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Biomedical subjects

D R Thompson

Publications and source records attributed to D R Thompson.

138 records · Page 8Linked to original sources
PubMedDate not supplied

Brainstem auditory-evoked potentials in Holstein cows.

Brainstem auditory-evoked potentials (BAEP) were recorded from 29 Holstein cows in a typical clinical setting. The latencies of five positive peaks in the BAEP were measured, and latency-intensity functions were determined. The BAEP was similar to that reported in humans, dogs, horses, and other species. The responses were reproducible for each cow, with low variability between cows. Four peaks (I, II, III, V) were present in all recordings, and a fifth (IV) was present infrequently. All peak latencies decreased as click-stimulus intensity increased. The threshold for detection of the BAEP was higher than expected for the cow compared with the horse.

Animals↗
PubMedDate not supplied

Selective stimulation of latissimus dorsi muscle for cardiac assist.

The contractile power of the latissimus dorsi muscle (LDM) is used in skeletal muscle cardiac assist (SMCA) to augment the blood pumping ability of a failing heart. The LDM has three anatomically distinct, independently innervate segments-the transverse, oblique, and lateral. There are potential advantages to selectively stimulating these LDM regions. We hypothesized that (1) the three nerve branches could be stimulated selectively to activate individual muscle regions with little or no functional overlap, (2) the three muscle regions would generate similar force, and (3) nerves stimulated in combinations would generate forces corresponding to the sum of forces generated by the individual regions. In acute studies of canine LDM (n=5), regional electromyogram (EMG) and isometric force were recorded while branches of the thoracodorsal nerve were stimulated (via nerve-cuff electrodes) individually and in combinations. Analysis of regional EMG and force confirmed selective activation. Stimulation of lateral, oblique, and transverse branches of thoracodorsal nerve activated 53+/-5%, 20+/-9%, and 36+/-9% of the muscle, respectively; with corresponding developed forces of 48+/-6%, 21+/-8%, and 31+/-8% of total muscle force (R=0.98, p<0.05). Selective activation of LDM is possible with little or no functional overlap; however, the muscle regions were nonuniform. Selective stimulation may ultimately facilitate the use of performance enhancing stimulus protocols for SMCA.

Animals↗
PubMedDate not supplied

A safety assessment of diaspirin cross-linked hemoglobin (DCLHb) in the treatment of hemorrhagic, hypovolemic shock.

OBJECTIVE: To determine the safety and possible efficacy of diaspirin cross-linked hemoglobin (DCLHb) in the treatment of patients in Class II-IV hemorrhagic, hypovolemic shock. DESIGN: Multicenter, randomized, normal saline-controlled, dose-escalation study. SETTING: Eleven hospitals in the U.S. and Belgium. SUBJECTS: One hundred and thirty-nine (139) hospitalized patients with Class II-IV hemorrhagic, hypovolemic shock within the previous 4 hours who still were requiring therapy for shock. INTERVENTIONS: Beginning with the lowest dose, patients were randomized to receive 50, 100, or 200 mL of either 10% DCLHb or normal saline infused intravenously over 15 minutes. Following infusion of either treatment, further fluid resuscitation could be given, as necessary, to maintain perfusion. Vital signs, laboratory assessments, blood and fluid administration, complications, and adverse events were recorded at various times from the end of infusion through 72 hours after infusion. RESULTS: A total of 29 (13 DCLHb- and 16 saline-treated) patients died during the study period. Adverse events were experienced by 61% of patients in the DCLHb group and 53% of patients in the saline group; serious adverse events occurred in 28% of DCLHb-treated patients and 30% of saline-treated patients. The incidence of prospectively defined, clinical complications, including renal insufficiency and renal failure, was similar between the treatment groups except for the occurrence of dysrhythmias/conduction disorders, which occurred significantly more frequently in the saline-treated patients than the DCLHb-treated patients (p = 0.041). At the highest dose level (200 mL), statistically significant between-group differences were observed with greater increases in serum amylase, LDH, the isoenzymes LD1,2,4 and 5, and CK-MB in the DCLHb group compared to the control group; none were of clinical significance. The volume of blood administered did not differ between the groups. Overall 24- and 72-hour survival rates were similar between treatment groups, although the hospital discharge rate was slightly higher in the DCLHb-treated patients (80%) compared with the saline-treated patients (74%). CONCLUSION: Administration of 50 to 200 mL of DCLHb to patients in hemorrhagic, hypovolemic shock was not associated with evidence of end organ toxicity or significant adverse events. Further studies involving larger doses and, perhaps, earlier administration of DCLHb are warranted.

Adult↗
PubMedDate not supplied

A trial of povidone-iodine antiseptic solution for the prevention of cannula-related thrombophlebitis.

In a prospective trial of 200 adult patients, using a semiquantitative technique for culturing material from intravenous cannulae, we studied the efficacy of povidone-iodine antiseptic solution (test), and the use of no topical agent whatsoever (control). The incidence of cannula-related thrombophlebitis was slightly higher in the test group than in the control group. It is concluded that the use of povidone-iodine antiseptic solution does not reduce the incidence of cannula-related thrombophlebitis.

Adult↗
PubMedDate not supplied

The cost of cardiac rehabilitation services in England and Wales.

A random sample of 25 cardiac rehabilitation programmes in England and Wales was surveyed by questionnaire. Using workload and resource data returned, costs were calculated per centre, per patient and per session. Sixteen (64%) of the centres returned full details. Annual staffing costs per cardiac rehabilitation centre were in the range 10,000 Pounds to 62,000 Pounds, with a mean of just under 33,0000 Pounds (median 32,000 Pounds). Mean cost per patient completing the rehabilitation programme was 370 Pounds (median 223 Pounds), and mean cost per patient per session was 47 Pounds (median 26 Pounds). There was substantial intercentre variation in costs. Cost per patient was closely related to patient throughput and hours of contact time. The costs of rehabilitation programmes in this survey exceed earlier estimates. To assess the implications for the cost-effectiveness of such programmes, reliable data on the effectiveness of such programmes are now required.

Costs and Cost Analysis↗
PubMedDate not supplied

The development and testing of a cardiac rehabilitation audit tool.

Cardiac rehabilitation is a multidisciplinary activity and as such necessitates the development of audit systems that cut across professional boundaries. The objective of this paper is to describe the development and testing of an audit tool for cardiac rehabilitation. The tool, based on published guidelines, comprised three proformas: one for each patient entering a cardiac rehabilitation programme, one for a summary of a series of patients and one for the facilities available. The proformas were tested in three centres that were assessed as either 'high', 'moderate' or 'low' providers of cardiac rehabilitation. The cardiac rehabilitation programme coordinator of each centre examined a consecutive series of 30 patients' case notes and completed the proformas. The proformas were found to be clear and easy to use. Information was obtained that informed users of current practice and provided pointers to improvements in the provision of care. In conclusion, the cardiac rehabilitation audit tool proved to be effective in determining the documented evidence of practice, was better for determining the level of provision than a purely subjective judgement and provided information indicating an individual programme's strengths and weaknesses. This is the first attempt at producing an audit tool for cardiac rehabilitation. However, further work may be required in its refinement.

Heart Diseases↗
PubMedDate not supplied

International comparison of awareness and attitudes towards coronary risk factor reduction: the HELP study. Heart European Leaders Panel.

BACKGROUND: An international survey was conducted to assess public awareness and attitudes to coronary heart disease and to establish the frequency with which certain health-related behaviours are practised in five European countries. METHODS: Members of the general public (n=5013), individuals at increased risk of coronary disease (n=2500), patients who had suffered a myocardial infarction (n=1256) and members of their families (n=1249) were interviewed in a study conducted in France, Germany, Italy, Sweden and the UK. Questions were asked about respondents' attitudes to their health and about their current health practices. RESULTS: The survey revealed a considerable degree of indifference to coronary heart disease, despite the possession of a reasonable level of knowledge of the risks involved, even among patients who had suffered a myocardial infarction. At the same time, respondents declared themselves satisfied with the quality of advice about coronary health that they obtained from the medical profession and regarded these sources of information as highly credible. Media health campaigns, by contrast, had comparatively little impact. CONCLUSION: A survey of five European countries shows that individuals possess reasonable levels of knowledge about coronary heart disease. They also have access to sources of heart health information that are perceived as highly credible. Nonetheless, such information has a very limited impact on their practice of health-related behaviours.

Adult↗