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Biomedical subjects

R Shively

Publications and source records attributed to R Shively.

5 recordsLinked to original sources
PubMed1992

Phage pattern-specific oxacillin-resistant and borderline oxacillin-resistant Staphylococcus aureus in U.S. hospitals: epidemiological significance.

For a 13-year period (1978 through 1990), oxacillin-resistant (MIC, greater than 4 micrograms/ml) Staphylococcus aureus (ORSA) strains were collected from Clinical Center (National Institutes of Health) patients and patients from five other U.S. hospitals. From Clinical Center patients, 251 of 253 isolates (99%) were bacteriophage typed as phage group III. Five other hospitals contributed 203 ORSA strains, of which 188 (93%) were group III. The group III ORSA strains predominantly included a characteristic core pattern of phages, 7/47/53/54/75/77. For the low-level (borderline) oxacillin-resistant strains (MIC, 2 to 4 micrograms/ml), amoxicillin-clavulanic acid combination (Augmentin) testing disclosed 62 hyper-beta-lactamase producers, of which 59 (95%) were of a separate, distinct S. aureus strain, with the phage pattern 92/94/96/292/D-11 (group V). Thus, ORSA and hyper-beta-lactamase producing S. aureus are distinct epidemic strains.

Bacteriophage Typing↗
PubMed1991

Effects of local anesthesia on recovery after outpatient arthroscopy.

The effects of intraarticular bupivacaine administration on postoperative pain and mobilization were evaluated in 97 healthy outpatients undergoing knee arthroscopy under general anesthesia. After completion of the operation, which was performed using a standardized general anesthetic technique, the patient's knee was injected with 30 mL of either 0.5% bupivacaine or saline solution (control), according to a randomized, double-blind protocol. Although there were no statistically significant differences in the patient's assessment of postoperative pain, patients receiving bupivacaine required significantly less opioid analgesic medication in the postoperative period. More importantly, ambulation occurred more rapidly in those patients treated with bupivacaine (versus saline solution), permitting them to be discharged earlier than the control patients (145 +/- 51 min vs 173 +/- 50 min). No adverse effects were noted after the 150-mg intraarticular dose of bupivacaine. On the day after operation, no differences in physical activity or analgesic requirements were detected between the two treatment groups. In conclusion, bupivacaine reduced the opioid requirements and facilitated earlier mobilization after knee arthroscopy without altering the patients' perception of postoperative pain.

Adult↗
PubMed1979

Straightening the twisted nose.

For correction of the twisted nose, the use of a dorsal onlay cartilage graft, obtained from the resected septum, produces the illusion of a straight nose. This persists in spite of any recurrences of deviations in the septum or upper lateral cartilages.

Cartilage↗
PubMedDate not supplied

A nonparallel, nonisometric synthetic graft augmentation of a patellar tendon anterior cruciate ligament reconstruction. A model for assessment of stress shielding.

The potential for a rigidly fixed synthetic graft placed in the over-the-top position to be stress shielding/stress sharing with the patellar tendon autograft was assessed in a primate model. A patellar tendon autograft was placed anatomically and tensioned at 2 pounds for all of the groups. In the augmented animals, a 30 strand braided graft 10 cm in length of expanded polytetrafluoroethylene was tightened with the knee in full extension. After 6 months of unrestricted cage activity the animals were sacrificed and biomechanical testing performed. The augmented patellar tendon autografts demonstrated less laxity in extension as compared to the autografts alone. A minimal decrease in the load and stiffness to failure for the augmented groups as compared to the nonaugmented knees was noted. However, both the reconstruction groups had a significant decrease in the load to failure at 6 months (50% of the normal ACL). In summary, this study demonstrated that a synthetic graft augmentation can be performed in the over-the-top position and minimize knee laxity, especially during terminal extension. With this technique, the laxity was minimized while the incorporation and strengthening of the biologic autograft occurred at a rate similar to the unaugmented reconstruction.

Animals↗