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Biomedical subjects

K Byrne

Publications and source records attributed to K Byrne.

68 records · Page 4Linked to original sources

Ranitidine compared to cimetidine in multiagent pharmacological treatment of porcine Pseudomonas ARDS.

The effects of two pharmacologically distinct histamine H2 receptor antagonists were studied in combination with ibuprofen (I) and diphenhydramine (D) in a porcine model of septic ARDS. Cimetidine (C) is reported as having direct oxygen radical scavenging abilities and is an inhibitor of cytochrome P-450, whereas ranitidine (R) acts solely by H2 receptor blockade. Four groups were studied: Group Ps (n = 8) received a continuous infusion of live Pseudomonas aeruginosa 5 x 10(8) CFU/ml at 0.3 ml/20kg/min, Group C (n = 6) received a control saline infusion, and the treatment groups received I (12.5 mg/kg) and D (10 mg/kg) in combination with either C (150 mg, CID, n = 6) or R (25 mg, RID, n = 5) given at 20 and 120 minutes after the onset of Ps. Pulmonary (PAP) and systemic (SAP) arterial pressures, cardiac index (CI), PaO2, thermal cardiogreen extravascular lung water (EVLW) and scintigraphically determined pulmonary albumin flux (slope index, SI) were measured. Ps infusion produced significant (p less than 0.05) cardiovascular collapse, hypoxemia and increased EVLW and SI. Both CID and RID temporarily reversed pulmonary arterial hypertension and maintained PaO2, EVLW, SAP and CI at control levels throughout the study, and significantly improved SI at 180 min. These results suggest that cimetidine and ranitidine act in this combination therapy primarily as H2 receptor antagonists.

Animals↗

Plasmodium falciparum: an abundant stage-specific protein expressed during early gametocyte development.

A stage-specific protein has been identified in gametocytes of Plasmodium falciparum. The protein is represented on two-dimensional electrophoresis by peptides of two apparent Mr of 27,000 and 25,000, each of which has at least four different isoelectric points between pH 6.0 and 5.0. The protein is designated Pfg 27/25 (P. falciparum gametocyte-specific antigen of 27 and 25 kDa). By indirect immunofluorescence with a monoclonal antibody 1H12 specific for Pfg 27/25, this protein is present in gametocytes within 30 to 40 hr after invasion of a red blood cell by a merozoite and is present throughout subsequent maturation of the gametocyte; Pfg 27/25 is not detectable on the surface of extracellular gametes by immunofluorescence with Mab 1H12. Pfg 27/25 is absent from asexual stages of P. falciparum at any stage in their development. Pfg 27/25 is an abundant protein in gametocytes and represents between 5 and 10% of total protein of these stages. Pfg 27/25 is also a major immunogen in man during P. falciparum infection. Antibodies to this protein were readily detected in human sera from an area of holoendemic P. falciparum and also from an individual following a primary attack of P. falciparum.

Animals↗

Prenatal diagnosis of tetrasomy 47,XY,+i(12p) confirmed by in situ hybridization.

A case of tetrasomy i(12p) detected prenatally is reported. The patient, a black, 32-year-old G3P2002 at 24 weeks' gestation with an unremarkable family history presented herself for prenatal care. Ultrasound examination showed a fetus with diminished femoral and humeral lengths, and hydramnios. A level II scan confirmed the presence of an omphalocele. Amniocentesis at 31 weeks showed 47,XY,+i(12p) karyotype. An infant with multiple congenital anomalies was delivered at 34 weeks. The infant died after 5 h. Genetic and ultrasonographic examinations in the third trimester were helpful in the investigation of this fetus with multiple congenital anomalies. The careful, complete team counselling afforded by this approach enabled the mother and family to be well adjusted to the strong possibility (and subsequent reality) of an abnormal infant.

Adult↗

Lightning injury.

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Burns, Electric↗

Establishing the psychiatric liaison nurse role: collaboration with the nurse administrator.

By helping patients, families, the hospital staff deal with the emotional effects of illness, the psychiatric liaison nurse plays a significant role in patients' healing. Since this type of role may be new to the organization, the psychiatric nurse and the nursing administrator must work in tandem to ensure successful role development and entry into the hospital system, both of which are crucial to the effectiveness of the liaison nurse. In our clinical experience, these issues need careful consideration and attention by both nurse administrators and psychiatric liaison nurses. We have attempted to provide practical considerations for facilitating the success of a psychiatric liaison nurse in the hospital system and justifying the value of this role.

Administrative Personnel↗

Computer-assisted curriculum for medical students on early diagnosis of substance abuse.

A computer-assisted curriculum on early diagnosis of substance abuse was developed for third-year medical students on their required family medicine rotation. Three computer-assisted instruction modules on early diagnosis, attitudes, and screening questionnaires were followed by two conferences: 1) a discussion and review session, and 2) a tutorial and role playing on engaging patients with substance abuse in treatment. Finally, students identified an ambulatory patient at risk for substance abuse and performed an evaluation. All 33 unselected students gave high ratings to all of the learning activities and the entire curriculum. Almost all were satisfied with the emphasis on substance abuse in their clerkship and expressed motivation to learn more. Student acceptance of teaching on substance abuse can be attained by a curriculum in which goals, objectives, and expectations are delineated clearly; in which the content is clinically relevant; which uses computer-assisted instruction, role playing, and a clinical exercise to stimulate problem-solving and skill development; in which conferences are discussion oriented; and for which pretests are used to promote learner receptivity.

Curriculum↗

Carotid artery atheroma: comparison of preoperative B-mode ultrasound appearance with carotid endarterectomy specimen pathology.

This paper describes a prospective study comparing the preoperative Duplex ultrasound appearance of carotid bifurcation atheroma with the pathological characteristics found in the endarterectomy specimens of the same vessels. Initial studies of carotid atheroma using Duplex scanning classified plaques into heterogeneous and homogeneous and found a strong correlation between heterogeneous lesions and the presence of intraplaque haemorrhage or ulceration in the endarterectomy specimen. The B-mode classification of plaque appearance described in this paper is an expansion of the above classification. The study group comprised 220 patients who underwent 244 procedures. The indication for carotid endarterectomy was symptomatic disease in the great majority of cases. We found a high incidence of unstable plaque pathology in the operative specimens, and a predominance of the more echolucent ultrasound plaque appearances (types 1 and 2). There is a statistically significant relationship (p less than 0.001) between ultrasound appearance types 1 and 2 and the presence of either intraplaque haemorrhage or ulceration in the endarterectomy specimen.

Aged↗

Carotid artery disease: the influence of diabetes mellitus.

Patients with diabetes mellitus are more prone to stroke than non-diabetic patients. Using Duplex ultrasound imaging of the carotid bifurcation, we have found it possible to classify atherosclerotic plaques into four groups which appear to reflect the plaque pathology. Using this classification we have found that diabetics and non-diabetics have similar ultrasound plaque type distributions in symptomatic patients. Further subdivision of the diabetic patients on the basis of their mode of diabetic control has shown that insulin treated diabetics tend to show little evidence of intraplaque haemorrhage and ulceration. These features suggest that factors other than atherosclerosis at the carotid bifurcation may be responsible for the increased stroke risk in diabetic patients. Diabetic microangiopathy and reduced vessel compliance due to medial calcification have been suggested as possible factors. Insulin treatment of diabetics may protect against the development of occlusive atherosclerosis.

Aged↗