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Biomedical subjects

W Donovan

Publications and source records attributed to W Donovan.

At least 19 recordsLinked to original sources
PubMed2000

Urinary tract infection prophylaxis using Escherichia coli 83972 in spinal cord injured patients.

PURPOSE: Escherichia coli 83972 was previously shown to establish bladder colonization in select patient groups. We evaluate the safety and feasibility of using bacterial interference with E. coli 83972 to prevent urinary tract infection in spinal cord injured patients. MATERIALS AND METHODS: A total of 21 men and women with neurogenic bladder secondary to spinal cord injury underwent intravesical inoculation with E. coli 83972. Frequency of symptomatic urinary tract infection before and after colonization was compared. RESULTS: Successful long-term bladder colonization was achieved in 13 study participants. Mean duration of colonization was 12.3 months (range 2 to 40). Subjects had no symptoms of urinary tract infection while colonized with E. coli 83972 (0 infection per 18.4 patient-years). Successfully colonized subjects had experienced a mean of 3.1 symptomatic urinary tract infections per year (range 2 to 7) before colonization. Symptomatic infection also occurred in 4 subjects who were not successfully colonized with E. coli 83972 and in 7 others after spontaneous loss of colonization. Colonized subjects reported subjective improvement in quality of life with respect to urinary tract infection while colonized. CONCLUSIONS: E. coli 83972 may be safely used to establish long-term asymptomatic bladder colonization in spinal cord injured subjects. Preliminary findings suggest that colonization with E. coli 83972 may reduce the frequency of urinary tract infection in patients with neurogenic bladder secondary to spinal cord injury.

Adult↗
PubMed1999

Illness behaviour in elite middle and long distance runners.

OBJECTIVES: To examine the illness attitudes and beliefs known to be associated with abnormal illness behaviour (where symptoms are present in excess of objective signs and pathology) in elite middle and long distance runners, in comparison with non-athlete controls. METHODS: A total of 150 athletes were surveyed using the illness behaviour questionnaire as an instrument to explore the psychological attributes associated with abnormal illness behaviour. Subjects also completed the general health questionnaire as a measure of psychiatric morbidity. A control group of 150 subjects, matched for age, sex, and social class, were surveyed using the same instruments. RESULTS: A multivariate analysis of illness behaviour questionnaire responses showed that the athletes' group differed significantly from the control group (Hotelling's T: Exact F = 2.68; p = 0.01). In particular, athletes were more somatically focused (difference between means -0.27; 95% confidence interval -0.50 to -0.03) and more likely to deny the impact of stresses in their life (difference between means 0.78; 95% confidence interval 0.31 to 1.25). Athletes were also higher scorers on the Whiteley Index of Hypochondriasis (difference between means 0.76; 95% confidence interval 0.04 to 1.48). There were no differences in the levels of psychiatric morbidity between the two groups. CONCLUSIONS: The illness attitudes and beliefs of athletes differ from those of a well matched control population. The origin of these psychological attributes is not clear but those who treat athletes need to be aware of them.

Adult↗
PubMed1991

The pathology and medicolegal aspects of sexual activity.

The pathology of injury and its complications related to sexual activities has changed remarkably when compared with that of the past, which usually involved assaults or murders of female victims of varying ages, with moderate to serve beatings that may have accidentally resulted in the victim's death. Serial murderers, serial rapists, and molesters of both boys and girls have become much more prevalent in the last two decades in the United States. Unorthodox sexual behavior, such as "fisting," has increased in frequency, as has sexual violence related to cults, such as satanism. All of these present many challenges to medicolegal investigators. This report describes general and specific pathological sexual activities and injuries, some characteristics and methods of the perpetrators, and some specific cases as examples.

Adult↗
PubMed1989

Clinically intensive medical training for combat.

Medical training aimed at the rifleman, aidman, and unit operational level for a Ranger Battalion is described. Instruction in patient survey, cardiopulmonary resuscitation, first aid, intravenous resuscitation, and evacuation is given to all Rangers. Approximately one Ranger per rifle squad is trained as a certified Emergency Medical Technician. Aidmen attend advanced formal schooling and the Battalion runs its own medical sustainment training and Expert Field Medical Badge programs. Casualty play is integrated into exercises. We believe this training increases survivability of soldiers in the field and improves their morale and battlefield effectiveness. These programs can be applied to many organizations and situations.

Allied Health Personnel↗
PubMed1987

Genes encoding spore coat polypeptides from Bacillus subtilis.

Endospores of the Gram-positive bacterium Bacillus subtilis are encased in a tough protein shell, known as the coat, that consists of a dozen or more different polypeptides. We have cloned structural genes designated cotA, cotB, cotC and cotD that encode spore coat proteins of Mr 65,000, 59,000, 12,000 and 11,000, respectively. These genes were cloned by using as hybridization probes synthetic oligonucleotides that were designed on the basis of partial NH2-terminal sequence determinations of the purified coat proteins. To determine the location of the cot genes on the chromosome and to study their function genetically, we tagged each gene by insertion of a chloramphenicol-resistance determinant (cat) within its coding sequence. We then replaced each wild-type cot gene in the chromosome with the corresponding, insertionally inactivated gene. Genetic mapping experiments showed that cotA, cotB, cotC and cotD were located at 52 degrees, 290 degrees, 168 degrees and 200 degrees, respectively, on the B. subtilis chromosome. None of the cot::cat insertion mutants were Spo-, but spores of the cotD mutant were found to germinate somewhat more slowly than did wild-type spores, and the cotA mutant was found to be blocked in the appearance of the brown pigment characteristic of colonies of wild-type sporulating cells. Physical and genetic experiments established that cotA was identical to a previously identified gene called pig, known to be responsible for sporulation-associated pigment production. Spores from all four insertion mutants exhibited the wild-type pattern of coat polypeptides, except for the absence in each instance of the corresponding product of the cot gene that had been insertionally inactivated.

Amino Acid Sequence↗
PubMed1986

Estimating blood supply of the skin and intestine with the fluorescence camera.

We used fluorescein dye to evaluate the vascularity of flaps in 73 patients and of the left colon in 23 individuals after resection and replacement of the abdominal aorta. Instant photographs of the dye pattern were taken in the light using a specially modified Polaroid camera. All areas of skin and bowel that showed adequate staining with the dye survived, and all but one of ten areas that were nonfluorescent became necrotic unless they were excised or revascularized. The intraoperative use of fluorescein dye with the fluorescence camera is a useful technique for all surgeons who need to evaluate the vascularity of tissue.

Aorta, Abdominal↗
PubMed1985

An evaluation of eight methods of using fluorescein to predict the viability of skin flaps in the pig.

The brightness of the fluorescence of fluorescein can be increased by the use of special (interference) filters that allow visualization of the dye when much smaller doses have been given. Standard random-pattern skin flaps were made in pigs and low (1 mg/kg) and high (500 mg) doses of fluorescein were given intravenously. The dye distribution in the flaps was evaluated visually, photographically, and with a dermofluorometer. All the methods proved reasonably accurate in predicting survival, although in an occasional flap, readings by all the methods were off by as much as 3.5 cm. The traditional Wood's lamp visualization proved to be as accurate as any of the newer methods. The inaccuracies of the fluorescein test are probably inherent in the method, since it only measures vascularity at the time the dye is given--and blood supply can change. The main advantage of low-dose fluorescein is that it allows repeated injections at reasonably close intervals. For serial observations, the dermofluorometer is unquestionably the best method.

Animals↗
PubMed1985

How to make superb microangiograms at reasonable X-ray exposures.

The technical factors in microangiography were studied, and we found that the main limiting factor in resolution was film grain size. Ultrafine grain films exist, but they are very slow, necessitating exposures of several hours at conventional settings. Using a modern beryllium window x-ray unit, equally good images can be made in 2 to 5 minutes by using the minimum tube-to-film distance (32 cm) and the maximum kilovoltage (110 kV).

Angiography↗
PubMed1983

The fluorescence camera: how to use fluorescein dye in a normally illuminated room.

The Polaroid SX 70 Sonar camera has been modified so that it will produce instant photographs of the fluorescence of fluorescein in illuminated rooms. The camera was used to record the dye pattern in 40 rats and 65 patients. The photographic method proved to be as good as--but no better than--the visual one in predicting the viability of skin flaps. The camera eliminates the need to totally darken the room and use an ultraviolet lamp; it provides useful information to the surgeon and a permanent record for the chart.

Animals↗
PubMed1983

The perioperative management of the patient with pressure sores.

The occurrence of pressure sores is a major obstacle to the long-term rehabilitation of the spinal cord--injured patient. To achieve the best functional result with the most efficient use of resources, a comprehensive treatment plan is needed. In our twenty-five-year experience we have evolved guidelines for the perioperative management of the spinal cord-injured patient with pressure sores. Through a team approach such as that used at TIRR, the spinal cord-injured patient with a decubitus ulcer can be treated and rehabilitated. Our aim is to decrease morbidity, achieve better functional outcome, and efficiently utilize public and private resources to rehabilitate such patients.

Anti-Bacterial Agents↗
PubMed1982

Ketoconazole therapy for systemic fungal infections: inadequacy of standard dosage regimens.

We treated 29 patients with ketoconazole for systemic mycoses. Twenty-two had coccidioidomycosis, 5 had histoplasmosis, and 2 had sporotrichosis. Of the 25 patients who received 200 mg/day, 16% improved on that dose. Of 17 patients who did not improve on 200 mg/day, 71% responded after the dose was increased to 400 or 800 mg/day. Treatment periods ranged from 21 days to more than 600 days. Five patients relapsed. In 2, ketoconazole had been reduced in dose or discontinued. In 3, the drug was still being given. Ketoconazole is effective in suppressing disease in various mycoses. However, patients may require high doses for prolonged periods to achieve maximal benefit.

Adolescent↗
PubMed1981

Inguinal hernia repair: an experimental model in the rat to evaluate technical factors.

An experimental model in the rat has been developed that we believe simulates the situation in inguinal hernia. Using this model, the bursting strength of wounds made by approximating uninjured fascia were compared with wounds made by apposing either incised fascia or the raw edges left after excising fascia. The strongest healing resulted when raw edges were apposed and when continuous sutures were used. We believe that these studies give support the use of Shouldice's hernia repair.

Animals↗
PubMed1981

The effect of local anesthesia and epinephrine on the size of cryolesions in the experimental animal.

Using the pig as an experimental animal, cryolesions were made 20 minutes after injecting the freeze sites with either saline, 1% Lidocaine, or 1% lidocaine with Epinephrine 1:100,000. The size of the cryolesion was measured 1 week later by injecting the animal with a vital dye and measuring the nonstained areas with a compensating planimeter. Saline and lidocaine had no consistent effect on the size of the necrotic tissue produced by freezing, but epinephrine significantly augmented (47 percent) the killing effectiveness of cryosurgery. If local anesthesia is to be used for cryosurgery, it should contain a vasoconstricting agent.

Anesthesia, Local↗
PubMed1978

Cryosurgery of the skin: an experimental and clinical study.

Using three different instruments, cryolesions were made in the skin of experimental animals (pigs) and the extent of necrosis was determined after one week. The most efficient device was a probe using liquid nitrogen; the amount of tissue killed varied directly with contact time. With all the instruments, a freeze of three minutes consistently led to full-thickness necrosis of the skin. The freeze-thaw-refreeze technique did not produce as much necrosis as a single continuous freeze of the same duration. Cryosurgery was used on 65 benign skin tumors in patients. Pain was minimal and the cosmetic results were excellent. The only difficulty with the method was that it occasionally failed to kill the lesion. For that reason, at present cryosurgery is recommended only for benign lesions. If one suspects that a tumor might be cancerous, it should be biopsied before freezing. If it proves to be malignant, further treatment (excisional or x-ray) should be considered strongly.

Animals↗
PubMed1977

Cryosurgery of the anus.

To further study the effectiveness of cryosurgery of the anus, cryolesions were produced in the rectum of pigs and healing was followed by microangiography and histologic study. In addition, cryosurgery was used on 105 patients (35 as outpatients) with anal pathologic lesions. Results demonstrated that cryosurgery is an effective method of curing most anal lesions. Since the method produced partial anesthesia, postoperative pain was decreased. The cryolesions healed rapidly and well, without major complications. The experimental work demonstrated destruction of the submucosal veins without distortion of muscles or excessive scarring. The mucosa sloughed but healed within two weeks. Cryosurgery makes office hemorrhoidectomy a reality.

Anal Canal↗
PubMed1976

Lack of effect of skin cycle on survival of experimental skin flaps in rats.

Skin flaps were raised in 83 rats. In 58 of them the skin cycle was determined before the flap was raised, and in 25 of them the flap was raised without regard to cycle. There was no significant difference in the surviving length of flaps raised in early anagen, midanagen, telogen, or in randomly selected animals.

Animals↗