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Biomedical subjects

E Blackwell

Publications and source records attributed to E Blackwell.

11 recordsLinked to original sources

Controlled trial of behavioural therapy for separation-related disorders in dogs.

A generic programme of behavioural modification for the clinical treatment of separation-related behaviours in dogs was assessed in a controlled replicated trial. After 12 weeks of treatment, 56 per cent of the owners of the treated dogs reported significant improvements in their dogs' behaviour, and a further 25 per cent reported a slight improvement. The owners' reports were generally supported by changes in the behaviour of the dogs as recorded on video when they were left alone. The majority of the untreated dogs continued to show the same degree of separation-related behaviour throughout the 12 weeks of the trial. In a supplementary set of 30 case studies, treated with a behavioural programme tailored to the specific diagnosis for each dog, all the owners reported improvements in their dogs' behaviour after 12 weeks of treatment.

Animals↗

Life tables.

Explore the source record for details and available documents.

Adolescent↗

Coagulation parameter instability as an early predictor of intracranial hemorrhage during extracorporeal membrane oxygenation.

Extracorporeal membrane oxygenation (ECMO) has been used to treat over 2,000 neonates with severe respiratory distress due to a number of different diagnoses. Its application has been expanded into the pediatric population as well. Despite both technical advances and refinement of management techniques, intracranial hemorrhage remains a major cause of both morbidity and mortality during ECMO. We reviewed our ECMO experience with regard to the diagnosis of intracranial bleeding, and gave particular attention to the technicians' written records. Seven of 50 patients had a documented intracranial event during ECMO, and in all 7, the technicians noted increasing difficulty with control of the activated clotting time (ACT), platelet count, or both. This manifested itself as both inability to raise the ACT and/or platelet count, or inability to decrease the ACT, despite discontinuation of heparin. The patients with intracranial hemorrhages had a significantly greater number of changes in the rate of heparin infusion than matched controls. None of the patients with intracranial bleeding had any signs of extracranial hemorrhage, and none manifested any hemodynamic abnormalities. In 4 cases, the regularly scheduled echoencephalogram was obtained earlier in the day, and the patients were subsequently weaned and decannulated. We conclude from this review that instability of previously well-controlled coagulation parameters is an early predictor of an intracranial event. However, the impact of earlier diagnosis on outcome is less clear from this small number of patients.

Blood Coagulation↗

In vitro and in vivo studies of heparinized-collageno-elastic tubes.

Heparin was covalently coupled to collageno-elastic grafts (CET) derived from lamb carotid arteries, by using the crosslinking agent 1-ethyl-3 (3-dimethyl-aminopropyl) carbodiimide (EDC). The collagenous grafts were pretreated with various aminating agents in order to enhance the number of available binding sites on the collagen surface. By varying the EDC/heparin weight ratio, the pH of the immobilization media, and the pretreatment agent, a global search pattern maximized heparin loading at 3.90 +/- 0.36 USP heparin/cm2 collagenous graft surface when the EDC/heparin ratio was 2:1 at a pH of 1.5 with 1 M hydroxylamine sulfate as the pretreatment agent. Heparinized CETs were superior to nonheparinized CETs by exhibiting both enhanced antiplatelet activity in using an in vitro differential recirculation reactor with chromium-51 tagged platelets and enhanced patency when interposed in canine carotid arteries. Both antiplatelet activity and patency duration for heparinized CETs were independent of heparin loading.

Animals↗

Doppler ultrasound scanning of the carotid bifurcation.

The results of Doppler scanning of 146 carotid bifurcations in 86 patients were correlated with carotid arteriography. The correlations for normal carotid arteries ranged from 63% to 98%; the correlation for occlusions of carotid arteries was 100%. The Doppler scan correlated in 70% to 85% of stenoses of the internal or external carotid arteries near their origins. The technique may be performed by a well-trained technician or physician.

Carotid Arteries↗

Nabumetone-associated interstitial nephritis.

An 84-year-old woman was admitted to the hospital for progressive edema and decreased urine output. She had been taking nabumetone for 6 months, but had discontinued the agent 2 weeks before admission due to progressive edema. On admission she had 2-3+ pitting edema. Her serum electrolytes were sodium 122 mEq/L, potassium 5.9 mEq/L, chloride 93 mEq/L, and carbon dioxide 19 mEq/L. A urinalysis was significant for protein 3061 mg/dl, ketones 15 mg/dl, blood 2+, leukocytes 26-50/high-power field, and a protein:creatinine ratio 24.9. The serum creatinine and blood urea nitrogen concentrations were 2.7 mg/dl and 70 mg/dl, respectively. Throughout hospitalization the patient underwent aggressive diuresis. She developed congestive heart failure, and hemodialysis was initiated. A renal biopsy specimen on hospital day 9 showed tubular damage with minimal glomerular changes consistent with a diagnosis of nonsteroidal agent-induced nephropathy. On day 13, a 24-hour urine collection had a protein excretion of 3151 mg. Although the patient recovered from her renal failure (creatinine clearance 43 ml/min), the nephrotic syndrome persisted (13 g protein/day). The patient developed infectious complications and died on hospital day 32.

Aged↗