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Biomedical subjects

S W Allen

Publications and source records attributed to S W Allen.

At least 37 records · Page 2Linked to original sources
PubMed1993

Circulating immunoreactive endothelin-1 in children with pulmonary hypertension. Association with acute hypoxic pulmonary vasoreactivity.

To determine whether circulating levels of endothelin-1 (ET-1), a potent vasoconstrictor peptide, are elevated in children with pulmonary hypertension and related to the degree of hypoxic pulmonary vasoconstriction, we measured arterial and mixed venous plasma concentrations of immunoreactive ET-1 (irET-1) in 13 children during cardiac catheterization. Clinical diagnoses in seven children with pulmonary hypertension (PH) included chronic lung disease (four children), congenital heart disease after surgical repair (two children), and primary ("reactive") pulmonary hypertension (one child). Blood samples were simultaneously obtained from pulmonary artery (venous) and systemic arterial sites during baseline conditions. Plasma irET-1 was elevated in children with PH (12.3 +/- 3.4 versus 3.6 +/- 0.7 pg/ml, PH versus non-PH; p < 0.01). Arterial/venous irET-1 ratios in the PH group (1.1 +/- 0.2) were not different from those in the non-PH group. During acute hypoxia, mean Ppa increased from 27 +/- 3 to 40 +/- 5 mm Hg. Basal irET-1 correlated strongly with the degree of elevation of mean Ppa during acute hypoxia (r = 0.69; p < 0.02). We conclude that irET-1 levels are often elevated in children with PH, and they are strongly correlated with pulmonary vasoreactivity during acute hypoxia. Whether elevated irET-1 levels contribute directly to or are markers of altered pulmonary vascular tone and reactivity in children with PH remains speculative.

Blood Pressure↗
PubMed1993

Apparent dietary protein requirement of dogs with portosystemic shunt.

Current medical management of dogs with portosystemic shunt (PSS) includes dietary protein restriction. After establishment of baseline values, 32 dogs underwent portosystemic anastomosis to induce PSS. They were assigned to 1 of 4 dietary treatments, and given 11 or 24% crude protein (CP); 20% of the protein was derived from branched chain or aromatic amino acids. The apparent digestibility of CP and of total digestible energy were not affected by PSS. The apparent digestibility of fat decreased from 92% to 85% in dogs with PSS (P < 0.01). Across all diets, the apparent dietary protein requirement (ADPR) was 2.07 g of CP/kg of body weight/d in clinically normal dogs and 2.11 g of CP/kg/d after PSS. Dietary amino acid composition had no effect on ADPR. The ADPR for dogs fed the 11% protein diets was 1.69 g of CP/kg/d in clinically normal dogs and 1.62 g of CP/kg/d after PSS, whereas the ADPR in dogs fed the 24% protein diets was 3.94 g of CP/kg/d before PSS and 3.31 g of CP/kg/d after PSS. Serum total protein, urea nitrogen, and albumin concentrations were lower in dogs with PSS fed the 11% protein diets, compared with those fed the 24% protein diets. We conclude that there is no difference in ADPR in dogs with PSS; however, the low protein intake of 1.62 g of CP/kg/d appeared inadequate to maintain normal protein stores. Dietary protein that provides at least 2.1 g of CP/kg/d is recommended for dogs with PSS.

Animals↗
PubMed1992

Maximal voluntary work and cardiorespiratory fitness in patients who have had Kawasaki syndrome.

To assess the natural history of Kawasaki syndrome and its effect on maximal voluntary work and cardiorespiratory fitness, we performed cycle ergometry testing in 47 patients who had had the syndrome. Forty-one patients performed maximal effort as judged by achievement of 95% predicted heart rate response. Oxygen consumption, carbon dioxide production, and minute ventilation were performed in 23 patients. There was no difference in maximal voluntary work (total work, mean power) or maximal oxygen consumption between case subjects and control subjects. There were no differences between patients with and those without aneurysms. Serial exercise studies were performed in 10 patients; of these, two with initially normal exercise study findings had decreased maximal voluntary work and oxygen consumption with ischemic changes, and both were at high risk for the development of stenotic or occlusive coronary arteries. The other eight patients had normal cardiorespiratory reserve and no ischemic changes with serial studies. These results suggest that patients have normal cardiorespiratory fitness after Kawasaki syndrome. With the development of ischemic heart disease, they may have decreased cardiorespiratory reserve. Serial evaluation of cardiorespiratory fitness may demonstrate ischemic heart disease.

Adolescent↗
PubMed1991

Role of specific similarity in a medical diagnostic task.

Three experiments are reported showing that diagnosis of skin disorders by medical residents and general practitioners was facilitated by similar cases previously seen in the same context. Diagnosis of similar cases was facilitated more than that of dissimilar cases in the same diagnostic category, demonstrating that facilitation was not solely due to activation of the diagnostic category as a whole. Because diagnosis was posed in a multiple-choice format that always included the correct diagnosis, the relative disadvantage of dissimilar items was not due to the unavailability of the category name. The similarity effect also occurred with 2-week delay between the initial case and the test cases. Variations in diagnostic procedure, ranging from giving a quick first impression to arguing for given alternative diagnoses before selection, did not interact with the effect of similarity. This result suggests that the similarity effect is not strongly dependent on a particular diagnostic strategy.

Adult↗
PubMed1991

Surgical management of pharyngeal disorders in the dog and cat.

Disorders of the pharynx are relatively uncommon in the dog and cat. There are a number of potential causes of pharyngeal problems, but the underlying presenting clinical sign is that of dysphagia. This chapter will discuss the differential diagnosis of dysphagia with emphasis on oropharyngeal swallowing disorders. A separate discussion of special considerations to be made in the placement of pharyngostomy tubes also will be presented.

Animals↗
PubMed1990

Reinstating study context produces unconscious influences of memory.

Having read a word does more to benefit its later perceptual identification when many, rather than few, of the words in the test list have been previously read. Some have suggested that this proportion overlap effect is produced by an intentional use of recognition memory or recall in the perceptual identification task. Contrary to this account, we found that words that are easily recognized (words generated from an anagram at study) do not gain more from increasing overlap than do words that are poorly recognized (words read at study). These findings are problematic for claims that word perception relies on a module, such as a logogen system, that is separate from the rest of memory.

Adult↗
PubMed1990

Identification and anatomic categorization of the vascular patterns to the pelvic limb muscles of dogs.

The vascular patterns to pelvic limb muscles were studied in 6 dogs (12 limbs) to identify muscles most suitable for transposition in the treatment of large wounds. Gross dissection of injected specimens and angiography were used to identify the vascular pedicles. The vascular pedicles to several muscles were generally consistent, and any variations would not interfere with most muscle transfers. The cranial part of the sartorius, gracillis, semitendinosus, and rectus femoris muscles were identified as suitable candidates for transfer. The caudal part of the sartorius, cranial tibial, and long digital extensor muscles have segmentalized vascular patterns that would limit its arc of rotation.

Animals↗
PubMed1989

Recall by expert medical practitioners and novices as a record of processing attention.

Using recall of clinical protocols as a measure of expertise in medicine has yielded disappointingly small effects. Experiments using recall of clinical laboratory data are presented to provide an explanation. In one experiment, subjects either deliberately memorized or first diagnosed and then were incidentally asked for memory. With incidental instructions, experts recalled over twice as much data as did students, but with memorization instructions, student performance approximated that of experts. Experts also showed a large advantage over students in incidental recall of data that were not relevant to the problem solution. These results suggest that expert processing in this "discrete, independent inputs" domain requires effortful analysis with minimal reliance on default values, rather than relatively effortless pattern perception reported in highly visual areas of expertise. For this area, intentional memory is a misleading measure of expertise. However, incidental memory is a valuable measure of processing during diagnosis.

Adult↗
PubMed1989

The development of expertise in dermatology.

To examine the development of expertise in dermatology, accuracy of diagnosis and response times of subjects at five levels of expertise were assessed. A total of 100 slides, 2 typical and 3 atypical slides from each of 20 common skin disorders, were presented to six subjects at each of the following levels: second-year preclinical medical students, final year medical students, residents in family medicine, general practitioners, and dermatologists. Accuracy of diagnosis rose from 21% for medical students to 87% for dermatologists. Correct diagnosis was associated with a decrease in response time with expertise, whereas errors were associated with a dramatic increase in response time, and was slower than correct response times at all levels, suggesting that errors do not result predominantly from carelessness or speed. Typical slides accounted for a constant proportion of diagnostic errors at all higher levels of expertise, and experts continued to make a significant proportion of errors on slides shown to be relatively easy for residents. The results are shown to be at variance with any model that equates expertise with the mastery of complex rules, but they are consistent with models of expertise that propose that expertise is equated with a rapid "pattern-recognition" process, and errors result from unintended confusion with previous similar examples.

Dermatology↗
PubMed1988

Malignant fibrous histiocytoma in a cat.

A malignant histiocytoma of the carpus and distal portion of the right antebrachium of a cat was treated by forelimb amputation. The tumor remained in remission 35 months after surgery. The response to treatment in this cat and similar findings reported by others suggest that the biological behavior of malignant fibrous histiocytoma is such that prolonged remission, if not cure of the disease, can be achieved with early radical excision of the tumor.

Animals↗
PubMed1986

Cytologic differentiation of benign from malignant canine mammary tumors.

Cytologic and histologic examination of 91 canine mammary masses was performed by two cytologists and two histopathologists. Ten important cytologic criteria of malignancy for canine mammary tumors were identified. A cytologic grading system for differentiation of benign from malignant mammary tumors was proposed using these criteria. With this system, approximately one fourth of the malignant mammary tumors were given a concordant cytologic diagnosis. Approximately one-half of the benign masses were given a concordant cytologic diagnosis by the two cytologists. One-half of all the tumors examined were given inconclusive cytologic diagnoses by both cytologists. The cytologic identification of spindle cells did not differentiate complex and mixed mammary tumors from simple tumors. Only five of the animals studied died of mammary cancer, precluding a critical analysis of the cytologic criteria for prediction of cancer mortality.

Animals↗
PubMed1972

Liver resection.

Explore the source record for details and available documents.

Accidents, Traffic↗
PubMedDate not supplied

Analgesic effect of the transdermal fentanyl patch during and after feline ovariohysterectomy.

OBJECTIVE: To evaluate the efficacy of the transdermal fentanyl patch in relieving perioperative pain and stress associated with ovariohysterectomy in cats. STUDY DESIGN: Prospective laboratory trial. ANIMALS: Twenty-four female, purpose-bred cats. METHODS: Each cat was randomly assigned to groups 1-3. Group 1 received a 25-microg/h transdermal fentanyl patch only. Group 2 received the patch and anesthesia. Group 3 received anesthesia only. Patches were left in place for 72 hours. Rectal temperature, heart rate, respiratory rate, indirect blood pressure, blood glucose, serum cortisol concentration, plasma fentanyl concentration, pain score, and excitement/sedation score were monitored at prescribed intervals over an 81-hour period. Cats from groups 1-3 were reassigned to groups 4 and 5. Group 4 received the patch, anesthesia, and an ovariohysterectomy. Group 5 received anesthesia and an ovariohysterectomy only. The study period and monitored parameters were the same as for groups 1-3. RESULTS: Serum cortisol concentrations were significantly lower in group 4 than group 5 during the surgical and early postsurgical time periods. A similar effect was noted in blood glucose concentrations during the surgical period. Rectal temperature was significantly higher in group 2 when comparing all anesthetized groups during the early postsurgical period. Pain scores were significantly higher in groups 4 and 5 than in groups 2 and 3 during the early postsurgical period. There was no significant difference in pain scores between groups 4 and 5 during this period, however. CONCLUSIONS: The transdermal fentanyl patch affects biochemical markers of perioperative pain and stress associated with ovariohysterectomy in cats, attenuating rises in serum cortisol and blood glucose concentrations during the surgical and early postsurgical periods. CLINICAL RELEVANCE: The transdermal fentanyl patch is effective in alleviating perioperative pain and stress associated with ovariohysterectomy in cats as evidenced by attenuated rises in cortisol and blood glucose concentrations in cats that were operated on and treated with the patch.

Administration, Cutaneous↗
PubMedDate not supplied

A comparison of two methods of partial pancreatectomy in the dog.

Partial pancreatectomy was performed in 9 dogs by dissection and ligation of the pancreatic ductule and blood vessels, and in 10 dogs by a suture fracture technique. The dogs were evaluated for detrimental effects by (1) monitoring clinical signs and serum amylase and lipase activities and (2) examining the excision sites grossly and histologically at necropsy. There were no clinically apparent detrimental effects with either technique. The suture fracture technique evoked more histologic inflammation than the dissection and ligation technique.

Amylases↗
PubMedDate not supplied

Treatment of trochanteric ulcers with cranial sartorius and rectus femoris muscle flaps.

Five dogs with pressure ulcers over the greater trochanter were treated by debridement and transposition of the cranial part of the sartorius or the rectus femoris muscle. Both muscles had vascular anatomy that allowed transposition based on a major vascular pedicle. All wounds healed promptly by primary intention and no ulcer recurred. The cranial sartorius flap technique was easier to perform than the rectus femoris technique.

Animals↗