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Biomedical subjects

S Goodall

Publications and source records attributed to S Goodall.

29 records · Page 2Linked to original sources

Ultrasound-based quantification of emboli during conventional and endovascular aneurysm repair.

PURPOSE: To differentiate and quantify the type and number of lower limb emboli occurring during endovascular aneurysm repair, as compared to conventional surgery. METHODS: Thirty-eight patients underwent elective infrarenal aneurysm repair using a conventional surgical approach in 18 and an endovascular procedure in 20. Emboli were detected using a Doppler ultrasound system with a 2-MHz transducer interrogating the mid superficial femoral artery. Lower limb emboli were differentiated as particulate or gaseous based on the physical distance traversed by the embolic signal. RESULTS: Significantly more particulate (median 108 versus 59, p = 0.015) and gaseous (134 versus 46, p = 0.008) emboli were detected during endovascular aneurysm repair as compared to conventional surgery. Clinically, no case of massive microembolization occurred in either group, but one patient in the conventional group required a femoral embolectomy, and three patients undergoing endovascular repair developed self-limiting trash feet postoperatively. In patients undergoing endovascular aortomonoiliac aneurysm repair, there was only a poor correlation between the number of particulate emboli and either procedural duration or operator experience. CONCLUSIONS: The apparent lack of a relationship between particulate embolization and operative time or technical experience suggests that manipulation of endoluminal devices within the aneurysm sac may not be the sole determinant of intraprocedural embolization. Other as yet undetermined factors may predict patients at high risk for massive embolization.

Aged↗

Comparison of predicted with measured creatinine clearance in cardiac surgical patients.

OBJECTIVE: To determine whether creatinine clearance can be determined from a single plasma creatinine measurement in patients up to 5 days after cardiac surgery. DESIGN: Observational longitudinal study. SETTING: Cardiac intensive care unit in a tertiary referral center for cardiothoracic surgery. PATIENTS: Seventy-five patients (54 men, 21 women) scheduled for elective coronary artery surgery (93 postoperative patient days). INTERVENTIONS: Creatinine clearance measurement using a 4-hour urine collection and a single arterial blood sample. MEASUREMENTS AND MAIN RESULTS: There was significant agreement (Deming analysis r = 0.63-0.84, correlation r = 0.76-0.95, p < 0.05) between the predicted creatinine clearance and the measured creatinine clearance on each of the postoperative days. This was maintained even if the patients required inotrope or vasoconstrictor therapy, were receiving parenteral nutrition, or had changing renal function (Deming analysis r = 0.67-0.7; correlation r = 0.8-0.93, p < 0.001) but does not apply to patients with preexisting renal dysfunction (Deming analysis r = 0.36; correlation r = 0.57, p = 0.002). CONCLUSIONS: In cardiac surgical patients with normal preoperative renal function, predicted creatinine clearance is as reliable as measured creatinine clearance up to the fifth postoperative day.

Cardiac Surgical Procedures↗

Scalloped wings is the Lucilia cuprina Notch homologue and a candidate for the modifier of fitness and asymmetry of diazinon resistance.

The Scalloped wings (Scl) gene of the Australian sheep blowfly, Lucilia cuprina, is shown to be the homologue of the Drosophila melanogaster Notch gene by comparison at the DNA sequence and genetic levels. A L. cuprina genomic fragment, which shows strong identity with the Notch (N) gene at the molecular level, hybridizes to the location of the Scl gene on polytene chromosomes. The two genes are functionally homologous; the dominant and recessive Notch-like phenotypes produced by mutations in the Scl gene allow these alleles to be classed as N-like or Abruptex-like. The Scl gene is under investigation as a candidate for the fitness and asymmetry Modifier (M) of diazinon resistance. We show that M affects the penetrance of wing and bristle phenotypes associated with two Scl alleles in a manner consistent with the M being an allele of Scl. In addition, we report a phenotypic interaction between the diazinon-resistance mutation, Rop-1, and the same alleles of Scl. We propose that the product of Rop-1, an esterase, may be involved in cell adhesion in developmental processes involving the Scl gene product.

Alleles↗

Modeling brain adaptation to focal damage.

Determining how feature maps in the cerebral cortex adapt to sudden, focal damage is important for gaining a deeper understanding of neurological illnesses such as stroke. In this paper we describe a neural model of the region of primary sensory cortex related to upper extremity proprioception, and show how the feature map there reorganizes following a simulated lesion. A perilesion zone with decreased activity appears and then gradually expands with time. These results differ from those seen with previous models of cortical lesions, and offer an alternative mechanism to the "ischemic penumbra" seen in certain types of stroke.

Brain Mapping↗

Automated determination of cross-linked fibrin derivatives in plasma.

Automated assays for the measurement of cross-linked fibrin derivatives in plasma (XL-FbDP) have been developed utilizing latex beads coated with anti-D dimer monoclonal antibody (DD-3B6/22) for both the Cobas Fara Chemistry Centrifugal and the Cobas Mira analysers (Roche, Basle, Switzerland). The analysers were programmed to mix plasma and latex reagent simultaneously and analyse absorbance changes over a 10-15 min period. Results were interpolated by the analyser from a standard curve derived from a polymer of D-dimer. Both assays had high precision (< 5% CV) for values between 100 and 1000 ng/ml and provided clear discrimination between normal samples and samples from patients suffering from the thrombotic diseases, DVT/PE and DIC. The results obtained for XL-FbDP determination with both methods compared well with established methods: a high correlation was obtained with a semi-quantitative manual latex method for both the Fara (r = 0.92) and Mira (r = 0.83) and correlations (r) of 0.81 (Fara) and 0.84 (Mira) were obtained with an enzyme immunoassay (EIA). Correlation between the two automated procedures was high (r = 0.96). The automated method will enable laboratories to provide a rapid and accurate quantitation of XL-FbDP.

Antibodies, Monoclonal↗

Pituitary function tests in the elderly: are hypothalamic releasing factors the investigation of choice?

The use of the new hypothalamic releasing factors corticotrophin releasing factor (CRF) and growth hormone releasing factor (GHRH) has been proposed as a potential replacement for the insulin stress test in the investigation of pituitary function. The response to the injection of 100 micrograms of each compound was studied in nine elderly in-patient subjects. In response to GHRH, only four subjects demonstrated a rise in growth hormone; in response to CRF, only one subject showed a rise in cortisol. In the patients studied the combined GHRH and CRF test did not cause any cortisol or GH response in the majority.

Aged↗

Peripheral vascular disease.

This article discusses peripheral vascular disease and its associated risk factors. It outlines clinical patient assessment, medical interventions and the role of the nurse in secondary prevention.

Education, Nursing, Continuing↗

Living with pain.

Explore the source record for details and available documents.

Adaptation, Psychological↗