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Biomedical subjects

D W Ryan

Publications and source records attributed to D W Ryan.

At least 55 records · Page 3Linked to original sources
PubMed1986

Charcoal-column haemoperfusion does not significantly enhance chlormethiazole removal.

A 26-year-old man had convulsions after taking an overdose of slow-release aminophylline tablets. The convulsions were treated with an infusion of chlormethiazole and theophylline was removed by charcoal-column haemoperfusion. It has been suggested that haemoperfusion might be useful for removing chlormethiazole and this was investigated. There was no evidence that charcoal-column haemoperfusion could remove clinically significant amounts of chlormethiazole.

Adult↗
PubMed1986

The anion gap.

The majority of doctors can recognize and treat obvious biochemical disturbances on the basis of routine urea and electrolyte results. A useful (although nonspecific) guide to acid-base status is also contained among those figures: this is a derivative known as the anion gap. This article is a guide to the anion gap.

Acid-Base Imbalance↗
PubMed1985

Demonstration of a reduction in postoperative body protein breakdown using the Clinitron fluidized bed with an ambient temperature of 32 degrees C.

Patients managed at an elevated ambient temperature after major surgery have a less pronounced rise in postoperative urinary nitrogen excretion. To investigate the mechanism involved, body protein breakdown was assessed, using a tracer dose of labelled amino acid, in patients following aorto-bifemoral bypass surgery nursed on either a Clinitron fluidized bed at 32 degrees C or a hospital bed at 22 degrees C and correlated with urinary total nitrogen excretion. Results showed a small reduction in measured body protein breakdown on the second postoperative day in patients managed on the Clinitron fluidized bed at 32 degrees C (2.92 +/- 0.91 versus 3.23 +/- 0.84 g protein kg-1 day-1; mean +/- s.d.), which was equivalent to the mean protein sparing (0.29g protein kg-1 day-1) demonstrated by the significant improvement in urinary total nitrogen excretion (9.20 +/- 2.0 versus 12.48 +/- 3.9 g N day-1; mean +/- s.d.: P less than 0.05). Urinary total nitrogen excretion (N) and body protein breakdown (B) showed a weak though significant positive correlation (B = 1.25 + 13.13N; r = +0.55: P = 0.05), whereas no correlation existed between urinary total nitrogen excretion and the derived rate of body protein synthesis. There was also a significant decrease in postoperative stress, measured during the isotope infusion, in patients managed on the Clinitron fluidized bed at 32 degrees C (12.3 +/- 2.2 versus 16.1 +/- 3.2 per cent activity incorporated into plasma proteins; mean +/- s.d.: P less than 0.05). These results show the beneficial effect of managing postoperative patients on a Clinitron fluidized bed at 32 degrees C in conserving body nitrogen through a reduction in body protein breakdown, probably as a consequence of decreased postoperative stress.

Aged↗
PubMed1984

Acute respiratory insufficiency after endoscopy for bleeding oesophageal varices.

Two patients with alcoholic liver disease and gross ascites underwent endoscopic injection and compression by Sengstaken tube of oesophageal varices under general anaesthesia. Postoperatively both patients developed acute respiratory failure, which resolved after air had been aspirated from the stomach via the Sengstaken tube. All air should be aspirated at the end of the procedure in patients with ascites who undergo endoscopy, and respiration should be carefully supervised postoperatively.

Adult↗
PubMed1983

Fluidised beds.

Explore the source record for details and available documents.

Beds↗
PubMed1983

The influence of environmental temperature (32 degrees C) on catabolism using the Clinitron fluidised bed.

The metabolic response to injury can be modified by raising the environmental temperature to 32 degrees C. A prospective study using the Clinitron fluidised bed showed this to be a suitable alternative to a warm room. Overall total urinary nitrogen savings were significant (p less than 0.001) in a warm environment although individual patients showed some variation in the degree of response. Overall the trend is encouraging and merits further attention an investigation in severe injury.

Aged↗
PubMed1983

Plain bupivacaine 0.5%: a preliminary evaluation as a spinal anaesthetic agent.

Three hundred and forty consecutive patients received successful spinal anaesthesia with 0.5% plain bupivacaine. A small randomised study of 40 of these cases showed little difference between 3.5 and 3 ml; however, analysis of its use in 200 patients receiving 3.5 ml (mean block T10.5 +/- 1 segment) and 100 receiving 3 ml (T10 +/- 0.5 segment) confirmed the impression that the smaller volume produced a more limited range of segmental block, which was desirable notably in the over-70-year age group. The main complications were hypotension (14.1%) and headache (1.5%).

Adult↗
PubMed1982

Replanning of an intensive therapy unit.

Considerable effort is needed when replanning an intensive therapy unit to avoid repeating mistakes in design, such as lack of windows and an impractical working area. Early consultation with the nursing and medical staff primarily responsible for such a unit is essential. The considerable technological innovations in intensive care will require flexibility in the future if they are to be incorporated into existing facilities.

England↗
PubMed1982

Anaesthesia for cystectomy. A comparison of two anaesthetic techniques.

Sixty-two patients who underwent radical cystectomy for deeply infiltrating cancer of the bladder were reviewed. Twenty-four received an epidural anaesthetic and 38 a conventional muscle relaxant and fentanyl anaesthetic. The epidural technique was found to offer advantages because of its hypotensive effects reducing blood loss intra-operatively and its use to provide analgesia after surgery. A high incidence of complications accompanied the surgery and frail patients (below 50 kg) and those with symptomatic respiratory disease had a high mortality. Greater attention to pre-operative care of such patients is indicated.

Anesthesia, Epidural↗
PubMed1982

An appraisal of S3 blocks in the management of incontinence.

Sixteen patients were treated for incontinence by S3 blocks when other means had failed. CMG had demonstrated detrusor instability in 14 and was not performed in 2 patients. Ten patients are continent, 2 are improved. There have been no complications or side effects. These results suggest that S3 blocks should be considered as an additional method of treatment of detrusor instability.

Adult↗