 episodes of clinical pneumonia in 38 patients who underwent bronchoscopy and PSB as well as tracheal aspirate cultures. SETTING: The study took place in long-term, acute care hospital associated with a university medical school. This hospital specializes in ventilator-assisted patients. PATIENTS: The patient population consisted of long-term ventilated patients (average ventilation time was 22 weeks; range, 4 weeks to 3 years) who presented with the clinical diagnosis of VAP (fever, increased white blood cell count, new infiltrate on chest radiograph, and bronchorrhea). No patient had received antibiotics for the preceding 5 days at the time of bronchoscopy or tracheal aspirate culture. MEASUREMENTS: The tracheal aspirate and PSB culture and sensitivities results. RESULTS: Identical organisms were recovered in both the tracheal aspirate and PSB cultures in 36 of 52 episodes of VAP (69 percent). No organism was recovered in either the tracheal aspirate or the PSB in 4 of 52 suspected episodes (8 percent). Positive bacterial cultures in the tracheal aspirate but not the PSB were found in 8 of 52 (15 percent) episodes. In 3 of 52 episodes (6 percent), 1 isolate of pathogenic bacteria was found on PSB and 2 were found on tracheal aspirate cultures. However, all three isolates had the similar antibiotic sensitivities. In the final episode, the PSB culture grew an organism that was not present in the tracheal aspirate culture (2 percent). When comparing the tracheal aspirate with the PSB, the following were calculated: sensitivity = 97.7 percent; specificity = 50 percent; positive predictive value = 91.3 percent; and negative predictive value = 80 percent. CONCLUSION: Tracheal aspirate cultures correlate with PSB cultures in patients receiving long-term ventilation who have clinical pneumonia, and they can be used to direct initial antibiotic therapy in this group of patients.

Aged↗
PubMed1994

Elbow and forearm anatomy and surgical approaches.

In this article the authors outline the fundamentals of elbow and forearm anatomy. The most useful surgical approaches for the elbow and forearm are then discussed, with emphasis placed on the importance of internervous planes of dissection. The most common pitfalls of surgical anatomy are also explained.

Elbow↗
PubMed1993

[Subdural exudate in bacterial meningitis in children].

A subdural exudate (SE) complicating bacterial meningitis in 28 children was diagnosed by the findings at diaphanoscopy, subdurography, thermography, CT, EEG, echo-EG, rheo-EG in the evidence of aggravating neurological symptoms. SE drainage was carried out in all the cases, in 20 patients it was bilateral. CNS age-specific anatomicophysiological features responsible for emergence of the exudate primarily in the anterior hemispheric compartments subject to consequent atrophy are considered when assessing mechanisms of the exudate development in infants.

Acute Disease↗
PubMed1990

Use of adult psychiatric services by primary care physicians in midwestern cities.

Primary care physicians in the tri-state area of Nebraska, Iowa and South Dakota were surveyed concerning their baseline practices in requesting psychiatric consultations, and their recommendations for improvement in psychiatric consultation. A two-page questionnaire was used to collect data. The information obtained was analyzed by tetrachoric correlations. Our results indicate that most primary care physicians refer patients to psychiatrists and prescribe psychotropic medications. It was generally noted that the respondents do not do psychotherapy themselves. In contrast to studies from other areas, our research showed that the symptoms which prompted psychiatric referral the most are psychosis and depression. Suggestions for improvement in psychiatric consultations included that psychiatrists need to be more available to the primary care practitioner. It was also indicated that financial constraints, social stigma and psychiatric shortage were problems in referral of patients to psychiatrists.

Adult↗
PubMed1987

[Pathological anatomy and problems of the pathogenesis of pneumococcal meningoencephalitis in children].

The analysis of morphological, clinical and bacteriological data on 31 deceased children with pneumococcal meningoencephalitis is presented. The lesions observed at early and late stages of the disease are characterized in detail and the tendency of pneumococcal meningoencephalitis to a chronic course in the presence of the viable pathogen is shown. The majority of pneumococcal meningoencephalitides were proved to develop primarily, and in their pathogenesis significant role is played by the lesions of hematoencephalic barrier caused by respiratory viruses. High lethality and frequency of severe residual changes in the children with pneumococcal meningoencephalitis are due to early lesions of choroid plexuses and brain matter. In the experiment on 18 rabbits with their suboccipital challenge with 3 different pneumococcal strains, the influence of the biological properties of the pathogen on the clinical and morphological features of the illness is shown.

Acute Disease↗
PubMed1985

Effects of cigarette nicotine content on smoking behavior of baboons.

Human cigarette smokers modify the way in which they smoke cigarettes of differing nicotine content, apparently to maintain nicotine exposure at a preferred level. The effects of changing from moderate to high or low nicotine content cigarettes were examined in 11 baboons (superspecies Papio cynocephalus) trained to smoke cigarettes for water rewards. Relative to the moderate nicotine content cigarette, the animals took significantly (p less than .05) more puffs on the high nicotine content cigarette, and the puffs on the high nicotine cigarette were significantly larger in volume. The animals made the same number of puffs, relative to the moderate nicotine content cigarette, on the low nicotine content cigarette, but the volume of the puffs was significantly smaller. The cotinine output in urine varied significantly and was directly related to cigarette nicotine content; cotinine is the primary metabolite of nicotine. Baboons, like people, prefer high nicotine content cigarettes. Nonhuman primates also regulate nicotine exposure by modification of their puffing behavior. These results indicate that the nonhuman primate also can be used as a model for the investigation of the behavioral aspects of cigarette smoking.

Animals↗
PubMed1980

Atherosclerosis-related responses to cigarette smoking in the baboon.

Thirty-six young adult male baboons (Papio cynocephalus) were fed an atherogenic diet (40% calories from lard, 1.5 mg cholesterol/kcal) and taught to puff by operant conditioning with water rewards. Eighteen baboons (smokers) were assigned randomly to smoke 43 cigarettes a day, and 18 baboons (shams) were assigned randomly to puff air under conditions equivalent to those of the experimental group. During months 14-19 of smoking, cigarette-smoking baboons had significantly higher carbon monoxide and thiocyanate concentrations in blood and cotinine concentrations in urine. There were no significant differences in serum total cholesterol, VLDL + LDL cholesterol, HDL cholesterol or triglyceride concentrations of smokers and shams. Smoking baboons had significantly higher fasting blood glucose concentrations and lymphocyte counts. Platelet count, platelet aggregation, food and water intake, and body weight were not significantly different in the two groups.

Animals↗