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Biomedical subjects

J Boland

Publications and source records attributed to J Boland.

At least 55 records · Page 3Linked to original sources
PubMed1990

The concurrent in vitro and in vivo release of PGE2 from a controlled-release hydrogel polymer pessary for cervical ripening.

Twenty five patients booked for induction of labour, at 38 weeks or more gestation, were administered a controlled release vaginal polymer pessary containing 10 mg prostaglandin E2 (PGE2), designed to release 0.6 mg per hour in vivo. The release profile from the polymer was linear throughout the eight hour observation period with a correlation coefficient of 0.81, and regression slope of 0.93 mg/hr. with 95% confidence intervals of 0.63 mg/hr. to 1.23 mg/hr. This compared with a concomitant release profile in vitro which was uniform with time for the first five hours, but then continued at a decreasing rate with a correlation coefficient of 0.98. The relationship between PGE2 release and cervical score change was linear, with a correlation coefficient of 0.65. The results show that PGE2 release from the pessary in vivo is predictable, and suggest that the controlled release pessary offers the advantages of greater control of cervical ripening than alternative vehicles currently available.

Cervix Uteri↗
PubMed1990

The Ciba Corning ACS:180 benchtop immunoassay analyzer.

We describe a new clinical laboratory instrument, the ACS:180, used to automate heterogeneous immunoassay testing. The ACS:180 automates immunoassays in which paramagnetic particles are the solid phase and changes in chemiluminescence are measured. The system can accommodate both competitive and sandwich-type assay configurations. The microprocessor-based instrument fully automates each step of the assay, including sample and reagent addition, separation and wash of paramagnetic particles, and generation and acquisition of the chemiluminescent signal. The instrument has the flexibility to operate in random-access or batch mode. The time from application of sample to first result is less than 15 min; throughput is as much as 180 tests per hour.

Autoanalysis↗
PubMed1989

Lexical structure in Parsing long-distance dependencies.

We review a series of experiments investigating lexical influences in parsing sentences with long-distance dependencies. We report three primary results. First, gaps are posited and filled immediately following verbs that are typically used transitively, even when the filler is an implausible object of the verb. However, gaps are not posited after verbs that are typically used intransitively. Second, plausibility determines whether or not a filler is treated as the object of a verb when the verb is typically used with both a direct object and an infinitive complement. Finally, verb control information is used immediately in determining which noun phrase will be interpreted as the "understood" subject of an infinitive complement.

Cognition↗
PubMed1988

Prognostic significance of angina pectoris before first acute myocardial infarction.

To delineate the clinical significance and prognostic importance of a history of chronic or new onset angina pectoris before acute myocardial infarction (AMI), 732 consecutive patients admitted for a first AMI were studied and divided into 3 groups. Two hundred patients (27%) had chronic angina before AMI (greater than 1 month); 247 patients (34%) had new onset angina before AMI (less than 1 month) and the 285 remaining patients (39%) never had angina before AMI. All clinical characteristics were similar in the group of patients with chronic angina and in the group of patients with new onset angina, including in-hospital mortality (10 vs 9%) and 3-year post-hospital mortality (16 vs 16%). Compared to the 285 patients without angina, the 447 patients with angina before AMI were older, more likely to be women, and had a higher frequency of anterior AMI and early post-infarction angina. Both groups had a similar in-hospital mortality (10 vs 8%, not significant), but patients with angina had a higher 3-year post-hospital mortality (16 vs 7%, p less than 0.001). In the group of patients with angina before AMI who were discharged from the hospital, the comparison of nonsurvivors and survivors showed that the patients who died were older, presented more frequently with a non-Q-wave myocardial infarct and more often had left ventricular failure and complete bundle branch block during hospital stay. Chronic and new onset angina before AMI have the same clinical characteristics and deleterious long-term prognostic significance.

Age Factors↗
PubMed1988

Short-term risk stratification at admission based on simple clinical data in acute myocardial infarction.

Simple clinical data, available in all coronary care units, were recorded in 1,013 consecutive patients with acute myocardial infarction (AMI). In order to identify the patients at highest and lowest risk of mortality during hospital stay, a prognostic index was established from a stepwise logistic discriminant analysis of 10 clinical variables obtained at admission in a consecutive series of 477 patients hospitalized in 1 of 2 coronary care units admitting new patients on alternate days and treating them similarly. This prognostic index was applied to a comparison group of 536 consecutive patients admitted to the other coronary care unit. In the experimental group, 57 of the 477 patients (12%) died during hospital stay; 60 of the 536 patients (11%) died in the comparison group. As individual variables, age, previous history of AMI, anterior site and left ventricular function on admission were associated with increased mortality. Three variables were selected from the stepwise logistic discriminant analysis of the experimental group: age; site (anterior = 1, other = 0); and grade of left ventricular function (0 to 4). Prognostic index = 5.9019 - 0.8961 function - 0.5708 location - 0.0369 age. This index was validated in the comparison group. Patients were allocated into different classes with increasing index values associated with decreasing risk. Three subgroups of patients were identified: high risk of hospital mortality (index less than or equal to 1; mortality: 51%), intermediate risk (index 1 to 3; mortality: 18%) and low risk (index greater than 3; mortality: 4%). The use of this simple prognostic index may improve clinical management and selection of patients for intervention trials.

Female↗
PubMed1988

Complications of carotid endarterectomy: the influence of case load.

We reviewed the records of 508 consecutive carotid endarterectomies done by 19 surgeons during a five-year period in one medical center to evaluate postoperative complications (stroke and death). Each of 16 surgeons did 32 operations or fewer, with case loads ranging from one to 32. Three surgeons did 70, 98, and 172 respectively. The incidence of stroke among patients of the 16 surgeons combined who did 32 cases or fewer in five years (fewer than ten cases per year) was 7%, with a combined stroke and death rate of 8%; in contrast, patients of the combined surgeons who did more than 32 operations in five years (more than ten cases per year) had a stroke rate of 3%, with a combined stroke and death rate of 3%. When the carotid disease was examined separately, it was apparent that the adverse event rate among patients with asymptomatic or nonhemispheric disease accounted for the difference. Patients of surgeons with fewer cases had 18% adverse events, whereas those of more experienced surgeons had 2% adverse events. The adverse events were similar for both groups in patients with focal transient ischemic attacks or stroke. Seven of the 16 surgeons who did fewer than 32 cases had no patients who had stroke, despite the few carotid endarterectomies they had done. Thus, the stroke rate was somewhat lower in the hands of those surgeons who did endarterectomy more often, but the number of carotid endarterectomies done by a surgeon is not the only factor to decrease the stroke rate. Proper selection of patients and attention to risk factors and technique are essential.

Adult↗
PubMed1988

Left main coronary dissection after mild chest trauma. Favorable evolution with fibrinolytic and surgical therapies.

A 32-year-old woman had acute anterior myocardial infarction after a mild chest trauma (automobile accident). Unstable angina recurred shortly after admission, and extensive dissection of the left coronary artery was demonstrated. Medical therapy including systemic fibrinolysis was started but clinical stabilization and good long-term result was achieved only by aortocoronary bypass grafting.

Accidents, Traffic↗
PubMed1986

Treatment of secondary orgasmic dysfunction: an outcome study.

This study investigated the differential effectiveness of various treatment formats for 55 couples in which the woman reported secondary orgasmic dysfunction (defined as the inability of the woman to reach orgasm during intercourse, with or without clitoral stimulation, more than 50% of the time for the last 5 months). Couples received two 2-hr sessions of sexual reeducation and were then assigned into one of four treatment conditions (a communication skills format, a sexual skills format, one of two combination formats) or into one of two control conditions (an attention-comparison control condition which consisted of didactic presentations, or a waiting-list control condition). Treatment was conducted by one of two female clinical psychologists in groups of between four to six couples. No significant differences were found between the different treatment conditions at the posttest or at the 6-month follow-up. Statistical comparisons conducted between the combined treatment and combined control conditions showed that the couples who received treatment reported significantly less overall sexual dissatisfaction and significantly greater sexual harmony at the posttest; however, these differences became nonsignificant at the follow-up. In comparison with the women in the control conditions, a significantly greater number of women who received treatment reached or exceeded the project's 50% criterion for coital orgasmic functioning at the posttest; however, these differences became nonsignificant at the follow-up. Couples who reported less relationship adjustment prior to treatment showed greater overall gains in coital orgasmic frequency than couples who reported better relationship adjustment.

Adult↗
PubMed1984

Cyclosporin-associated central nervous system toxicity after allogeneic bone marrow transplantation.

Five of 64 recipients of HLA-identical sibling marrow allografts who were given cyclosporin (CSP) to minimize graft-versus-host disease posttransplant had a serious neurological illness thought to be due to CSP. Characteristic clinical features included a motor spinal cord syndrome, a cerebellar-like syndrome, and mental confusion. All five recovered when the CSP dose was reduced or the drug was stopped.

Acute Kidney Injury↗
PubMed1984

Tissue distribution and toxicity of cyclosporin A in the mouse.

Groups of mice were given cyclosporin A (CyA) subcutaneously for 6 wk at a dose of 12.5, 50 or 200 mg/kg/d. After 7, 21 and 42 days of CyA administration the CyA content of serum, thymus, mesenteric lymph nodes, spleen, kidney, liver, lung, small and large intestine and brain was measured, each organ was examined histologically, and the total viable nucleated cell content of thymus, mesenteric lymph nodes, spleen and femoral marrow was analysed. CyA was detected in every organ assayed at each concentration of CyA administered. The mean concentration of CyA per organ was consistently highest in organs of mice given CyA 200 mg/kg/d and lowest in those given 12.5 mg/kg/d at each time point, but there was pronounced variability in the concentration of CyA between individual mice. Repeated administration of CyA after the first week did not further elevate CyA tissue concentrations. At doses of 50 or 200 mg/kg/d CyA caused weight loss, diarrhea, intussusception and fatal neurotoxicity. In addition, the spleen, thymus and mesenteric lymph nodes of mice given CyA 50 or 200 mg/kg/d were hypocellular and disorganized, and all lymphoid organs contained numerous pyknotic lymphocytes. The liver showed fatty change and the kidney degeneration of proximal tubules. Femoral marrow showed enlarged and congested sinuses. No abnormalities were noted in mice given CyA 12.5 mg/kg/d.

Animals↗