Search PubMed⌕ Search

Biomedical subjects

D McHugh

Publications and source records attributed to D McHugh.

At least 37 records · Page 2Linked to original sources
PubMed1994

Enhancement of pain control with ketorolac tromethamine in patients with sickle cell vaso-occlusive crisis.

Twenty one patients with sickle cell disease admitted to the hospital with the pain of vaso-occlusive crisis (VOC) were treated by continuous IV infusion of ketorolac or normal saline for up to 5 days. All patients received supplemental IM injections of meperidine, 100 mg, as necessary, but not more frequently than every 3 hr. Over the 5 days the ketorolac treated patients (KT) required 33% less meperidine than did the placebo treated patients (PL), P = 0.04, and had significantly better pain relief as assessed by categorical, visual analog, and pain relief scales. By the end of 5 days infusions had been discontinued in six KT and one PL. The time to discontinuation of the infusion was significantly shorter in KT, (P = 0.009). The median duration of hospital stay from the start of treatment was 3.3 days for KT and 7.2 days for PL, P = 0.027. Adverse events were mainly related to the digestive system. This study showed that continuous infusion of ketorolac significantly reduced total meperidine requirement and that the analgesia produced by this combination was superior to that produced by meperidine alone. Further evaluation of this drug in the management of sickle cell VOC is warranted.

Adult↗
PubMed1994

Contact diode laser cyclo-photocoagulation for refractory glaucoma. A pilot study.

Initial experience with non-contact diode cyclo-photocoagulation for refractory glaucoma has shown positive results. Diode laser irradiation applied via a contact probe results in greater transmission through the sclera and delivery of more energy to the ciliary body. A trial was performed to evaluate the effects of contact diode cyclo-photocoagulation. A total of 12 patients with glaucoma due to conditions such as central retinal vein occlusion were treated. A mean of 22 pulses (810 nm) with powers of up to 2 W and of 2 s duration were applied via a fibre-optic delivery system and a contact probe. The mean intra-ocular pressure dropped from 42.3 to 13.6 mmHg over 3 months. Four patients required retreatment. Three patients had side effects that included hyphaema, anterior fibrinous uveitis and pupil block. In conclusion, contact diode cyclo-photocoagulation had a significant ocular hypotensive action in the treatment of refractory glaucoma. As compared with non-contact diode cyclo-photocoagulation, the contact modality produced more marked non-therapeutic side effects.

Adult↗
PubMed1994

Long-term results of ab externo neodymium:YAG cyclophotocoagulation.

Neodymium: YAG cyclophotocoagulation (CPC) was performed in 128 eyes of 123 patients with refractory glaucoma. In each eye, 40 burns delivered with energy of up to 7 J were placed 1.5 mm behind the limbus in a 360 degrees pattern. The minimal follow-up period was 24 months, with the mean being 36.9 (range, 24-84; SD, 5.8) months. The mean intraocular pressure was 35.0 (range 23-54; SD, 12.2) mmHg preoperatively, 20.6 (range 15-24; SD, 3.5) mmHg after 1 year, and 20.2 (range 12-24; SD, 8.1) mmHg after 2 years. A total of 25 eyes (19.5%) lost 2 or more lines in visual acuity. Success was defined as a lowering of intraocular pressure by > 30% and a decrease in visual acuity of < 2 Snellen lines. By this definition the success rate was 52.4%. There was no correlation with either the diagnosis, the stage of the disease, or the pigmentation of the trabecular meshwork, although patients with secondary traumatic or uveitic glaucoma tended to be less responsive to CPC. The most common acute complication of treatment was transient corneal edema. Phthisis bulbi developed in 1 eye (0.8%). In conclusion, CPC achieved satisfactory long-term control of intraocular pressure in the majority of patients with severe late-stage glaucoma.

Adolescent↗
PubMed1994

Reaccreditation.

Explore the source record for details and available documents.

Certification↗
PubMed1993

A programmable Doppler string test object.

A prototype water filled ultrasound string test object is presented for performance checks on Doppler ultrasound systems. The string motion produces realistic and reproducible Doppler wave forms on the system by means of a programmable stepper motor. Wave forms can be generated using a computer, and programmed into the device. The test object can be used to check Doppler calculation parameters, such as pulsatility index and resistance index, as well as range gate registration and wall filter function. The test object is water filled, and the lack of attenuation did prove to be a problem on some systems. The object was tested using five different duplex and colour scanners, and found to be sufficiently reproducible for use as a field test object for Doppler ultrasound machines. The device is compact and portable, making it suitable for checks in the field for both longterm monitoring of performance and inter-machine comparisons.

Humans↗
PubMed1992

Current uses of ophthalmic lasers.

Current laser treatments are quick, relatively painless, and well tolerated. Some ophthalmic techniques can be performed only by laser while others have a lower morbidity than alternative treatments. Peripheral retinal photocoagulation and focal photocoagulation now offer greatly improved visual prognosis for diabetic patients with proliferative diabetic retinopathy or diabetic macular disease. Selected cases of macular degeneration may be treated by focal laser photocoagulation. The role of lasers in treating sub-retinal neovascular membranes is limited by the extent and location of the membrane at presentation and the high risk of recurrence after treatment. Patients with distorted vision must be referred urgently for specialist ophthalmic assessment. Flat retinal holes and tears may be sealed by laser therapy, thus preventing retinal detachment. Short pulsed neodymium-YAG photodisruptive capsulotomy effectively clears the visual axis of thickened posterior lens capsule after cataract surgery. Short pulsed neodymium-YAG photodisruptive iridotomy may be used to treat and prevent angle closure glaucoma. Laser trabeculoplasty aids the control of open angle glaucoma. Research is continuing into the role of other lasers in managing open angle glaucoma and of photoablative lasers in treating refractive errors and superficial corneal disorders.

Cataract Extraction↗
PubMed1992

Comparison of the efficacy and safety of ketorolac and meperidine in the relief of dental pain.

A single-dose, randomized, double-blind study of parallel design was conducted to determine the analgesic efficacy and safety of ketorolac tromethamine in patients who experience moderate or severe pain after the surgical removal of three or more third molars, one of which was a bony-impacted mandibular molar. Meperidine hydrochloride was used as the control analgesic. In this 8-hour study, assessments were made of pain intensity, pain relief, and overall rating of the medication in 145 patients, each of whom had received an intramuscular injection of 10 mg, 30 mg, or 90 mg of ketorolac, or 50 mg or 100 mg of meperidine. The summed pain intensity and total pain relief scores showed that, at 3 and 8 hours, the effectiveness of 30 mg of ketorolac was similar to that of 90 mg ketorolac and that both of these doses were significantly more efficacious than 10-mg ketorolac, 50-mg meperidine, or 100-mg meperidine. Patients who received 30 mg or 90 mg of ketorolac gave the study medication significantly higher ratings overall than did patients who received 50 mg or 100 mg of meperidine. Significantly fewer patients treated with ketorolac reported adverse events in comparison with those treated with meperidine (17% and 59%, respectively), which suggests that it possesses a better therapeutic index than meperidine. Thus, ketorolac appears to represent an important advance in analgesic therapy.

Analgesics↗
PubMed1991

Pseudophakic retinal detachment.

A total of 93 cases of pseudophakic retinal detachment are reported. The present study showed that vitreous loss had occurred during cataract surgery in 28% of eyes, indicating that anterior segment complications are an important contributory factor to aphakic retinal detachment in these cases. There was impairment of the retinal view in 46% of eyes, and in 22.5% no retinal breaks could be identified. The main factor responsible for poor visibility was inadequate pupillary dilatation, which was found particularly in association with the use of iris-supported lenses. Detachment of the macula was unexpectedly found to occur in as many as 88% of cases. Reattachment of the retina either by conventional detachment procedures or by pars plana vitrectomy was achieved in 76.3% of eyes. Complications directly attributable to the presence of an intraocular lens (such as dislocation or haemorrhage) are described. Failure of surgery was more likely to occur in eyes exhibiting a poor fundal view, in which the detection of retinal breaks was difficult. The best results were achieved in eyes in which posterior-chamber lenses had been implanted.

Adult↗
PubMed1991

Tumour size as a prognostic factor in carcinoma of the cervix: assessment by transrectal ultrasound.

Transrectal ultrasound (TRUS) was used to measure tumour size in patients with carcinoma of the cervix and to assess its prognostic significance. Clinical staging was conducted and at the time of examination under anaesthesia, TRUS was used to assess maximum transverse diameter of the tumour. Eighty-one patients were studied. FIGO stages were 1B 34 patients, IIA seven patients, IIB 31 patients, IIIA two patients and IIIB seven patients. Mean tumour diameters by stage were IB 37 mm, IIA 37 mm, IIB 49 mm, IIIA 42 mm and IIIB 50 mm. There was a significant correlation between size and stage (p = 0.001). With a median follow-up of 18 months, 16 relapses have occurred. The actuarial relapse rates at median follow-up by stage were IB 10%, IIA 17%, IIB 22%, IIIA 0% and IIIB 35%. The actuarial relapse rates by size grouping at median follow-up were less than 30 mm 0%, greater than 30 and less than 40 mm 11%, greater than 40 and less than 50 mm 22%, and greater than 50 mm 38%. There was a significant difference between the mean recorded size of the tumours in the relapsed group and the relapse-free group (p = 0.02). Despite the small number of patients and short follow-up, tumour size as measured by TRUS appears to predict relapse.

Adult↗
PubMed1990

Diode laser trabeculoplasty (DLT) for primary open-angle glaucoma and ocular hypertension.

A pilot study has been carried out to examine the efficacy of diode laser trabeculoplasty in the treatment of primary open-angle glaucoma and ocular hypertension. The device used was portable and could be attached to a standard slit-lamp microscope. Powers of 0.8-1.2 W were used, with a spot size of 100 microns and a pulse of 0.20 second. Laser trabeculoplasty carried out on 20 eyes for glaucoma resulted in a mean ocular hypotensive effect of 10.2 mmHG at two weeks after treatment and of 9.55 mmHg at 6 months. It is concluded that diode laser trabeculoplasty is an effective mode of treatment for eyes with open-angle glaucoma or with ocular hypertension.

Aged↗
PubMed1989

Modulation of mesolimbic dopaminergic projections by beta-endorphin in the rat.

Intracerebroventricular injection of beta-endorphin stimulated the metabolism of dopamine in a dose-dependent, opiate antagonist-reversible manner. Local injections into the nucleus accumbens also caused similar increases, indicating that the actions of this peptide on mesolimbic dopaminergic projections were occurring at opioid receptor sites within the nucleus accumbens. Tolerance experiments suggested that epsilon opioid receptors may be involved in mediating these effects in the n. accumbens, unlike in the striatum.

3,4-Dihydroxyphenylacetic Acid↗
PubMedDate not supplied

TRPC1 store-operated cationic channel subunit.

TRPC1 is a membrane protein that is highly conserved in mammals, amphibians and birds. It is widely expressed in cells throughout the body including in the heart and nervous system. Amino acid sequence analysis and over-expression studies indicate it is an ion channel that allows the transmembrane flux of small cations including sodium and calcium. In some cell types it is apparent that at least a fraction of TRPC1 exists in the plasma membrane. Inhibition of TRPC1 expression or block by TRPC1-specific antibody leads to attenuation of the plasma membrane calcium influx that occurs in response to depletion of calcium levels in sarcoplasmic or endoplasmic reticulum. TRPC1 would, therefore, seem to be a key subunit of store-operated channels (SOCs). TRPC1 is, nevertheless, unlikely to act alone. There is good evidence that it can heteromultimerise with the related proteins TRPC4, TRPC5 and polycystin-2; a tetrameric arrangement is envisaged, but not demonstrated. Like its relative in Drosophila, TRPC1 looks likely to function in a signalplex, a protein complex including inositol 1,4,5-triphosphate (IP(3)) receptor, plasma membrane calcium-ATPase, caveolin-1 and calmodulin. Its localisation in membranes is punctate and associated with functionally discrete calcium signals. TRPC1's function may not only be linked to SOCs but also to other cellular events including the nuclear translocation of the NFAT transcription factor. There is still much to be learned about this fundamental protein.

Amino Acid Sequence↗