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Biomedical subjects

C A Bernstein

Publications and source records attributed to C A Bernstein.

7 recordsLinked to original sources
PubMed2000

Dilutional acidosis following hetastarch or albumin in healthy volunteers.

BACKGROUND: The intent of this study was to evaluate the impact of the commonly used colloids-hetastarch and albumin-on in vivo acid-base balance. From this evaluation, a better understanding of the mechanism of dilutional acidosis was expected. METHODS: In a prospective, randomized fashion, 11 healthy volunteers were administered 15 ml/kg hetastarch solution, 6%, or 15 ml/kg albumin, 5%, intravenously over 30 min. Four weeks later, the study subjects were administered the other colloid. Arterial blood gas and electrolyte parameters were measured at baseline and at 30, 60, 90, 120, 210, and 300 min after colloid administration. Pre- and postlaboratory values were compared within groups using a paired t test and a Wilcoxon signed rank test and between groups using repeated-measures analysis of variance and a Wilcoxon rank sum test. RESULTS: Thirty min after infusion, subjects who were administered hetastarch showed statistically significant changes (P < 0.05) in base excess (from 2.5 +/- 0.9 mEq/l to 0.7 +/- 1.1 mEq/l), HCO3- concentration (from 27 +/- 1.0 mEq/l to 25 +/- 1.3 mEq/l), Cl- concentration (from 108 +/- 2 mEq/l to 112 +/- 2 mEq/l), albumin concentration (from 4.4 +/- 0.2 g/dl to 3.5 +/- 0.5 g/dl), and arterial carbon dioxide tension (Paco2; from 40.8 +/- 2.3 mmHg to 39. 2 +/- 3.2 mmHg), whereas only the albumin concentration (from 4.4 +/- 0.2 g/dl to 4.8 +/- 0.6 g/dl) changed significantly in the albumin-treated group. CONCLUSIONS: Decreases in base excess were observed for 210 min after hetastarch administration but not after albumin. The mechanism for this difference is discussed.

Acidosis↗
PubMed1997

Acute hemorrhagic leukoencephalitis: recovery and reversal of magnetic resonance imaging findings in a child.

A case of acute hemorrhagic leukoencephalitis (AHLE) in a 6-year-old girl is reported. The presentation was typical for acute hemorrhagic leukoencephalitis, with acute onset of a rapidly progressive neurologic disorder with asymmetric involvement of brain, with polymorphonuclear predominant peripheral leukocytosis and cerebrospinal fluid pleocytosis. Cerebrospinal fluid findings not previously reported included elevation of IgG and the presence of myelin basic protein. Additional previously unreported findings were striking abnormalities on magnetic resonance imaging (MRI) of the brain, in contrast to normal findings on computed tomography (CT). The child was treated with high dose intravenous steroids and made a full recovery, with a parallel disappearance of all of her cerebrospinal fluid abnormalities and almost all of her abnormalities on MRI. Detailed examination of cerebrospinal fluid and MRI of brain should facilitate early diagnosis in other cases of suspected acute hemorrhagic leukoencephalitis and high-dose steroid therapy may lead to improved clinical outcomes.

Anti-Inflammatory Agents↗
PubMed1996

Preoperative glycopyrrolate: oral, intramuscular, or intravenous administration.

STUDY OBJECTIVE: To evaluate the effects of oral, intramuscular (i.m.) and intravenous (i.v. glycopyrrolate on oral and gastric secretions, and to assess how these routes of administration change intubating conditions. DESIGN: Randomized, double-blinded study. SETTING: University hospital operating room. PATIENTS: 37 ASA status I and II general anesthesia patients. INTERVENTIONS: Patients were randomized to receive glycopyrrolate or placebo just before surgery by three routes: oral, i.m., and i.v.. Glycopyrrolate was received once by one route and placebo by the other two routes. A placebo group received three placebos and no glycopyrrolate. MEASUREMENTS AND MAIN RESULTS: Mouth conditions and intubating conditions were qualitatively assessed by the patient and the intubating anesthesiologist. No difference between groups was noted. Oral and gastric volumes were measured and showed significantly less gastric volume for the i.v. group as compared with the other groups. Oral secretions were reduced in both the i.v. and i.m. groups when compared with placebo or glycopyrrolate administered orally. CONCLUSIONS: Preoperative glycopyrrolate is significantly more effective at reducing oral and gastric secretions if administered intravenously immediately before induction.

Adjuvants, Anesthesia↗
PubMed1990

Medical and dental students' attitudes about the AIDS epidemic.

This study investigated changes, over a one-year period, in medical and dental students' attitudes toward various issues related to contact with AIDS patients. In 1988 and 1989, the authors surveyed second- and third-year medical and dental students at one medical school both before and after they completed a year of required clinical training. The dental students remained consistently more anxious and more restrictive in their attitudes toward treating patients with AIDS than did their medical student counterparts, and became more conservative (fearful) in their attitudes after working with AIDS patients, whereas the medical students became more liberal. Overall, both groups were more concerned about contracting AIDS in their professional lives than in their personal lives. Over one-third of the medical students and two-thirds of the dental students indicated that they did not wish to train in a specialty or hospital with a high percentage of AIDS patients, and a substantial minority of the students in both groups did not feel that they were responsible for treating all patients whom they were qualified to treat. These and related results suggest that AIDS-related anxiety may influence students' career choices and behaviors and the quality of care patients receive. Suggestions for educational strategies to address students' fears--both warranted and unwarranted--and the differences in attitudes between students of different health-care professions are discussed.

Acquired Immunodeficiency Syndrome↗