Search PubMed⌕ Search

Biomedical subjects

A McCluskey

Publications and source records attributed to A McCluskey.

45 records · Page 3Linked to original sources
PubMed1997

Dose-response relationship and effective time to satisfactory intubation conditions after rocuronium in children.

We assessed the neuromuscular blocking effects of, and intubation conditions following, rocuronium in 81 children aged 2-12 years. The study was conducted in three parts. Parts 1 and 2 were undertaken during anaesthesia with thiopentone, alfentanil and nitrous oxide. Neuromuscular blockade was evaluated by recording the force of contraction of the adductor pollicis in response to train-of-four stimulation at 2 Hz repeated every 10s. In Part 1 the potency of rocuronium was determined in 15 children using a single dose-response technique; in Part 2 onset and recovery times were determined in six children following rocuronium 0.6 mg.kg-1. In Part 3 of the study, intubation conditions were assessed in five groups of 12 children whose tracheas were intubated 30, 40, 50, 60 and 70s after rocuronium 0.6 mg.kg-1 during anaesthesia with thiopentone. The times to satisfactory intubation conditions in 50% and 90% of children were determined by probit analysis. The effective doses of rocuronium to produce 50% and 95% twitch depression were 151 micrograms.kg-1 (95% confidence intervals: 129-173 micrograms.kg-1) and 331 micrograms.kg-1 (95% confidence intervals: 249-543 micrograms.kg-1), respectively. The mean times (SD) to 90% and 100% depression of control twitch following rocuronium 0.6 mg.kg-1 were 42 (11.8) s and 60.3 (19.3) s, respectively. The times to 5%, 25%, 75% and 90% recovery were 20.5 (3.1) min, 26.1 (4.1) min, 35.1 (5.4) min, and 39.5 (6.4) min, respectively. Intubation conditions were satisfactory in 4/12 children at 30 s, 6/12 at 40 s, 8/12 at 50 s, 11/12 at 60 s and 12/12 at 70 s. The times to satisfactory intubation conditions in 50% and 90% of children after rocuronium 0.6 mg.kg-1 were 38 s (95% confidence intervals: 30-44 s) and 61 s (95% confidence intervals: 55-70 s), respectively.

Androstanols↗
PubMed1996

Dose-response and minimum time to satisfactory intubation conditions after mivacurium in children.

We assessed neuromuscular blocking effects and tracheal intubation conditions following mivacurium in 121 anaesthetised children aged 1-10 years. The study was conducted in three parts. Parts 1 and 2 were undertaken during thiopentone-alfentanil-nitrous oxide anaesthesia; neuromuscular blockade was evaluated by recording the force of contraction of the adductor pollicis in response to train-of-four stimulation at 0.1 Hz. In part 1 the potency of mivacurium was determined in 15 children using a single dose-response technique; in part 2 onset and recovery times were determined in six children following a dose of mivacurium 0.2 mg.kg-1. In part 3 of the study, clinical intubation conditions were assessed in two groups of 50 children whose tracheas were intubated 60 or 90 s after injection of mivacurium 0.2 mg.kg-1 during thiopentone-nitrous oxide anaesthesia. The ED50 and ED95 of mivacurium were 54 and 105 micrograms.kg-1 respectively. The times to 90% and 100% depression of control twitch were 1.3 (0.3) and 1.9 (0.5) min; times to 5%, 25%, 75% and 90% recovery were 6.4 (1.0), 8.4 (1.1), 12.5 (1.1) and 14.4 (1.9) min, respectively. Intubation conditions were rated satisfactory in 33/50 children (0.66, 95% confidence interval 0.51-0.79) at 60 s and in 49/50 children (0.98, 95% confidence interval 0.89-1.0) at 90 s (p = 0.0001). Intubation conditions 90 s after mivacurium 0.2 mg.kg-1 were significantly better than those obtained in 10 patients given anaesthetic drugs alone (p = 0.002).

Alfentanil↗
PubMed1996

The prognostic value of serial measurements of serum albumin concentration in patients admitted to an intensive care unit.

The prognostic value of serial measurements of serum albumin concentration during the first 72 h after admission to a general adult intensive care unit was retrospectively reviewed in 348 consecutive critically ill patients over a one year period. The accuracy of the admission APACHE II (Acute Physiology And Chronic Health Evaluation) score in correctly predicting patient outcome was compared with the serum albumin concentration measured at different times after intensive care unit admission. Multiple logistical regression analyses were performed to evaluate whether combining APACHE II and serum albumin into a unified risk index improved prognostic accuracy. Serum albumin concentration on admission was lower in non-survivors than in survivors and decreased more rapidly in non-survivors (p < 0.001). The admission serum albumin concentration was found to be an insensitive prognostic indicator. However, serum albumin measured after 24 h was as accurate as the admission APACHE II score in correctly classifying patients according to outcome. There was a good correlation between the admission APACHE II score and serum albumin measured after 24 h but not between the admission APACHE II and the admission serum albumin. Combining the APACHE II score and serial albumin concentrations into a unified risk of death equation did not improve the accuracy of outcome prediction.

APACHE↗
PubMed1995

Evaluation of the Pneupac Ventipac portable ventilator: comparison of performance in a mechanical lung and anaesthetized patients.

The performance of the Pneupac Ventipac portable gas-powered ventilator was evaluated in two stages. The accuracy of delivery of the ventilator was assessed using a mechanical lung model at different combinations of compliance and airway resistance to simulate normal and diseased lungs. The performance of the ventilator was then assessed in 20 anaesthetized patients. The tidal volume delivered by the ventilator in airmix mode (nominal inspiratory oxygen fraction (FIO2) 0.45) was between -20 and +30% of the preset tidal volume with the mechanical lung model adjusted to normal adult values of compliance and airway resistance. The corresponding value with the ventilator set to deliver 100% oxygen was between -22 and -7% of the preset tidal volume. The performance of the ventilator decreased when either compliance was reduced or airway resistance was increased in the mechanical lung model; this effect was greater in airmix mode. Delivered tidal volume was between -19 and +12% of the present tidal volume in the group of anaesthetized patients using the ventilator in airmix mode. The ventilator was reliable and simple to use, and performance was within acceptable limits in the anaesthetized patients. However, we recommend that a means of verifying the adequacy of ventilation should always be used when transporting critically ill or anaesthetized patients with any portable ventilator, particularly when lung compliance or airway resistance may be abnormal.

Adolescent↗
PubMed1994

Oral administration of midazolam as a premedicant for paediatric day-case anaesthesia.

Fifty-four children aged 1-10 years, scheduled for day-case anaesthesia were prescribed either oral midazolam 0.5 mg.kg-1 or a placebo preparation 30-60 min pre-operatively on a double-blind basis. On arrival at the induction room, anxiolysis was satisfactory in 23 out of 24 (96%) children who received midazolam compared with 12 out of 27 (44%) of those who received placebo (p < 0.001); at induction of anaesthesia these proportions were 21 out of 24 (88%) and nine out of 27 (33%) respectively (p < 0.001). The time to early recovery from anaesthesia was somewhat longer in children premedicated with midazolam compared with controls (28.2 vs 21.9 min) (p < 0.05). Similarly, the time to hospital discharge was longer in the midazolam group (244 vs 185 min) (p < 0.01). Analysis of behavioural questionnaires completed by parents 2 weeks after hospitalisation indicated that there were fewer postoperative behavioural disturbances in children premedicated with midazolam compared with controls (p < 0.05).

Administration, Oral↗
PubMed1984

Microtubule-associated protein 2: monoclonal antibodies demonstrate the selective incorporation of certain epitopes into Alzheimer neurofibrillary tangles.

Neurofibrillary tangles (NFT) are the principal structural alteration of neuronal cell bodies in Alzheimer disease as well as in normal aging of the human brain. While the ultrastructure of these intraneuronal lesions has been extensively studied, the biochemical composition of the fibers comprising the NFT is unknown. We report the production of three monoclonal antibodies against the microtubule-associated protein 2 (MAP-2), one of which intensely labels Alzheimer NFT. All three antibodies specifically recognize MAP-2 on immunoblots and stain brain tissue in a characteristic dendritic pattern. The three antibodies are directed against at least two different antigenic sites on the MAP-2 molecule, and one appears to recognize a phosphorylation site on MAP-2. That only one of the three antibodies immunolabels NFT suggests that the formation of the tangle involves some modification of the MAP-2 molecule. Our findings suggest that one aspect of Alzheimer-type neurofibrillary pathology is an aggregation of MAP-2 or MAP-2 fragments with altered neurofilamentous elements present in NFT. Normal interactive function, which putatively occurs between neurofilaments and MAP-2, may thus be disrupted in Alzheimer disease.

Alzheimer Disease↗
PubMedDate not supplied

A gene therapy/targeted radiotherapy strategy for radiation cell kill by.

BACKGROUND: Although [131I]meta-iodobenzylguanidine (MIBG) is currently one of the best agents available for targeted radiotherapy, its use is confined to a few neural crest derived tumours which accumulate the radiopharmaceutical via the noradrenaline transporter (NAT). To determine whether this drug could be used for the treatment of non-NAT expressing tumours following genetic manipulation, we previously showed that plasmid mediated transfection of NAT into a non-NAT expressing glioblastoma cell line, UVW, endowed the host cells with the capacity to actively accumulate [131I]MIBG. We now present data defining the conditions required for complete sterilisation of NAT transfected cells cultured as multicellular spheroids and treated with [131I]MIBG. METHODS: NAT transfected UVW cells, grown as monolayers and spheroids, were treated with various doses of [131I]MIBG and assessed for cell kill by clonogenic survival and measurement of spheroid volume over time (growth delay). Spheroids were left intact for different time periods to assess the effect of radiation crossfire on cell death. RESULTS AND CONCLUSIONS: Total clonogen sterilisation was observed when the cells were grown as three-dimensional spheroids and treated with 7 MBq/ml [131I]MIBG. The added benefit of radiation crossfire was demonstrated by the improvement in cell kill achieved by prolongation of the maintenance of [131I]MIBG treated spheroids in their three-dimensional form, before disaggregation and clonogenic assay. When left intact for 48 h after treatment, spheroid cure was achieved by exposure to 6 MBq/ml [131I]MIBG. These results demonstrate that the efficiency of cell kill by [131I]MIBG targeted therapy is strongly dependent on beta-particle crossfire irradiation. This gene therapy/targeted radiotherapy strategy has potential for [131I]MIBG mediated cell kill in tumours other than those derived from the neural crest.

3-Iodobenzylguanidine↗