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Biomedical subjects

W Holcomb

Publications and source records attributed to W Holcomb.

13 recordsLinked to original sources

The efficacy of video feedback for learning the golf swing.

This study was designed to examine the efficacy of video instruction relative to that of verbal and self-guided instruction. Before training, 30 golfers were assigned at random to one of three groups: video, verbal or self-guided instruction. Video instruction was defined as a practice session in which the teacher was aided by the use of video. Verbal instruction was defined as practising with the teacher providing verbal feedback. Self-guided practice was defined as practising without the aid of a teacher. The participants had a pre-test, four 90 min practice sessions, an immediate post-test and a 2 week delayed post-test. During the pre-test and post-tests, all participants were required to strike 15 golf balls, with a 7-iron, from an artificial turf mat for distance and accuracy. The results showed that all groups were equal on the pre-test. On the first post-test, the two instruction groups performed worse than the self-guided group. However, on the second post-test, the two instruction groups performed better than the self-guided group, with the video group performing best. We interpret these results to mean that video analysis is an effective means of practice, but that the positive effects may take some time to develop.

Adult↗

Intrapartum management of nonvertex second-born twins: a critical analysis.

OBJECTIVE: Our purpose was to assess the impact of the mode of delivery--vaginal delivery versus cesarean section--on the perinatal outcomes of the second-born breech twins. STUDY DESIGN: This study was a retrospective analysis of second-born breech twins with a gestational age of > or =24 weeks at the onset of labor. The patients are divided into three groups: cesarean section without labor (group I), cesarean section after labor (group II), and vaginal breech delivery (group III). RESULTS: There were 141 patients: 40 in group I, 66 in group II, and 35 in group III. There was no birth injury or neonatal death. Group II had one fetus with grade II intraventricular hemorrhage. There was no significant difference among the groups with regard to gestational age, birth weight, hyaline membrane disease, Apgar scores at 1 and 5 minutes, and cord blood gas indices, except venous pH in infants with birth weights <1500 g. CONCLUSIONS: Vaginal delivery of breech second-born twins, with gestational ages of at least 24 weeks, especially those with birth weights of > or =1500 g, appears to be a safe alternative to cesarean section.

Birth Weight↗

Tocolysis with advanced cervical dilatation.

OBJECTIVE: To assess the feasibility and potential benefit of delaying delivery in women with advanced preterm labor. METHODS: Two hundred fifty-seven gravidas with intact membranes and preterm labor at cervical dilatations of at least 3 cm were studied. Women were excluded if they had premature rupture of membranes, gestational age less than 24 or more than 35.9 weeks, complete cervical dilatation, severe hemorrhage, chorioamnionitis, and triplets or higher-order gestations. Management consisted of tocolysis with intravenous magnesium sulfate as the primary agent, antenatal steroids, antibiotics, and amniocentesis. The primary endpoint was delay to delivery interval. Statistical analyses by cervical dilatation were performed using the Pearson chi2 test and a nonparametric test of trend. RESULTS: Eighty-one percent of pregnancies were referrals in utero from outlying hospitals. Delivery was delayed 24 hours or longer in 74% and beyond 48 hours in 60% of cases. Among 229 women who delivered at our center, 21% remained undelivered after 1 week. Evaluating delay as a function of cervical dilatation, trend analysis found a highly significant inverse relationship (P < .001). Among women dilated 5 cm, 46% delivered beyond 48 hours. Among those dilated 6 cm or more, 19% delivered beyond 48 hours. Mild pulmonary edema developed in five percent, and all responded promptly to medical interventions. Chorioamnionitis developed in eight percent. CONCLUSION: Delaying delivery 24-48 hours to allow antenatal steroid use or other interventions is possible in women with advanced preterm labor.

Cervix Uteri↗

Stress reactions of children and adolescents in war and siege conditions.

OBJECTIVE: This was a study of posttraumatic stress symptoms in children and adolescents during siege conditions in Sarajevo. METHOD: Seven hundred ninety-one students aged 7-15 years were surveyed to assess symptoms of posttraumatic stress and level of deprivation. RESULTS: Girls reported more stress than boys. Loss of family members and deprivation of basic needs were associated with more symptoms. CONCLUSIONS: Personal experiences of siege are related to increased stress.

Adult↗

The neonatal bisacromial diameter: a prenatal sonographic evaluation.

This study was designed to determine which fetal ultrasonographic parameter best correlates with the neonatal bisacromial diameter (BAD). The latter is defined as the distance between the two acromions of the scapulae. The study population included fifty-four uncomplicated singleton pregnant patients whose infants with birth weights of more than 3000 grams were delivered within a week of ultrasound examinations. Six fetal biometric parameters: circumferences of the chest, abdomen, head, arm, and thigh, and estimated fetal weight were obtained by ultrasonography and were compared with the BAD. The best predictor of the neonatal bisacromial diameter was the fetal chest circumference (r = 0.67, p = 0.003) followed by the arm circumference, (r = 0.59, p = 0.03). The fetal chest circumference correlates well with the neonatal shoulder girth as reflected by the neonatal bisacromial diameter.

Dystocia↗

A review of the results of laparoscopic versus open appendectomy.

Proponents of laparoscopic appendectomy emphasize the advantages of laparoscopic operation--decreased hospitalization, paralytic ileus, postoperative pain and wound complications, including infection. This study compared open laparoscopic appendectomy with laparoscopic appendectomy. To compare the two techniques, patients undergoing laparoscopic appendectomy at four hospitals were compared with patients undergoing open appendectomy during a six month period. Excluded were incidental appendectomies and patients with perforated appendicitis. An equal number of pediatric patients undergoing laparoscopic and open procedures were included in the analysis to avoid bias, because most of the laparoscopic appendectomies were performed in the adult patient population (age of more than 16 years). A University Medical Center, a Veterans Administration and two community hospitals were the settings. Patients undergoing laparoscopic appendectomy (n = 54) had an average age of 25.7 +/- 1.5 (range of six to 59 years). These patients were compared with 121 patients undergoing open appendectomy whose average age was 23.7 +/- 1.8 (range of three to 83 years). The race and gender distribution were similar in the two groups. Traditional open appendectomy was compared with a group of patients undergoing laparoscopic appendectomy. Variables evaluated were operating room time, number of patients who reported nausea, days until patient tolerated a regular diet, days of hospitalization, postoperative pain medication and wound infection rate. Results are expressed as the mean plus or minus standard error of the mean. Analysis of variance was used to compute continuous variables and Fischer's exact test was used for discrete variables. The laparoscopic approach was attempted in 61 patients and completed in 54 patients. Open appendectomy was performed upon 121 patients. Nineteen patients (18 who underwent open operation and one patient who underwent laparoscopic operation) were excluded from further analysis because of perforated appendicitis. The open procedure took less time (p < 0.05). However, there were more wound infections than in the laparoscopic group (seven of 103 versus zero of 53; p = 0.09). Patients with acute appendicitis recuperated more quickly from the laparoscopic procedure, as evidenced by the time until eating regular diet, period of hospitalization, incidence of nausea and pain medications on postoperative day one (p < 0.05). The absence of wound infections after laparoscopic appendectomy can be attributed to the practice of placing the appendix in a sterile bag or into the trocar sleeve before removal from the abdomen. Laparoscopic appendectomy reduces the period of hospitalization, postoperative ileus, nausea and postoperative pain in patients with acute appendicitis.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

Magnetic resonance, pathology and physiology of the BA1112 rhabdomyosarcoma in vivo.

We studied histology, findings on H-1 magnetic resonance (MR) imaging, and correlations of P-31 MR spectroscopy with microelectrode pH and pO2 measurements in the BA1112 rhabdomyosarcoma in WAG/Rij/Y rats. Intratumoral hemorrhage was a prominent feature on MR images and pathologic specimens. Eosinophilic necrosis could be seen microscopically but was not discernible on images. The peaks seen on P-31 MR spectra were similar to those reported in other tumors. The intratumoral pH was neutral despite low pO2 values and P-31 MR evidence for impaired metabolic status.

Animals↗

The detection of pulmonary emboli by magnetic resonance imaging. Evaluation of imaging parameters.

The authors studied the influence of gating, cardiac cycle, and timing of rephasing gradients upon the detection of pulmonary emboli by MRI. Serial single-section MR images were obtained in normal dogs and dogs with experimental pulmonary emboli. Images with cardiac gating, respiratory gating, and ungated images were obtained. Cardiac gating in systole and late magnetization rephasing had the best diagnostic accuracy. Gated images were clearly superior to ungated; with combined cardiac and respiratory gating, sensitivity was 82% and specificity 88%. These results are sufficiently promising to warrant further studies.

Animals↗

Venous clots: evaluation with MR imaging.

In vitro and in vivo studies were performed to determine the proton relaxation and imaging characteristics of static blood and acute and organized clot in canine jugular veins. In vivo, it was found that two inversion recovery sequences using a short inversion time (100 msec) demonstrated better differentiation of signal intensity of intravascular clot from surrounding soft tissues than did standard T1- and T2-weighted sequences. In vitro, quantitative measurements showed marked reduction of both T1 and T2 relaxation time of acute clot compared with stagnant blood. In addition, the T1 relaxation time, and to a lesser extent the T2 relaxation time, shortened as the clot aged, indicating a potential role for magnetic resonance imaging in determining the age of venous thrombi.

Animals↗