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Biomedical subjects

D F Stubbs

Publications and source records attributed to D F Stubbs.

13 recordsLinked to original sources
PubMed1986

Significance of infarct site and methylprednisolone on survival following acute myocardial infarction.

Eight hundred and forty-nine patients with confirmed myocardial infarction were enrolled in a double-blind, placebo-controlled clinical trial of the efficacy of methylprednisolone sodium succinate (MPSS, Solu-Medrol Sterile Powder, The Upjohn Company) for reduction of morbidity and mortality following an acute myocardial infarction complicated by left ventricular failure. Two study groups were prospectively defined based on time from onset of chest pain to administration of investigational therapy. Study Group 1 received investigational therapy before 6 hours had elapsed while Study Group 2 was treated 6 to 12 hours from the onset of chest pain. Both study groups were randomized to receive either a 30 mg/kg i.v. dose of MPSS (3 g maximum) or a matching placebo at the time of study admission, to be followed by an identical dose three hours later. Definitive electrocardiograms were available for 814 patients at admission. The mortality rates at 28 days and 6 months for the anterior transmural and nontransmural infarctions did not differ significantly with regard to time to treatment or investigational therapy. For the inferior/posterior transmural infarctions, however, there was a 92% relative reduction in mortality at 28 days in the MPSS treatment arm of Study Group 2 (1/83 [1.2%] for patients given MPSS versus 15/97 [15.5%] for those given placebo; p less than 0.001). This significant difference persisted at the 6 month follow-up evaluation (3/82 [3.6%] for patients on MPSS versus 17/96 [16.6%] for those on placebo, P less than 0.01). Site-specific efficacy has been reported for the anterior infarction groups of the major beta-blocker trials.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Trials as Topic↗
PubMed1986

Simple prediction of 28-day mortality following an acute myocardial infarction.

Upon admission to a drug study of 1,122 patients with myocardial infarction, twenty-seven questions relating to the patients' cardiac status were answered by the physicians. These questions were categorized into four groups of related items of signs and symptoms. Thus four scores could be completed: degree of infarction score, cardiogenic shock score, cardiac failure score, and overall-state-of-the-patient score. The scores were all found to be highly correlated with 28-day mortality. Also, since these scores can be easily and immediately determined at the bedside, or with standard tests, they are both convenient and accurate predictors of 28-day mortality following a myocardial infarction.

Heart↗
PubMed1986

Positive synergism between diuretics and methylprednisolone following acute myocardial infarction.

In studies of patients with cardiac failure following an acute myocardial infarction, 1114 patients were followed for 7-day mortality. In the 45% of patients receiving diuretics on day 1, the death rate was twice that of patients not receiving diuretics. In patients treated 6 to 12 hours following the onset of chest pain, mortality was 2.8 times that of patients treated within 6 hours of the onset of chest pain. Randomization to methylprednisolone sodium succinate (MPSS, Solu-Medrol Sterile Powder, The Upjohn Company) did not improve the low mortality rates of those patients who did not need diuretics nor who were treated early. However, patients who were treated late and who needed diuretics and who were randomized to MPSS had a death rate half that of those who received placebo.

Clinical Trials as Topic↗
PubMed1986

Post-acute myocardial infarction symptomatic pericarditis (PAMISP): report on a large series and the effect of methylprednisolone therapy.

One thousand one hundred and fifty-eight patients sustained a presumed myocardial infarction. Ninety-six per cent of the cases were complicated by ventricular failure. Five hundred and eighty-nine patients were randomized to receive methylprednisolone sodium succinate (MPSS, Solu-Medrol Sterile Powder, The Upjohn Company) (two doses of 2 to 3 g i.v. three hours apart within 12 hours of the onset of chest pain) and 569 to placebo. 7.5% of patients receiving MPSS and 18.5% of the patients on placebo had post-acute myocardial infarction symptomatic pericarditis (PAMISP) (p less than 0.001). The MPSS-treated patients needed less therapy for their PAMISP, and MPSS pre-treatment attenuated and limited the PAMISP. Patients who suffered PAMISP did not differ in age or sex from patients without PAMISP, but had a 3.4-fold greater incidence of anterior acute myocardial infarctions (AMIs). The literature is also reviewed to show that MPSS is a beneficial intervention in PAMISP and other pericarditides.

Adult↗
PubMed1977

Models of gastric emptying.

Some empirical and theoretical models of the emptying behaviour of the stomach are presented. The laws of Laplace, Hooke, and Poisseuille are used to derive a new model of gastric emptying. Published data on humans are used to test the model and evaluate empirical constants. It is shown that for meals with an initial volume of larger than or equal to 300 ml, the reciprocal of the cube root of the volume of meal remaining is proportional to the time the meal is in the stomach. For meals of initial volume of less than 300 ml the equation has to be corrected for the fact that the 'resting volume' of gastric contents is about 28 ml. The more exact formula is given in the text. As this model invokes no neural or hormonal factors, it is suggested that the gastric emptying response to the volume of a meal does not depend on these factors. The gastric emptying response to the composition of the meal does depend on such factors and a recent model of this process is used to evaluate an empirical constant.

Digestion↗
PubMed1975

The volume and energy content of meals as determinants of gastric emptying.

1. Results were collected from thirty-three published and unpublished studies of gastric emptying. The volumes of the meals ranged from 50 to 1250 ml., and composition varied from pure carbohydrates to ordinary food. 2. From the published composition of the meals, their nutritive density, as kcal/ml. (4-18 KJ/ml.) was computed: it ranged from zero to 2-3 kcal/ml. 3. The volume of each meal, or test meal, delivered to the duodenum in 30 min was determined, assuming that gastric emptying was exponential. 4. The greater the nutritive density of a meal, the less was the volume transferred to the duodenum in 30 min. The original volume of meal given was not a determinant of the rate of emptying (ml./min). 5. The slowing of gastric emptying with a meal of high nutritive density was not sufficient to prevent an increased rate of delivery of energy to the duodenum (nutritive density times volume delivered in unit time) with a meal of high nutritive density. 6. Assuming an appropriate relationship for the interaction of a stimulus (kcal/ml.) and duodenal receptors, it was possible to predict a rate of gastric emptying for each meal, given its nutritive density. Knowing the initial volume of the meal, it was possible to predict the mean half time for its emptying. 7. There were eight sets of anomalous results: in four the volumes of meal given were less than 200 ml.; explanations of the anomalies in the other four results could not be provided. 8. The results are consistent with equal slowing of gastric emptying by the duodenal action of the products of digestion of isocaloric amounts of fat, protein and carbohydrate, for example, 4 g fat or 9 g carbohydrate, both 36 kcal, taking carbohydrate and protein as 4 kcal/g and fat as 9 kcal/g.

Dietary Carbohydrates↗
PubMed1975

A relation between the energy of food and gastric emptying in men with duodenal ulcer.

Using information about the volume and energy density of meals, results from the literature on gastric emptying for healthy men can be marshalled into a consistent body. The same process applied to the published papers on men with duodenal ulcer shows that they have abnormally rapid gastric emptying, especially for meals of high-energy density. This provides confirmation of the view of Shay (1944) that the slowing of gastric emptying by duodenal receptors is less in men with duodenal ulcer than it is in healthy men.

Duodenal Ulcer↗
PubMedDate not supplied

Neurocomputers.

Explore the source record for details and available documents.

Artificial Intelligence↗