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Biomedical subjects

J F Cade

Publications and source records attributed to J F Cade.

At least 55 records · Page 3Linked to original sources
PubMed1982

Comparison of sodium and calcium heparin in prevention of venous thromboembolism.

The relative efficacy of sodium and calcium heparin in preventing venous thromboembolism and their relative side-effects were studied in 234 high-risk patients in a randomised, double-blind, placebo-controlled trial. The two heparin preparations were from the same batch and in the same concentration, and were given in a dose of 5000 U 12 hourly. Positive leg scans were found in 19% after placebo, 12% after sodium heparin and 8% after calcium heparin. Bruising at the injection site was more common after calcium heparin (66%) than after sodium heparin (53%) or placebo (38%). Pain at the injection site was also more common after calcium heparin (26%) than after sodium heparin (8%) or placebo (6%). Changes in the activated partial thromboplastin time were small and did not correlate with leg scan results or bruising. While there was a tendency for calcium heparin to be possibly more effective, it was followed by significantly more local haematoma and pain.

Adult↗
PubMed1982

Platelet function in coronary artery disease: effects of coronary surgery and sulfinpyrazone.

Platelet survival and plasma concentrations of beta thromboglobulin and platelet factor 4 were measured in 44 patients before and 6 months after coronary artery bypass grafting. Postoperatively, patients were randomized to receive sulfinpyrazone, 800 mg/day, or placebo. Preoperatively, platelet survival was significantly shorter than normal, and plasma concentrations of both platelet-specific proteins were significantly elevated. Postoperatively, all three indexes of platelet function tended to become normal, but these changes were statistically significant only in patients treated with sulfinpyrazone. Postoperative exercise testing correlated significantly with plasma concentrations of beta thromboglobulin and platelet factor 4 measured preoperative and postoperative. These results are consistent with reports of the effects of sulfinpyrazine on platelet involvement in other conditions, and suggest that the drug reduces platelet activation and inhibits actual destruction. The results also show a relationship between abnormalities of platelet function and an index of postoperative myocardial ischemia.

Angina Pectoris↗
PubMed1982

Herpes simplex virus from the lower respiratory tract in adult respiratory distress syndrome.

Herpes simplex virus (HSV) was found in the tracheobronchial secretions of 14 of 46 (30%) consecutive patients with the adult respiratory distress syndrome (ARDS). The HSV has not hitherto been associated with ARDS, and most previous reports of HSV in the lower respiratory tract have come from autopsy material. In the present study, the diagnosis during life was initially made by identification of the characteristic inclusion bodies of HSV in bronchial epithelial cells obtained from tracheobronchial aspiration. The presence of HSV in the lower respiratory tract was associated with the need for more prolonged respiratory support and an increased late mortality.

Adult↗
PubMed1981

Slow-reacting substance from alveolar macrophages--a mechanism of asthma?

The effects of alveolar macrophages on bronchial reactivity were studied in vitro to determine whether these cells could provide a pathogenetic link between cellular components of the inflammatory response, chemical medication of smooth muscle contraction and possible local mechanism of asthma. Alveolar macrophages harvested from rabbit lungs produced consistent and prolonged contractile responses in guinea-pig tracheal rings. The contractile material had the pharmacological and physical properties of slow-reacting substance (SRS) and, in particular, it was completely antagonized by minute concentrations (5 ng/ml) of a specific SRS antagonist, FPL 55712. The average contractile response per 10(6) macrophages was quantitatively equivalent to that produced by 76 ng methacholine. These findings not only support the view that local mechanisms may be of relevance in the pathogenesis of asthma, but could also have possible implications for therapy.

Animals↗
PubMed1980

Cystic fibrosis and bronchial hyperreactivity. Concomitant defects or cause and effect?

Bronchial reactivity and lung-function tests were measured in 19 young adults with cystic fibrosis. There was moderately severe airways obstruction without hyperinflation, and mild hypoxaemia with normocapnia. Bronchial reactivity (fall in FEV1 after the administration of methacholine aerosol) was increased in about two-thirds of patients, and was markedly enhanced in nearly half of them. It was considered that the airways obstruction characteristic of cystic fibrosis can have a reversible element, and that this may provide a rationale for the use of bronchodilators in some patients. Although bronchial hyperreactivity in cystic fibrosis could represent concomitant underlying defects, a more attractive suggestion is that the chronic inflammation of cystic fibrosis has, in turn, led to acquired bronchial hyperreactivity.

Adolescent↗
PubMed1980

Cardiac arrhythmais after chloral hydrate overdose.

A case of chloral hydrate overdose associated with ventricular arrhythmias which were refractory to treatment with lignocaine, but responsive to treatment with beta adrenergic blockade is reported. The probable mechanism of production of the arrhythmias is discussed together with its implications for management.

Adult↗
PubMed1980

Plasma concentrations of platelet-specific proteins correlated with platelet survival.

Relationships between 51Cr platelet survival and plasma concentrations of beta-thromboglobulin (betaTG) and platelet factor 4 (PF4) were analyzed in 91 studies of patients with coronary artery disease. betaTG was significantly correlated with platelet life-span, turnover, and the number of hits in the multiple hit model. PF4 was significantly correlated with life-span and turnover. The most significant relationship involving platelet-specific protein concentrations and life-span estimates was between betaTG and life-span estimated using the multiple hit model (r = -0.39, p less than 0.001). There was a high correlation between betaTG and PF4 (r = 0.62, p less than 0.001), and no improvement could be obtained by combining the measurements of the two proteins in any regression with life-span or turnover. The results indicate that the patients with the shortest platelet survival time in this group tended to have the highest plasma concentration of betaTG and PF4 and thus probably increased in vivo release of betaTG and PF4. They strengthen the claim that these platelet-specific proteins may be indicators of platelet involvement in disease.

Blood Platelets↗
PubMed1979

Guidelines for the management of oral anticoagulant therapy in patients undergoing surgery.

The management of patients who require surgery while being treated with oral anticoagulants is a difficult balance between the risks of bleeding and those of recurrent thromboembolism. The urgency and the extent and site of surgery are important considerations, as are the strength of the indication for anticoagulants and the degree of anticoagulation. A practical approach is outlined for various situations that may be encountered.

Administration, Oral↗
PubMed1979

"Barbiturate burns" caused by glutethimide.

A case of glutethimide overdose associated with skin lesions resembling burns is reported. These characteristic skin lesions are usually ascribed to barbiturates. Their aetiology, incidence, and association with other drugs and neurological disorders are discussed.

Adult↗
PubMed1979

Intravenous erythromycin in acute chest infections in critically ill patients.

Superinfections with resistant micro-organisms have recently become an increasing problem in hospital patients and are throught to be contributed to by inappropriate use of newer, broad-spectrum antibiotics. Erythromycin exhibits a more limited spectrum of antibacterial activity and was therefore re-evaluated in the treatment of acute chest infections in critically ill patients. Twenty-one patients were given erythromycin in a dose of 1.8 g per day by continuous intravenous infusion for up to five days. A satisfactory clinical response occurred in ten patients, in all of whom erythromycin-sensitive micro-organisms were isolated from sputum. An unsatisfactory response occurred in six patients, all associated with micro-organisms insensitive to erythromycin and requiring alternative antibiotic treatment. No undesirable side-effects were noted. It is concluded that erythromycin is a safe and useful agent in the routine treatment of acute chest infections in critically ill patients.

Acute Disease↗
PubMed1976

Heparin kinetics in venous thrombosis and pulmonary embolism.

The response to a standard dose of heparin was studied in 20 patients with venous thromboembolism. The heparin regimen consisted of intravenous injection of 70 units per kg, followed after 90 minutes by a maintenance dose of 400 units per kg per 24 hours given by continuous infusion. Plasma heparin activity and the activated partial thromboplastin time (APTT) were measured at intervals to determine clearance of the initial injection and the response to maintenance dose. Large inter-individual variations were found in the anticoagulant effect and these were due in part to differences in heparin clearance and in part to differences in the APTT response to given amounts of heparin (heparin effect index). The heparin half-life was 63 +/- 15 minutes when plasma heparin activities were used for this calculation and 84 +/- 71.5 minutes when the APTT was used. These results are similar to values previously reported in normal volunteers. Four of the 20 patients had pulmonary embolism and in these heparin half-life was significantly shortened (P less than 0.005).

Adult↗
PubMed1976

Disseminated intravascular coagulation.

Disseminated intravascular coagulation (DIC) is a syndrome of deposition of platelet-fibrin thrombi in the microcirculation, with consumption of platelets and clotting factors and possible clinical features of bleeding or thrombosis or both. It may be produced by activation of coagulation, platelet aggregation or endothelial damage. It is not a primary disease, but a common and important complication of many serious illnesses, especially sepsis, carcinoma and obstetrical accidents. Shock and acidosis are frequent precipitating factors, and vitamin K deficiency is a common complicating factor. DIC usually produces no clinical features, but it may give rise to bleeding, ischemic organ damage or shock. Although its clinical contribution is often difficult to separate from that due to the underlying disease, DIC remains the commonest cause of a generalized bleeding tendency in acutely sick patients. Laboratory confirmation consists of the demonstration of thrombocytopenia, coagulation impairment, hypofibrinogenamia, raised levels of fibrin degradation products, and positive results of para-coagulation tests. The most important therapeutic measure is control of the underlying disease, but replacement therapy and heparin may be required, especially if bleeding is significant and the process is not acute and self-limited.

Disseminated Intravascular Coagulation↗
PubMed1975

Coagulation and fibrinolysis in the dog.

A range of tests of coagulation and fibrinolysis was measured in "normal" dogs and compared with values obtained in "normal" humans by the same methods. The hematocrit platelet count, fibrinogen and plasminogen were similar in dogs and in humans. The prothrombin and partial thromboplastin times were considerably shorter in the dog than in man but the thrombin clotting time was comparable. Fibrinolysis was more active in dogs but the levels of fibrin degradation products were low, suggesting that there was no significant fibrin deposition and lysis occurring in vivo.

Animals↗