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Biomedical subjects

C Elliott

Publications and source records attributed to C Elliott.

At least 19 recordsLinked to original sources
PubMed1995

Intrathecal narcotics for labor using combined spinal epidural technique: an attractive option for solo anesthesia providers.

A 31-year-old primigravida woman presenting with term pregnancy was admitted for labor and delivery. After approximately 10 hours of labor, which included an oxytocin infusion, she requested anesthesia intervention. A combined spinal/epidural (CSE) block was administered featuring a 3 1/2-in, 18-gauge Hustead epidural needle into the epidural space, through which was placed a 4 11/16-in, 27-gauge Whitacre spinal needle into the subarachnoid space. Fifty micrograms of fentanyl, 0.25 mg of morphine, 0.2 mg of epinephrine, and 2 mL of perservative-free normal saline were given intrathecally, the spinal needle was withdrawn, and a catheter placed into the epidural space. Profound analgesia without motor impairment was achieved. After the patient failed to progress, 2% lidocaine was administered epidurally to provide anesthesia to a T4 level, and a cesarean section was performed. The CSE technique provides a safe, flexible choice of anesthesia for labor and delivery. Monitoring of the patient by the anesthetist is necessary for only the initial 30 minutes after block administration. This, coupled with the advantage of having an epidural catheter as a backup, makes it an especially attractive alternative for the solo anesthetist.

Adult↗
PubMed1994

The effects of a peripherally selective alpha 2-adrenoceptor antagonist, MK-467, on the metabolic and cardiovascular response to exercise in healthy man.

1. A double-blind, placebo controlled study has been conducted to investigate the consequences of i.v. treatment with MK-467, a peripherally selective alpha 2-adrenoceptor antagonist in exercising healthy male subjects. In particular, the effects on blood pressure, heart rate, circulating catecholamines (noradrenaline (NA) and adrenaline (A)), insulin, glucose and free fatty acids (FFA) were determined. 2. Exercise produced increases in catecholamines, blood pressure and heart rate. FFA increased at the start of the exercise but then declined as exercise progressed. 3. MK-467 significantly increased NA, in a dose-dependent manner, before and during exercise without altering A. Blood pressure and heart rate were not affected by drug treatment. 4. The insulin and FFA response to exercise was significantly enhanced by MK-467 although glucose was unaltered by drug. 5. It is concluded that both pre- and post-junctional peripheral alpha 2-receptors play an important role in the metabolic response to exercise in man.

Adrenergic alpha-Antagonists↗
PubMed1994

Comparison of body sway analysis techniques. Assessment with subjects standing on a stable surface.

Different analysis methods for the objective measurements of body sway were examined to establish the most sensitive method for identifying changes in stability. Changes between stability with eyes open and eyes closed were used to assess the techniques. Body sway was measured in a group of normal subjects standing on a stable surface using "sway magnetometry," which measures hip movement in the sagittal and coronal planes by magnetic field detectors worn at the waist. The following analysis methods were studied; path length, mean distance from the centre, the area enclosed by the path of movement, and the areas of a convex hull, an ellipse and a circle enclosing the sampled points. The results showed that the path length technique had the smallest inter-subject variability, both with eyes open and eyes closed, and was the only technique whose mean Romberg Coefficient (Eyes Open/Eyes Closed) was more than two standard derivations from 1.0 (0.74 +/- 0.11, mean +/- S.D.), indicating that this technique showed greatest sensitivity for detecting changes in body sway.

Adult↗
PubMed1994

Eutectic mixture of local anesthetic cream--topical anesthesia for extracorporeal shock wave lithotripsy.

A 44-year-old man presented with a history of sudden onset left flank pain, accompanied by nausea and microhematuria. The diagnosis of ureteropelvic junction calculus was made and the patient was scheduled for extracorporeal shock wave lithotripsy (ESWL). ESWL uses an electrical spark to generate a shock wave that is focused on a stone in the ureter or kidney. The shock waves mechanically stress and crush the stone, eliminating the need for manipulation or open procedure. The pain of ESWL is caused by skin sensation. Eutectic mixture of local anesthetics (EMLA) cream (2.5% lidocaine and 2.5% prilocaine) has been used as a topical anesthetic on intact skin for various minor procedures. Studies have shown that it is effective in dramatically decreasing or eliminating the pain of ESWL. The use of topical EMLA as an anesthetic management technique for a patient undergoing ESWL is described.

Administration, Cutaneous↗
PubMed1994

A survey of methods of processing and storage of bone marrow and blood stem cells in the EBMT.

We conducted a survey to identify current practices in bone marrow processing, preservation and storage by mailing a questionnaire to 155 bone marrow transplant centres listed in the EBMT records. Approximately 57% of centres replied. There were wide variations in methodology which reflected the different types of disease being treated, local conditions and personal preferences. A number of areas where more caution could be exercised were identified: possible reinfusion of excessive quantities of heparin, possible misuse of disposable needles and lack of awareness of the implications of product liability rules relating to cooling rate, storage and viability data.

Anticoagulants↗
PubMed1993

Contribution of hyperoxia to reduced pulmonary function after deep saturation dives.

Pulmonary function was measured before and after a 28-day saturation dive to a pressure of 0.25 MPa in eight subjects. PO2 was 40 kPa, with periods of 75 kPa for 2 h every 2nd day during the first 14 days, 50 kPa for the next 12 days, and a gradual fall to 21 kPa over the last 2 days in decompression. A 28-day saturation dive with six subjects to a pressure of 0.15 MPa and a PO2 of 21 kPa was used as control. The measurements included static and dynamic lung volumes and flows, transfer factor for carbon monoxide (TLCO), and a cycle ergometer exercise test. There was a significant reduction in TLCO of 9.8 +/- 6.0% (P < 0.001) after the dive when values were corrected for hemoglobin concentration changes. Effective alveolar volume was unchanged. There was a reduction in forced midexpiratory flow rate of 9.8 +/- 7.0% (P < 0.01), but forced vital capacity and forced expired volume in 1 s were unchanged. Peak oxygen uptake was reduced by 10.1 +/- 5.3% (P < 0.001). There were no significant changes in any of the lung function variables after the control dive. Exposure to raised PO2 contributes significantly to the changes in pulmonary function that have been reported after deep saturation dives to pressures of 3.1-4.6 MPa with a similar profile of oxygen exposure. TLCO is apparently a more sensitive index than vital capacity for oxygen toxicity.

Adult↗
PubMed1992

Audiological, vestibular and radiological abnormalities in Kallman's syndrome.

Kallman's syndrome is a multifaceted congenital disorder with predominantly endocrine abnormalities. We have characterized the associated mixed hearing loss and identified consistent radiological evidence of abnormal temporal bone anatomy. Abnormal labyrinthine morphology is accompanied by a complete absence of response to vestibular stimulation with caloric or rotational chair testing. The endocrine abnormalities are correctable and Kallman's syndrome is a diagnosis worthy of consideration when assessing children with congenital hearing loss.

Adult↗
PubMed1992

Diagnosing blame: responsibility and the psychopath.

The diagnosis of psychopathy is controversial largely because of two notions: first, that because of their defects, psychopaths cannot understand morality, and second, that these defects should thus excuse psychopaths from moral responsibility for their actions. However, it is not clear just what is involved in understanding morality. The argument that the psychopath is ignorant of morality in the same way that one might be ignorant of facts is difficult to sustain. However, a closer examination of the psychopath's peculiar deficiencies reveals that the psychopath's understanding of mortality might be impaired in other ways.

Antisocial Personality Disorder↗
PubMed1992

Ketorolac as a preoperative nonnarcotic analgesic to enhance anesthesia and postanesthesia recovery.

The benefits of using ketorolac as a preoperative intramuscular (IM) non-narcotic analgesic are described and illustrated by the presentation of two case reports. Case Summary--Patient 1: A 53-year-old female who had experienced refractory nausea and vomiting after six previous exposures to anesthesia presented for outpatient ureteroscopy and dilatation of strictures. Instead of using an opiate narcotic, ketorolac 60 mg IM was given 1 hour before induction as the analgesic portion of anesthesia. Case Summary--Patient 2: A 65-year-old male with mild chronic obstructive lung disease presented for extracorporeal shock wave lithotripsy (ESWL). To avoid the respiratory depression associated with opioid narcotics, ketorolac 60 mg IM was given as an analgesic 1 hour before the ESWL procedure.

Aged↗
PubMed1991

Role of plasma non-esterified fatty acids during and after exercise.

1. The importance of circulating non-esterified fatty acids as a substrate during and after low-grade exercise has been examined by using a nicotinic acid analogue to inhibit lipolysis. Seven healthy men received acipimox or placebo on separate occasions. After 90 min, bicycle exercise was performed for 45 min (40% of pre-determined maximum oxygen uptake), followed by a 60 min recovery period. 2. The plasma concentration of non-esterified fatty acids increased during exercise after placebo (320 +/- 80 to 630 +/- 110 mumol/l) and remained elevated in the post-exercise period. Basal concentrations were lower after acipimox (100 +/- 10 mumol/l; P less than 0.05); they declined to 60 +/- 10 mumol/l during exercise and remained at this level for the rest of the study. 3. Lipid oxidation increased from 0.8 +/- 0.1 to 4.2 +/- 0.5 mg min-1 kg-1 during exercise after placebo (P less than 0.001) and remained elevated in the post-exercise period (1.2 +/- 0.1 mg min-1 kg-1). It was lower after acipimox, but still increased from 0.3 +/- 0.1 to 2.3 +/- 0.2 mg min-1 kg-1 with exercise. Carbohydrate oxidation was increased after acipimox compared with after placebo, but only reached significance during the post-exercise period (P less than 0.05). 4. Although acipimox abolished the rise in the plasma concentration of non-esterified fatty acids during exercise, there was only a 50% decrease in the rate of lipid oxidation. This suggests that an alternative source of non-esterified fatty acids makes an important contribution to the supply of lipid for oxidation during exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗