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Biomedical subjects

E Bradshaw Bunney

Publications and source records attributed to E Bradshaw Bunney.

10 recordsLinked to original sources
PubMed2005

Management of chronic heart failure: an old disease with a new face.

Heart failure is a leading cause of morbidity and mortality. It affects over 5 million patients annually. There are an estimated 400,000-700,000 new cases diagnosed each year. The management of heart failure has changed significantly over the last decade. This review focuses on the pharmacologic management of systolic heart failure, and provides current recommendations for the practicing acute care provider.

Adrenergic beta-Antagonists↗
PubMed2004

Intramuscular antipsychotics: clinical experience review.

Acute agitation is a therapeutic dilemma. Rapid control of agitation is necessary to minimize danger both to recipients of care and to caregivers. Although a comprehensive assessment may ultimately be necessary to determine the cause of agitation and to identify or exclude underlying medical illness, it is often imperative to treat agitation immediately. In this imperfect clinical world, it is essential to have treatments that are both safe and effective for patients with a wide variety of causes of agitation.

Antipsychotic Agents↗
PubMed2004

Knowledge of heart disease among women in an urban emergency setting.

OBJECTIVE: To test the hypothesis that the higher prevalence of heart disease-related illnesses in women in urban areas may be attributed to lack of knowledge. DESIGN: A prospective survey of 224 women presenting to an urban emergency department. INTERVENTION: All study participants were surveyed about their knowledge of heart disease and associated risk factors. RESULTS: Two-hundred participants correctly completed the surveys. Only 25 (13%) of women correctly identified heart disease as the leading cause of death in women. Similarly, only 12 (6%) of women surveyed felt heart disease was the greatest health issue facing women today. The majority of women felt breast cancer was the most important health issue and responsible for the greatest mortality in women. Only three of the traditional cardiac risk factors were correctly identified by half of the women surveyed: hypercholesteremia (56%), hypertension (54%), and tobacco (52%). Family history was correctly identified by 44%, and only 20% of women felt diabetes was a risk factor for cardiovascular disease. CONCLUSIONS: Despite increased medical education and media time spent on women's health issues, up to 87% of women in this urban population did not know the leading cause of death for their gender.

Adult↗
PubMed2003

Serotonin reduces the hyperpolarization-activated current (Ih) in ventral tegmental area dopamine neurons: involvement of 5-HT2 receptors and protein kinase C.

Dopaminergic neurons of the ventral tegmental area (VTA) have been implicated in the rewarding properties of drugs of abuse and in the etiology of schizophrenia; serotonin modulation of these neurons may play a role in these phenomena. Whole cell patch-in-the-slice recording in rat brain slices was used to investigate modulation of the hyperpolarization-activated cationic current Ih by serotonin in these neurons. Serotonin (50-500 microM) reduced the amplitude of Ih in a concentration-dependent manner; this effect was reversible after prolonged washout of serotonin. This effect was mimicked by the 5-HT2 agonist alpha-methylserotonin (25 microM) and reversed by the 5-HT2 antagonist ketanserin (25 microM). Serotonin reduced the maximal Ih current and conductance (measured at -130 mV) and caused a negative shift in the voltage dependence of Ih activation. The serotonin-induced reduction in Ih amplitude was antagonized by intracellular administration of the nonspecific protein kinase inhibitor H-7 (75 microM) and the selective protein kinase C inhibitor chelerythrine (25 microM). The protein kinase C activator phorbol 12, 13 diacetate (PDA, 2 microM) reduced Ih amplitude; when PDA and serotonin were applied together, the effect on Ih was less than additive. These data support the conclusion that serotonin reduces Ih in dopaminergic VTA neurons by acting at serotonin 5-HT2 receptors, which activate protein kinase C. This reduction of Ih may be physiologically important, as the selective inhibitor of Ih, ZD7288, significantly increased dopamine inhibition of firing rate of dopaminergic VTA neurons, an effect that we previously demonstrated with serotonin.

Animals↗
PubMed2002

Variation in patient management based on ECG interpretation by emergency medicine and internal medicine residents.

This study was performed to determine the impact of electrocardiogram (ECG) interpretation on urgent patient care decisions by internal medicine (IM) and emergency medicine (EM) resident physicians. Six clinical scenarios and ECGs were given to 31 IM residents and 31 EM residents at a university medical center. Based on the ECG interpretation, the residents were asked to select the best patient management from a list of choices. IM and EM residents were equally likely to choose the correct management for complete heart block (90% IM v 97% EM, P = NS), and pulseless ventricular tachycardia (VT) (94% IM v 97% EM, P = NS). IM residents were less likely to choose the correct management for acute posterior wall myocardial infarction (MI) (26% IM v 74% EM, P <.0001) and unstable supraventricular tachycardia (SVT) (87% IM v 100% EM, P <.05). Residents in both programs were equally likely to misinterpret left ventricular hypertrophy (LVH) (23% IM and 16% EM, P = NS) and benign early repolarization (BER) (48% IM and 52% EM, P = NS) as acute myocardial ischemia when presented with a clinical history not suggestive of cardiac ischemia. IM and EM residents were equally likely to choose the correct management for complete heart block and pulseless VT. Compared with EM residents, IM residents were less likely to choose the correct management of posterior wall MI and unstable SVT. Both IM and EM residents were prone to misinterpreting LVH and BER as acute myocardial ischemia. Resident education in both specialties should focus on ECG interpretation skills to improve patient management decisions.

Aged↗