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Biomedical subjects

M Burgess

Publications and source records attributed to M Burgess.

At least 19 recordsLinked to original sources
PubMed1992

Immunization status of casualty attenders: risk factors for non-compliance and attitudes to 'on the spot' immunization.

Outbreaks of vaccine preventable infections have focused attention on 'missed opportunities' for immunizing children. The immunization status of 520 consecutive children attending Casualty during a 10 day period was studied. Only 70% of children had received their diphtheria, tetanus, pertussis (DTP) and poliomyelitis immunization at the appropriate time, 13% had completed the schedule later than recommended and 17% had immunizations overdue by 4 weeks or more. For measles (mumps/rubella) vaccine (MM or MMR) 75% were up to date, 10% were given late and 15% were overdue. A subset of 171 families was interviewed to evaluate factors affecting compliance. Families possessing a Social Security 'Health Care Card', whose father was unemployed, who spoke poor English or who had lived in Australia for 5 years or less were significantly more likely (P < 0.02) to be inadequately immunized. There were 84 children whose immunization was overdue and who were well enough to be immunized. The parents of 70 (83%) of these 84 said that they would agree to 'on the spot' immunization if it were available; 14 (17%) parents refused, the commonest reason for refusal being that the parents felt that the child was too sick at the time to be immunized.

Child↗
PubMed1987

Acute abdominal distension following Cryptosporidium infection.

Two children, aged 15 months and 3 years, developed abdominal distension following proven Cryptosporidium enteritis. Both required readmission to hospital and both improved rapidly, one spontaneously and one with the help of an enema. The association of abdominal distension and Cryptosporidium infection has not been described previously.

Abdomen↗
PubMed1986

Clinical pharmacology of 4-demethoxydaunorubicin (DMDR).

DMDR, a daunorubicin derivative with a higher therapeutic index and lower cardiotoxicity than either the parent drug or doxorubicin, is active when given PO in experimental animals. We studied its pharmacokinetics in ten patients receiving DMDR IV or PO or IV and PO sequentially at 10-12.5 mg/m2. DMDR and its metabolites were quantified by high-performance liquid chromatography and fluorometry. In nine patients who received DMDR IV the unchanged drug disappeared from the plasma biphasically with a mean terminal half-life of 27.0 +/- 5.5 h, an apparent volume of distribution of 63.9 +/- 12.61 kg-1, and a total clearance of 1.9 +/- 0.41 kg-1 h-1. In 24 h only 5.1% +/- 1.1% of the dose was excreted in the urine. In comparison, in 19 studies the plasma half-life of DMDR given PO was 34.8 +/- 6.7 h, 2.3% +/- 1.3% was excreted in the urine in 24 h, and the maximum plasma drug concentration was reached in about 1 h. The bioavailability of DMDR given PO was about 39% according to comparison of the areas under the plasma DMDR concentration versus time curves for the two routes, but 45% according to comparison of the 24-h cumulative urinary excretion rates. In one patient with severe liver dysfunction following oral administration, the plasma DMDR half-life was 56.8 h, more than twice the average length. By either route, the drug was quickly metabolized to one major metabolite, DMDR-ol. The plasma half-life of DMDR-ol was 72.5 +/- 24.7 h, or 35.7 +/- 7.4 when DMDR was administered IV or PO. In the plasma, DMDR-ol always exceeded DMDR in concentration. Moreover, the 24 h cumulative urinary excretion of DMDR-ol as a percentage of the dose of DMDR administered was 7.8 following IV and 7.4 following PO administration.

Daunorubicin↗
PubMed1986

Prognostic factors in metastatic carcinoma of unknown primary.

From January 1980 to June 1984, 70 patients with metastatic carcinoma of unknown primary treated with combination chemotherapy were analyzed for prognostic factors influencing objective response and survival. Suspicious germ-cell tumors and neuroendocrine tumors were excluded since patients with these malignancies tend to live longer than those with metastatic carcinoma of unknown primary. Objective response rate to combination chemotherapy was 28%. Median survival of all patients responding to combination chemotherapy was better than those not responding (16 v 3 months). In patients with good performance status, median survival was longer in responders than nonresponding patients (17 v 7 months). External lymph nodes or subcutaneous disease as the only site of disease and good performance status favorably influenced both objective response and survival, while the number of different metastatic sites favorably influenced only survival. Neutropenia and thrombocytopenia were appreciable but not fatal or a great cause of morbidity in those with good performance status. Thus, patients with metastatic carcinoma of unknown primary with good performance status or only external nodes or subcutaneous disease should be treated with combination chemotherapy regardless of age, histology, or number of different metastatic sites of disease.

Adenocarcinoma↗
PubMed1986

Clinical pharmacology of homoharringtonine.

Clinical pharmacokinetics of homoharringtonine (HHT) were studied in eight patients who received uniformly labeled HHT at 3-4 mg/m2 (150 mu Ci) by continuous 6-hour infusion. The drug and metabolites were quantified by radiochemical and high-performance liquid chromatographic techniques. Computerized nonlinear least-square regression and curve stripping were used to characterize HHT and total [3H]HHT equivalent pharmacokinetics. Unchanged HHT in the plasma declined biphasically, with an alpha-half-life of 0.5 +/- 0.1 hours and a beta-half-life of 9.3 +/- 1.4 hours. The total clearance of HHT was 177.4 +/- 27.7 ml X hour-1 X kg-1, and the apparent volume of distribution, estimated from the area under the drug concentration versus time curve, was 2.4 +/- 0.4 L X kg-1. Correspondingly, the total [3H]HHT equivalent disappeared from the plasma in a triphasic manner. Compared with the pharmacokinetic parameters of unchanged HHT, the terminal half-life of total 3H was 67.5 +/- 7.5 hours, 7.4 times longer; the total clearance was 30.9 +/- 3.1 ml X hour-1 X kg-1, 5.5 times slower; but the volume of distribution by area was 2.7 +/- 0.1 L X kg-1, nearly the same. The 72-hour cumulative urinary excretion of total tritium was 28.2% of the administered dose and only 38.3% of this resided in unchanged HHT. Thus, urinary excretion was not a major route of elimination of HHT. Moreover, HHT underwent extensive metabolism; one major and two minor unidentified products were detected in both plasma and urine.

Adolescent↗
PubMed1982

Clinical kinetics of 1, 4-dihydroxy-5,8-bis [(2-[(2-hydroxyethyl) amino] ethyl] amino ]-9, 10-anthracenedione.

The clinical kinetics of 1, 4-dihydroxy-5,8-bis[[ 2-[(2-hydroxyethyl) amino] ethyl] amino]-9,10-anthracenedione dihydrochloride (DHAQ) are reported. DHAQ, 1 to 3 mg/m2, was administered as an intravenous bolus to six patients with metastatic cancer. Plasma clearance of the drug followed a biphasic pattern with a harmonic mean initial half-life (t 1/2) of 13.7 min and a terminal t 1/2 of 37.4 hr. Recovery of unchanged drug in the urine was 6.8% at 24 hr and 7.3% at 72 hr, while the corresponding recovery of total radioactivity was 9.4% and 11.3%. Apparent volume of distribution of DHAQ was about 13.8 +/- 2.9 l/kg. Total clearance was 238.7 ml/kg/hr, twice the creatinine clearance.

Adult↗
PubMed1981

Sequences of early and late phases of repolarization on dog ventricular epicardium.

Monophasic action potentials from 32 to 43 epicardial sites were recorded with concentric suction electrodes in 11 dogs during atrial pacing at a constant rate. The duration of action potentials and the sequence of repolarization referenced to the onset of ventricular activation at 50% of the highest plateau amplitude and the end of the action potential were determined. These quantities were correlated with activation sequence determined from action potential upstrokes. On the anterior ventricular surface, both 50% and 100% repolarization sequences were qualitatively similar to activation sequence and showed positive correlation coefficients. On the posterior ventricular surface, 50% and 100% repolarization sequences had little qualitative resemblance to activation sequence and showed lower correlation coefficients. Correlations between the patterns of 100% repolarization and action potential duration were significantly higher on the posterior than the anterior ventricular surface. These findings demonstrate that activation sequence has less influence on repolarization sequence on the posterior than the anterior wall and that action potential duration is the major determinant of repolarization sequence on the posterior wall. These findings extend previous descriptions of the normal sequence of ventricular repolarization and the relative roles of activation and action potential duration in determining that sequence. The study also showed differences between the sequences of 50% and 100% repolarization suggesting different slopes of action potential downstrokes at various ventricular sites with steeper slopes at the posterior basal and upper anterolateral left ventricular wall. This finding adds new detail to previous descriptions of the distribution of intrinsic ventricular recovery properties.

Action Potentials↗