Naval Regional Medical Center Research Articles

In memoriam: Robert T. Leshner, MD

In memoriam: <scp>Robert T. Leshner</scp>, <scp>MD</scp>

Defining myocardial infarction for future care

Joseph Alpert speaks to Adam Born, Assistant Commissioning Editor: Joseph Stephen Alpert is Professor of Medicine and Director of the Coronary Care Unit at University of Arizona Medical Center–University Campus (AZ, USA). A native of CT, USA, Alpert obtained his Bachelor of Arts degree (magna cum laude) from Yale University (CT, USA). He obtained his medical doctorate (cum laude) from Harvard Medical School (MA, USA). Alpert did his internal medicine residency and cardiology training at Peter Bent Brigham Hospital (MA, USA) and was a Research Fellow of the Massachusetts Heart Association (MA, USA) and the National Institutes of Health (MD, USA). Following his fellowship, Alpert became a staff cardiologist and Director of the Coronary Care Unit at the Naval Regional Medical Center in San Diego (CA, USA) and an Assistant Clinical Professor of Medicine at the University of California, San Diego (CA, USA). Following his military service, he returned to Harvard Medical School and was appointed as Assistant Pro...

Nuclear imaging for musculoskeletal infections in children.

We retrospectively reviewed all patients who underwent bone scanning for possible osteomyelitis at the Naval Regional Medical Center (Portsmouth, VA, U.S.A.) between 1980 and 1983. Among 63 children, there were 20 sites of osteomyelitis. We were able to conclude that a high proportion of neonates with septic arthritis will have osteomyelitis and that bone scan is not helpful in this age group. Nuclear imaging of the foot was less reliable than imaging of the remainder of the extremities. The bone scan can be a useful adjunct in the diagnosis of osteomyelitis in certain children, but is not a substitute for an accurate clinical examination and appropriate workup.

A laboratory model for vascular microsurgery.

This article describes the microsurgical training model used at the Naval Regional Medical Center in San Diego, where first year residents spend two weeks of concentrated effort developing basic skills in microsurgery. This training is done outside the busy hospital environment so that no interruptions are encountered. Following this initial experience, weekly research sessions are continued to maintain proficiency and to develop new techniques. A description of the medical center's modifications of several previously used microsurgical techniques is presented. This model is economical and realistic for a student's initial exposure to microvascular surgery. It also serves as an expedient, yet challenging, means of maintaining proficiency when laboratory time is limited.

Child abuse in a military population.

A retrospective review of all Child Advocacy Committee records at Naval Regional Medical Center, Portsmouth, Virginia, was carried out in an attempt to characterize abuse in a military population. We found little difference between our 273 cases of documented abuse and previous reports from civilian institutions as far as patient age, death rate, types of injuries, and social factors involved. We attributed our low incidence of fractures (11%) to our active Child Advocacy Committee. Spiral fractures in children less than 3 years old were the most common orthopedic injury and we concluded that a high index of suspicion should be maintained in young children with spiral fractures.

Antenatal Diagnosis of Cystic Meconium Peritonitis

Journal of Ultrasound in MedicineVolume 2, Issue 1 p. 49-50 Article Antenatal Diagnosis of Cystic Meconium Peritonitis CDR Robert W. Hartung, CDR Robert W. Hartung Radiology Service. Naval Regional Medical Center, Camp Pendleton California. Currently with the Department of Radiology, University of Iowa Hospitals, Iowa City, IowaSearch for more papers by this authorLCDR Thomas S. Kilcheski, LCDR Thomas S. Kilcheski Department of Radiology, Naval Regional Medical Center, San Diego, CaliforniaSearch for more papers by this authorLCDR Richard B. Greaney, LCDR Richard B. Greaney Department of Radiology, Naval Regional Medical Center, San Diego, CaliforniaSearch for more papers by this authorCDR Randall W. Powell, CDR Randall W. Powell Department of Surgery, Naval Regional Medical Center, San Diego.Search for more papers by this authorCAPT Larry R. Evertson, CAPT Larry R. Evertson Department of Obstetrics and Gynecology, Naval Regional Medical Center, San Diego.Search for more papers by this author CDR Robert W. Hartung, CDR Robert W. Hartung Radiology Service. Naval Regional Medical Center, Camp Pendleton California. Currently with the Department of Radiology, University of Iowa Hospitals, Iowa City, IowaSearch for more papers by this authorLCDR Thomas S. Kilcheski, LCDR Thomas S. Kilcheski Department of Radiology, Naval Regional Medical Center, San Diego, CaliforniaSearch for more papers by this authorLCDR Richard B. Greaney, LCDR Richard B. Greaney Department of Radiology, Naval Regional Medical Center, San Diego, CaliforniaSearch for more papers by this authorCDR Randall W. Powell, CDR Randall W. Powell Department of Surgery, Naval Regional Medical Center, San Diego.Search for more papers by this authorCAPT Larry R. Evertson, CAPT Larry R. Evertson Department of Obstetrics and Gynecology, Naval Regional Medical Center, San Diego.Search for more papers by this author First published: 01 January 1983 https://doi.org/10.7863/jum.1983.2.1.49Citations: 2AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume2, Issue1Jan 1983Pages 49-50 RelatedInformation

THE ROLE OF EXERCISE IN THE RETARDATION OF GLUCOSE INTOLERANCE AND CORONARY RISK FACTORS IN DIABETICS

Human Performance Lab., University of California, Berkeley, CA 94704, and Clinical Investigation Center, Naval Regional Medical Center, Oakland, CA 94627

The dysplastic nevus syndrome: what is it?

From the Department of Dermatology and the Clinical Investigation Center, Naval Regional Medical Center, San Diego, California.

Esophageal Perforation: Its Early Diagnosis and Treatment

Perforation of the esophagus is potentially the most lethal of any site in the gastrointestinal tract and is also the greatest therapeutic challenge. Although uncommon, esophageal perforation continues to occur even in the hands of very well-trained and experienced endoscopists. The literature reports the incidence of instrumental esophageal perforation to be between 0.25% and 1%. A review of 374 consecutive rigid esophagoscopies at the Naval Regional Medical Center, Oakland, CA, over a three-year period revealed three perforations for an overall incidence of 0.8%. This paper will review cases.

Reversible pure red cell hypoplasia in pregnancy

PREGNANCY is normally a state of erythroid hyperplasia. Increased erythropoiesis during pregnancy is controlled by erythropoietin, which is augmented by the action of placental lactogen and inhibited by high levels of estrogen.¹We describe a case of a patient with pure red cell hypoplasia during pregnancy that resolved completely in the postpartum period. <h3>Report of a Case</h3> On Jan 22, 1981, a 23-year-old primigravida came to the obstetric clinic at Naval Regional Medical Center (NRMC), Charleston, SC, for an initial prenatal visit at approximately 24 weeks' gestation. A routine hemoglobin level and hematocrit reading were noted to be 9.0 g/dL and 27.1%, respectively. Administration of ferrous sulfate, 325 mg, one tablet three times a day, was begun. A follow-up visit four weeks later revealed a hemoglobin level of 7.1 g/dL and a hematocrit reading of 24.3%. The patient denied noncompliance with respect to self-administration of the prescribed medication. The

Reversible Pure Red Cell Hypoplasia in Pregnancy

PREGNANCY is normally a state of erythroid hyperplasia. Increased erythropoiesis during pregnancy is controlled by erythropoietin, which is augmented by the action of placental lactogen and inhibited by high levels of estrogen.¹We describe a case of a patient with pure red cell hypoplasia during pregnancy that resolved completely in the postpartum period. <h3>Report of a Case</h3> On Jan 22, 1981, a 23-year-old primigravida came to the obstetric clinic at Naval Regional Medical Center (NRMC), Charleston, SC, for an initial prenatal visit at approximately 24 weeks' gestation. A routine hemoglobin level and hematocrit reading were noted to be 9.0 g/dL and 27.1%, respectively. Administration of ferrous sulfate, 325 mg, one tablet three times a day, was begun. A follow-up visit four weeks later revealed a hemoglobin level of 7.1 g/dL and a hematocrit reading of 24.3%. The patient denied noncompliance with respect to self-administration of the prescribed medication. The

Legionnaires' Disease in an Immunologically Normal Child

Legionnaires' disease is being recognized more frequently in children. Recent reports of cases in a child with lymphocytic leukemia 1 and in one with Down's syndrome 2 emphasize the possibility that immunocompromise is an antecedent risk factor. We report a case of Legionnaires' disease in an immunologically normal child. Report of a Case. —A 4-year-old girl was referred to Naval Regional Medical Center, Portsmouth, Va, for fever, dyspnea, and an abnormal chest roentgenogram on March 1, 1980. Her illness had begun five days previously with mild congestion and generalized malaise. Four days prior to admission, a school physical examination had revealed an erythematous throat but with no complaints. A throat culture had been done. During the 72 hours before admission, she had had temperature of 39.5 °C, and right-sided chest and shoulder pain had developed with rapid, shallow respirations. Chest roentgenogram revealed a right middle lung field perihilar infiltrate. She

Transthoracic gastric stapling: Effective new surgical approach to morbid obesity

"There is a consensus that jejunoileal bypass is no longer an acceptable operation for the treatment of morbid obesity because of well-documented serious complications." Over the past 3 years, experience with the gastric stapling procedure has shown it to be a safe and effective operation for the surgical treatment of morbid obesity. The purpose of the operation is to establish a very small proximal gastric reservoir with a tiny outlet for passage of digested food into the distal stomach. By permitting a comfortable intake of only 2 ounces at a time, the procedure affords an average weight loss of 8 pounds per month. At the Naval Regional Medical Center, Oakland, California (NRMC-O), a new approach to gastric stapling using a transthoracic, transdiaphragmatic technique has been initiated. The transthoracic approach offers the following advantages over the transabdominal approach: (1) better and easier exposure, (2) less chance of splenic injury, (3) a thinner layer of subcutaneous fat through which to dissect, (4) decreased problem with postoperative ileus, and (5) decreased incidence of wound infection and dehiscence. Twenty patients have undergone this procedure at NRMC-O over the past 16 months with no significant morbidity and no deaths. Th average operative time is 2 hours and the average hospital stay in 8 days. Beneficial metabolic and endocrine effects of weight loss have been recorded through our computerized data bank. The data confirm that gastric stapling is a safe and effective procedure and that the transthoracic approach offers ease of exposure and minimizes postoperative complications.

POST-OP BP IN CLONIDINE OR METHYLDOPA-TREATED PATIENTS

Department of Anesthesiology, US Naval Regional Medical Center, Oakland, California 91627, National Naval Medical Center, Bethesda, Maryland 20014, and the Bowman Gray School of Medicine, Winston-Salem, North Carolina 27103

Dynamic Bracing

Conventional bracing places constraints on the determinants of gait, which in the borderline patient, may derange gait as much or more than the postural deformity being treated. A small number of children with cerebral palsy, spina bifida, and muscular dystrophy were treated with below-knee orthoses (BKO) along with elastic bracing of the remainder of the limb. The elastics were used to augment muscle power in weakness, oppose spastic muscles, supply antagonism to unopposed muscle, and improve function. The key elements in this system include proximal attachment of elastics to the below-knee orthosis resultin in effective knee action independent of foot control; variable 2-joint function of elastics; and emphasis on a BKO-shoe combination, which positions the knee in front of the ankle at midstance. Because a small number of components are employed to produce a variety of actions, an understanding of the mechanics fo gait is needed for the rational application of this method of treatment as well as for the selection of suitable patients.

Bridging the Gap Between Inhospital and Outpatient Care

ANNE M. DEVNEY, R.N., B.S., a lieutenant commander in the United States Navy Nurse Corps, was charge nurse of the Intermediate Medical Intensive Care Unit at the Naval Regional Medical Center, San Diego, Calif., when she wrote this article.

Ventilatory and Cardiovascular Effects of Enflurane Anesthesia during Spontaneous Ventilation in Man

Departments of Anesthesia, University of California, San Diego, U. S. Naval Regional Medical Center, San Diego, University of Bristol, Bristol, United Kingdom, and University of California, San Francisco

GLUCOSE CONTROL IN NORMAL AND OBESE SURGICAL PATIENTS

Department of Anesthesia, Bowman Gray School of Medicine, Winston-Salem, North Carolina 27103, and Department of Anesthesiology and the Clinical Investigation Center, Naval Regional Medical Center, Oakland, California 94627

Direct calculation of MTF from ERF

Medical PhysicsVolume 6, Issue 5 p. 460-461 Direct calculation of MTF from ERF James W. Israel, James W. Israel Naval Regional Medical Center, Phidelphia, Pennsylvania 19145Search for more papers by this author James W. Israel, James W. Israel Naval Regional Medical Center, Phidelphia, Pennsylvania 19145Search for more papers by this author First published: September 1979 https://doi.org/10.1118/1.594601AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume6, Issue5September 1979Pages 460-461 RelatedInformation

Incompatibility between Carbenicillin Injection and Promethazine Injection

Journal Article Incompatibility between Carbenicillin Injection and Promethazine Injection Get access Glen E. Otterman, Jr., LCDR, MSN, Glen E. Otterman, Jr., LCDR, MSN Coordinator, Clinical Pharmacy Department of the Navy Naval Regional Medical Center San Diego, CA 92134 Search for other works by this author on: Oxford Academic Google Scholar Duane W. Samuelson Duane W. Samuelson Department of the Navy Naval Regional Medical Center San Diego, CA 92134 Search for other works by this author on: Oxford Academic Google Scholar American Journal of Hospital Pharmacy, Volume 36, Issue 9, 1 September 1979, Page 1156, https://doi.org/10.1093/ajhp/36.9.1156b Published: 01 September 1979