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Biomedical subjects

D Banks

Publications and source records attributed to D Banks.

At least 55 records · Page 3Linked to original sources
PubMed1995

Long-term safety of statin-fibrate combination treatment in the management of hypercholesterolaemia in patients with coronary artery disease.

OBJECTIVE: To evaluate the long-term safety profile of treatment with a statin-fibrate combination in a cohort of patients with documented coronary artery disease. DESIGN: Retrospective cohort analytical study. SETTING: District general hospital. PATIENTS: 102 (81 male and 21 female) hypercholesterolaemic (total cholesterol concentration > 6.5 mmol/l) patients with documented coronary artery disease and who had been treated with a statin-fibrate combination for over 1 year. Coronary artery disease was confirmed by angiography in 93 patients and by a positive (Bruce protocol) exercise test in the remainder. Fifty eight patients had a history of previous coronary bypass graft surgery. INTERVENTIONS: Twice daily lipid lowering treatment was given, with the fibrate administered in the morning (either bezafibrate 400 mg (n = 101) or fenofibrate 200 mg (n = 1)) and the statin in the evening (either simvastatin 10 mg (n = 23), 20 mg (n = 72), or 40 mg (n = 2) or pravastatin 10 mg (n = 1) or 20 mg (n = 4)). Treatment continued for 1 (n = 9), 2 (n = 58), or 3 (n = 35) years. MAIN OUTCOME MEASURES: Selected laboratory variables (total cholesterol concentration and liver (aspartate transaminase (AST)) and muscle enzyme (creatine kinase (CK)) activities) and documented symptomatology. RESULTS: A mean (SD) total cholesterol concentration of 5.2 (0.8) mmol/l was achieved after combined treatment for 1 year which was maintained at annual follow up. Over a maximum 3 year follow up no patient reported myalgic symptoms and none had a measured CK activity > 10 times above nomal. Four men on a simvastatin-bezafibrate combination had a CK activity rise to less than three times normal. Fourteen patients with a negative history of alcohol excess (consumption < 21 units/week) had borderline raised AST values. CONCLUSIONS: Statin-fibrate combination treatment for up to 3 years in a cohort of patients with coronary artery disease was not associated with serious disturbances in biochemical markers of muscle or liver function.

Adult↗
PubMed1994

An experimental evaluation of an incentive program to reduce serum cholesterol levels among health fair participants.

OBJECTIVE: To evaluate the impact of a health fair and incentive program on the reduction of serum cholesterol levels among participants. DESIGN: Pretest-posttest control group design, with a 6-month delay between pretest and posttest screenings. SETTING: Health fair program for employees of a large midwestern school district. PARTICIPANTS: Volunteer sample among persons with serum cholesterol levels above 5.17 mmol/L (200 mg/dL). Participants were randomly assigned to experimental (N = 29) and comparison groups (N = 34). INTERVENTION: The intervention consisted of four components: a health fair, health risk information, announcement of follow-up screening, and an incentive program. The incentive program consisted of five $100 cash prizes for reducing serum cholesterol levels by 20% or below 5.17 mmol/L (200 mg/dL). The comparison group received only the first three components. MAIN OUTCOME MEASURE: Serum cholesterol levels were measured by a venipuncture, nonfasting, chemical analysis process. RESULTS: The experimental group showed a 13.2% reduction in serum cholesterol levels, and the comparison group exhibited an 11.3% reduction (P < .05). CONCLUSIONS: A health fair, consisting of information on the level of risk and how to reduce risk, and announcement of follow-up screening and incentives can reduce the risk for cardiovascular disease.

Adult↗
PubMed1994

Treatment of high-dose intrathecal morphine overdose. Case report.

The case is reported of a 45-year-old woman who was being treated for chronic back and right leg pain with intrathecal morphine administered via a subcutaneous continuous-infusion device. She received an accidental 450-mg bolus injection of morphine intrathecally and developed hypertension, status epilepticus, intracerebral hemorrhage, and respiratory failure. Treatment with continuous intravenous naloxone infusion, lumbar catheter drainage of cerebrospinal fluid, and control of hypertension and status epilepticus resulted in an excellent outcome with return to neurological baseline. Care providers who refill pump reservoirs with morphine must be knowledgeable about these devices and the life-threatening consequences associated with errors in refilling them. This case describes the complications and successful treatment of high-dose intrathecal morphine overdose.

Drug Overdose↗
PubMed1993

A technique for recording the activity of brain-stem neurones in awake, unrestrained cats using microwires and an implantable micromanipulator.

A new technique is described which is suitable for long-term recording of the activity of neurones in the brain of an awake, unrestrained cat. By using telescopic electrodes, neurones up to 39 mm from the cranial surface can be reached with a miniature micromanipulator which is small enough to be left in place between recording sessions. The most stable recordings have been obtained with electrodes made from microwire, with which units have been held for up to 8 h.

Animals↗
PubMed1993

Exposure of rats to hyperoxia: alteration of lavagate parameters and macrophage function.

Exposure of rats to hyperoxia (100% oxygen for 64 h) resulted in striking alterations in the properties of samples obtained by bronchoalveolar lavage. The yield of neutrophils, lymphocytes, and red blood cells was increased, while the number of harvested alveolar macrophages decreased. The acellular lavage fluid level of protein was elevated, indicating lung damage. However, acellular phospholipid levels were unchanged. The ability of alveolar macrophages to produce reactive forms of oxygen in response to zymosan was significantly decreased by oxygen exposure. This impaired function was not fully explained by a decrease in viability of these phagocytes. In contrast, stimulant-induced chemiluminescence was elevated after hyperoxia. This rise was not due to a change in cellular antioxidant levels or to a discernible increase in arachidonic acid metabolites. However, it was associated with increased cellular lipid peroxidation.

Animals↗
PubMed1992

Vertebral artery dissection from neck flexion during paroxysmal coughing.

Vertebral artery dissection has a characteristic presentation that should be considered when symptoms are preceded by any trauma that causes neck movement. We present the case of a man with vertebral artery dissection following severe coughing that presented as a postero-inferior cerebellar artery territory stroke. The patient was anti-coagulated, and his neurologic deficits were partially resolved. The mechanism and presentation of vertebral artery dissection are discussed with an emphasis on early detection.

Adult↗
PubMed1992

High-dose magnesium sulfate attenuates pulmonary oxygen toxicity.

BACKGROUND AND METHODS: Rats rapidly develop respiratory distress when exposed to 100% oxygen and die within a few days. Autopsy of the lung shows severe histologic damage characteristic of the adult respiratory distress syndrome. The purpose of this study was to evaluate the effects of magnesium sulfate loading in a rat model of acute oxygen toxicity. Thirty-four rats were divided into three groups. Group 1 (n = 18) served as a control (no magnesium therapy), while group 2 (n = 8) and group 3 (n = 8) received varying amounts of magnesium sulfate. All animals were exposed to 100% oxygen for 96 hrs or until death. Lung damage was quantitated by measuring the lung injury score on histologic examination. RESULTS: Administering magnesium sulfate in moderate doses at infrequent intervals to rats (group 2) resulted in less severe oxygen-induced lung damage than that which occurred in rats not receiving magnesium (control group). However, the difference was not statistically significant. Rats (group 3) given doses of magnesium sulfate in amount and frequency adequate to maintain a serum magnesium concentration recognized as therapeutic in eclampsia significantly reduced oxygen-induced lung damage. CONCLUSION: High-dose magnesium sulfate therapy can reduce lung injury caused by acute oxygen toxicity in rats.

Animals↗
PubMed1992

Modulation by peripheral conditioning stimuli of the responses of trigeminal brain stem neurones and of the jaw opening reflex to tooth pulp stimulation in chronically prepared, anaesthetized cats.

The effects of peripheral conditioning stimuli on the thresholds of the jaw opening reflex (JOR) and of trigeminal brain stem neurones to tooth pulp stimulation were examined in chronically prepared, anaesthetized cats. High intensity electrical conditioning stimuli applied to the ipsilateral forepaw produced an increase in the thresholds of both responses, with the JOR thresholds being elevated significantly more, and remaining elevated for significantly longer, than those of the neurones. These findings suggest that the elevation of the JOR cannot be explained just by inhibitory effects on the brain stem neurones.

Animals↗
PubMed1991

Methods for recording the jaw-opening reflex to tooth-pulp stimulation in awake cats.

Techniques are described for use in awake, unrestrained cats which enable recordings to be made from the digastric muscle, electrical stimuli to be applied to the teeth, and intravenous injections to be made via an indwelling cannula. A headpiece was fixed to the skull of the animal and leads were passed subcutaneously from it to electrodes in the muscle and the teeth. A silicone rubber cannula was inserted into the external jugular vein and connected to an injection port in the headpiece. The headpiece incorporated a miniature 9-way connector which was connected to the electrode leads.

Animals↗
PubMed1991

A technique for recording from brain-stem neurones in awake, unrestrained cats.

A method is described which enables single unit recordings to be made from neurones over a wide area of the brain-stem of awake, unrestrained cats. A small headpiece, made from titanium and acrylic, was fixed to the skull over a craniotomy at pre-set stereotaxic co-ordinates. Between recording sessions the craniotomy was sealed. During recording, a miniature micro-manipulator and adjustable titanium support was screwed into the headpiece and recordings were made with tungsten electrodes.

Animals↗
PubMed1988

Activation of hypothalamic arcuate but not paraventricular neurons following carotid body chemoreceptor stimulation in the rat.

The effect of carotid body chemoreceptor stimulation on 292 neurons in midline hypothalamic nuclei has been examined electrophysiologically in ethyl carbamate/sodium pentobarbitone anaesthetized rats. Experiments demonstrated that specific stimulation of carotid body chemoreceptors activates a small group (16) of neurons in the mediobasal hypothalamic arcuate nucleus, but has no effect on neurons (157) in the hypothalamic paraventricular nucleus or the anterior hypothalamus. Of 16 arcuate neurons activated by the stimulus, six projected to the median eminence and three projected to the dorsal medulla, as defined by antidromic invasion. Three of the neurons activated from the carotid body also showed a resting discharge that was linked with ventilation rate, suggesting that the arcuate nucleus may have some involvement with respiratory processing. The activation of neurons projecting to the median eminence implies that the release of adenohypophyseal hormones may also be influenced by carotid body chemoreceptors.

Animals↗
PubMed1987

Activation within dorsal medullary nuclei following stimulation in the hypothalamic paraventricular nucleus in rats.

The influence of the hypothalamic paraventricular nucleus (PVN) on neurones in the dorsal medulla has been examined in 71 urethane/sagatal-anaesthetised rats. Of 536 neurones localised and tested for responses to electrical stimulation of both the vagus and/or the PVN, 378 were synaptically or antidromically activated following vagal stimulation 72 of which were synaptically activated by stimulation within PVN. The majority of those were located at the border between NTS and dorsal motor nucleus of the vagus in caudal NTS. None showed cardiac or ventilatory rhythm. Neurones showing such rhythms were not affected from PVN. Of 89 neurones in dorsal motor nucleus of the vagus, ten were synaptically activated and two synaptically depressed from PVN. PVN activated neurones in NTS tested for responses to stimulation of arterial baroreceptors and carotid body chemoreceptors were either unaffected or inhibited, but gastric inflation excited them. The results suggest a powerful PVN influence on the dorsal medulla, which is largely confined to the ventral and caudal NTS. There is little evidence for an effect on neurones with a cardiovascular function, but the abdominal vagal influence suggests a link with feeding.

Animals↗
PubMed1987

Factors influencing mortality from infective endocarditis in two district general hospitals.

Factors influencing mortality were studied in 92 consecutive cases of infective endocarditis admitted to two district general hospitals between January 1975 and April 1982. Thirty two patients died, an overall mortality of 35%, 13 patients died before diagnosis and 19 despite aggressive antimicrobial therapy. Bactericidal antibiotic levels were monitored in 39 cases but these did not appear to influence outcome. Mortality was lowest for Streptococcus viridans infection (15%) but rose to 50% for infections with S. faecalis and other less common organisms. Most deaths were in patients over 50. Cardiac failure on admission was a poor predictor of mortality, although this was the principal cause of death during treatment (14 cases). Eight patients had emergency valve replacement and 3 died post-operatively. When the diagnosis was missed during life (13 cases) arterial embolus was a common presenting feature (46%). Classical signs of endocarditis, other than pyrexia, were absent. A cardiac murmur (always mitral incompetence) was noted in only 6 cases and considered to be insignificant.

Age Factors↗
PubMed1987

A trichoepithelioma in a wild eastern grey kangaroo (Macropus giganteus).

The gross and microscopic pathology of a neoplastic skin lesion from the chest of a wild adult eastern grey kangaroo (Macropus giganteus) was consistent with the diagnosis of a trichoepithelioma. This was a benign lesion of the epithelial cells of the hair follicle and is the second type of skin neoplasm reported from macropodids.

Animals↗
PubMed1984

The afferent pathway for carotid body chemoreceptor input to the hypothalamic supraoptic nucleus in the rat.

The pathway for chemoreceptor input to hypothalamic supraoptic nuclei has been examined in anaesthetised lactating and non-lactating rats. In lactating rats, the increase in intramammary pressure following bilateral carotid occlusion, which is probably mainly due to vasopressin, was abolished by lesions in the septum, but not by lesions in more caudal regions of the hypothalamus. In non-lactating rats, electrophysiological experiments demonstrated that the input from carotid body chemoreceptors to phasically-discharging supraoptic neurones is ipsilateral only. The effects of chemoreceptor stimulation on the neurones can be mimicked by electrical stimulation within the medial preoptic area and anterior hypothalamus in a region medial and rostral to the supraoptic nuclei. Lesions within this region abolish the chemoreceptor input to the supraoptic nuclei, but leave the baroreceptor input intact. It is proposed that chemoreceptor afferents to the supraoptic nuclei pass in the lateral hypothalamus to the region of the septum where they turn medially and descent through the medial part of the rostral hypothalamus. The results are discussed in terms of the general role of the chemoreceptor reflex and, more specifically, with respect to the possible significance of vasopressin in the control of arterial blood pressure.

Afferent Pathways↗