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Biomedical subjects

G Burr

Publications and source records attributed to G Burr.

8 recordsLinked to original sources
PubMed1992

Decreased brain metabolism in neurologically intact healthy alcoholics.

OBJECTIVE: The extent to which cerebral dysfunction in alcoholics is related to the direct effects of alcohol in the brain rather than to indirect mechanisms and/or alcohol withdrawal remains unclear. The purpose of this study was to evaluate whether healthy alcoholics with no evidence of alcohol-associated complications showed changes in brain glucose metabolism. METHOD: Positron emission tomography and [18F]-fluorodeoxyglucose were used to measure regional brain metabolism. The study group consisted of 22 normal, healthy, right-handed volunteers and 22 neurologically intact, healthy, right-handed alcoholics tested 6 to 32 days after alcohol discontinuation. RESULTS: Alcoholics showed significantly lower whole brain metabolism than normal control subjects. Normalization of regional metabolic values to the whole brain metabolic rate revealed that the left parietal and right frontal cortices were the most affected regions. Although the whole brain metabolic rate was correlated with the amount of time since alcohol discontinuation, the "normalized" decreases in left parietal and right frontal glucose metabolism were not. CONCLUSIONS: These findings support the contribution of the direct effect of alcohol as well as alcohol withdrawal on the changes in regional brain metabolism seen in alcoholics. They also provide evidence of cerebral changes in neurologically intact healthy alcoholics.

Adult↗
PubMed1991

Lead exposure from conventional and cottage lead smelting in Jamaica.

A survey was conducted to determine the distribution and determinants of environmental and blood lead levels near a conventional and several cottage lead smelters and to assess the relationship between environmental and blood lead levels in a tropical, developing-country setting. Fifty-eight households were studied in the Red Pond community, the site of the established smelter and several backyard smelters, and 21 households were studied in the adjacent, upwind Ebony Vale community in Saint Catherine Parish, Jamaica. Households were investigated, using questionnaires, soil and housedust lead measurements, and blood lead (PbB) measurements from 372 residents. Soil lead levels in Red Pond exceeded 500 parts per million (ppm) at 24% of households (maximum--18,600 ppm), compared to 0% in Ebony Vale (maximum 150 ppm). Geometric mean PbB in Red Pond, where 44% of children less than 6 years of age had PbB levels greater than or equal to 25 micrograms per deciliter (micrograms/dL), was more than twice that Ebony Vale in all age groups (p less than 0.0005). Within Red Pond, proximity to backyard smelters and to the conventional smelter were independent predictors of soil lead (p less than 0.05). Soil lead was the strongest predictor of PbB among Red Pond subjects under 12 years of age. The blood lead--soil lead relationship in children differed from that reported in developed countries; blood lead levels were higher than expected for the household-specific soil lead levels that were observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1991

Intensive care of the crush victim. Part 1.

The victims of disasters, accidents and many forms of trauma are often trapped or wedged under and within rubble which can lead to crush injury. Prolonged immobility can also cause crush injury if the weight of a person's body compresses muscle and soft tissue for an extended period of time. Extensive muscular tissue pathology can result from the crush injury itself and once the pressure, or compressive force, is removed a predictable sequence of events can cause widespread haemodynamic and metabolic disturbances--the crush syndrome. Part one includes the mechanism of crush injury and the pathophysiology underlying the clinical manifestations of the crush syndrome. The aims of assessment and management are discussed as well as a brief review of the literature related to management of the local crush site and the potential problem of compartment syndrome. Part two involves a case study of a person who was trapped for 10-12 hours following a motor vehicle accident. This patient was transported to 2 country centres and then transferred to a major teaching hospital in Sydney. Discussions will centre on the classic nature of the case, and the findings and management strategies will be correlated with the literature. The implications for nursing practice are explored and include the need for astute assessment and monitoring based on a thorough understanding of the sequelae of crush. Interventions are aimed at minimising discomfort and reducing complications both at the local crush site and generalised systemic level. Close monitoring and interpretation of the patient's response to interventions is essential for the continuation of definitive care.

Critical Care↗
PubMed1991

A new approach to dose reduction in chronic schizophrenia.

The bromocriptine growth hormone test (BGHT) was used to monitor D2 receptor activity in a group of 16 chronic schizophrenics who during the baseline phase were receiving greater than or equal to 20 mg/day haloperidol. In all subjects at baseline, the rise in plasma GH in response to the oral administration of bromocriptine (50 micrograms/kg) was blocked. The dose of haloperidol was then gradually reduced; the BGHT was repeated as each new dose was established. No escape from blockade of the GH response was observed until the dose of haloperidol was lowered to 10 mg/day (3 of 16 subjects escaped from blockade). At this dose the average plasma haloperidol level was 4 ng/ml. Two additional subjects escaped as the dose was reduced to 5 mg/day and six more escaped as the dose was reduced to 2.5 mg/day. The average haloperidol plasma level at 5 and 2.5 mg/day was 1.6 and 1.2 ng/ml respectively. The remaining five subjects escaped from blockade as the dose was reduced to 0 mg/day. In five subjects, escape from blockade was associated with a significant decrease in positive psychotic symptoms; in these subjects reestablishing the "just" blockade dose of haloperidol did not increase psychotic symptoms. In nine subjects escape from blockade was associated with an increase of positive psychotic symptoms; in six of these patients, reestablishing the "just" blockade dose of haloperidol attenuated psychotic symptoms to near baseline levels. We conclude that the GH challenge test is a useful adjunct to dose-reduction in the chronic patient. Furthermore, for some patients the "just" blockade dose appears to be near the minimum dose with the maximum therapeutic effect.

Adult↗
PubMed1990

Acute effects of ethanol on regional brain glucose metabolism and transport.

To evaluate the effects of ethanol in the human brain, we tested six normal subjects and six alcoholics using positron emission tomography and 2-deoxy-2-[18F]-fluoro-D-glucose (FDG) under baseline conditions and 24 hours later after ethanol administration (1 g/kg). Ethanol inhibited cortical and cerebellar glucose metabolism with relative sparing of the basal ganglia and corpus callosum. This inhibition was more pronounced in the alcoholics than in the controls. Measurement of the constants for glucose transport and utilization showed that decreased glucose metabolism was due to a reduction in glucose phosphorylation and not to a change of glucose transport into the tissue. The pattern of regional metabolic inhibition by alcohol paralleled the distribution of benzodiazepine receptors in the human brain.

Adult↗
PubMed1989

Lead exposure among lead-acid battery workers in Jamaica.

To assess lead exposure in the Jamaican lead-acid battery industry, we surveyed three battery manufacturers (including 46 production workers) and 10 battery repair shops (including 23 battery repair workers). Engineering controls and respiratory protection were judged to be inadequate at battery manufacturers and battery repair shops. At manufacturers, 38 of 42 air samples for lead exceeded a work-shift time-weighted average concentration of 0.050 mg/m3 (range 0.030-5.3 mg/m3), and nine samples exceeded 0.50 mg/m3. Only one of seven air samples at repair shops exceeded 0.050 mg/m3 (range 0.003-0.066 mg/m3). Repair shop workers, however, had higher blood lead levels than manufacturing workers (65% vs. 28% with blood lead levels above 60 micrograms/dl, respectively). Manufacturing workers had a higher prevalence of safe hygienic practices and a recent interval of minimal production had occurred at one of the battery manufacturers. Workers with blood lead levels above 60 micrograms/dl tended to have higher prevalences of most symptoms of lead toxicity than did workers with lower blood lead levels, but this finding was not consistent or statistically significant. The relationship between zinc protoporphyrin concentrations and increasing blood lead concentrations was consistent with that described among workers in developed countries. The high risk of lead toxicity among Jamaican battery workers is consistent with studies of battery workers in other developing countries.

Adult↗
PubMed1989

Lead poisoning among household members exposed to lead-acid battery repair shops in Kingston, Jamaica.

To investigate the risk of lead poisoning among household members exposed to 'backyard' battery repair shops (BBRS) in Kingston, Jamaica, environmental and blood lead (PbB) were measured at 24 households (112 individuals) with a BBRS worker or located at a BBRS premises and at 18 neighbourhood control households (74 individuals). Elevated PbB (greater than or equal to 25 micrograms per decilitre [micrograms/dl]) was common among subjects of all ages living at BBRS premises, especially among children less than age 12, 43% of whom had PbB greater than 70 micrograms/dl. Potentially hazardous soil and house dust lead levels were also common at BBRS premises, where 84% of yards had soil lead levels above 500 parts per million (geometric mean 3388 parts per million [ppm] at BBRS premises households with a BBRS worker). Geometric mean blood and environmental lead levels were significantly lower at control households, where less than 10% of subjects in all age groups had elevated PbB (maximum 33 micrograms/dl). Sharing a premises with a BBRS was a stronger determinant of household blood lead and environmental contamination than was the presence of a BBRS worker in a household. Blood lead levels were associated with soil and house dust lead levels in all age groups. We conclude that small battery repair shops, which have also been described in other developing countries, create a high lead poisoning risk for nearby residents.

Adolescent↗