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Biomedical subjects

G A Finley

Publications and source records attributed to G A Finley.

27 records · Page 2Linked to original sources
PubMed1995

Successful treatment of painful crises of Fabry disease with low dose morphine.

Fabry disease is an X-linked disorder characterized in childhood by angiokeratoma, corneal opacities, and pain. At age 7 years our patient began experiencing an intermittent intense "burning" sensation within his feet and hands (acroparesthesias). Treatment with aspirin, acetaminophen, acetominophen with codeine, and phenytoin was unsuccessful. Carbamazepine and phenytoin reduced the frequency and duration of painful crises to 3-4 times annually. A treatment plan was developed consisting of a low-dose morphine infusion with increasing dosage until pain was relieved. Over the subsequent 28 months, we have had experienced treating 7 crises with morphine given as 0.06 mg/kg IV push, followed by a continuous infusion of 0.02 mg/kg/hr with amitriptyline 0.25 mg/kg at bedtime. Pain control is immediate, with the infusion gradually tapered after 24 hours.

Amitriptyline↗
PubMed1995

Cues parents use to assess postoperative pain in their children.

OBJECTIVE: Very little is known about the cues parents use to assess pain in their children. This study has described the cues (verbal and nonverbal) parents reported using to determine how their children felt following surgery. DESIGN AND SUBJECTS: The subjects were 176 parents of children undergoing short-stay or day surgery. Using pain diaries, parents were asked to provide written responses to the question "Did your child give you any clues on how they were feeling?" for the day of surgery and 2 days after their children's surgery. Parents also provided ratings of their children's pain five times per day using a visual analogue scale. SETTING: The study was conducted at a tertiary care children's hospital. RESULTS AND CONCLUSIONS: Parents frequently cited using verbal report and appetite as cues to how their children were feeling. A variety of other cue types were also reported by parents, including activity level, sleep quality, visible/audible discomfort, and physiological observations. Cue types were not significantly related to the child's gender, and only one cue type was significantly related to the child's age (appetite was used more often for older children than younger children). The presence or absence of illness behavior cues (e.g., protective behavior, visible/audible discomfort) as well as disruptions to normal behavior pattern cues (e.g., sleep, level of activity) was related, in the expected direction, to the pain intensity ratings. This study provides insights into the cues parents use to assess pain in their children and serves as a foundation for future studies on parents' assessment of children's pain.

Adolescent↗
PubMed1993

Delayed seizures following sedation with propofol.

Seizures occurred in two adolescents approximately six hours after sedation with propofol for bone marrow biopsy. Case #1 was a patient with chronic renal failure, hypertension, and anaemia. Case #2 had just been diagnosed with acute lymphocytic leukaemia. Neither child had experienced seizures before, and both recovered without neurological sequelae. Although other factors may have caused the seizures, the episodes have raised concerns about the safety of propofol for patients travelling home after out-patient surgery. Further study is required to explain the cause of this complication or, at least, to identify risk factors.

Adolescent↗
PubMed1992

Efficacy, duration, and absorption of a paediatric oral liquid preparation of ranitidine hydrochloride.

The objectives of this study were to assess the clinical efficacy of a new oral ranitidine liquid preparation in reducing gastric acidity and volume, to determine the degree of absorption of the drug, and to determine the duration of drug effect. Eighty preoperative children between the ages of one and six years were enrolled in each of three centres. Each subject was allocated to one of the following groups: Group A - apple juice, 5 ml.kg-1 plus placebo liquid; Group B - apple juice, 5 ml.kg-1 plus ranitidine hydrochloride 2 mg.kg-1; Group C - water, 5 ml and placebo liquid; or Group D - water, 5 ml and ranitidine liquid 2 mg.kg-1. All study agents were administered at least two hours before surgery along with a dye marker, sulfobromophthalein 1 ml (50 mg.ml-1). Following induction of anaesthesia, gastric fluid was aspirated, and analyzed for pH, volume, and sulfobromophthalein content (as an index of the ingested fluids). A serum sample was also drawn and analyzed for ranitidine content by high performance liquid chromatography. Groups B and D had fewer subjects with pH below 2.5 and gastric volume > 0.4 ml.kg-1. The duration of reduced volume and acidity was shown to be greatest from two to four hours after drug administration. Thirty-three percent of subjects receiving oral ranitidine, 2 mg.kg-1 hydrochloride as a single dose demonstrated no measurable effect on gastric pH and volume; 28 of those subjects had adequate ranitidine serum levels.

Absorption↗
PubMed1991

Perceived urgency and the anaesthetist: responses to common operating room monitor alarms.

Increasing numbers and varieties of electronic monitors are used in hospital operating rooms. Many of these are equipped with auditory alarms which are loud, insistent, or irritating, and thus are frequently disabled by the anaesthetist. This study was planned to evaluate two components of auditory alarm design which may influence the usefulness of the alarm: the perceived urgency of the auditory signal and its correlation with the urgency of the corresponding clinical situation. We also assessed the ability of practising anaesthetists to identify the monitor or condition responsible for the alarm. Sixty-four anaesthetists attending a national conference assessed ten common operating room alarm sounds for perceived urgency. Results were compared with the urgency of the corresponding clinical situation as determined by 12 senior anaesthetists. Discrepancies between the clinical and perceived urgencies of several monitor alarms were found, and there was no correlation between the two measures. The subjects were also tested for their ability to identify the alarm sounds correctly. The overall correct identification rate was 33%, and only two monitors were correctly identified by more than 50% of the subjects. The results of this study have implications for design and use of auditory alarms in hospitals and suggest the need for further research.

Adult↗
PubMed1989

Anaesthesia for a patient with Friedreich's ataxia and cardiomyopathy.

Friedreich's ataxia is an inherited neuromuscular disorder often associated with significant cardiac disease. We report a case of Friedreich's ataxia in a 13-year-old girl with ulcerative colitis and hypertrophic cardiomyopathy who was successfully managed for subtotal colectomy with general anaesthesia and epidural narcotic. Anaesthetic considerations included the maintenance of fluid volume and stable cardiovascular variables in the intra- and postoperative periods.

Adolescent↗