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Biomedical subjects

A Watson

Publications and source records attributed to A Watson.

At least 343 records · Page 19Linked to original sources
PubMedDate not supplied

A randomized trial of vasopressin and vasopressin plus nitroglycerin in the control of acute variceal hemorrhage.

A randomized trial was undertaken to determine efficacy of nitroglycerin when added to a vasopressin infusion in both reducing the complication rate and giving improved control of acute variceal hemorrhage. Seventy-two bleeding episodes in 57 patients were included, with vasopressin being used on 34 occasions and vasopressin plus nitroglycerin on 38 occasions, for an infusion period of 12 hr. At the end of the 12-hr period, hemorrhage had been controlled significantly more frequently in those receiving combined therapy (26 of 38; 68%) than in those given vasopressin alone (15 of 34; 44%, p less than 0.05), although this difference was not statistically significant if those patients in whom therapy was discontinued due to drug complications were excluded from the analysis [hemorrhage controlled in the combined group (68%) and vasopressin alone (48%); chi 2 = 2.4, p greater than 0.05]. Major complications requiring cessation of therapy were significantly less common in those given nitroglycerin--one occasion compared to seven in those given vasopressin alone (p less than 0.02). Thus, the addition of nitroglycerin to a vasopressin infusion results in a lower rate of complications and is more effective in controlling variceal hemorrhage.

Blood Transfusion↗
PubMedDate not supplied

Operable esophageal cancer: current results from the West.

Results are presented from a consecutive series of 396 patients referred to hospital in one of the areas of highest incidence in the United Kingdom in a unit that saw all referred cases for assessment and subsequent decision on the most appropriate therapeutic modality. Standard criteria were applied when selecting those patients in whom an attempt at curative resection was justified. Of the 396 patients, only 164 (41%) were considered fit enough to undergo thoracoabdominal resection and to have a tumor that had not invaded contiguous structures or metastasized. The remainder were treated by palliative intubation and more recently by laser photocoagulation. Of the patients who underwent resection, most had an Ivor Lewis esophagogastrectomy and lymphadenectomy, those with proximal lesions undergoing three-stage total esophagectomy. The overall 30-day mortality was 8.3%, falling to 6.7% during the period 1985-1990 when thoracic epidural analgesia was used routinely and fatal respiratory complications were avoided. Overall 5-year survival rate was 23%. However, stratification for tumor staging showed that the 5-year survival for node-negative patients was 47% and for tumors confined within the adventitia 71%. Results of surgical treatment of squamous esophageal carcinoma in the West are considerably more depressing than those in many Eastern series. This difference is largely related to the late presentation in the West, as the relatively low incidence does not justify screening programs. However, results equivalent to those in Eastern series are obtained for the small subset of patients who do present with early disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Case report: renal osteodystrophy in association with spinal stenosis in achondroplasia.

A 54 year old woman with achondroplasia presented with symptoms of spinal stenosis. Subsequent studies revealed end-stage renal disease with severe renal osteodystrophy that was characterised by radiographs and new bone biomarkers. We speculate that renal osteodystrophy accentuated spinal stenosis, which is a common feature of achondroplasia in adults.

Achondroplasia↗
PubMedDate not supplied

Acute renal failure in orthotopic liver transplantation.

Acute renal failure (ARF) is a frequent complication of orthotopic liver transplantation (OLT) and is a major cause of mortality and morbidity. We report the incidence, management and outcome of ARF in OLT patients during the first year of a liver transplant programme.

Acute Kidney Injury↗
PubMedDate not supplied

Screening for dialysis access graft malfunction: comparison of physical examination with US.

PURPOSE: To test the reliability and performance of two physical diagnosis algorithms for use in physical examination of vascular access grafts. MATERIALS AND METHODS: Grafts were assessed in 39 patients by means of physical examination performed by four observers. Grafts were characterized as having a thrill, pulse, or indeterminate examination at three locations (arterial, midpoint, venous). Findings with this algorithm were compared with those from ultrasound (US) with volume flow measurements. RESULTS: Patients with a thrill at all three locations of the graft all had volume flows greater than 450 mL/min (negative predictive value = 100%). Of patients with a pulse at any of three locations, only 28% (positive predictive value) had a volume flow of 450 mL/min or less. CONCLUSION: Physical examination is a good screening test for ruling out the low flows associated with impending access graft failure, thereby eliminating the need for routine US for many patients.

Adult↗
PubMedDate not supplied

Solid-phase oligonucleotide synthesis and flow cytometric analysis with microspheres encoded with covalently attached fluorophores.

A novel combinatorial approach to synthesize oligonucleotides on fluorescently encoded microspheres based on flow sorting and segmental solid-phase synthesis is described. BODIPY dyes were covalently attached to polystyrene (8.8 microm, 55% DVB) microsphere particles to generate four fluorescently encoded sets. 20-mer oligonucleotide sequences can be synthesized on these microspheres with yields comparable to conventional CPG supports (80% overall yield, average stepwise yield = 99%). The concept of segmental solid-phase synthesis by flow sorting was demonstrated by synthesizing unique 20-mer oligonucleotide sequences on each of four fluorescently encoded microsphere sets by including a flow sorting step (after first eight base additions) and flow cytometric detection of sequences synthesized on each microsphere set by hybridization with fluorescently labeled complementary sequence.

Boron Compounds↗
PubMedDate not supplied

Cochrane review: post-operative procedures for improving fertility following pelvic reproductive surgery.

The objectives of the study was to determine the effectiveness of post-operative procedures following female pelvic reproductive surgery. A systematic review employing the principles of the Cochrane Menstrual Disorders and Subfertility Group was used. Five randomized controlled trials were included. Participants were women undergoing pelvic reproductive surgery; interventions were any post-operative procedure designed to improve fertility; outcomes were pregnancy, live birth, ectopic pregnancy and miscarriage rates and the rates of tubal patency and procedure-related complications. Summary statistics were expressed as odds ratios. The results showed that the odds of pregnancy, live birth, ectopic pregnancy and miscarriage were not significantly altered by post-operative hydrotubation nor second-look laparoscopy with adhesiolysis. Whether hydrotubation was early or late and whether hydrotubation fluid contained steroid or not had no significant impact on the odds of pregnancy, live birth, ectopic pregnancy or miscarriage. The odds of pregnancy and live birth were significantly increased and infective complications significantly decreased by hydrotubation with fluid containing antibiotic compared with hydrotubation with fluid containing no antibiotic, in late hydrotubation following tubal stent removal 6 weeks after tubal surgery. The odds of at least one patent Fallopian tube were significantly increased with late hydrotubation following tubal stent removal compared with early hydrotubation in women who had no tubal stenting, but this intervention had no significant impact on the odds of pregnancy, live birth, ectopic pregnancy or miscarriage. In conclusion, there is insufficient evidence to support the routine practice of hydrotubation or second-look laparoscopy following female pelvic reproductive surgery. The studies on which this conclusion is based were either poor quality or underpowered. Post-operative hydrotubation with fluid containing antibiotic following tubal surgery may offer benefit over hydrotubation fluid without antibiotic. A randomized controlled trial of post-operative hydrotubation with antibiotic-containing fluid versus no hydrotubation for improving fertility following tubal surgery is justified.

Abortion, Spontaneous↗
PubMedDate not supplied

Focal segmental glomerulosclerosis in Hodgkin's disease.

Development of Nil disease and focal segmental glomerulosclerosis (FGS) in sequential renal biopsies is reported in a patient with Hodgkin's lymphoma. Although steroid resistance was demonstrated, a complete and sustained clinical remission of the renal lesion followed anti-Hodgkin's chemotherapy. These findings support the hypothesis that Nil disease and FGS are manifestations of the same clinical entity.

Adult↗
PubMedDate not supplied

Modulation of the pathophysiology of primate focal cerebral ischaemia by indomethacin.

The effect of indomethacin (3mg/kg IA) preloading on the pathophysiology of a model of acute cerebral ischaemia has been tested. Primates anaesthetised with alpha-chloralose were used. Indomethacin reduced basal blood flow by 39% and reduced CO2 reactivity by 71%. Water content changes of the cerebral cortex and relationships between blood flow and extracellular potassium (Ke), and calcium (Cae) activities have been measured. Indomethacin infusion did not effect the water content of the left side but there was more water in all regions of the right hemisphere which were rendered ischaemic. There water increases were significant for blood flows greater than 5ml/100g/min in exposed areas. There was a significant increase in the flow thresholds for change in Ke and Cae. Possible mechanisms for these changes have been discussed.

Animals↗
PubMedDate not supplied

The effects of a calcium antagonist, nimodipine, upon physiological responses of the cerebral vasculature and its possible influence upon focal cerebral ischaemia.

The effects of a calcium antagonist, nimodipine, were tested on the response of the cerebral circulation to arterial pCO2 and blood pressure changes. The effects of reduced blood flow upon oedema formation and extracellular ion homeostasis under nimodipine preloading were studied. Both open and closed skull primate models were used, with alpha-chloralose anaesthesia. Nimodipine infusion increased basal blood flow in the open skull, but not the closed skull animals. Autoregulation to increased blood pressure was little affected. Responses to arterial pCO2 changes and autorerulation to reduced blood pressure were severely imparied. Residual blood flow after middle cerebral artery occlusion was significantly higher with nimodipine than in controls. The threshold levels of blood flow for the development of cortical oedema and for disturbance of ion homeostasis were, however, increased, suggesting that nimodipine interferes with cellular energy metabolism and increases the susceptibility of tissue to ischaemic damage.

Animals↗