Search PubMed⌕ Search

Biomedical subjects

G Shepherd

Publications and source records attributed to G Shepherd.

15 recordsLinked to original sources
PubMed1992

Allergy to latex surgical gloves: an unfamiliar cause of intraoperative anaphylaxis.

Natural rubber products, including surgical gloves, are known to be associated with contact dermatitis in allergic individuals. These cell-mediated immune reactions are usually not serious. However, an increasing number of reports have appeared recently in the medical literature concerning the association of latex with type I IgE-mediated anaphylactic reactions. We report on a patient with a history of cutaneous sensitivity to latex who experienced an intraoperative anaphylactic reaction felt to be secondary to latex surgical gloves. This report is intended to familiarize clinicians with this unexpected cause of intraoperative anaphylaxis.

Anaphylaxis↗
PubMed1991

Distribution of single-channel conductances in cultured rat hippocampal neurons.

1. The nonhomogeneous spatial distribution of ionic channels in neurons has been implied from intracellular recordings at somatic and dendritic locations. These reports indicate that Na- and Ca-dependent regenerative currents are distributed differently throughout the neuron. Although a variety of K conductances and a noninactivating Na conductance have been described in intracellular studies, little is known about the spatial distribution of inward and outward currents throughout different regions of the neuron. 2. We recorded from cell-attached patches from cultured hippocampal cells from 1-day-old rats. The cells were cultured for 3-21 days. The spatial distribution of a variety of ionic channels was determined by comparing the conductances from somatic and dendritic membranes. Single-channel currents obtained from cell-attached patches were identified by the time course of ensemble (averaged) responses, voltage dependence, and the effect of channel blocking agents. 3. We consistently observed that only the rapidly inactivating inward current was localized to the soma. The other channel types that we studied, including an inward noninactivating, delayed rectifier and transient A-type currents, were observed in both the somatic and dendritic regions. 4. We suggest that the distribution of ionic conductances that we have observed may be functional in limiting excitability during development of neurons.

Animals↗
PubMed1990

Developments in the care of 'new' long-stay inpatients in the United Kingdom--implications for Japanese psychiatry.

The English "ward-in-a-house" for new long-stay patients (NLS) is described. NLS are usually defined as (a) aged between 18 and 65, (b) continuously in hospital for between 1 and 5 years, and (c) individuals for whom it has not been possible to find alternative accommodation outside hospital, despite repeated attempts to do so. The "ward-in-a-house" combines the best features of high quality hospital care with the best features of community-based residential units. The "Koike-dormitory" which was set up more than 20 years ago in Maebashi city had many of the characteristics of the English "ward-in-a-house" and this is also described. The possibility of developing a "ward-in-a-house" in Japan is then discussed.

Adolescent↗
PubMed1990

Dave's return.

Explore the source record for details and available documents.

Adult↗
PubMed1988

Prediction of favourable responses to long term vasodilator treatment of pulmonary hypertension by short term administration of epoprostenol (prostacyclin) or nifedipine.

Eighteen patients with moderate to severe pulmonary hypertension were studied, nine with intracardiac shunts and nine without. The effects of an incremental infusion of epoprostenol (prostacyclin) (0.5-8 ng/kg per minute) or sublingual nifedipine (20-30 mg) were compared with the response to three months' treatment with oral nifedipine. Both epoprostenol and sublingual nifedipine caused a fall in pulmonary vascular resistance and pressure and a rise in cardiac output. Patients with intracardiac shunts had higher systemic blood flows than those without shunts. Exercise in the shunt group was accompanied by systemic desaturation and hyperventilation. Analysis of individual results showed that the size of the response was inversely related to the severity of the pulmonary vascular disease. A good long term response to nifedipine seemed to be as readily predicted by the resting control values for haemodynamic variables as by values after short term treatment. A favourable response was likely if the pretreatment mean pulmonary artery pressure was less than 50 mm Hg, the ratio of total pulmonary to systemic resistance was less than 0.7, or the ratio of mean pulmonary artery pressure to systemic artery pressure was less than 0.6. Short term vasodilator protocols may do harm. If such studies are carried out, an adequate dose range must be tried before the long term efficacy of an individual drug can be forecast.

Administration, Oral↗
PubMed1979

Organization and interaction in psychiatric day centres.

One of the major problems in the care of chronic patients is the design of suitable long-term environments. Following from the work of Tizard and his colleagues, a study is described which investigated the aspects of the organization, management practices and social interactions in 4 local authority day centres for the care of chronic patients in the community. It was found that these centres differed markedly in terms of their organization and management practices and that these differences were correlated with the nature and quality of staff-client (although not staff-staff) interactions. Client-oriented management attitudes were correlated with a more personal approach to clients' problems and a warmer quality of interaction. These differences did not seem attributable to different kinds of clients being involved in each centre. The results are discussed in terms of the possible causal mechanisms involved and their implications for designing systems of long-term care.

Adult↗
PubMed1977

The multiple techniques approach to behavioural psychotherapy: a retrospective evaluation of effectiveness and an examination of prognostic indicators.

A retrospective evaluation of the multiple techniques approach to behaviour therapy is described. The effectiveness of the approach seems to compare favourably with a single-technique approach as far as can be ascertained. The observed improvement can be attributed to some aspect of the treatment package and not to 'spontaneous remission' factors. A prospective trial would not seem valuable, providing the problems of replication can be solved. An examination of prognostic indicators reveals a range of variables associated with outcome. Amongst the diagnostic groups, the 'social phobics' and 'anxiety states' did poorly. A number of general adjustment variables also seemed important, particularly marriage, and social and vocational adjustment. The implications of these findings for the nature and deployment of services and briefly discussed.

Adult↗
PubMed1975

Effects of local anesthetics on membrane properties. I. Changes in the fluidity of phospholipid bilayers.

The effect of the local anesthetic dibucaine on the solid to liquid-crystalline phase transition in phospholipid vesicles was studied by calorimetry and fluorescence polarization. The partition coefficient (greater than 3000) of dibucaine in the membranes of vesicles prepared from acidic phospholipids was more than 20 times higher than in neutral phospholipid membranes under the same conditions. Calorimetric measurements on vesicles prepared form acidic phospholipids (bovine brain phosphatidylserine; dipalmitoylphosphatidylglycerol) showed that dibucaine (1 with 10(-4) M) produced a significant reduction in the gel-liquid crystalline transition temperature (Tc). This fluidizing effect of dibucaine on acidic phospholipid membranes was even more marked in the presence of Ca2+. In contrast, dibucaine at the same concentration did not alter the Tc of neutral phospholipids (dipalmitoylphosphatidylcholine). Significant increase in the fluidity of neutral phospholipid membranes occurred only at higher dibucaine concentrations (2 with 10(-3) M). Measurements of the fluorescence polarization and lifetime of the probe, 1,6-diphenylhexatriene, in acidic phospholipid vesicles revealed that dibucaine (1 with 10(-4) M) caused an increase in the probe rotation rate indicating an increase in the fluidity of the phospholipid membranes. A good correlation was obtained between fluorescence polarization data on dibucaine-induced changes in membrane fluidity and calorimetric measurements on vesicles of the same type.

Anesthetics, Local↗