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Biomedical subjects

T Norris

Publications and source records attributed to T Norris.

10 recordsLinked to original sources
PubMed2002

Pulmonary barotrauma-induced cerebral arterial gas embolism with spontaneous recovery: commentary on the rationale for therapeutic compression.

Pulmonary barotrauma-induced cerebral arterial gas embolism (CAGE) continues to complicate compressed gas diving activities. Inadequate lung ventilation secondary to inadvertent breath holding or rapid buoyant ascent can quickly generate a critical state of lung over-pressure. Pulmonary over-pressurization may also occur as a consequence of acute and chronic pulmonary pathologies. Resulting barotrauma frequently causes structural failure within the terminal distal airway. Respiratory gases are then free to embolize the systemic circulation via the pulmonary vasculature and the left heart. The brain is a common target organ. Bubbles that enter the cerebral arteries coalesce to form columns of gas as the vascular network narrows. Small amounts of gas frequently pass directly through the cerebral circulation without occlusion. Larger columns of gas occlude regional brain blood flow, either transiently or permanently, producing a stroke-like clinical picture. In cases of spontaneous redistribution, a period of apparent recovery is frequently followed by relapse. The etiology of relapse appears to be multifactoral, and chiefly the consequence of a failure of reperfusion. Prediction of who will relapse is not possible, and any such relapse is of ominous prognostic significance. It is advisable, therefore, that CAGE patients who undergo spontaneous recovery be promptly recompressed while breathing oxygen. Therapeutic compression will serve to antagonize leukocyte-mediated ischemia-reperfusion injury; limit potential re-embolization of brain blood flow, secondary to further leakage from the original pulmonary lesion or recirculation of gas from the initial occlusive event; protect against embolic injury to other organs; aid in the resolution of component cerebral edema; reduce the likelihood of late brain infarction reported in patients who have undergone spontaneous clinical recovery; and prophylax against decompression sickness in high gas loading dives that precede accelerated ascents and omitted stage decompression.

Adult↗
PubMed1996

Real-time two-photon confocal microscopy using a femtosecond, amplified Ti:sapphire system.

The bilateral imaging approach known from confocal applications operating in the line mode was used to realize real-time two-photon imaging. It is shown that the sectioning inherent to two-photon imaging could be improved by the introduction of a confocal line aperture in the imaging path. Using a high-power, low-repetition-rate amplified Ti:sapphire system, various biological objects were visualized including live boar sperm.

Animals↗
PubMed1996

Do program directors and their chief residents view the role of chief resident similarly?

BACKGROUND: The chief resident plays an important role in family practice residencies and is positioned at the nexus of the relationship between the faculty and the residents. It is unknown if program directors and their respective chief residents view this position and the role of training and faculty development similarly. METHODS: Parallel surveys were sent to all family practice residency program directors and their respective chief residents to explore their perceptions of the importance of the tasks and roles of the chief resident and the effects that perceived training, feedback, and support have on the chief resident's satisfaction. RESULTS: Fifty-one percent of chief residents and their program directors returned surveys that could be analyzed in parallel. Program directors placed relatively greater importance on the administrative role of chiefs. Mentioned most frequently as problems were balancing administrative duties with other tasks, dealing with personnel issues, and working with the lack of a clear job description. Chiefs who participated in formal training programs and who perceived better burnout prevention were more satisfied with their position. CONCLUSIONS: A large number of chief residents perceived gaps in the preparation for their position, particularly with regard to administrative skills. These deficiencies are particularly ironic in light of program directors' perceptions that administrative duties are of the highest importance among the tasks assigned to chief residents. Faculty development strategies and a program of burnout prevention for chief residents should be incorporated into each residency.

Adult↗
PubMed1994

Esophagogastroduodenoscopy for the family physician.

Esophagogastroduodenoscopy is most commonly performed for evaluation of epigastric pain, severe heartburn, chronic nausea and other dyspepsia syndromes that are not relieved by medical therapy. It should not be performed as an in-office procedure in patients with unstable angina, respiratory failure, active upper gastrointestinal bleeding or hemodynamic instability. Although office esophagogastroduodenoscopy is safe for low-risk patients, the risks associated with anesthesia and the need for postprocedure observation may require other patients to undergo the procedure in a hospital setting. Use of a local anesthetic throat spray reduces the gag response that occurs when the endoscope is swallowed. Sedation is commonly achieved with intravenous administration of a benzodiazepine plus a narcotic, and the effects of these drugs can be rapidly reversed. Complications are rare and most frequently result from medications rather than from the procedure itself.

Endoscopy, Digestive System↗
PubMedDate not supplied

The healthy communities movement and the coalition for healthier cities and communities.

Part One of this article describes the principles and origins of the Healthy Communities movement. Part Two describes the Coalition for Healthier Cities and Communities, a national network of partnerships and organizations. The authors argue (a) that to sustain community initiatives, practitioners must move from projects that address symptoms of social problems to changing the underlying community cultures, incentives, and settings that give rise to these symptoms, and (b) that the Coalition's continued relevance depends on its ability to help leaders make that transition.

Community Health Planning↗