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Biomedical subjects

D B Gould

Publications and source records attributed to D B Gould.

32 records · Page 2Linked to original sources
PubMed1983

Bupivacaine cardiotoxicity in a patient with renal failure.

Bradycardia and hypotension were the first major signs of toxicity from a 250 mg bupivacaine axillary brachial plexus block experienced by a patient with chronic renal failure, who had an anion gap acidosis and hyperkalaemia. Without these metabolic abnormalities, this patient received four similar blocks: three were without incident and one was complicated by seizure. Acidosis and/or hyperkalaemia in man appears to increase the myocardial susceptibility to bupivacaine toxicity into the range of arterial concentrations of the drug normally produced by plexus blocks, even in the absence of drug-induced cerebral toxicity, seizures and hypoxia.

Acidosis↗
PubMed1982

Effect of nitrous oxide solubility on vaporizer aberrance.

Concentrations of halogenated anesthetics produced by contemporary vaporizers vary from vaporizer dial settings when carrier gas is not 100% oxygen. This effect is most marked when carrier gas changes from 100% O2 to 100% nitrous oxide (N2O). Vapor concentrations of halothane and enflurane from vaporizers with 6 L/min carrier gas flows were reduced to 3% from 4% until absorption of N20 by the liquid anesthetic ceased. Presaturation of liquid anesthetics with N2O eliminated the transient decrease of vapor output. Steady-state outputs of halothane and enflurane in 100% N2O were 10% below dial settings. The significance of these changes in administration of closed-circuit anesthesia with an out-of-circuit vaporizer is discussed.

Anesthesiology↗
PubMed1975

Immune complex nephropathy i schistosomiasis.

In a patient with chronic hepatosplenic schistosomiasis a segmental sclerosing nephropathy led to terminal renal failure. The demonstration of glomerular capillary deposition of immunoglobulin and complement with electron dense deposits and lucent deformities of the glomerular basement membrane and the presence of antischistosome adult worm antibody in serum suggested that this was an example of immune complex nephropathy. Successful renal transplantation followed by niridazole treatment of the schistosomiasis induced a transient relapse of renal dysfunction with proteinuria and a fall in serum complement. The pathogenic schistosomal adult worm antigen was identified by immunofluorescence in the mesangium of the transplant; complement and immunoglobulin were present also in that site.

Adult↗