Search PubMed⌕ Search

Biomedical subjects

G Goldfarb

Publications and source records attributed to G Goldfarb.

At least 37 records · Page 2Linked to original sources
PubMed1989

Comparative effects of halothane and isoflurane anesthesia on the ultrastructure of human hepatic cells.

The effects of halothane and isoflurane on the ultrastructure of the liver cells in adult patients with normal liver-function tests were compared. After induction of anesthesia with thiopental, fentanyl, and pancuronium, 18 patients were randomly divided into three groups of six each. Anesthesia was maintained with droperidol (droperidol group), with halothane (1.7 MAC, halothane group), or with isoflurane (1.7 MAC, isoflurane group). During the surgical procedure, 1 hr after the induction, a liver biopsy was performed in each patient and processed for light and electron microscopy. All biopsies were normal on light microscopy. On electron microscopy, no mitochondrial abnormalities were found. In all three groups, irregular nuclear membranes, dilation of the rough endoplasmic reticulum, and vesiculation of the smooth endoplasmic reticulum were seen, without any significant differences between the groups. There were significantly more lysosomes in the hepatocytes of patients receiving halothane than in the hepatocytes of patients receiving isoflurane or droperidol. This study shows that halothane can induce ultrastructure abnormalities very early after the beginning of its administration while, under the same conditions, isoflurane does not.

Adult↗
PubMed1988

[Postoperative analgesia: epidural injection of dexamethasone sodium phosphate].

Epidural administration of steroids has been suggested for the prevention of postoperative epidural fibrosis after lumbar lamino-arthrectomy. In order to assess the efficacy of this technique on pain occurring after such surgery, the demand of pentazocine during the first 24 postoperative hours was studied in 39 patients randomly assigned to two groups. Pain intensity was assessed by a five-point verbal scale (0: none; 1: poor; 2: moderate; 3: severe; 4: very severe) at five intervals (0-4, 5-8, 9-12, 13-16 and 17-24 h). The patients in group T (n = 20) did not receive any steroid, whereas those in group C (n = 19) were given, just after the end of surgery, a single dose of dexamethasone (4 mg) via an epidural lumbar catheter previously inserted by the surgeon. In group T, 18 patients required one or several intramuscular injections of pentazocine, whereas only three patients of group C (p less than 0.001) did so. Patients in group T expressed more severe pain (4 moderate, 12 severe, 3 unbearable) than those patients who had received steroids (1 moderate, 1 severe, 1 unbearable). As a consequence, they requested more pain killer (30 injections vs 8 injections, respectively; p less than 0.001) and sooner than patients of the steroid group (8 h vs 12 h; p less than 0.05). It was concluded that epidural administration of dexamethasone was helpful in preventing postoperative pain after lumbar lamino-arthrectomy.

Adult↗
PubMed1984

In vitro effect of benzodiazepines on polymorphonuclear leukocyte oxidative activity.

The effect of three benzodiazepine compounds, diazepam, flunitrazepam, and clorazepate, on oxidative activity of human polymorphonuclear leukocyte (PMN) was investigated. The oxidative activity of zymosan-stimulated PMN in the presence of three concentrations (10, 20, and 40 micrograms/ml) of these compounds was measured polarographically. In addition, zymosan-stimulated nitroblue tetrazolium (NBT) reduction was measured in the presence of various concentrations of flunitrazepam. All three compounds inhibited oxygen consumption of the PMN. The extent of inhibition was linear with respect to log-concentrations; oxygen consumption was reduced 50% for concentrations of diazepam, flunitrazepam, and clorazepate of 13 micrograms/ml, 56 micrograms/ml, and 285 micrograms/ml, respectively. In addition 30% and 100% inhibition of NBT reduction by flunitrazepam were observed at respective concentrations of 10 micrograms/ml and 60 micrograms/ml. The clinical relevance of these findings remains to be determined.

Anti-Anxiety Agents↗
PubMed1984

Continuous axillary brachial plexus block--a clinical and anatomical study.

In order to decrease both the failure rate and inadvertent arterial puncture rate that may be associated with continuous axillary brachial plexus block, a new technique of insertion of the catheter in the axilla was studied in 52 patients and in 12 fresh cadavers. With the arm abducted, externally rotated, and flexed at the elbow, an 80-mm long catheter was inserted under the skin at a site located 40-mm below the axilla and medial to the biceps muscle. Injection of lidocaine and bupivacaine produced sensory and motor blockades of the median, radial, ulnar, and musculocutaneous nerves in 98% of the patients. Arterial puncture occurred in one. The catheter was left in situ up to 9 days without complications. In the anatomical study, injection of dye and molding solutions showed that the tip of the catheter lay not in the perivascular sheath, but in a virtual cavity that was very superficial, under the skin, and surrounding the perivascular space. The technique used was safe and had a high success rate. It is particularly useful in patients undergoing long operations and in patients in whom pain would otherwise prevent postoperative physiotherapy of the upper arm.

Adult↗
PubMed1984

[Systemic circulatory hyperkinetic syndrome in patients with cirrhosis. Relation with hepatocellular failure and portal hypertension].

Hyperkinetic circulatory state is common in patients with cirrhosis but the cause of this syndrome has not been clearly elucidated. Systemic hemodynamic changes and their relationship to liver failure and splanchnic hemodynamics were studied in 100 patients with cirrhosis and were compared to a group of 15 patients without portal hypertension. Cardiac output was significantly higher and systemic vascular resistance was significantly lower in cirrhotic patients than in control patients. Multivariate analysis revealed that among different clinical, biochemical and splanchnic hemodynamic data, serum albumin, serum bilirubin, plasma prothrombin, and gastrointestinal bleeding significantly and independently explained the variation of cardiac output and systemic vascular resistance. No relationship was found between hepatic venous pressures or the presence of ascites and the hyperkinetic syndrome. From these results, it is concluded that in patients with cirrhosis liver failure is partly responsible for the hyperkinetic state.

Adult↗
PubMed1983

Efficiency of respiratory assistance in cirrhotic patients with liver failure.

In a 25-month period, 100 cirrhotic patients, in our intensive care unit (ICU) needed endotracheal intubation and mechanical ventilation. The overall mortality rate was 89%; the mortality rate was 100% among patients with septic shock and/or superimposed acute hepatitis and/or severe cirrhosis defined with clinical signs: jaundice and/or ascites and/or spontaneous hepatic encephalopathy and/or severe malnutrition. With these prognostic indices, using Bayes theorem, the probability of fatal evolution ranges from 95%-100% (alpha = 5%). These results allow a group of patients with high cost and poor prognosis to be defined.

Female↗
PubMed1983

Impaired in vitro bactericidal power of polymorphonuclear leukocytes in patients with protein calorie malnutrition.

Bactericidal power of polymorphonuclear leukocytes was determined in eight patients with protein calorie malnutrition before and after nutritional therapy. Oxygen consumption associated with the uptake of zymosan particle by polymorphonuclear leukocytes, which is an exact reflection of the bactericidal power of leukocytes, was significantly decreased in untreated patients in the presence of both autologous and AB serum when compared with two control groups of eight normal patients. After nutritional therapy, oxygen consumption was found to be in the normal range in the presence of both autologous and AB serum. It is concluded that, in patients with protein calorie malnutrition, polymorphonuclear leukocytes have an intrinsic dysfunction, and this dysfunction is corrected after nutritional repletion.

Adult↗
PubMed1982

Transvenous liver biopsy: an experience based on 1000 hepatic tissue samplings with this procedure.

Transvenous liver biopsy was attempted 1033 times in 932 patients in whom percutaneous liver biopsy was contraindicated. A hepatic tissue specimen was obtained in 1000 out of these 1033 attempts. The specimen was unfragmented and/or large enough to allow correct evaluation of liver architecture in 518 of the 807 successful biopsies (64.2%) in patients with liver fibrosis or cirrhosis and in 191 of the 193 successful biopsies (98.9%) in patients with nonfibrotic lesion of the liver. Transvenous liver biopsy was followed by no or minor complication in all our patients except for one who suffered fatal intraperitoneal bleeding due to perforation of the liver capsule. It is concluded that transvenous liver biopsy is a workable, efficient, safe procedure for obtaining hepatic tissue specimens and that this method is essential in a department of hepatology.

Biopsy↗