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Biomedical subjects

L Briggs

Publications and source records attributed to L Briggs.

At least 19 recordsLinked to original sources

A comparison of the insertion characteristics of the laryngeal tube and the laryngeal mask airway: a study of the ED50 propofol requirements.

The purpose of this prospective randomised double-blind study was to determine the effective dose of propofol required for the successful first attempt insertion of the laryngeal tube compared with the laryngeal mask airway in patients co-induced using alfentanil 5 microg.kg(-1), undergoing short elective gynaecological procedures. The first patient in each group received propofol 2.5 mg.kg(-1) for induction. In accordance with Dixon's up-and-down method, the dose of propofol for consecutive patients in each group was varied with increments or decrements of 0.5 mg.kg(-1) based on the previous patient 'all-or-none' purposeful movement response to first attempt of insertion of the randomised device. The ED50 (SD) of propofol was 2.66 (0.86) mg.kg(-1) and 2.33 (0.37) mg.kg(-1) for the laryngeal tube and laryngeal mask patients, respectively, which did not reach statistical significance (p = 0.40). We conclude therefore that the insertion of the two airway devices requires similar bolus doses of propofol when alfentanil is used as the co-induction drug.

Adult↗

Promoter variants in tissue inhibitor of metalloproteinase-3 (TIMP-3) protect against susceptibility in pigeon breeders' disease.

BACKGROUND: Tissue inhibitors of metalloproteinases (TIMPs) play a major role in extracellular matrix turnover in the lung. However, in chronic lung disorders such as idiopathic pulmonary fibrosis (IPF) and pigeon breeders' disease (PBD), TIMPs may promote an adverse non-degradative environment. We hypothesised that polymorphisms in TIMP-3 could affect susceptibility to IPF and PBD. METHODS: Two promoter variants, -915A>G and -1296T>C, were genotyped in 323 healthy subjects, 94 subjects with IPF, 115 with PBD, and 90 exposed to avian antigen but without PBD. The severity of fibrosis in lung tissue and the clinical outcome after 1 year was determined in the PBD group. RESULTS: The variants did not influence susceptibility to IPF, but the rare alleles of both variants appeared to be protective against susceptibility to PBD (odds ratio (OR) for carriage of at least one rare allele from either variant 0.48, 95% CI 0.30 to 0.76, p = 0.002). Haplotype analysis of positions -915 and -1296 estimated four haplotypes: *A*T, *G*T, *A*C and *G*C, respectively. Their frequencies differed overall between subjects with PBD and healthy subjects (p = 0.0049) and this was attributable primarily to the *G*C haplotype (OR 0.53, 95% CI 0.36 to 0.77, p = 0.001). The severity of fibrosis correlated with poorer outcome in the PBD group (r = 0.73, p<0.01) but no relationship was seen between the *G*C haplotype and outcome or fibrosis. However, PBD subjects with the *G*C haplotype did have proportionally fewer lymphocytes in their bronchoalveolar fluid than those with the common *A*T haplotype (p = 0.029). CONCLUSIONS: TIMP-3 variants appear to contribute to susceptibility to PBD. This may be through the inflammatory reaction rather than the fibrotic reaction.

Adult↗

Comparison of wounds created by non-bladed trocars and pyramidal tip trocars in the pig.

Wounds made by the Endopath nonbladed obturator, the Step trocar, and conventional pyramidal tip trocars were compared. The endopath nonbladed obturator and the Step trocar made wounds by separating tissue fibers, whereas the pyramidal tip trocar cut tissue fibers. The wounds of the Endopath nonbladed obturator and the Step trocar were similar in length but were narrower than wounds made by the pyramidal tip trocar. Further studies are needed to determine whether the wounds made by the Endopath nonbladed obturator and the Step trocar will have fewer complications than conventional pyramidal tip trocars.

Abdominal Muscles↗

Papillon-Lefèvre syndrome: a case report.

This case report discusses a very rare condition; Papillon-Lefèvre Syndrome. This is an autosomal recessive condition in which the main features are hyperkeratosis of the palms and the soles and severe periodontal destruction.

Child, Preschool↗

What determines post-traumatic stress disorder symptomatology for survivors of childhood sexual abuse?

OBJECTIVE: The aim of this paper was to ascertain which childhood abuse experiences are associated with post-traumatic stress disorder (PTSD) symptomatology for women survivors of childhood sexual abuse (CSA). METHOD: Seventy-three women attending a Family Health Counselling Service's Sexual Abuse Program were invited to participate in a study looking at the effectiveness of sexual abuse counselling. Initially, the women completed a series of self-report questionnaires including a measure of PTSD symptoms, and were interviewed about childhood abuse experiences. RESULTS: PTSD symptoms were associated with higher levels of all psychopathology. However, more interestingly, the severity of PTSD symptoms was also associated with the extent of CSA which involved actual sexual intercourse. This association of repeated abuse involving sexual intercourse with PTSD symptoms was still significant (partial coefficient = .30, p, .000) even when controlling for general level of psychopathology. CONCLUSIONS: One of the long-term effects of child sexual abuse (CSA) is post-traumatic stress disorder (PTSD), and the women who reported multiple abusive episodes which involved sexual intercourse had increased symptoms of PTSD.

Adult↗

Evaluation of comprehensive violence prevention education: effects on student behavior.

PURPOSE: This study evaluates the impact on student behavior of violence prevention education in school settings. METHODS: School records were obtained for three panels (1985, 1986, and 1987) of urban public high school students (n = 1,523) who were nonrandomly assigned to three different conditions of school-based violence prevention education: (1) in a class-specific comprehensive educational intervention, (2) as part of a school-wide violence prevention initiative, and (3) no exposure. Changes in suspension status from sophomore to junior year were tracked within exposure groups and the risk of junior year suspension was compared across exposure groups, controlling for age, gender, race, absenteeism, and previous year suspension. RESULTS: The class-specific exposure, compared to a not-exposed group from the same school showed a significant 71% reduction in suspension rates (RR = .286, CI .12, .66). The school-wide exposure school shows reductions in and maintenance of very low rates of junior year suspension in each cohort year, although these are not always statistically significantly different from not-exposed groups. CONCLUSION: Results indicate that violence prevention education can reduce negative school behaviors, particularly when other supportive curricula and activities are added.

Absenteeism↗

A single i.v. dose of ondansetron 8 mg prior to induction of anaesthesia reduces postoperative nausea and vomiting in gynaecological patients.

The effect of a single intravenous dose of ondansetron in preventing postoperative nausea and emesis (retching and vomiting) (PONV) was investigated in a randomized, double-blind, placebo-controlled, multicentre, international study. Women of ASA class I-III, requiring gynaecological laparotomy, vaginal hysterectomy, or major vaginal surgery were selected for study. Two hundred and thirty-five received placebo, 231 received 1 mg ondansetron, 228 received 8 mg ondansetron and 229 received 16 mg ondansetron, as an infusion over five minutes before the induction of anaesthesia. A standardized balanced anaesthetic technique was employed. This consisted of premedication with either diazepam or temazepam, thiopentone induction, maintenance with nitrous oxide in oxygen supplemented with enflurane or isoflurane, intraoperative analgesia with fentanyl, neuromuscular blockade with any choice of agent and reversal with neostigmine and atropine. Postoperative analgesia was achieved with morphine, and prochlorperazine or metoclopramide were given if a rescue antiemetic was required. A greater percentage of patients in the 8 mg and 16 mg ondansetron groups experienced no postoperative emesis (44% and 39% respectively) than in the placebo and 1 mg ondansetron groups (29% and 28% respectively) for the first 24 hr postoperative period (8 mg vs placebo and 1 mg: P < or = 0.001; 16 mg vs placebo: P < 0.05; 16 mg vs 1 mg: P < 0.05). Similarly, the percentage of patients who did not experience postoperative nausea were 20%, 26%, 31% and 28% for the placebo, 1 mg, 8 mg and 16 mg ondansetron treatment groups, respectively (8 mg and 16 mg vs placebo P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Seniors caring for seniors. Expanding eldercare services.

The Visiting Nurse Associations of America is spearheading a national demonstration project to create partnerships between nonprofit, community-based visiting nurse associations and the Senior Companion Program in an attempt to expand the scope of person-to-person volunteer programs and long-term care services.

Activities of Daily Living↗

Effects of a chiropractic adjustment on changes in pupillary diameter: a model for evaluating somatovisceral response.

The relationship between a cervical chiropractic adjustment, in subluxated vs. unsubluxated subjects, and autonomic response monitored as change in pupillary diameter was evaluated in 15 subjects. The results indicate that: a) a successful adjustment elicits either a parasympathetic or sympathetic response; b) the vertebral level at which the adjustment is administered has undetectable specificity for the parasympathetic or sympathetic input to the pupil; c) unsubluxated subjects generally exhibit no change in pupillary diameter following a sham adjustment and d) subluxated subjects exhibit variable preadjustment pupillary diameters, with significant pupillary diameter changes in response to an adjustment. These data suggest that autonomic input to the pupil may be influenced by subluxation, as well as the magnitude and direction of force exerted during the chiropractic adjustment. An anatomical pathway through which the observed responses may occur is proposed.

Adult↗

Effect of erythrocyte storage and oxyhemoglobin affinity changes on cardiac function.

Storage of blood can depress erythrocyte 2,3-diphosphoglycerate (DPG) levels and thereby increase oxyhemoglobin affinity and potentially decrease capillary-to-tissue oxygen transport. We measured myocardial function and metabolism in isolated rabbit hearts with fixed coronary flow under basal conditions and during isoproterenol stress at 37 and 30 degrees C, comparing high and low oxyhemoglobin affinity (OHA) erythrocytes. The high OHA state resulted from standard storage conditions, which caused depressed values of DPG and P50 (the oxygen tension at which hemoglobin is 50% saturated). The low OHA erythrocytes were initially stored and then underwent biochemical treatment to restore the DPG and P50 values to normal. The low OHA cells released more oxygen, and myocardial oxygen consumption and contractile function were increased relative to the high OHA cells during both the basal and stress states at both 37 and 30 degrees C. These observations may be relevant for patients with limited coronary flow when such patients receive large transfusions of stored blood.

Animals↗