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Biomedical subjects

J T Davidson

Publications and source records attributed to J T Davidson.

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

Effect of physostigmine on morphine-induced postoperative pain and somnolence.

The effects of physostigmine 1 mg i.v. were studied on the analgesia, sedation and reduction in respiratory rate induced by morphine 10 mg/60 kg i.v. in 10 patients recovering from surgery. Within 5-10 min, physostigmine abolished the somnolent effect of morphine and restored the respiratory rate to pre-drug values. Analgesia, assessed by an independent observer and by the patient was, if anything, increased by physostigmine. The analeptic effect of physostigmine lasted 40-60 min.

Adult↗
PubMed1982

Surgical management of Crohn's disease: experience with 135 patients.

Crohn's disease may involve any portion of the alimentary tract and is being seen with increasing frequency. This report details the results in 135 patients undergoing 214 operations for Crohn's disease. There were 68 males and 67 females ranging in age from 10 to 76 years. Thirty-two per cent of patients underwent multiple operations. The recurrence rate was 53 per cent, with an average follow-up of four years. The common sites of involvement by Crohn's disease were ileocolic (36%), ileum (31%), and perianal (16%). Patients were also managed for Crohn's disease of the esophagus, stomach, and duodenum. Our patient patient with Crohn's disease of the esophagus is very unique, as only 20 such cases have been reported. Primary resection of diseased bowel with re-anastomosis is the preferred operative management. A bypass procedure was done in only four patients. The mortality rate was 2.2 per cent. The incidence of carcinoma is increased in patients with small bowel regional enteritis. A recent literature review reports 36 patients with adenocarcinoma of the small bowel affected with regional enteritis. Three of the patients developed an adenocarcinoma in association with Crohn's disease.

Adenocarcinoma↗
PubMed1981

Spinal narcotics and central nervous system depression.

A case of central nervous system depression which developed 7 hours after an intrathecal injection of 4 mg of morphine is described. The patient lapsed into coma with bradypnoea and "pin-point' pupils and there was no response to naloxone 0.4 mg. Treatment was continued for 3 hours. No postoperative analgesics were required for 126 hours. The problems associated with the use of intrathecal opiates are reviewed, delay in onset being the usual feature. Use of hyperbaric solutions of the narcotic and maintenance of a head-up posture may protect against respiratory depression.

Adult↗
PubMed1981

Epidural morphine for the control of pain after cesarean section.

Epidural morphine was evaluated for the control of postoperative pain after cesarean section (CS). Sixty-five patients undergoing elective CS with epidural bupivacaine were studied. Of these, 40 were given a single dose of 4 mg of morphine through an epidural catheter on termination of surgery. The remaining 25 patients received no postoperative epidural medication. In all cases, the catheters were withdrawn before the patients left the operating theater and 15 mg doses of papaveretum (OMNOPON) ordered as required for pain relief. The ward staff was unaware of the study. The time between the termination of surgery and the first administration of postoperative narcotic was noted, as was the total dose, for 48 h. The epidural morphine was associated with a prolonged period of postoperative analgesia and a greatly reduced total papaveretum requirement for the 48 h (30.9 mg for the study group in contrast to 67.6 mg for the controls). The difference between the two groups was significant (P less than 0.001). We concluded that epidural morphine is an efficient method for the control of postoperative pain following CS, a single dose of 4 mg providing relief from pain for 8 to 12 h and sometimes longer.

Cesarean Section↗
PubMed1980

Blood viscosity and the overnight fast.

A 12-hour overnight fast in 17 subjects did not result in a significant increase in blood viscosity, as occurs after a 24-hour fast. The usual preoperative fast does not therefore appear to have any adverse rheological effect. However, when it is necessary to prolong the fast, intravenous fluids should be given to prevent the expected increase in blood viscosity which then might have clinical effects as a result of decreased organ perfusion.

Adolescent↗
PubMed1980

Observations on extradural morphine analgesia in various pain conditions.

We report the extradural administration of low-dose morphine in 10 ml of 10% dextrose (2-3 mg) to 98 adult patients with various types of acute and chronic pain. Extradural morphine injections were given either via a Tuohy needle (single or repeat injection) or via an extradural catheter. Pain relief was evaluated by subjective scoring and by the subsequent need for systemic analgesics. In 56% of patients, pain relief was considered good or excellent, in 24% it was fair, and in 20%, poor. The best results were after surgery and trauma and in patients with advanced peripheral vascular disease. The analgesia of each dose of extradural morphine lasted for 8 h (mean range 4-36 h). There was no motor, sensory or sympathetic blockade and no respiratory or haemodynamic complications. Dizziness and vomiting occurred in two patients, and urinary retention for about 12 h in three.

Adult↗
PubMed1980

Surgical therapy for diffuse granulomatous colitis.

Of 16 patients with diffuse granulomatous colitis treated surgically, nine initially had total proctocolectomy and seven had abdominal colectomy with ileorectal anastomosis. There was no mortality in either group, and there was no anastomotic leak from ileorectal anastomosis. Disease recurred in 22% of patients after proctocolectomy and in 57% of patients with ileorectal anastomosis. A review of the literature on the surgical management of Crohn's colitis reveals a recurrence rate of 3% to 46% (average 20%) after proctocolectomy and a recurrence rate of 6.6% to 75% (average 46%) after ileorectal anastomosis. Colectomy with ileorectal anastomosis is the operation of choice for Crohn's colitis where feasible.

Adult↗
PubMed1979

Epidural morphine in treatment of pain.

Epidural injections of a 2 mg morphine were given to 10 patients with severe acute or chronic pain. All cases had considerable amelioration of pain, which commenced within 2-3 min, reached a peak in 10-15 min, and was effective for 6-24 h. It is suggested that the morphine reached the subarachnoid space and produced its effect by direct action on the specific opiate receptors in the substantia gelatinosa of the posterior-horn cells of the spinal cord.

Acute Disease↗
PubMed1979

Effect of an acute increase in cerebrospinal fluid pressure on lung compliance in the rabbit.

Cerebrospinal fluid pressure (Pcsf) was increased acutely by the injection of normal saline into the cisterna magna of anaesthetized rabbits to values which interrupted cerebral flow. When increased Pcsf was maintained for a minimum of 3 min, static lung compliance decreased and lung weight (after sacrifice) increased without marked change in arterial blood-gas tensions. The magnitude of the increase in Pcsf did not affect the change in compliance and weight. There was marked unexplained metabolic acidosis. The pulmonary findings may result from a massive shift of blood from the systemic to the pulmonary circulation leading to increased permeability of the interendothelial junctions of the pulmonary capillaries.

Acidosis↗
PubMed1979

Effect of a 24-hour food-and-water fast on viscosity of whole blood and plasma.

As a result of abstaining from food and water for 24 h during the midsummer Tishah-b'Ab fast, blood viscosity increased by 16.5% in 27 subjects studied; plasma viscosity increased by 10.3% in nine; hematocrit, by 3.1% in 27; serum total protein, by 6.3% and albumin, by 7.7%, both in 29 subjects. These changes were statistically significant. Plasma fibrinogen did not increase significantly. Fasting-induced changes could impair blood supply to vital organs in patients with vascular insufficiency.

Adult↗
PubMed1978

Intermittent mandatory ventilation during anaesthesia using the Manley Servovent ventilator.

The lungs of 25 patients were ventilated with intermittent mandatory ventilation (IMV) during anaesthesia using the Manley Servovent Model MS. This ventilatory mode is especially suitable for prolonged operations in which there is no need for muscle relaxation. While incorporating the advantages of spontaneous and mechanical ventilation, it is superior to both in selected cases. The Manley Servovent Model MS ventilator is capable of delivering IMV without modification, using a single source of gas.

Adolescent↗
PubMed1977

Anaesthesia in the Guillian-Barré syndrome. A case report and recommendations.

A large proportion of patients with the Guillain Barré syndrome show signs of involvement of the autonomic nervous system beside the better known motor and sensory features of this disease. These patients present a substantial anaesthetic risk because of autonomic dysfunction. We present here an illustrative case in which the administration of a low subarachnoid block resulted in cardiac arrest and offer suggestions for the anaesthetic management of such cases.

Aged↗
PubMed1977

Cyclic AMP in the CSF of patients with schizophrenia.

The dopamine hypothesis of schizophrenia proposes that schizophrenia is associated with increased brain dopaminergic function. Because dopamine is thought to stimulate the production of cyclic AMP in the brain, we hypothesized that CSF cyclic AMP would be increased in schizophrenia. Cyclic AMP in the CSF was determined in 19 schizophrenic patients who had not received neuroleptic treatment in the preceding two weeks. No significant difference could be shown between CSF cyclic AMP in these patients and CSF cyclic AMP in 10 psychiatrically normal controls.

Acute Disease↗