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Biomedical subjects

B Bell

Publications and source records attributed to B Bell.

At least 73 records · Page 4Linked to original sources
PubMed1990

Phase I evaluation of diaziquone in childhood cancer. A Pediatric Oncology Group study.

We conducted a phase I clinical study of aziridinylbenzoquinone (Diaziquone, AZQ) given as a 4 hour infusion weekly X 4. Forty-five children with recurrent acute leukemia and 33 children with various advanced solid tumors participated. Severe myelosuppression was the dose limiting toxic effect, occurring in all patients at the upper dose levels. Gastrointestinal and hepatic toxicities were infrequent and not severe. No allergic reactions occurred. Objective tumor regression was noted in 3 of 25 patients with a CNS tumor and in 6 of 45 patients with acute leukemia. For phase II trials the recommended dosage of Diaziquone given by this schedule is 18 mg/M2/week X 4 for patients with a solid tumor, and is 30 mg/M2/week X 4 for children with acute leukemia.

Adolescent↗
PubMed1990

Response to nondepolarizing muscle relaxants in children with tumours.

The rate of onset of action of d-tubocurarine (64 patients) or alcuronium (36 patients) was studied electromyographically in 100 children who had abdominal, bone or cerebral tumours. It was found that there was a significantly delayed onset (over three times longer than controls) or additional doses were required in patients with malignant liver, renal and bone tumours who received d-tubocurarine. The onset of alcuronium blockade was also prolonged but to a lesser extent. When tumours with an abnormal prolongation of onset of relaxation were successfully treated by chemotherapy and/or surgery, the response reverted to normal. Children with benign tumours or masses had normal responses. In contrast, neuroblastomas were associated with little prolongation of onset. Cerebral tumours showed a variable response, with the observed changes being unreliable indicators of degree of malignancy.

Adolescent↗
PubMed1990

Suxamethonium--electromyographic studies in children.

Suxamethonium was administered to 225 children aged from one to sixteen years, in doses varying from 0.1 to 0.5 mg/kg. Dose responses were determined. ED95 was 445 micrograms/kg in one to four year olds, 454 micrograms/kg in the five to ten years group and 270 micrograms/kg in eleven to fifteen year olds (P less than 0.05). There is a wider variability in patient responses to 0.1 and 0.2 mg/kg than to the higher doses. Sixty-two children in the three age groups were given suxamethonium 1 mg/kg. The time from injection to maximum block and to 50% recovery increased with increasing age (P less than 0.05).

Adolescent↗
PubMed1990

Does suxamethonium influence the subsequent dose requirements of alcuronium and its reversibility in children?

Suxamethonium is often used for intubation prior to the use of a nondepolarizing muscle relaxant. This study was performed to determine whether suxamethonium altered the dose of alcuronium required to produce neuromuscular block. The findings were that suxamethonium 1.0 mg/kg did not alter the depth, duration or reversibility of block if given before alcuronium 0.3 mg/kg. Reversal with neostigmine was more rapid following 50 micrograms/kg than after 25 micrograms/kg. If recovery from neuromuscular block was greater than 25 per cent, the lower dose produced satisfactory reversal, whether or not suxamethonium had been given previously.

Adolescent↗
PubMed1989

Randomized, controlled trial of clonidine for smoking cessation in a primary care setting.

Clonidine hydrochloride has been reported to reduce tobacco withdrawal symptoms and facilitate smoking cessation. We enrolled 185 subjects, 92 receiving clonidine and 93 receiving placebo, in a randomized, double-blind study of clonidine for smoking cessation in a primary care setting. Clonidine had no demonstrable effect on withdrawal (8 of 11 measures favoring placebo). At 4 weeks, 17 (18%) subjects receiving clonidine had quit compared with 13 (14%) receiving placebo (chi 2 = 0.7; 90% confidence interval of benefit from clonidine, -4% to 13%). At 4 weeks, the mean number of cigarettes smoked was 17.7 for those receiving clonidine and 17.5 for those receiving placebo (t = 0.1; 90% confidence interval of benefit from clonidine, -4.1 to 3.7 cigarettes per day). These results provide little support for a beneficial effect of clonidine on tobacco withdrawal symptoms, quitting, or smoking reduction in a primary care setting.

Adolescent↗
PubMed1989

Small cell carcinoma of the pleura.

Extrapulmonary small cell carcinoma is uncommon. Small cell carcinoma of pleural primary origin has not, based on a literature review of the past three decades, been reported. We have reported a case of small cell carcinoma of the pleura, discussed its management and significance, and briefly reviewed the pertinent literature.

Aged↗
PubMed1988

Long term renal prognosis of Henoch-Schönlein purpura in an unselected childhood population.

All 270 patients presenting with Henoch-Schönlein Purpura over a 13-year period from a total childhood population of 155,000 were studied. This is an incidence of 13.5/100,000 children per year. Fifty-five (20%) were found to have initial evidence of renal involvement, and were re-examined at a mean of 8.3 years later. The 37 with isolated haematuria or haematuria with mild proteinuria (67%) recovered completely. Eighteen (33%) had nephritic or combined nephritic/nephrotic features, of these one died in the acute phase of the illness, only three others have persistent urinary abnormalities but have no biochemical evidence of renal impairment and only minor histological changes. The overall prognosis in this unselected population is therefore good with a mortality less than 1% overall and low long term morbidity of 1.1%. This study indicates a more optimistic outcome in this condition than the majority of published estimates based on more selected groups of patients.

Child↗
PubMed1988

Effects of vasodilators on rates of change of nasopharyngeal temperature and systemic vascular resistance during cardiopulmonary bypass in anaesthetized dogs.

The effects of various vasodilating agents on the rates of change of nasopharyngeal temperature and total systemic vascular resistance of anaesthetized dogs during cardiopulmonary bypass were studied. Intravenous administration of nitroglycerine (14 micrograms/kg per min, infused at 35 degrees C and 36 degrees C), sodium nitroprusside (5 micrograms/kg per min, infused at 36 degrees C) and phenoxybenzamine (1 mg/kg bolus, given at 32 degrees C and 36 degrees C) did not have any effect on the total cooling time or the rate of cooling from 36 degrees C to 18 degrees C. However, in dogs treated with phenoxybenzamine the time taken to rewarm to 36 degrees C was significantly shorter than those observed in the control, nitroglycerine or sodium nitroprusside treated animals. This difference in rewarming time was mainly due to the more even rate of rewarming induced by phenoxybenzamine. Moreover, a significantly greater reduction in systemic vascular resistance was observed in phenoxybenzamine treated animals than in the other treatment groups.

Anesthesia↗
PubMed1987

Electromyographic responses to small doses of suxamethonium in children after burns.

Integrated electromyographic studies in burned patients, and in normal controls, during the administration of small doses of suxamethonium (0.1 or 0.2 mg kg-1) have shown that the level of paralysis and the duration of paralysis are significantly increased in burn patients and that the effect is greater with larger burns. Repeated studies on patients using these small doses have shown that patients with burns pass through a phase of extreme sensitivity to the effects of suxamethonium, usually sometime between 4 and 12 days after the burn.

Burns↗
PubMed1987

Liver tumours and muscle relaxants. Electromyographic studies in children.

Electromyographic studies of the onset of action of tubocurarine or alcuronium were performed on eight occasions in five patients who had liver masses. There was a slow onset of action and an increased dose requirement in those with malignant disease. Normal responses were found in a patient with benign nodular hyperplasia and in another where the malignant tumour was successfully treated with chemotherapy.

Alcuronium↗
PubMed1987

The influence of age on the cardiovascular toxicity of intravenous bupivacaine in young dogs.

A study in anaesthetised dogs aged 2, 6, 13, 26 and 52 weeks or older was done to determine the dose of IV bupivacaine given by infusion required to produce severe cardiovascular depression as measured by a drop in mean blood pressure to about 25 mmHg or the development of life-threatening dysrrhythmias. Plasma local anaesthetic concentration was analysed at the time of ceasing the infusion. The toxic dose was significantly less in the six-week-old group than younger or older animals. The plasma concentrations associated with toxicity in the groups 13 weeks and younger were significantly lower than in the older dogs. Treatment of the induced toxicity included hyperventilation, adrenaline infusion, bretylium and/or cardioversion. The response to treatment was better in young dogs than adult dogs.

Age Factors↗
PubMed1985

Giant lymph node hyperplasia (Castleman's disease) of hyaline vascular type. Clinical heterogeneity with immunohistologic uniformity.

Of three patients with giant lymph node hyperplasia (GLNH) of hyaline vascular type, one had multicentric involvement and systemic symptoms, and had the nephrotic syndrome develop. The two others had localized adenopathy and were asymptomatic. Immunohistochemistry carried out on frozen and paraffin-embedded tissue was uniform in all cases. For the most part this revealed a polyclonal B-cell population and a reactive T-cell population in keeping with reactive follicular hyperplasia. In contrast to the latter, however, was a total absence of Leu-7 (natural killer cell) activity. The significance of this is unclear but may represent an abnormal immunologic response in the face of overwhelming antigenic stimulation. GLNH is a clinically and pathologically heterogeneous disorder, the management of which is dependent on both the clinical presentation of the patient and the histologic appearances of the involved lymph nodes.

Adult↗