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Biomedical subjects

H Fisher

Publications and source records attributed to H Fisher.

At least 181 records · Page 10Linked to original sources
PubMedDate not supplied

The Limerick Leg-Ulcer Project: early results.

Nurse led clinics in joint hospital and community settings are now being advocated as the most effective and economic way of dealing with leg ulcers. However, little information exists on the profile and outcome of patients with venous ulcers treated either in the community or in the hospital setting. Over a 2 yr period we assessed 134 patients with leg ulcers of whom 122 were deemed suitable for compression bandaging therapy. Thirty-four patients (28 per cent) were treated by the newly developed community service and 88 (72 per cent) were treated at the hospital clinic. Our overall healing rate for venous ulcers was 50 per cent @ 40 weeks. This probably reflects the long duration (48 per cent > 2 yr) and large size (0.5-600 cm2) of ulcer prior to treatment. There were no differences in outcome between hospital (50 per cent @ 40 weeks) and community (35 per cent @ 40 weeks) based treatment (p > 0.05). We conclude that most venous ulcers can be effectively treated in the community and resources should be provided to achieve this goal.

Adult↗
PubMedDate not supplied

A new approach to emergency department therapy of migraine headache with intravenous haloperidol: a case series.

Six case reports are presented that describe the use of intravenous haloperidol for patients with migraine headache. Haloperidol was used in a dose of 5 mg following a 500- to 1000-cc bolus of normal saline. Headache was completely or substantially relieved in all six patients 25 to 65 min after administration of haloperidol; the median time until discharge was 51 min. Side effects were minimal or nonexistent. None of the patients returned to the Emergency Department (ED) for any reason over the next 48 h. It is concluded that haloperidol may play a role in treatment of migraine headache in the ED, and that further study is warranted.

Adult↗
PubMedDate not supplied

Simultaneous changes in striatal dopamine, serotonin, and metabolites after withdrawal seizures in rats from dependence on alcohol.

Ethanol dependence was achieved in male, Long-Evans rats after 8 days on a balanced liquid diet that supplied 4.5% ethanol. After 1-h access to a solution of 10% ethanol (95%)/5% sucrose, the rats were deprived of food, water, and ethanol for 9 h. Following 30-s key jingling, about 80% of the animals exposed to ethanol experienced tonic-clonic seizures. Neurochemical analyses of striatal tissues revealed a significant (p < 0.05) increase in dopamine (DA) and a significant decrease in serotonin (5-HT) in the ethanol-exposed rats that had seizures compared to control rats. Homovanillic acid concentrations of the ethanol-treated rats with seizures were significantly higher than the levels found in ethanol-treated animals that had experienced no seizures. Daily average ethanol intake of the rats that had seizures vs. those that did not was almost the same at 16 g/kg/day. The findings indicate that rats experiencing ethanol withdrawal-induced seizures manifest opposite alterations in dopaminergic and serotoninergic activity compared to controls. The present results do not reveal if the striatal changes are caused by ethanol rather than by the seizures.

Acoustic Stimulation↗
PubMedDate not supplied

Diet composition, alcohol utilization, and dependence.

Experiments were carried out in which a nutritionally balanced liquid diet previously used in this laboratory was modified as to total calorie content and high or low carbohydrate and fat concentration. Ethanol was added at 4.5% and 6.2% of diet weight and provided either 27% or 34-37% of total calories depending upon the changes in nutrient content. Measurements included 8-day food/calorie and ethanol consumption, plasma ethanol level, liver alcohol dehydrogenase (ADH) activity, and rate of audiogenic-induced withdrawal seizures. The original liquid diet with 4.5% ethanol was consumed in significantly lesser amounts than the alcohol-free diet, and essentially no body weight gain occurred, regardless if the major nonalcohol, nonprotein calorie source was fat or carbohydrate. When the calorie content of the diet was boosted through the addition of extra carbohydrate or fat (at the expense of water), appreciable weight gain was noted; in the case of the higher calorie diet boosted with more carbohydrate (maltodextrin) calories, growth was similar to that observed on the alcohol-free control diet. On this latter diet ethanol calories appeared to be utilized close to their theoretical value of 7 kcal/g. Blood alcohol levels were significantly higher on the lower calorie diets and were lowest on the high-calorie, high-carbohydrate, 4.5% ethanol diet. This diet also allowed for the lowest rate of withdrawal seizures despite an ethanol intake that was as high as on the lower calorie diets. Essentially, no differences were noted among ADH activities for the dietary treatments studied and thus, did not explain the differences observed among blood ethanol levels. When the alcohol concentration in the high-carbohydrate, high-calorie diet was raised to 6.2% from 4.5% to provide 34% of total calories, the rats responded by decreasing their food (and alcohol) intake to the same level as did the animals receiving a much lower calorie diet, but with 37% of caloric alcohol content. This suggests that at a diet alcohol concentration of 34-37%, one or more nutrient metabolites become limiting in the utilization of ethanol, resulting in food intake adjustments that maintain similar amounts of alcohol consumption.

Alcohol Drinking↗
PubMedDate not supplied

A call to arms: the emergency physician, international perspectives on firearm injury prevention and the Canadian gun control debate.

There are more than seven million firearms in Canada and approximately 1400 firearm-related deaths per year. These figures are far greater than those for most European countries, but far less than those for the United States. This article will discuss the different classes of firearm deaths and the associated costs. Public health issues will be explored, especially as they relate to the involvement of the Canadian Association of Emergency Physicians, as well as injury control recommendations.

Accidents↗
PubMedDate not supplied

Amphetamine and fenfluramine suppress ethanol intake in ethanol-dependent rats.

Alcohol intake or preference for alcohol has been attributed to concomitant dopamine and serotonin dysfunction in rats. Amphetamine and fenfluramine, administered alone, have been shown to reduce food and fluid intake as well as alcohol consumption while acute coadministration of these agents has been shown to suppress audiogenic seizure in rats withdrawn from alcohol. The present study was designed to assess the effectiveness of chronic amphetamine and fenfluramine coadministration on reducing alcohol intake. Chronic coadministration of amphetamine (2 mg/kg) and fenfluramine (8 mg/kg) reduced alcohol consumption during choice trials in both alcohol-dependent and alcohol-nondependent rats while not affecting water intake. The findings indicate that coadministration of amphetamine and fenfluramine, a treatment effective in reducing alcohol withdrawal seizures, also selectively attenuates alcohol consumption.

Alcohol Drinking↗