An investigation of the pharmacokinetics, toxicity, and clinical efficacy of Neoral cyclosporin in cystic fibrosis patients.
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Administration, Oral↗
Biomedical subjects
G Mikhail
Publications and source records attributed to G Mikhail.
Long-term results of heart-lung transplantation for pulmonary hypertension.
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Actuarial Analysis↗
Hemodynamic and emotional responses to a psychological stressor after cardiac transplantation.
OBJECTIVE: Because cardiac transplantation entails neuronal decentralization, cardiac responses to a psychological stressor in transplant patients would be expected to rely on circulating hormonal factors and therefore to be delayed and prolonged. We tested this prediction by comparing stress responses after transplantation with those in patients with coronary artery bypass grafts (to control for experience of surgery) or heart failure (to control for heart disease). METHODS: Fifty-six transplantation patients, 66 bypass patients, and 40 patients with heart failure underwent a 10-minute, computer-generated, Stroop color-word conflict test. Heart rate and systolic and diastolic blood pressures were recorded continuously for 1 minute before, during, and 12 minutes after the stressor. Emotional state was measured periodically by questionnaires. RESULTS: All hemodynamic variables were increased by the Stroop test. There was a pattern of blunted response to the Stroop test after cardiac transplantation, particularly in comparison with bypass patients, and slower recovery in comparison with both control groups. Emotional stress responses were similar in each group. CONCLUSIONS: This pattern cannot be attributed to the experience of major heart surgery or to cardiac disease. Nor can it be explained by differences in central processing of stress. Correspondingly the changed hemodynamic response to the Stroop test after cardiac transplantation evidently does not affect patients' emotional responses. The hemodynamic findings are consistent with an increased reliance on hormonal rather than neuronal hemodynamic regulation after cardiac transplantation.
Analysis of Variance↗
Primary pulmonary hypertension: pathologist as patient.
We describe the case of Julia Polak, an internationally known pathologist with an interest in primary pulmonary hypertension, a condition which she was subsequently diagnosed to have. This was successfully treated by heart/lung transplantation and she was then in the unique position to study and present her own pulmonary pathology. Professor Polak's case illustrates the difficulty in diagnosis, the frequent failure of medical treatment and an excellent outcome from heart/lung transplantation. Based on a presentation to a clinico-pathological conference at Hammersmith Hospital.
Adult↗