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Biomedical subjects

L Baldwin

Publications and source records attributed to L Baldwin.

13 recordsLinked to original sources
PubMed1994

Effect of postoperative low-dose dopamine on renal function after elective major vascular surgery.

OBJECTIVE: To determine the effect on renal function of postoperative low-dose dopamine in volume-replete patients after elective, major vascular abdominal surgery. DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: Intensive care unit of a referral hospital in Brisbane, Australia. PATIENTS: 37 patients having elective repair of an abdominal aortic aneurysm or having aortobifemoral grafting; 18 received dopamine, and 19 received placebo. Two patients were excluded from the 5-day analysis because of perioperative death. INTERVENTIONS: Patients were randomly assigned to receive either placebo or a low-dose infusion of dopamine (3 micrograms/kg per minute) in saline. Patients in both groups were given sufficient crystalloid to maintain a urine flow of more than 1 mL/kg per hour during the first 24 postoperative hours. Care in the intensive care unit was otherwise usual and was the same for each group. MEASUREMENTS: Plasma creatinine levels, urea levels, and creatinine clearance were measured preoperatively and postoperatively (at 24 hours and 5 days). Urine flow and the volume of crystalloid during the first 24 hours were recorded. RESULTS: Two postoperative deaths occurred in the dopamine group (from renal failure and myocardial infarction). Four patients had myocardial infarction, three of whom received dopamine. Plasma creatinine levels remained unchanged in both groups. At 24 hours, the mean plasma urea level decreased by 1.07 mmol/L in the dopamine group compared with 1.84 mmol/L in the placebo group, a difference of 0.77 (95% CI, -0.12 to 1.67). The mean 24-hour creatinine clearance increased by 0.165 mL/s (9.89 mL/min) in the dopamine group and by 0.199 mL/s (11.98 mL/min) in the placebo group (P > 0.2). Urine volumes were slightly higher in those receiving dopamine (1.83 mL/kg compared with 1.6 mL/kg, a difference of 0.23 [CI, -0.18 to 0.64]). None of these differences were statistically or clinically significant. CONCLUSIONS: Within the limits of the small size of the study, low-dose dopamine appeared to offer no advantage to euvolemic patients after elective abdominal aortic surgery. However, patients with acute oliguric renal failure were not included in the study.

Acute Kidney Injury↗
PubMed1994

A computer-generated shift report.

To maintain quality patient care while reducing overtime costs, a change in the traditional verbal shift report was needed. A pilot study examined alternate methods, format changes, benefits and nursing recommendations. Using a computer-generated nursing care plan cover sheet, a change was made to an automated written shift report.

Florida↗
PubMed1993

Spontaneous Clostridium perfringens lung abscess unresponsive to penicillin.

Clostridial necrotising pneumonia is a rare complication of aspiration, bronchial tumour or foreign body, pulmonary infarction, trauma and debilitating medical conditions. Although spontaneous clostridial pneumonia has been reported previously, close scrutiny of those case reports suggests that most of the patients had a recognised predisposing cause. We report a case of true spontaneous Clostridium perfringens pneumonia complicated by septic shock, pneumothorax and pulmonary necrosis. The patient responded poorly to conventional treatment with benzylpenicillin, and although the addition of metronidazole produced dramatic resolution of the sepsis, lobectomy was required to effect cure.

Clostridium Infections↗
PubMed1985

Centromeric satellite DNA in the newt Triturus cristatus karelinii and related species: its distribution and transcription on lampbrush chromosomes.

Two abundant satellite DNA sequences have been identified in and cloned from the DNA of Triturus cristatus karelinii. The smaller of these with a repeat unit of 33 base pairs (bp) is designated TkS1, the larger with 68 bp is designated TkS2. These satellites are also present in DNA from T.c. cristatus, T.c. carnifex and T. marmoratus but in substantially lower copy number. In situ hybridisations to lampbrush chromosomes of T.c. karelinii and T.c. cristatus have shown that the satellites are concentrated in the heterochromatic centromere bars of T.c. karelinii and in a region around the centromere granule in T.c. cristatus. The satellites also bind specifically to the centromere regions of mitotic metaphase chromosomes. They do not bind to the heteromorphic arms of chromosome 1, which have previously been shown to be rich in highly repeated DNA. DNA/RNA-transcript in situ hybrids to lampbrush chromosomes with TkS1 suggest that this sequence is occasionally transcribed on lampbrush loops near the centromeres.

Animals↗
PubMed1980

Brain maturation followed by computed tomography.

Computed tomography scans of normal infants were analyzed by computer methods to determine the average brain tissue density during development. A 20% increase was found from term to 20 weeks of age (29 to 35 Hounsfield units); then no further significant change was found over the next 60 weeks. The increase in density parallels the known increase in dry weight of the tissue, but calculations indicate that biochemical changes, such as the accumulation of lipids, are also important.

Age Factors↗