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Biomedical subjects

P Sullivan

Publications and source records attributed to P Sullivan.

At least 235 records · Page 13Linked to original sources
PubMed1984

Central and peripheral noradrenergic tone in primary hypertension.

The contents of norepinephrine (NE), epinephrine (E), dopamine (DA), normetanephrine (NMN), and 4-hydroxy-3-methoxyphenylethylene glycol (MHPG) were measured in the plasma and cerebrospinal fluid (CSF) of 66 patients with primary hypertension and 24 patients with normal blood pressure and minor neurological disorders. Plasma and CSF NE and NMN concentrations were raised in the hypertensive patients. The plasma and CSF NE levels and arterial blood pressure of a small subset of hypertensive patients were normalized after clonidine therapy. In hypertensive patients the content of DA was lower and the ratio of NE/DA was greater; CSF and plasma NE contents were related to the level of arterial blood pressure; and the content of MHPG in CSF was linked strongly with NE content in plasma and CSF and to the level of arterial blood pressure. Thus both central sympathetic nerve tone and peripheral sympathetic nerve tone were enhanced in young patients with uncomplicated hypertension. The elevated levels of neurohormones and their metabolites in some patients with primary hypertension may be related to increased synthesis and release of neural NE and may be pathogenic in the blood pressure elevation.

Blood Pressure↗
PubMed1983

Failure to demonstrate effectiveness of an anticholinergic drug in the symptomatic treatment of acute travelers' diarrhea.

Seventy adults in the United States with acute diarrhea who were attending classes in Guadalajara, Mexico, enrolled in a double-blind placebo-controlled treatment study of an anticholinergic drug, mepenzolate bromide (MZB). Thirty-five patients received MZB (50 mg) and 35 received placebo each taken 4 times daily for 48 hours. No significant difference was detected between the MZB- and placebo-treated patients in symptoms or in the frequency or character of stools. Recovery rates of 24.1% and 31% for placebo- and MZB-treated patients were similar. Despite the occurrence of anticholinergic side effects in 51% of MZB- versus 14% of placebo-treated patients (P less than 0.001), therapeutic efficacy was not detected. We do not recommend anticholinergic drugs for therapy in acute infectious diarrhea.

Acute Disease↗
PubMed1983

Bicozamycin, a poorly absorbable antibiotic, effectively treats travelers' diarrhea.

The efficacy of bicozamycin, a poorly absorbable antibiotic, in the treatment of acute diarrhea was assessed in a prospective, double-blind study of 140 adults from the United States visiting Guadalajara, Mexico. Patients randomly received bicozamycin (500 mg orally four times daily) or placebo for 3 days. The mean duration of illness was shorter in the bicozamycin than the placebo treatment groups for patients with diarrhea due to Shigella (37 versus 96 hours; p = 0.01), toxigenic Escherichia coli (31 versus 60 hours; p = 0.003), and unknown pathogens (18 versus 41 hours; p = 0.02). Cramps were significantly relieved by bicozamycin in all patients. Treatment failed in significantly fewer patients treated with bicozamycin than those treated with placebo when diarrhea was associated with Shigella, Salmonella or toxigenic E. coli. Bicozamycin was well tolerated and appears to be effective therapy for acute travelers' diarrhea of diverse causes. These data show the value of an antibiotic in the therapy of toxigenic E. coli infection and indicate a need to reevaluate the clinical dictum that nonabsorbable antibiotics are ineffective against invasive enteropathogens.

Absorption↗
PubMed1982

Chemotherapy and cyclic radiation therapy in locally advanced non-small cell lung carcinoma.

Nine patients with non-small cell lung carcinoma (4 squamous, 4 adenocarcinoma, 1 large cell) were treated with a combination of radiation therapy and cyclic chemotherapy with 5-fluorouracil, methotrexate and platinum. Four previously untreated patients had stage III, 2 having distant metastases, 5 previously treated patients were restaged as stage III with distant metastasis in one. Moderate hematologic toxicity was noted. Objective responses occurred in 67 per cent, regardless of previous treatment or performance status. Responders survived for a median of 11 months with one complete response patients surviving at 14 months while 5 partial response patients survived for a median of 10 months. This regimen is feasible and its utility as the initial treatment of locally advanced disease should be further investigated.

Adenocarcinoma↗
PubMed1980

Disarming the bluebottle: treatment of Physalia envenomation.

Clinical tests of the efficacy of various treatments of bluebottle (Physalia physalis) stings were conducted on 20 volunteers. Vinegar and aluminium sulphate solution (Stingose) gave a significant reduction in pain 15 minutes after application when compared with the control sites which were treated with sea water. The application of methylated spirits caused a significant increase in pain compared to salt water.

Acetates↗
PubMed1980

Prevention of traveler's diarrhea (emporiatric enteritis). Prophylactic administration of subsalicylate bismuth).

The efficacy of a daily dosage regimen of subsalicylate bismuth in preventing or reducing the severity of diarrhea among young healthy adults was evaluated in a double-blind, randomized, placebo-controlled trial. Diarrhea developed in 14 (23%) of 62 students receiving subsalicylate bismuth compared with 40 (61%) of 66 students taking a placebo. The protective effect of subsalicylate bismuth was apparent within a day or two of the study onset and became more obvious as the number of days at risk increased. The students treated with subsalicylate bismuth experienced fewer intestinal complaints and were less likely to pass soft or watery stools of any number. Once diarrhea occurred, enteropathogens were less commonly identified in stools of students receiving subsalicylate bismuth (33%) compared with placebo (71%). Subsalicylate bismuth was well tolerated by students during the 21-day trial.

Adult↗
PubMed1980

Central and regional normetadrenaline in evaluation of neurogenic aspects of hypertension: aid to diagnosis of phaeochromocytoma.

1. Free normetadrenaline concentrations in plasma of patients with phaeochromocytoma were elevated 20-1000-fold as compared with values in primary hypertensive subjects. 2. Spinal fluid normetadrenaline was 1.8-16% of the simultaneous plasma values in patients with phaeochromocytoma, whereas levels in spinal fluid exceeded those of plasma in primary hypertension. 3. Spinal fluid noradrenaline was 7.9-58% of simultaneous values of plasma noradrenaline in patients with phaeochromocytoma, whereas values in plasma and cerebrospinal fluid were similar in primary hypertension. 4. Plasma noradrenaline and normetadrenaline levels were both elevated in veins from regions subsequently found to harbour chromaffin tumours. 5. The excessive amounts of normetadrenaline produced in phaeochromocytoma enters plasma but not spinal fluid and can be used for diagnosis and localization of phaeochromocytoma.

Adrenal Gland Neoplasms↗
PubMed1980

The role of location of food consumption in the prevention of travelers' diarrhea in Mexico.

The location of food consumption was recorded daily for 3 wk by 130 United States summer students newly arrived in Guadalajara, Jalisco, Mexico, as part of an assessment of bismuth subsalicylate vs. placebo in the irevention of travelers' diarrhea. Eating at locations other than homes and apartments (P < 0.025), and specifically at restaurants, was associated with an increased occurrence of diarrhea. Less eating at restaurants (P < 0.005), street vendors (P < 0.005), and school cafeterias (P < 0.01) was associated with reduced occurrence of travelers' diarrhea, even among persons taking bismuth subsalicylate as a preventive measure.

Bismuth↗
PubMed1979

Cholestyramine treatment of chronic diarrhea associated with immune deficiency syndrome.

A 5-year-old boy with known severe combined immunodeficiency disease presented with chronic diarrhea, malabsorption and retarded growth. Candida albicans was found in distal duodenal fluid, and invading the intestinal mucosa. Chronic diarrhea persisted after antimycotic therapy, but responded to treatment with cholestyramine. Repeated courses of cholestyramine resin over a 6-month period were required for complete resolution of the gastrointestinal symptomatology.

Candidiasis↗
PubMed1978

Studies on the activity of the sympathetic nervous system in essential hypertension.

Plasma catecholamine and norepinephrine concentrations have been measured in carefully characterized ambulatory patients with essential hypertension under basal conditions and following experimental procedures known to enhance sympathetic activity. The studies have demonstrated increased levels of plasma catecholamines in patients with mild hypertension as compared with matched controls following 70 degree upright tilt or cold pressor testing. Considerable heterogeneity was apparent in the population of patients with essential hypertension with respect to their plasma norepinephrine concentrations. Significantly greater levels of plasma norepinephrine were present in patients with high plasma renin activity and lesser levels in patients with low renin activity than in normal renin or labile hypertensives. Blood pressure correlated significantly with plasma norepinephrine in male patients with normal renin essential hypertension but not in females. Administration of the diuretic furosemide produced an increase in plasma norepinephrine in almost all hypertensive subjects studied. These studies suggest that peripheral sympathetic activity is abnormal in certain patients with essential hypertension. The results underscore the need to differentiate between subgroups of essential hypertension in studies relating to the role of the adrenergic system in the hypertension. The findings also suggest that the recently developed sensitive techniques for measuring plasma catecholamines of plasma norepinephrine are of value in assessing changes in peripheral sympathetic activity but that enzymatic assays of serum dopamine-beta-hydroxylase activity are probably not useful for this purpose.

Adult↗
PubMed1978

Hepatic scintigraphy in Caroli's disease.

Caroli's disease (communicating cavernous ectasia of the intrahepatic bile ducts) is manifested on the 99Tc-sulfur colloid images as multiple focal defects in the liver. Since several other conditions have a similar presentation, intravenous or transhepatic cholangiography may be of assistance in reaching the correct diagnosis.

Bile Ducts, Intrahepatic↗