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At least 19 recordsLinked to original sources
PubMed1977

Aortic valve replacement: a ten-year follow-up of non-cloth-covered vs cloth-covered caged-ball prostheses.

From 1965 to 1976, 721 isolated aortic valve replacements were performed at the University of Oregon hospitals, utilizing Starr-Edwards caged-ball prostheses. Three models of aortic prostheses were introduced during this period: a non-cloth-covered model has been in continuous use since 1965; a cloth-covered model was begun in 1968 and has been supplanted by the modified composite-strut or "track" model since 1972. The 5-year actuarial survival rate for operative survivors is about 80% for both non-cloth-covered and cloth-covered valves, while the 10-year survival is 61%, based on the older model only. The actuarially-determined percentages of patients experiencing significant thromboembolic episodes (i.e., all except transient ischemic episodes) at 5 years are 7% for the cloth-covered and 9% for the non-cloth-covered model. If transient ischemic attacks are included, the cloth-covered model has only an 8% incidence at 5 years compared to a 22% incidence for the older model. However, the cloth-covered valves are subject to a higher risk of reoperation because of the possibility of cloth injury. The "track" valve, therefore, was designed with exposed metal on the inner surface of each strut to prevent ball-cloth contact. In 107 patients (mean follow-up period 1 year) receiving anticoagulation, this prosthesis has maintained the same low incidence of thromboembolism as the previous cloth-covered model, with no reoperations for valve failure.

Aortic Valve↗
PubMed1978

Complications due to cloth wear in cloth-covered Starr-Edwards aortic and mitral valve prostheses--and their management.

Five cases of complications due to cloth wear in cloth-covered composite-seat Starr-Edwards aortic and mitral valvular prostheses are described. The complications of cloth wear were recurrent systemic emboli in three patients, two with aortic and one with mitral prosthesis, and severe hemolytic anemia in two patients with aortic prosthesis. The over-all incidence of clinically significant complications due to cloth wear in aortic and mitral valve prosthesis was 2.5 per cent. The diagnosis of cloth wear is impossible before reoperation and it was made by exclusion of other causes of recurrent transient cerebral ischemic attacks or systemic emboli and by exclusion of other causes of hemolytic anemia. Clinical and laboratory findings suggestive of cloth wear are described. Aggressive management of complications of cloth wear by reoperation is likely to prevent disabling or lethal consequences. Porcine xenograft aortic and mitral bioprostheses were used in these patients to replace the cloth-covered valvular prostheses. The symptoms due to cloth wear were abolished in all patients by reoperation, and all patients are off anticoagulants postoperatively. The operative mortality rate for reoperation in this small group of patients was zero.

Adult↗
PubMed1977

Studies on water vapor pressure gradient from external air through clothing to the skin in relation to external humidity and clothing conditions.

Using a hygrometric capsule method developed by the authors, water vapor pressure was measured at each layer of clothing as well as at the skin surface on a human subject under actual wearing conditions. The pattern of vapor pressure gradient from the skin surface through clothing to the external air was examined in relation to the ambient vapor pressure and ths sort of textiles worn. The following findings were obtained. 1) Water vapor pressure gradient was greater between coat and external air than that between coat and underwear. The gradient became steeper again between underwear and the skin. 2) Under given clothing conditions, vapor pressure at each layer of clothing as well as at the skin varied according to the ambient humidity. However, the pattern of vapor pressure gradient from the skin through clothing to the external air was not greatly influenced by the external humidity. 3) The pattern of vapor pressure gradient from the skin through clothing to the external air was not greatly influenced by the external humidity. 3) The pattern of vapor pressure gradient through the clothing as a whole differed according to the kinds of textiles used for coat and underwear.

Adult↗
PubMed1977

Attempts to control clothes-borne infection in a burn unit. I. Experimental investigations of some clothes for barrier nursing.

Clothes-borne transmission is an important way of spread of infection from patient to patient which is not interrupted by common cotton gowns. New barrier garments were designed from spun-bonded olefin that, in particle penetration tests, was 100 times better as a filter than cotton cloth. Three designs, a gown, a loose coverall and a close overall, were compared with each other and with conventional cotton gowns in experimental exercise and nursing procedures. Staphylococcus aureus from burned patients were used as markers. The close coverall was 4-7 times better than the loose coverall or gown in preventing the soiling of clothes worn underneath it, but appeared to permit substantially more transfer from garments underneath it to a mock 'patient' and to the air than did the looser garments. A cotton gown reduced the soiling of clothes underneath it by more than 10 times and the contamination of a mock patient by more than 30 times as compared with no barrier garment. The close coverall further diminished the contamination of clothes but not the transfer to the patient. The possible mechanisms for the discrepancy between particle transmission tests annd experimental porcedures are discussed.

Aerosols↗
PubMed1977

Clothing adaptations: the occupational therapist and the clothing designer collaborate.

An occupational therapist and a clothing designer collaborated in solving the dressing problem of a child with multiple amputations. The dressing problems were identified and solutions for clothing adaptations relating to sleeves, closures, fasteners, fit, and design were incorporated into two test garments. Evaluation of the garments was based on ease in dressing and undressing, the effect on movement and mobility, the construction techniques, and their appearance. A description is given of the pattern adjustments, and considerations for clothing adaptations or selection or both are discussed. These clothing adaptations can be generalized to a wider population of handicapped persons.

Amputees↗
PubMed1979

Attempts to control clothes-borne infection in a burn unit, 2. Clothing routines in clinical use and the epidemiology of cross-colonization.

Previous investigations have shown that cross-contamination in a burn unit is mainly clothes-borne. New barrier garments have been designed and tried experimentally. The aim of the present study was to investigate the effects of different clothing routines on cross-contamination. In a long-term study, the rates and routes of colonizations with Staphylococcus aureus, Streptococcus groups A, B, C, F, and G and Pseudomonas aeruginosa were examined. The exogenous colonization rates were, with S. aureus 77%, with Streptococcus species 52% and with Ps. aeruginosa 32%. The colonization rate with Ps. aeruginosa was higher in patients with larger burns. Patients dispersed Streptococcus and Ps. aeruginosa as well as S. aureus into the air of their rooms in considerable amounts, but dispersers were not more important as sources of cross-colonization than non-dispersers. In comparison of clothing routines, there was no difference in overall colonization rates. The newly designed barrier garment that was made from apparently particle-tight material did not reduce the transfer of bacteria from patient to patient. A less rigid routine than that previously used did not increase the risk of cross-contamination. A thorough change of barrier dress after close contact nursing delayed the first exogenous S. aureus colonization from day 6 to day 14 after admission. This routine might be recommended for clinical use. Otherwise, methods must be developed for adequate selection of materials intended for barrier garments.

Air Microbiology↗
PubMed1976

Mitral valve replacement: a 10-year follow-up of non-cloth-covered vs. cloth-covered caged-ball prostheses.

The timing of operation and the selection of prosthesis depend upon the evaluation of long-term results at 5 years and beyond. From 1965 to 1975, 290 patients had isolated mitral valve replacement with currently used prostheses, resulting in a 6.6% operative mortality and 64% relative survival at 10 years. In considering mortality, the results obtained with both series of valves were combined and a search made for significant differences in preoperative variables between the operative deaths and operative survivors. The significant variables for operative mortality were valve model, preoperative functional class, pump time, and the presence or absence of right ventricular hypertrophy on electrocardiography. There were significant differences in long-term survival only with regard to preoperative functional class, pulmonary vascular resistance, and pump time. Exponential curves were fitted to the event-free rates, and long-term results were then extrapolated. The 10-year projection of the percentage of patients alive and free of embolus (disregarding transient ischemic attacks) for the Model 6310-6320 (50%) was similar to that actually observed for the Model 6120 (46%). Although further experience may show one prosthesis more effective than the other, statistical extrapolations suggest continued comparable performance.

Female↗
PubMed1977

[Evaluation of the effects of cooling clothes on the adaptation to prolonged exertion in high temperatures by miners].

In order to improve the working conditions of coalminers exposed to high ambient temperature, the authors have studied the effects of wearing an under-vest and a cowl covering the head and shoulders made in sponge-cloth and soaked with cold water (cooling clothes). Eight coalminers volunteered for this study which included three sessions of prolonged intermittent exercise performed in a climatic room with the following ambient temperatures:--experiment A (comfortable environment): td = 28 degrees C; twb = 20 degrees C; bare head and bare torso;--experiment B (hot environment) :td = 38 degrees C; twb = 30 degrees C; bare head and bare torso;--experiment C (hot environment and cooling clothes) : td = 38 degrees C; twb = 30 degrees C; wet undervest and cowl soaked with cold water (16 degrees C) every 15 minutes. Each experiment included 5 periods of exercise each lasting 15 minutes separated by periods of rest lasting 15 minutes; the exercises were performed on a bicycle ergometer or on a treadmill and their intensity corresponded to 50% of the maximal oxygen intake. In the comfortable environment (experiment A), all subjects completed the experiment without undue fatigue; the final heart rate was 81/min and the final rectal temperature was 37.6 degrees C; the weight loss never exceeded 1 Kg. In the hot environment (experiment B), all subjects were exhausted at the end of the study which had to be shortened in 2 cases. The final heart rate was 125/min and the final rectal temperature 38.8 degrees C; the weight loss was above 2 Kg. The use of the "cooling clothes" in the hot environment (experiment C) resulted in significantly (p less than 0.001) lower heart rate (104/min), rectal temperature (38.3 degrees C) and weight loss (1.5 Kg); all subjects completed the experiment, none was exhausted and the "cooling clothes" were appreciated by all subjects. We conclude that the "cooling clothes" tested in the present study significantly reduce the physiological and subjective strain due to intermittent work in a hot environment; this cooling system is simple, of low cost and our results indicate that it is will be very useful in climatic conditions similar to those adopted in the present experimental protocol. Its usefulness in less severe climates has to be established but it might be limited by the subjective reactions of the subjects to the transient but sudden sensation of cold given by the "cooling clothes".

Adaptation, Physiological↗
PubMed1978

Evaporative heat loss and clothing.

Several experiments have been conducted on the effect of clothing on evaporative heat loss. 1) The movement of sweat from production to evaporation was observed in nude subjects, on subjects wearing underwear and underdrawers, and on subjects wearing two layers of clothing during a two-hour heat exposure period. The percentage of evaporated sweat was found to be inversely proportional to total sweat loss. When this relation was taken into consideration, it was revealed that the percentage of evaporated sweat was smaller if more layers of clothing were added, or if water-proof or vapor-proof materials were added. 2) Using a so-called "sweating cylinder," the cooling power of water dissipated from the surface of the cylinder was measured when the cylinder was covered with one, two, or three layers of various kinds of cloths. The cooling efficiency (actual evaporative cooling/latent heat of total water lost) was about 95% when the cylinder was uncovered. As more layers of covering cloth were added, the cooling efficiency became less. When the covering cloth touched the wet surface of the cylinder directly and absorbed water, the cooling efficiency was remarkably reduced because a large portion of the water absorbed in the cloth remained unevaporated.

Adult↗
PubMed1978

Teaching retarded women a clothing selection skill using community norms.

Five institutionalized retarded women were taught a clothing selection skill to coincide with popular fashion. Normative data concerning popular styles of color-coordinated clothing were collected through observations of women's apparel in a local community. Using a puzzle simulation of a woman with alternative pieces of colored clothing, color coordination training was conducted using modelling, instructions, practice, praise, and feedback to teach popular selections of color combinations. A generalization training component with actual clothing was also included. Training was accompanied by large increases in percentage of popular color selections with the puzzle and actual clothing. The increases maintained over a seven- to 14-week followup period. Time efficiency measures supported the use of the simulation procedure as opposed to total reliance on actual clothing. The results underscore the utility of local norms in community preparation programs and the efficacy of instructional procedures for severely and profoundly retarded persons as part of their participation in the deinstitutionalization movement.

Adult↗
PubMed1976

Clothing as a nonverbal communicator or sexual attitudes and behavior.

To test the hypotheses that people believe that certain kinds and styles of clothing are indicative of liberal sexual attitudes and behavior and these beliefs are correct, questionnaires were filled out by 259 subjects. These questionnaires asked each subject for the frequencies with which he wore various items and styles of clothing, his attitude toward premarital sexual relations, the number of persons with whom he had had sexual relations, the frequencies with which he believed sexually liberal men and women wore various items and styles of clothing, and the frequencies with which he felt sexually conservative men and women wore various items and styles of clothing. Correlations showed that, although subjects believed that a large number of items and styles of clothing are indicative of liberal sexual attitudes and behavior, only a few items and styles actually were associated with liberal sexual attitudes and reported behavior.

Attitude↗
PubMed1979

Thermal strain resulting from protective clothing of an armored vehicle crew in warm conditions.

The purpose of the study is to define a method of evaluation of physiological strain resulting from protective garments worn in warm conditions by the armored vehicle crew. A technique is developed evaluating evaporative transfer through clothing by continuous weighing of the active man (accuracy +/- 3/g). An index is defined (Iw) as the ratio of steady-state evaporating rate in clothed conditions to steady-state evaporation of nude subject in the same conditions of work and heat stress. The Iw index is significantly related to physiological strain determined by increased body heat content and reduced tolerance time. The results are compared to other previous findings concerning evaporative transfer through clothing and physiological strain indexes. The technique shows that evaporation through heavy clothing is not negligible. It is suggested that usual static measurements using physical models underestimate the evaporative heat transfer through clothing layers.

Body Temperature↗
PubMed1976

The relationship of skin temperatures of clothed adults to ambient temperature in a warm environment.

In forty-one apyrexial adult male patients, who were clothed in light-weight cotton pyjamas, mean skin temperature was determined and, simultaneously, ambient temperature and the temperature of air space under clothing were measured. Both mean skin temperature and the temperature of the air space under clothing showed a linear increase with ambient temperature. Heat loss by vapourization of water is known to have a curvilinear relationship to ambient temperature. Application of the temperature relationships obtained in this study to the vapourization curve indicates that clothing shifts the point of sharp upward inflection of the curve to the left; and, if ambient temperature is to be employed to predict the amount of cutaneous water loss in clothed individuals, the extent of this shift must be determined. The data obtained in the present study has been applied to studies of evaporative water loss in Lagos.

Adult↗
PubMed1977

Long-term results in 1375 patients undergoing valve replacement with the Starr-Edwards cloth-covered steel ball prosthesis.

The two principal considerations with prosthetic valves are durability and thromboembolism. With the widespread interest in recently developed prosthetic valves (porcine, tilting disc, Cooley), the long-term results at one institution with a single prosthesis were considered of particular importance. Accordingly, a 97% follow-up has been completed on 1375 patients (pts) undergoing prosthetic valve replacement with the Starr-Edwards cloth-covered steel ball prosthesis at New York University between October 1967 and December 1975. Operative procedures were as follows: aortic valve replacement (AVR): 470 pts; mitral valve replacement (MVR): 362 pts; combined AVR and MVR: 129 pts; other combined procedures: 414 pts. Overall operative deaths were 13.7%, 9% for AVR, 10.8% for MVR, and 18.6% for combined AVR and MVR. At seven years, AVR survival was 64%, and MVR survival 64.5%. There has been widespread pessimism, usually without significant data, about the cloth-covered prosthesis, because of concern of cloth wear, hemolysis and other complications. Therefore, a particularly significant finding by actuarial analysis was that 85% of surviving patients with isolated AVR remained free of emboli for five years. In pts surviving isolated MVR, 80% remained free of emboli for five years. Of those having embolic episodes, 33% were not on anticoagulants. Fatal hemorrhage from anticoagulants occurred in 0.8% of pts. Endocarditis occurred in 5.7% of the entire group, with 1.3% requiring reoperation. Clinically significant hemolysis occurred in 5.1% of the group, with only 0.2% requiring reoperation. Hence, the total frequency of clinically significant cloth-wear was less than 0.5%. These data indicate both the reliability and the limitations of the Starr-Edwards cloth-covered steel ball valve and can be used in comparing experiences with the more recently developed prostheses.

Aortic Valve↗