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Biomedical subjects

B A Simpson

Publications and source records attributed to B A Simpson.

At least 19 recordsLinked to original sources

Treatment of a vancomycin-resistant Enterococcus faecium ventricular drain infection with quinupristin/dalfopristin and review of the literature.

Central nervous system infections involving vancomycin-resistant Enterococcus faecium (VREF) are infrequently described and pose significant therapeutic difficulties, because these organisms are intrinsically resistant to many antibiotics. We describe the use of intrathecal quinupristin/dalfopristin to treat a VREF-associated infection in a neuro--surgical patient.

Acetamides↗

Supraspinal inhibition of nociceptive dorsal horn neurones in the anaesthetized rat: tonic or dynamic?

1. Tonic inhibition of sensory spinal neurones is well known to descend from the rostroventral medulla. It is not clear if this inhibition is dynamically activated by peripheral noxious stimuli. 2. Transection of the ipsilateral dorsolateral funiculus (DLF) removed a descending inhibition of multireceptive spinal neurones and disproportionally prolonged the after-discharge component of their response to a noxious cutaneous stimulus. 3. Microinjection of GABA or tetracaine into the medullary nucleus gigantocellularis pars alpha (GiA) similarly prolonged the after-discharge in response to noxious stimuli. 4. Recordings of GiA cells, initially using minimal surgery, revealed that many had low levels of spontaneous activity and responded vigorously to noxious stimuli applied to any part of the body surface. One hour after the surgery necessary to expose the spinal cord, GiA cells had a high firing rate but responded weakly to noxious stimuli. 5. The response of GiA cells to noxious stimuli was abolished by transection of only the DLF contralateral to the stimulus. 6. It is concluded that the inhibition of multireceptive dorsal horn neurones from GiA is dynamically activated by noxious cutaneous stimuli via a projection in the contralateral DLF. Surgical exposure of the spinal cord tonically activates this inhibition and masks the dynamic component.

Anesthesia↗

Recurrent self-inflicted craniocerebral injury: case report and review of the literature.

Self-inflicted craniocerebral injuries have been reported exclusively in mentally disturbed patients and criminals. We report a 28-year-old man with a severe mental disorder who initially hammered a nail into his brain and subsequently repeatedly inserted foreign objects into his brain. The literature is reviewed and the surgical and psychiatric management discussed.

Adult↗

Spinal cord stimulation in 60 cases of intractable pain.

Sixty patients with spinal cord stimulators implanted for intractable pain lasting up to 50 years were followed for up to nine years. Forty seven per cent derived significant benefit, 23% modest benefit, 20% experienced no effect and 6.7% were made worse. Two were made worse after initial benefit. Complications, indications and factors relevant to the mode of action are discussed.

Adult↗

Diagnosis and repair of malfunctions of implanted central nervous system stimulators.

Neurostimulator malfunctions must be located and repaired if patients are to receive maximum benefit from central nervous system stimulation. This report lists the problems encountered with the stimulators from four manufacturers. Procedures for locating the source of malfunctions are discussed in some detail.

Central Nervous System Diseases↗