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Biomedical subjects

D Davis

Publications and source records attributed to D Davis.

At least 199 records · Page 11Linked to original sources
PubMed1989

Measuring outpatient satisfaction with rehabilitation services.

Rehabilitation Services Department staff at University Hospital-UBC site (Vancouver, British Columbia) conducted a patient satisfaction survey in 1987 to measure outpatient satisfaction with the care received. Fifty completed surveys, which represented approximately 10% of the outpatient population discharged during the study period, indicated that outpatients were primarily satisfied with the actual care and services provided and least satisfied with environmental factors, such as parking, waiting area conditions, and directions to treatment facility.

Adolescent↗
PubMed1989

Cifenline in the short-term treatment of patients with ventricular premature complexes: a double-blind placebo-controlled study.

To study the efficacy and safety of cifenline (cibenzoline), a new antiarrhythmic agent, we enrolled 46 patients with greater than 700 premature ventricular complexes (VPCs)/24 h in an ambulatory electrocardiography study. During an open-label titration phase, 25 patients showed greater than 75% VPC suppression while receiving 130 mg (15 patients) or 160 mg (10 patients) cifenline twice daily. During a double-blind placebo-controlled phase in 23 of these patients, cifenline was more effective than placebo in controlling VPCs (p less than 0.0001) and VPC pairs (p less than 0.025). A small (0.01 s) increase in QRS duration was observed (p less than 0.05) during cifenline treatment. Adverse experiences included gastrointestinal complaints and dizziness as well as two instances of hypotension and one instance of symptomatic ventricular tachycardia. Cifenline appears to be effective and well tolerated in the treatment of VPCs.

Adult↗
PubMed1989

Remembering Danny.

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Acquired Immunodeficiency Syndrome↗
PubMed1989

EGF content in the gastrointestinal tract of rats: effect of age and fasting/feeding.

Immunoreactive rat epidermal growth factor (EGF) was measured in the pancreas and in the mucosa and lumen of the stomach, duodenum, jejunum, midjejunum, ileum, and colon of fed or fasted 5- and 12-day-old suckling, and 3- to 4-month-old adult male rats using a homologous radioimmunoassay. The EGF levels in the pancreas in sucklings were lower than in adults and were unaffected by fasting. Both gastrointestinal mucosal and luminal EGF levels were higher in suckling rats than in adults. Fasting caused a significant decrease in gastrointestinal levels of EGF in the suckling rats but resulted in minimal changes in the adults. Our results show that the content of EGF in gastrointestinal tract is dependent on both age and dietary status. Together with the fact that milk contains a large amount of EGF (O. Koldovský and W. Thornburg, J. Pediatr. Gastro. Nutr. 6: 172-196, 1987) and that labeled EGF is absorbed to a considerable extent by the gastrointestinal tract of suckling rats (P.A. Gonella et al., J. Clin. Invest. 80: 22-32, 1987: W. Thornburg et al., Am. J. Physiol. 246: G80-G85, 1984), our present study implicates milk as an important source of EGF in the suckling period.

Age Factors↗
PubMed1989

Development and validation of in vitro induction assays for toxic halogenated aromatic mixtures: a review.

Halogenated aromatic industrial compounds, typified by the polychlorinated dibenzo-p-dioxins (PCDDs), dibenzofurans (PCDFs) and biphenyls (PCBs) have been identified as residues in almost every component of the global ecosystem. Risk assessment of the complex mixtures of halogenated aromatics found in environmental samples is complicated by analytical problems and the lack of toxicological information on individual compounds and mixtures. Research in our laboratory has focused on the development and vadidation of the in vitro aryl hydrocarbon hydroxylase (AHH) induction assay in rat hepatoma H-4-II E cells in culture for quantitating individual toxic halogenated aryl hydrocarbons and their mixtures. For several PCB, PCDD, PCDF congeners, their mixed bromo/chloro analogs and reconstituted mixtures there was an excellent linear correlation between their -log ED50 values for AHH induction in rat hepatoma cells and their -log ED50 values for in vivo hepatic microsomal AHH induction, inhibition of body weight gain and thymic atrophy in the rat. It has also been shown for selected compounds that there was a good correlation between their in vitro AHH induction potencies and their effects in guinea pigs (AHH induction, inhibition of body weight gain) and mice (immunotoxicity). This assay system has been utilized to quantitative the "2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) equivalents" present in extracts from diverse sources including fly ash from a municipal incinerator and pyrolyzed brominated flame retardants which contain a complex mixture of halogenated dibenzo-p-dioxins and dibenzofurans.

Animals↗
PubMed1989

Hospitality audits.

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Health Facility Environment↗
PubMed1989

Primary immune response to liposomal tetanus toxoid in mice: the effect of mediators.

Primary immune response (IgG1) to tetanus toxoid entrapped in liposomes composed of equimolar egg phosphatidylcholine and cholesterol, and the effect of a variety of physiological and non-physiological mediators (co-entrapped with the toxoid or entrapped in separate liposomes) on such responses, were studied in BALB/c mice. Results show that (i) primary responses, not detectable with the free antigen, were elicited with the same amount of antigen given in liposomes within a range (37.4:1-2857:1) of liposomal phospholipid to toxoid mass ratios. At a higher ratio (17,804:1) response was reduced to very low levels. Immune responses obtained with liposomal toxoid were maintained at measurable levels 24 weeks after immunization. (ii) Interleukin-2 (IL-2), interferon-gamma (IFN-gamma) and N-acetyl muramyl-L-threonyl-D-isoglutamine ([Thr1]MDP), but not its liposoluble 6-O-stearoyl derivative (6-O-S-[Thr1]MDP), co-entrapped with the toxoid at appropriate phospholipid to toxoid ratios, generally reduced primary response to levels below those achieved with liposomes containing the antigen alone. Further, responses obtained with 6-O-S[Thr1]MDP coentrapped with the toxoid or separately entrapped were higher than those seen with [Thr1]MDP in similar formulations. The significance of these findings is discussed in conjunction with the structural characteristics of liposomes.

Acetylmuramyl-Alanyl-Isoglutamine↗
PubMed1989

General anesthesia during percutaneous transluminary coronary angioplasty for acute myocardial infarction: results of a randomized controlled clinical trial.

Acutely ill patients with myocardial infarction may require immediate cardiac catheterization and coronary angioplasty to achieve myocardial reperfusion. To determine the feasibility of using general anesthesia under these circumstances, a randomized clinical trial was performed. Of 50 patients, 25 received anesthesia and 25 receive intravenous sedation. There were transient increases in heart rate and blood pressure after tracheal intubation in the anesthetized patients, followed by significant and sustained decreases below baseline values once steady state anesthesia was attained. Arterial oxygenation was significantly improved in anesthetized patients. There were no serious complications due to anesthesia, but the small sample size limited the power of the study to detect differences in morbidity or mortality. Patients strongly preferred anesthesia. These results show that general anesthesia is feasible in patients undergoing interventional cardiac catheterization during acute myocardial infarction, when pain, anxiety or agitation do not respond adequately to conventional measures.

Anesthesia, General↗
PubMed1988

Regional blood flow in congestive heart failure: concept of compensatory mechanisms with short and long time constants.

With physiologic stress to the cardiovascular system, some circulatory compensatory mechanisms are designed to restore homeostasis quickly (e.g., sympathetic nervous system activation and the Frank-Starling mechanism). These compensatory mechanisms are not nearly as effective when there is a chronic pathologic stress such as congestive heart failure (CHF). In this circumstance, other mechanisms that operate with longer time constants come into play (e.g., activation of the renin-angiotensin-aldosterone system, myocardial hypertrophy and deconditioning). The most successful chronic drug therapies of CHF are those that are designed to reverse the latter group of compensatory mechanisms, a process that is slow. It takes especially long to reverse those CHF-induced changes in blood vessels and skeletal muscle metabolism that are activated to cope with inadequate delivery of oxygenated blood to working muscles. The concept that compensatory mechanisms have either short or long time constants for activation, effectiveness and reversal may help explain why the improvement in exercise tolerance with effective heart failure therapy lags behind hemodynamic improvement.

Adaptation, Physiological↗
PubMed1988

Immunosuppressive activities of polychlorinated dibenzofuran congeners: quantitative structure-activity relationships and interactive effects.

The dose-response immunosuppressive effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), 2,3,4,7,8- and 1,2,3,7,9-pentachlorodibenzofuran (PeCDF), 2,3,7,8- and 1,3,6,8-tetrachlorodibenzofuran (TCDF) on the splenic plaque-forming cell (PFC) response to sheep red blood cells were determined in C57BL/6 mice. The ED50 values for immunosuppression were 2.4, 3.0, 14.0, 710, and 35,700 nmol/kg for 2,3,7,8-TCDD, 2,3,4,7,8-PeCDF, 2,3,7,8-TCDF, 1,2,3,7,9-PeCDF, and 1,3,6,8-TCDF, respectively, and the results confirmed that lateral chlorine substitutions were important structural determinants for the toxicity of the polychlorinated dibenzofuran congeners. Interaction of both 2,3,7,8-TCDD and 2,3,4,7,8-PeCDF with subimmunotoxic doses of 1,3,6,8-TCDF resulted in significant antagonism of the immunotoxic effects of both 2,3,7,8-TCDD and 2,3,4,7,8-PeCDF. Previous studies have also demonstrated that 1,3,6,8-TCDF also antagonizes the induction of aryl hydrocarbon hydroxylase by 2,3,7,8-TCDD and analysis of competitive receptor binding studies suggests that 1,3,6,8-TCDF acts as a competitive partial antagonist of the action of 2,3,7,8-TCDD. The antagonism of 2,3,7,8-TCDD immunosuppression was found to be dependent on the timing of administration of 1,3,6,8-TCDF. Using a protocol in which 2,3,7,8-TCDD is administered 5 days prior to the antigen and 9 days prior to assessing the splenic PFC response, it was possible to partially antagonize the immunosuppressive effects of 2,3,7,8-TCDD by administering the antagonist up to 5 days after the initial dose of the toxin. Administration of 1,3,6,8-TCDF after the antigen does not afford any significant protection from the effects of 2,3,7,8-TCDD and these results are consistent with the hypothesis that 2,3,7,8-TCDD modulates some early event in B-cell differentiation. However, these results do not exclude a role for 2,3,7,8-TCDD in modulating other cellular processes associated with the PFC response.

Animals↗
PubMed1988

Delayed reversal of impaired vasodilation in congestive heart failure after heart transplantation.

The effects of changes in central cardiovascular function on peripheral vasodilation were investigated. Strain gauge plethysmography was used to measure the maximal blood flow response following release of forearm arterial occlusion and the peak reactive hyperemic blood flow response (ml/min.100 ml) before and twice after orthotopic heart transplantation in 10 subjects with severe congestive heart failure. The 2 posttransplantation studies were done before hospital discharge (mean 18 days after transplantation) and again after discharge (mean 114 days after transplantation). Transplantation led to a significant but delayed increase in maximal vasodilation (reactive hyperemic blood flow: pretransplant 21 +/- 3; predischarge 25 +/- 2; postdischarge 43 +/- 5) and a concurrent significant reduction in minimal forearm resistance. Although the improvement in peripheral vasodilator function may be linked to improvement in cardiac function, this linkage is not direct, nor is it immediate. If the normalization of maximal metabolic blood flow is related to resumption of normal physical activity postdischarge, then much of the basic abnormality in vasodilator capacity in congestive heart failure may be related to physical deconditioning.

Adult↗
PubMed1988

Fatal adenovirus meningoencephalitis in a bone marrow transplant patient.

We describe a bone marrow transplant patient with fatal subacute adenovirus meningoencephalitis, the first such patient reported. Neuropathological examination revealed unique, bilaterally symmetrical degeneration in the inferomedial temporal cortex, amygdaloid nuclei, hippocampi, hypothalamus, and some brainstem nuclei. Viral intranuclear inclusions were noted in these areas by light microscopy and confirmed by electron microscopy. Identification was authenticated by viral culture and the isolation of adenovirus from cerebral cortical tissues, and further confirmed by immunofluorescence and serological methods.

Adenoviridae Infections↗
PubMed1988

Anesthetic implications for the management of patients with acute myocardial infarction: a matched cohort study of patients undergoing emergency myocardial revascularization.

Emergency coronary artery bypass grafting (CABG) is advocated as a treatment of acute myocardial infarction (AMI). To attempt to define anesthetic management problems in this patient group, a retrospective study was conducted comparing the perioperative courses of 23 patients undergoing emergency CABG during AMI with 23 elective patients, individually matched for gender, operating surgeon, ejection fraction, and aortic crossclamp time. The 23 AMI patients were anesthetized 5.98 +/- 3.0 (range 1.5 to 11.0) hours after the onset of chest pain. Anesthetic agents were similar for both groups. Induction of anesthesia was well tolerated by AMI patients. Tolerance of cardioplegic arrest was impaired in the AMI group as evidenced by the sharp increase in frequency of inotropic support required to discontinue bypass in the AMI group compared to elective patients (12/23 v 3/23; P less than .005). Fifteen AMI patients who received preoperative streptokinase had greater postoperative bleeding. Three AMI patients died postoperatively. The number of patients requiring prolonged postoperative ventilation and extended ICU care was higher in the AMI group. It is concluded that patients undergoing emergency CABG during AMI represent a greater risk than elective patients. They have a higher incidence of myocardial dysfunction following cardioplegic arrest during bypass. Those who receive preoperative thrombolytic therapy exhibit greater bleeding tendencies.

Anesthesia, Intravenous↗
PubMed1988

Identification of CD4+, 2H4+ (T8 gamma +) suppressor-inducer cells in normal human epidermis and superficial dermis.

Immunohistological staining of frozen sections of normal human skin demonstrated the presence of significant numbers of mononuclear cells expressing novel epitopes associated with CD4-positive suppressor-inducer functions. The cells were located around superficial vessels and within the basal layers of the epidermis and hair follicles. The antigen identified by the various antibodies has been shown to be functionally important in the induction of various suppressor cells capable of abrogating B cell responses to pokeweed mitogen. The presence in the skin of cells with possible down-regulatory functions in the immune response may be significant with respect to surveillance against neoplasms and control of appropriate responses to infectious agents.

Antibodies, Monoclonal↗
PubMed1988

Abnormalities in systemic norepinephrine kinetics in human congestive heart failure.

A high venous plasma norepinephrine (NE) level is a predictor of poor prognosis in congestive heart failure (CHF). To evaluate the mechanisms responsible for the high plasma NE in CHF, NE kinetics were studied in 19 patients with CHF and 18 normal subjects during a 90-min steady-state intravenous infusion of tracer [3H]NE of high specific activity. Venous plasma NE between 70 and 90 min of infusion was significantly higher in the CHF patients (CHF, 634, and normal, 247 pg/ml; P less than 0.001). The following equations were used: NE clearance = [3H]NE infusion rate (dpm/min)/plasma [3H]NE (dpm/l), and NE spillover = [3H]NE infusion rate (dpm/min)/[3H]NE specific activity (dpm/nmol). In CHF, a decreased clearance and an increased spillover contributed nearly equally to the high plasma NE (NE clearance: CHF, 0.99; normal, 1.48 l.min-1.m-2; P less than 0.001; NE spillover: CHF, 3.60; normal, 2.08 nmol.min-1.m-2; P less than 0.001). These data document that both NE clearance and NE spillover are abnormal in CHF, and they raise the new possibility that the factors responsible for the reduced NE clearance could be related to the factors linking a high plasma NE with early mortality.

Adult↗
PubMed1988

Effects of platelet-activating factor antagonist SRI 63-441 on endotoxemia in sheep.

We investigated whether platelet-activating factor (PAF) mediates endotoxin-induced systemic and pulmonary vascular derangements by studying the effects of a selective PAF receptor antagonist, SRI 63-441, during endotoxemia in sheep. Endotoxin infusion (1.3 micrograms/kg over 0.5 h) caused a rapid, transient rise in pulmonary arterial pressure (Ppa) from 16 +/- 3 to 36 +/- 10 mmHg (P less than 0.001) and pulmonary vascular resistance (PVR) from 187 +/- 84 to 682 +/- 340 dyn.s.cm-5 (P less than 0.05) at 0.5 h, followed by a persistent elevation in Ppa to 22 +/- 3 mmHg and in PVR to 522 +/- 285 dyn.s.cm-5 at 5 h in anesthetized sheep. Arterial PO2 (PaO2) decreased from 341 +/- 79 to 198 +/- 97 (P less than 0.01) and 202 +/- 161 Torr at 0.5 and 5 h, respectively (inspired O2 fraction = 1.0). SRI 63-441, 20 mg.kg-1.h-1 infused for 5 h, blocked the early rise in Ppa and PVR and fall in PaO2, but had no effect on the late phase pulmonary hypertension or hypoxemia. Endotoxin caused a gradual decrease in mean aortic pressure, which was unaffected by SRI 63-441. Infusion of SRI 63-441 alone caused no hemodynamic alterations. In follow-up studies, endotoxin caused an increase in lung lymph flow (QL) from 3.8 +/- 1.1 to 14.1 +/- 8.0 (P less than 0.05) and 12.7 +/- 8.6 ml/h at 1 and 4 h, respectively. SRI 63-441 abolished the early and attenuated the late increase in QL.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗