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Biomedical subjects

S Pollock

Publications and source records attributed to S Pollock.

At least 19 recordsLinked to original sources
PubMed1991

Phrenic nerve injury. A prospective study.

In cardiac surgery, topical iced saline solution slush has become an important adjunct in maintaining myocardial hypothermia during cardioplegic arrest. One complication of this technique is phrenic nerve injury (PNI). In an attempt to reduce the incidence of PNI, a prospective study was undertaken to evaluate the impact of phrenic nerve insulation on PNI during cardiac surgery. Seventy-six consecutive patients who underwent coronary revascularization constituted the control group (CG) and were compared with 76 patients who underwent a similar procedure with the addition of phrenic nerve insulation. In the intervention group (IG), a foam insulation pad was placed between the heart and the pericardium in an effort to reduce exposure of the phrenic nerve to iced saline solution slush. There was no difference in major demographic descriptors or operative variables between the CG and the IG, except that the internal mammary artery was used more frequently in the IG (64 percent vs 36 percent, p = 0.0006). The in-hospital mortality was similar between the groups (CG, 0.0 percent; IG, 1.3 percent; p = 1.0); however, the incidence of roentgenographically diagnosed PNI was much greater in the CG (14/76 patients [18 percent] vs 0/76 patients [0 percent]; p = 0.0006). Patients with and without PNI were similar with regard to age, gender, aortic cross clamp time, cardiopulmonary bypass time, and number of grafts (p greater than 0.05). All unilateral PNI occurred on the left. Three patients with bilateral PNI required tracheostomy and prolonged mechanical ventilation. In-hospital mortality was similar for patients with and without PNI (0 percent vs 0.7 percent), but mean postoperative hospital stay for patients with clinically diagnosed PNI was longer than for those without PNI (32 vs 11 days, p = 0.04). This prospective study demonstrates that the incidence of PNI can be significantly reduced by the routine use of phrenic nerve insulation.

Adult↗
PubMed1990

Somatization and illness behaviour in a neurology ward.

One hundred and thirty-three female patients admitted to a neurological ward were fully investigated for the presence of organic neurological disease, and assessed for psychiatric disorder and illness behaviour, using the Clinical Interview Schedule (CIS) and the Illness Behaviour Questionnaire (IBQ). The likelihood of the presenting symptoms being due to organic disease was expressed by the neurologists on a visual analogue scale and the psychiatrists used a similar technique to describe whether the symptoms could be the result of psychiatric disorder. Many patients either had clear organic disease or somatic presentation of psychiatric disorder 'somatization', but one-third fell between these two extremes and either had a complex mixture of the two types of illness or could not be accurately diagnosed. The IBQ scores were raised in those with psychiatric disorder but did not help to explain why some patients present to the neurologists with symptoms that are unexplained by either organic disease or psychiatric disorder. Close liaison between neurologists and psychiatrists increases the detection of psychiatric disorder but some patients would require long-term follow-up to understand the true nature of the underlying disorder.

Adolescent↗
PubMed1988

Psychiatric morbidity and illness behaviour in female neurological in-patients.

Ninety three female neurological in-patients were assessed in a collaborative neurological and psychiatric study. An overall prevalence of definite psychiatric disorder of 34% was found, depression being the most common diagnosis. Psychiatric morbidity was most common when the neurologist felt that the presentation could not be explained by a neurological disorder. The majority of such patients had symptoms which could be explained by the psychiatric disorder but a substantial number could not be given a definite diagnosis. The General Health Questionnaire was not found to be a useful screening instrument in this setting.

Cerebrovascular Disorders↗
PubMed1987

The morning glory disc anomaly: contractile movement, classification, and embryogenesis.

A case of the morning glory disc anomaly is reported in which alternating contraction and dilation movements were observed and documented with fundus photographs. The movements are attributed to an anomalous communication between the subretinal and subarachnoid spaces that permits flux of fluid to occur between the two compartments, with consequent variation in the degree of retinal elevation within the excavated portion of the lesion. The clinical features of the morning glory disc anomaly, peripapillary staphyloma and optic disc coloboma are presented, and the relationship among these lesions is discussed. The author concludes that the morning glory disc anomaly is a clinical entity distinct from peripapillary staphyloma and optic disc coloboma. It is thought to be due to dysgenesis of the distal optic stalk leading to anomalous persistence of the extension of the cavity of the optic cup into the stalk.

Coloboma↗
PubMed1987

Intermediate-term fate of cryopreserved allograft and xenograft valved conduits.

Actuarial freedom from reoperation for obstruction in 147 patients receiving cryopreserved or fresh allograft valved conduits between a ventricle and the pulmonary arteries was 94% at 3.5 years. The 2 patients undergoing reoperation were 6 and 36 months of age at the time of insertion of the allograft. Among 24 patients in whom cardiac catheterization was performed on indication late postoperatively, 5 had gradients of more than 40 mm Hg across the conduit. For comparison, among 78 patients receiving xenograft or irradiated allograft valved conduits, the percentages of freedom from conduit reoperation at 3.5, 5, 10, and 15 years were 99%, 95%, 59%, and 11%, respectively. The diameters of the allograft and xenograft valves inserted varied directly with the age and size of the patients, but in patients 3 to 5 years of age, allografts with a diameter of at least 21 mm could usually be used.

Aorta↗
PubMed1979

Fetal mediators of the relationships between increased pregnancy and labour blood pressure and newborn irritability.

A prospective study of primiparous English women and their newborns failed to replicate previous findings that greater irritability was related to higher maternal blood pressure during pregnancy and labour. This apparent lack of replication prompted a search for fetal variables capable of mediating the blood pressure--irritability relationships. Relative fetal growth retardation was found in newborns of women whose peak antenatal blood pressure occurred from 20 to 32 wk gestation. Prenatal growth retardation and exposure to either oxytocin-stimulated labour or higher maternal blood pressure during spontaneous labour were associated with lower intrapartum fetal heart rate. Lower heart rate, in turn, was associated with greater crying and more frequent changes of state during behavioural assessments on the first and fifth days. It is suggested that intrapartum hypoxia is an immediate antecedent of newborn irritability. The blood pressure--irritability relationships may therefore reflect the influence of growth retardation, attributable to increased pregnancy blood pressure, and higher labour blood pressure, respectively, on the ability of the fetus to withstand hypoxia and the degree of hypoxia encountered during labour.

Anesthesia, Obstetrical↗
PubMed1977

Amyloid AA protein. Cellular distribution and appearance.

To investigate the cellular distribution and possibly the cellular origin of the AA protein associated primarily with the fibrils of secondary amyloid deposits, a variety of human tissues was studied by indirect immunofluorescence using a specific anti-AA immunoglobulin and FITC-goat anti-rabbit IgG. Positive cells were most frequently identified in reactive lymphoid tissues. They were most numerous in tonsils and, to a lesser extent, frequent in spleens. Both cellular appearance and distribution of the positive cells suggested a plasmacytic nature. Double staining with rhodamine-labeled anti-IgG demonstrated IgG within some of these cells. The data suggest that the AA protein may be an immunoprotein. In the absence of kinetic data, however, it is not possible definitively to assign the origin of the AA protein to the plasma cell.

Amyloid↗