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Biomedical subjects

G C Hanson

Publications and source records attributed to G C Hanson.

At least 19 recordsLinked to original sources
PubMed1992

Chloroquine poisoning: ventricular fibrillation following 'trivial' overdose in a child.

A 13-year-old boy was admitted to hospital 45 min after the ingestion of approximately 750 mg of chloroquine base. A few minutes after gastric lavage with warm water he developed ventricular fibrillation from which he was promptly resuscitated. The plasma concentration of chloroquine was 4.2 mumol/l; significantly lower than the concentrations previously associated with a fatal outcome in adults. The clinical and electrocardiographic effects of chloroquine poisoning are discussed, and the literature reviewed regarding the role of specific management with diazepam and adrenaline infusions. A period of twenty four hours electrocardiographic (ECG) monitoring and pulse oximetry in an intensive care unit is advocated for all patient with ECG changes following chloroquine overdose.

Adolescent↗
PubMed1988

Management of patients with shock and sepsis.

The pathophysiology of shock associated with sepsis in complex, but granulocyte activation and production of toxic oxygen radicals, is of major importance in producing endothelial cell injury. Multiple organ failure including a reversible cardiomyopathy with impairment of left ventricular ejection fraction, are known factors complicating, and in the latter, perpetuating, shock. When treating the severely shocked patient, a systolic pressure of 100 mmHg and a PaO2 of greater than 8 kPa (60 mmHg) should be aimed for. Non-response to oxygenation, respiratory support, volume, and metabolic control, may be an indication for insertion of a thermodilution catheter into the right heart, so that cardiac output can be measured and oxygen delivery maintained above 10 mmol/kg/min. Where, by manipulation of respiratory indices and inotropic support, achievement of this level is not possible, the prognosis is grave. Antibiotic therapy is discussed, therapy being instituted if at all possible once the haemodynamic state has been improved.

Anti-Bacterial Agents↗
PubMed1988

Sedating ventilated asthmatics: etomidate reconsidered.

The use of etomidate and fentanyl infusions to sedate four asthmatics who required artificial ventilation and were receiving high dose steroids is described. The non-asthmatic patients who had not received steroids were also given etomidate combined with either fentanyl or alfentanil by infusion. Use of this sedative technique was suspended in June 1983, following reports of excess mortality associated with the long-term administration of etomidate. Retrospective measurements of plasma cortisols were subnormal in 5 of the 10 patients who did not receive steroids and remained low 12 hours after discontinuation of the infusion in two cases. All the asthmatics survived, but two of the non-asthmatic patients died. Despite its adverse effects, we still feel there may be a place for etomidate infusion in selected asthmatic patients, provided that steroid replacement is given.

Adolescent↗
PubMed1987

Cardiac arrest in near-term pregnancy.

This case study emphasises the multiple factors that may be involved in the precipitation of electromechanical dissociation, which are compounded by additional problems that relate to pregnancy. It reinforces the value of the tracheal route for drug administration when a central vein is not cannulated and stresses the importance of posture and early consideration of Caesarean section in the pre-term gravid patient who has sustained a cardiac arrest.

Adolescent↗
PubMed1986

Prostacyclin deficiency in a young woman with recurrent thrombosis.

A young woman with recurrent deep venous thromboses and spontaneous abortions was studied. She suffered an ovarian infarction followed by aortic thrombosis and renal failure. Evidence for deficient prostacyclin production was found and she responded to treatment with a prostacyclin infusion. This syndrome is identical with that seen in women with the lupus anticoagulant, but the lupus anticoagulant was not detected and no other cause was identified.

Abortion, Habitual↗
PubMed1984

Serum morphine levels. A comparison between continuous subcutaneous infusion and continuous intravenous infusion in postoperative patients.

A study was undertaken to compare continuous subcutaneous infusions of morphine with continuous intravenous infusions in patients whose lungs were mechanically ventilated for 24 hours postoperatively. Serum morphine levels were measured after the end of surgery and at 6, 12, 18 and 24 hours in nine patients receiving continuous subcutaneous morphine and in four patients receiving continuous intravenous morphine given at the same rate. At 6, 12, 18 and 24 hours the means of serum morphine levels in the intravenous group were 20 ng/ml, 17.75 ng/ml, 18.5 ng/ml and 18 ng/ml, respectively, the corresponding figures in the subcutaneous group being 23.2 ng/ml, 20 ng/ml, 20.7 ng/ml and 20 ng/ml. For the intravenous route the mean dose of supplementary analgesia was 14 mg of phenoperidine in the first 24 postoperative hours, whereas for the subcutaneous route the mean dose was 11.66 mg. The differences in the serum morphine levels and in the requirements of phenoperidine were not statistically significant. We conclude that a continuous subcutaneous infusion of morphine is a simple and effective means of achieving postoperative analgesia.

Humans↗
PubMed1979

Tyrosinase maturation and pigment expression in B16 melanoma: relation to theophylline treatment and intracellular cyclic AMP.

We have studied the effects of theophylline treatment on pigmentation characteristics and growth of two B16 melanoma cell lines, HFH-18 and P/140. Cell counts of control and theophylline-treated cultures confirmed that the drug inhibits cell growth. Light and electron microscope cytochemistry with the L-dopa reaction indicated that the two cell lines differ in their ability to transfer Golgi-associated tyrosinase to developing premelanosomes. The results of these experiments, considered with results of electrophoretic analyses and activity measurements by the Pomerantz method, also provide evidence that increased tyrosinase synthesis occurs in response to theophylline treatment. In addition, results indicate that theophylline induces changes in the rate of synthetic or degradative posttranslational modification of tyrosinase. Measurements of intracellular cyclic AMP levels by radioimmunoassay in control cultures and in theophylline- and alpha-MSH-treated cultures were made. Although the hormone induced spectacular increases in cyclic AMP levels, theophylline produced no detectable change. These results indicate that theophylline differs from alpha-MSH because theophylline-induced changes in pigmentation may not require the participation of intracellular cyclic AMP.

Animals↗
PubMed1979

Severe bronchial asthma requiring ventilation. A review of 20 cases and advice on management.

The natural history and outcome of 20 asthmatics who required mechanical ventilation is reviewed. Seven of these patients died. The majority of the deaths could have been prevented if: (1) The patient had been followed-up in an asthma clinic and had been fully informed of the danger of an asthmatic attack. (2) The medical staff had been trained more fully in the evaluation and management of a severe asthma attack. Careful sequential assessment will enable timely transfer of patients with severe bronchial asthma to a unit experienced in their management.

Adolescent↗
PubMed1979

Iatrogenic nondiabetic hyperosmolar states.

Four cases of the iatrogenic nondiabetic hyperosmolar state are presented. The clinical presentation, biochemical findings and management are discussed. No hypertonic solution should be infused at a rate above the level of patient tolerance; irrigation of a hollow viscus with a hypertonic solution should be avoided, and salt should not be used as an emetic. Patients under stress are particularly prone to this condition, largely because of the high circulating cortisol levels. The use of corticosteroids, salt-containing solutions in excess of patient requirements, water depletion and intravenous nutrition in the absence of careful biochemical monitoring, are all factors which may precipitate the hyperosmolar state in the critically ill.

Acid-Base Imbalance↗
PubMed1978

Severe chronic intra-abdominal sepsis: a report of 3 cases and a review of patient management.

The management of three cases (one fatal) with extensive intraabdominal sepsis, is described. Management included metabolic and fluid control, intravenous nutrition (where feeding by the oral route is impossible because of multiple intestinal fistuli), maintenance and support of vital organ function, and infection control. Appropriate and timely surgical intervention may be life saving.

Abdomen↗