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Biomedical subjects

A Heath

Publications and source records attributed to A Heath.

104 records · Page 6Linked to original sources
PubMed1980

Hemoperfusion with Amberlite resin in the treatment of self-poisoning.

Ten patients with various intoxications were treated with resin hemoperfusion. Three of four patients with grade IV coma due to tricyclic antidepressant (TCA) poisoning could be extubated during or on termination of hemoperfusion. Clearance values of 135--185 and 190--200 ml/min were obtained for amitriptyline and nortriptyline, respectively. One patient with severe chloral hydrate poisoning could be extubated after less than one hour's hemoperfusion. A clearance of 140 ml/min was obtained in a uremic patient with AV block II due to digitoxin intoxication. Four patients with mushroom poisoning were treated with combined hemoperfusion-hemodialysis. A transient fall in platelet count was seen in all patients. Resin hemoperfusion is of definite value in selected, severe cases of self-poisoning with psychotropic drugs such as TCA and possibly in cases of mushroom poisoning where the prognosis with hemodialysis and supportive therapy is doubtful.

Adult↗
PubMed1980

Increased platelet aggregation induced by glucagon administration.

The effect of 1 mg of intravenous glucagon on platelet aggregation has been investigated in 12 normal subjects pre-treated with salicylate. All subjects demonstrated the expected inhibition of collagen-induced secondary aggregation but retained the normal adenosine diphosphate (ADP)-induced primary aggregation phase 18 h after the salicylate therapy (600-1,200 mg). Subsequent administration of glucagon caused a significant increase in the ADP-induced primary aggregation phase in the 12 subjects. This data indicates that glucagon increases the reactivity of platelets to ADP and may help to explain the common clinical association of raised plasma glucagon, increased platelet aggregation and vascular disease.

Adenosine Diphosphate↗
PubMed1979

Self-poisoning treated in the ICU.

This retrospective study compares number and type of self-poisonings admitted to the intensive care units (ICU) at Sahlgren's Hospital, Gothenburg, during 1972 and 1976. The total number of patients requiring intensive care was unchanged, but a change in the pattern of self-poisoning was seen. In 1976 the number of patients requiring intensive care following acute alcohol intoxication had increased, whereas the number of barbiturate and methaqualone poisonings decreased. Tricyclic antidepressants formed the largest group in both years. Fewer patients needed endotracheal intubation and IPPV in 1976 than in 1972. Also, fewer complications were seen, and the death rate among ICU-treated patients decreased. In the Gothenburg area barbiturates accounted for one half of all deaths due to self-poisoning and tricyclic antidepressants for one fifth. Any expected decrease in intensive care as a result of fewer barbiturate and methaqualone poisonings was obscured by an increase in severe alcohol intoxication.

Alcoholic Intoxication↗
PubMed1978

Anticonvulsants and thyroid function.

Serum total and free thyroid hormone concentrations were estimated in 42 patients with epilepsy taking anticonvulsants (phenytoin, phenobarbitone, and carbamazepine either singly or in combination). There was a significant reduction in total thyroxine (TT4), free thyroxine (FT4), and free triiodothyronine (FT3) in the treated group compared with controls. Free hormone concentrations were lower than total hormone concentrations, suggesting that increased clearance of thyroid hormones occurs in patients receiving anticonvulsants. Detailed analysis indicated that phenytoin had a significant depressant effect on TT4, FT4, FT3, and reverse T3 (rT3). Phenobarbitone and carbamazepine had no significant main effects, but there were significant interactions between phenytoin and carbamazepine for TT4 and FT4. phenobarbitone and carbamazepine for FT3, and phenytoin and phenobarbitone for rT3.

Adolescent↗
PubMedDate not supplied

Role of extracorporeal drug removal in acute theophylline poisoning. A review.

Theophylline, with its narrow therapeutic margin, is a common cause of iatrogenic and deliberate overdose. Most cases of self-poisoning are with sustained release preparations, with peak concentrations occurring up to 12 or more hours after overdose. Toxic symptoms are often seen at concentrations above 15 mg/L. Theophylline is metabolised within the cytochrome P-450 system, with an average total body clearance of 50 to 60 ml/min. Clearance is, however, affected by many factors such as other drugs or disease, and in overdose zero order kinetics may result in prolonged half-lives. Toxicity is characterised by agitation, tremor, nausea, vomiting, abdominal pains, seizures, and tachyarrhythmias. Hypokalaemia and metabolic acidosis are more profound in acute toxicity, and hypercalcaemia is usually present. Seizures occur at lower concentrations after chronic over-medication than after acute overdose. Gastric lavage should be performed in all patients presenting early, and an oral multiple dose charcoal regimen started with 50 to 100g charcoal, repeating with 50g doses and checking theophylline concentrations at 2- to 4-hour intervals. Multiple dose charcoal can be expected to double the clearance of theophylline, being as effective as a haemodialysis. Of the invasive techniques available, charcoal haemoperfusion is the most effective, increasing clearance 4- to 6-fold. Supportive care is particularly important. The aggressive supplementation of potassium, treatment of emesis with droperidol and ranitidine, and treatment of tachyarrhythmias and hypotension (possibly with propranolol), together with oral multiple dose charcoal may obviate the need for haemoperfusion. Seizures suggest increased morbidity and mortality. Charcoal haemoperfusion should be considered if plasma concentrations are greater than 100 mg/L in an acute intoxication or greater than 60 mg/L in a chronic intoxication. The decision to haemoperfuse should not be based on plasma concentrations alone, but an overall evaluation of the patient's laboratory and clinical status.

Blood Transfusion↗
PubMedDate not supplied

The HeartSmart Family Fun Pack: an evaluation of family-based intervention for cardiovascular risk reduction in children.

In 1998, the Heart and Stroke Foundation launched the HeartSmart Family Fun Pack, a "user-friendly" resource to support family-based lifestyle changes among children age 6-12 years. Of 1,387 parents who completed a pre-intervention questionnaire, 300 (21%) were surveyed three months later. Comparisons of the pre- and post-intervention surveys show that the Family Fun Pack was effective in supporting healthy lifestyle changes (38% and 28% of families reported improvement in their child's nutrition and level of physical activity, respectively; 12% reported reduced passive smoking). Effectiveness was greatest among those families who self-identified themselves as being in what corresponds to the contemplation, preparation and action stages of change. This evaluation suggests that a relatively low-cost intervention can be effective in supporting positive lifestyle changes if targeted to families at specific points in the stages of change.

Canada↗