Biomedical subjects

L G King

Publications and source records attributed to L G King.

27 records · Page 2Linked to original sources

PubMed1995

The lipase to amylase ratio in acute pancreatitis.

OBJECTIVES: The ratio of serum lipase to serum amylase has been proposed to distinguish acute episodes of alcoholic from nonalcoholic pancreatitis. We evaluated the efficacy of this test in a community hospital setting. METHODS: Charts of all patients discharged with a diagnosis of acute pancreatitis over 19 months were retrospectively reviewed. Patients were excluded if their creatinine was greater than 3.0 mg/dl, if the amylase and lipase were not measured within 72 h of the onset of symptoms, or if the cause of pancreatitis was not known by the time of discharge. RESULTS: Of the 56 patients, 31 had alcoholic pancreatitis. The lipase to amylase ratio did not differ significantly between patients with alcoholic and nonalcoholic pancreatitis. Median amylase and lipase were significantly higher in nonalcoholic pancreatitis; however, the wide ranges of both meant that neither amylase nor lipase accurately determined the cause of pancreatitis. CONCLUSION: The lipase to amylase ratio does not appear to be sufficiently sensitive or specific to distinguish alcoholic from nonalcoholic acute pancreatitis.

Acute Disease↗

PubMed1994

Use of positive-pressure ventilation in dogs and cats: 41 cases (1990-1992).

Intermittent positive-pressure ventilation (PPV) is an invasive means of respiratory support that is indicated in animals with central and peripheral neuromuscular disease, as well as in those with primary disorders of the lung parenchyma. We reviewed the medical records of 34 dogs and 7 cats treated with PPV. The animals could be allotted to 2 groups; group 1 (21/41) had primary failure of ventilation attributable to neuromuscular disease or airway obstruction, and group 2 (20/41) had primary pulmonary parenchymal disease. Mean inspiratory time was 1.02 +/- 0.2 seconds (range, 0.6 to 1.5 seconds). Mean inspiratory flow was 26.9 +/- 18.5 L/min (range, 7 to 87 L/min), and was positively correlated with body weight (R = 0.57). Mean set respiratory rate was 19.6 +/- 10 breaths/min (range, 5 to 60 breaths/min), with mean tidal volume of 15.5 +/- 6.2 ml/kg of body weight. Positive end-expiratory pressure (PEEP) was required in 14 of 20 dogs in group 2. Mean peak airway pressure in group 1 was 21.6 +/- 6.3 cm of H2O, whereas in group 2 it was 32.9 +/- 12.5 cm of H2O. The higher peak airway pressure in group-2 dogs reflected poor lung compliance and the use of PEEP in dogs with parenchymal lung disease. Mean duration of PPV was 28.2 +/- 29.4 hours (range, 2 to 137 hours). The overall survival rate was 39% (16/41).(ABSTRACT TRUNCATED AT 250 WORDS)

Airway Obstruction↗

PubMed1994

Postoperative complications and prognostic indicators in dogs and cats with septic peritonitis: 23 cases (1989-1992).

Medical records of 21 dogs and 2 cats treated for septic peritonitis were reviewed. Animals were between 1 and 12 years old, (mean, 6.5 years) and weighed between 6 and 51.4 kg (mean, 22.7 kg). Overall, 13 animals survived and were discharged from the hospital. Immediately after surgical correction of the underlying cause of peritonitis, most animals were tachycardic (mean heart rate, 148 beats/min; range, 80 to 204 beats/min), and many were hypotensive (mean arterial pressure, 84.4 mm of Hg; range, 44 to 156 mm of Hg). Hypotension was attributed to sepsis and hypovolemia secondary to extensive loss of fluid into the peritoneal cavity. Survivors did not differ from nonsurvivors with regard to mean arterial pressure immediately after surgery, and in most animals, hypotension could be corrected by IV administration of fluids. Three animals died after failing to respond to fluid treatment, despite concurrent administration of inotropic or pressor agents. Mean rate for crystalloid fluid administration was 12.8 ml/kg of body weight/h (range, 5 to 23.5 ml/kg/h) during the first 24 hours after surgery. Six of 23 animals had low urine output for a short time after surgery, but urine output increased when fluids were administered. Hypoalbuminemia developed in all animals (mean serum albumin concentration, 1.17 g/dl; range, 0.6 to 2.3 g/dl), and peripheral edema developed in 13. Neither lowest mean serum albumin concentration nor fluid administration rate was significantly different between animals that developed peripheral edema and those that did not. Fluid administration rates were significantly higher in nonsurvivors (15 ml/kg/h; range, 5.5 to 23.5 ml/kg/h) than in survivors (11 ml/kg/h; range, 5 to 17.5 ml/kg/h).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1994

Acute vomiting.

Patients commonly present to the emergency clinician for evaluation of acute vomiting. The causes of vomiting range from trivial to life-threatening. The clinician must use the history, physical examination, emergency data-base, and abdominal radiographs to determine the severity of the underlying problem and the extent of the systemic side-effects of vomition. Based on this information, a plan can be devised for optimal emergency management of these patients.

Acute Disease↗

PubMed1993

Chlamydia trachomatis infections in female tertiary students.

Chlamydial infection of the endocervix was identified in 19.8% of 258 University students undergoing pelvic examination in a Student Services Health Clinic. The majority of consultations were for routine Papanicolaou smear. Chlamydial infection was present in 50% (12 of 24) of the women who had clinical evidence of mucopurulent cervicitis.

Adult↗

PubMed1992

Arterial blood gas tensions in healthy aged dogs.

Twenty-four healthy dogs > 8 years old were recruited. In each instance, arterial blood gas tensions were analyzed. The alveolar-to-arterial oxygen gradient (P[A-a]O2) was calculated to assess adequacy of pulmonary gas exchange. Thoracic radiographs were evaluated to ensure lack of visible signs of pulmonary disease and that lung features were similar to those in aged dogs of previous reports. Unlike findings in aged human beings, arterial partial pressure of oxygen (PaO2) was not decreased in this group of aged dogs (mean +/- SD, 102.9 +/- 7.8 mm of Hg). Similarly, P(A-a)O2 also was not increased. The thoracic radiographic findings were consistent with those of previous reports of pulmonary changes in aged dogs. The extent of radiographic abnormalities and the PaO2 were not correlated.

Aging↗

PubMed1991

Static thoracic compliance as a measurement of pulmonary function in dogs.

Thoracic compliance measurements by use of readily available equipment were determined to be practical and safe in dogs. Twenty healthy dogs (age 1 to 16 years, weight 2.3 to 49.5 kg) were anesthesized for routine procedures such as dentistry or neutering. The animals were first hyperventilated to reduce pulmonary atelectasis, to check for leakage at the endotracheal tube cuff, and to induce mild hypocarbia, thus minimizing voluntary respiratory efforts. Total thoracic compliance measurements were calculated as the difference between exhaled volumes at static inspiratory pressures of 15 and 20 cm of H2O, divided by the pressure difference, and expressed as a function of body weight. The procedure was easy, took 5 to 10 minutes, and caused no recognizable ill effects in any of the dogs studied. Mean total thoracic compliance was 42.25 +/- 32 ml/cm of H2O. There was a significant correlation with weight, but no significant relationship was seen between compliance and age, or gender. The mean weight-adjusted total thoracic compliance was 1.85 +/- 0.56 ml/cm of H2O/kg. In studies in a small group of dogs with documented respiratory tract disease, 4 of 7 had a mean compliance greater than 2 SD below the normal range. Thus, this test may become part of the routine workup of any animal being anesthetized for procedures such as bronchoscopy to evaluate respiratory tract disease. Routine monitoring of animals on ventilators could provide early warning of complications such as pneumonia, pleural effusion, or pulmonary edema.

Animals↗

PubMedDate not supplied

Analgesia in dogs after intercostal thoracotomy: a clinical trial comparing intravenous buprenorphine and interpleural bupivacaine.

We prospectively studied 26 dogs that presented for intercostal thoracotomy. Dogs were premedicated with oxymorphone, induced with diazepam and etomidate, and anesthesia was maintained with isoflurane in oxygen. Preoperatively, animal patients were randomly assigned to one of two groups. Group 1 (n = 13) received buprenorphine (10 microgram/kg intravenously [IV]) every 6 hours for 24 hours starting 10 minutes before tracheal extubation. Group 2 (n = 13) received 0.5% bupivacaine (1.5 mg/kg) administered interpleural (IP) by slow injection through a pediatric feeding tube fixed to the most dorsal aspect of the thoracotomy incision. Interpleural injections were administered with each dog placed in lateral recumbency with the incision positioned ventrally; IP injections were administered every 4 hours for 24 hours starting 10 minutes before tracheal extubation. All cases were monitored in the intensive care unit for 24 hours postoperatively. The analgesic efficacy of each regimen was evaluated using a pain scoring system that included a subjective pain score, heart rate, and respiratory rate. Arterial blood pressure, arterial blood gases, oxygen saturation, body temperature, and changes in the electrocardiogram or neurological status were also noted. Significant increases in mean heart rate, respiratory rate, and total pain score occurred after surgery in dogs in the buprenorphine group. In contrast, dogs in the bupivacaine group had no significant changes when compared with their preoperative values. Dogs in the bupivacaine group had significantly decreased total pain scores and better PaO2 and oxygen saturation values when compared with the dogs receiving buprenorphine. Hypoventilation did not occur in either group.

Analgesia↗

PubMedDate not supplied

Anemia of chronic renal failure in dogs.

Seventeen dogs with chronic renal failure (CRF) were studied to evaluate the incidence, type, and etiology of anemia in CRF. A nonregenerative, normochromic, normocytic anemia was seen in 12 of 17 dogs (70.6%). There was a direct correlation between the degree of anemia and the extent of CRF as assessed by serum creatinine concentrations (P = .0386, r = .50923). Erythrocyte concentrations of 2,3-diphosphoglycerate (DPG) were significantly increased in anemic animals and showed a close correlation to the degree of anemia. The high DPG concentrations may compensate for the anemia by decreasing the hemoglobin-oxygen affinity and thereby facilitating tissue oxygenation at low hematocrits. Serum concentrations of erythropoietin (Epo) were in the low to normal range, despite mild to moderate anemia, documenting a deficiency of Epo in dogs with CRF. The nonregenerative nature of the anemia supports impaired hematopoiesis as a significant etiologic factor. Other factors, such as increases in serum parathyroid hormone and phosphorus, were not found to correlate significantly with the degree of anemia, although there were significant differences between their concentrations in anemic compared with non-anemic dogs. There was no change in erythrocyte osmotic fragility with uremia. The documentation of a nonregenerative, normochromic, normocytic anemia, with failure of an appropriate increase in Epo production, supports the therapeutic use of Epo in the management of the anemia seen in CRF in the dog.

2,3-Diphosphoglycerate↗