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Biomedical subjects

L German

Publications and source records attributed to L German.

7 recordsLinked to original sources
PubMed2001

Dextrins as potential carriers for drug targeting: tailored rates of dextrin degradation by introduction of pendant groups.

There is a recognised need to identify new biodegradable polymers suitable for development as targetable drug carriers. The aim of this study was to determine the rate of degradation of two dextrin fractions (Mw 15.5 and 51 KDa) by alpha-amylase and liver lysosomal enzymes (tritosomes). Also experiments were conducted to discover whether backbone modification by succinolyation (1-34 mol%) or pendant group incorporation (e.g. doxorubicin) could be used to tailor the rate of polymer degradation. Dextrin (alpha-1,4 polyglucose) is a natural polymer used clinically as a peritoneal dialysis solution and as a controlled drug delivery formulation. Size exclusion chromatography (SEC) showed that dextrin was degraded rapidly (within 20 min) by rat plasma and porcine pancreatic alpha-amylase. In contrast over 48 h no degradation was observed in the presence of tritosomes. The rate of alpha-amylase degradation of succinoylated dextrins (Mw approximately 51 KDa) was dependant on the degree of modification (dextrin >1>5>15>34 mol% succinoylation). Dextrin-doxorubicin conjugates were prepared from the 15 and 34 mol% succinoylated intermediates to have a doxorubicin loading of 8 and 12 wt.%, respectively. These doxorubicin conjugates were more stable than their parent intermediates, and SEC showed an apparently higher molecular weight. The drug conjugates did however degrade slowly over 7 days to release oligosaccharide-doxorubicin species. This fundamental study demonstrates the possibility of controlling the rate of dextrin enzymolysis by backbone modification and thus affords the potential to rationally design dextrin-drug conjugates for specific applications as targetable carriers.

Animals↗
PubMed2000

Radiotherapy outpatient review: a nurse-led clinic.

The aim of this project was to improve the quality of the delivery of care to patients undergoing outpatient fractionated radiotherapy, in terms of effectiveness and efficiency. This article provides a descriptive account of the activities that took place within a traditional doctor-held radiotherapy review (floor) clinic (71 individual clinic episodes from 71 patients) and compares them with a nurse-led clinic (299 clinic episodes from 141 patients). The outcome measures encompassed the number and type of activities in both clinics, including the number of interventions that occurred, consultation time, waiting time, degree of involvement with other support services, reasons for doctor contact, and perceptions of patients, doctors, nurses and therapy radiographers. Nurse consultations lasted longer than doctor consultations. Waiting times were reduced. Of 299 nurse-led clinic episodes, only 21 contacts were made with the doctor. More interactions and activities occurred during nurse consultations. A greater number of referrals and liaisons with other support services occurred, resulting in the establishment of continuity of care. The results from this small sequential observational study require prospective confirmation, but they suggest that specialist nursing staff, given appropriate medical support, may provide more effective care for patients who are undergoing outpatient radiotherapy.

England↗
PubMed1988

Helicopter transport of patients during acute myocardial infarction.

Initial experience with a regional system of emergency helicopter transport of patients with acute myocardial infarction (AMI) referred for emergent cardiac catheterization and percutaneous transluminal coronary angioplasty (PTCA) is described. Two hundred fifty patients with AMI were transported from within a 150-mile radius to Duke University Medical Center over a 15-month period. All patients were within 12 hours of onset of symptoms. Thrombolytic therapy was administered to 240 (96%) patients (72% before or in-flight). The time to administration of thrombolytic therapy ranged from 30 to 120 minutes (median 180), while the time to arrival in the interventional catheterization laboratory ranged from 105 to 815 minutes (median 300). The flight time was 12 to 77 minutes (median 31). Most patients had 1- or 2-vessel coronary artery disease; the baseline ejection fraction ranged from 27 to 70% (median 42). Transient hypotension was the most common complication both pre-flight and in-flight. Third-degree atrioventricular block and nonsustained ventricular tachycardia were the next most common complications. Ventricular fibrillation or sustained ventricular tachycardia occurred before takeoff in 38 patients (15%). No patients had ventricular fibrillation, asystole or respiratory arrest during transport. Fluid boluses for hypotension were the most common intervention. Five patients required cardiopulmonary resuscitation in-flight; 3 before lift-off and 2 required a brief period of cardiopulmonary resuscitation during sustained ventricular tachycardia. Fourteen patients had pressor therapy, military antishock trousers or both to maintain adequate blood pressure. Neither cardioversion, defibrillation nor intubation were performed in-flight. Thus, inflight complications are infrequent and can be managed en route to an intervention center.(ABSTRACT TRUNCATED AT 250 WORDS)

Aircraft↗
PubMed1986

Catheter ablation for control of ventricular tachycardia: a report of the percutaneous cardiac mapping and ablation registry.

Catheter ablation of ventricular tachycardia is a procedure of last resort in critically ill patients. The Percutaneous Cardiac Mapping and Ablation Registry was able to collect data on 88 patients undergoing ablation of ventricular tachycardia foci. The mean following interval for the group was 10 +/- 8 months. Results were divided into three categories: Group I patients remained asymptomatic and were on no antiarrhythmic medications (33%); Group II remained asymptomatic and took antiarrhythmic agents (38%); Group III patients were considered unsuccessful and consisted of 29 percent of the total. More than one-third of patients received two shocks; the remainder received from one to five shocks. Overall mortality included four procedure-related deaths and total follow-up mortality was 25 percent. Catheter ablation for ventricular tachycardia should be undertaken only in highly specialized centers with an expert and experienced electrophysiologist with immediate surgical back-up available.

Adolescent↗
PubMed1977

Several goals set.

Explore the source record for details and available documents.

Organization and Administration↗
PubMedDate not supplied

Radiotherapy outpatient review: a nurse-led clinic.

The study reported here was a descriptive account of the activities which take place at a traditional doctor-held radiotherapy review clinic. Comparison is made with a nurse-led clinic. Outcome measures, including number of interventions, consultation time, waiting time and degree of involvement with other support services were evaluated. Nurse consultations lasted significantly longer than those of the doctor, although waiting time was reduced. A greater number of referrals and liaison with other support services occurred and resulted in increased continuity of care. The results suggest that specialist nursing staff, given appropriate medical support, provide more effective care by using a holistic model for reviewing patients undergoing outpatient radiotherapy.

Ambulatory Care↗