Search PubMed⌕ Search

Biomedical subjects

T Treasure

Publications and source records attributed to T Treasure.

At least 181 records · Page 10Linked to original sources
PubMed1987

The use of a new glycopeptide antibiotic, teicoplanin, in the treatment of bacterial endocarditis.

Teicoplanin, a new glycopeptide antibiotic, has been used to treat twelve patients with bacterial endocarditis due to Gram-positive organisms. Teicoplanin has activity against Gram-positive bacteria similar to vancomycin but therapeutic levels are maintained by a single daily dose, given as an intravenous bolus. Of six patients with native valve infections, two cases, due to viridans streptococci, were successfully treated with teicoplanin alone and two others, caused by Streptococcus faecalis, were cured by combinations including teicoplanin. One of these patients sustained high tone hearing loss during treatment. The remaining two patients were drug addicts with endocarditis due to Staphylococcus aureus which recurred despite repeated multiple therapy. Of six prosthetic valve infections, antibiotic combinations including teicoplanin cured three cases, caused by streptococci. Infection persisted or treatment was curtailed in three cases of Staphylococcus epidermidis endocarditis. In this small open study, teicoplanin appeared as effective as vancomycin in the treatment of endocarditis but had the considerable advantage of ease of administration.

Anti-Bacterial Agents↗
PubMed1987

Modifications of electrode design for recording monophasic action potentials in animals and humans.

An Ag-AgCl electrode for recording monophasic action potentials by pressure contact is described. The electrode is mounted in a hand-held support designed for epicardial recordings during open-heart surgery from both the anterior and lateral walls of the left ventricle with minimal displacement of the heart. The support allows the electrode to be manipulated without the need for direct vision by the surgeon to any desired position while ensuring perpendicular apposition of the electrode without risk of damage to the myocardium. The permanently mounted electrode is also suitable for animal experiments. The electrode may be used for endocardial recordings in animals by direct puncture. Either a straight or curved electrode may be chosen as dictated by the recording site. The monophasic action potentials recorded by this electrode are of a high quality in terms of configuration, lack of drift, and amplitude.

Action Potentials↗
PubMed1986

Use of monophasic action potential recordings during routine coronary-artery bypass surgery as an index of localised myocardial ischaemia.

In 8 patients undergoing routine coronary-artery bypass surgery, monophasic action potentials (MAPs) were measured by means of a hand-held pressure contact electrode to provide an index of local ischaemic changes. 4 patients received left internal mammary anastomoses (LIMA), and there were a total of 27 saphenous vein grafts (SVG). After completion of all grafts blood-flow to the myocardium was reduced for 90 s by means of different permutations of SVG and LIMA occlusion, either on or off bypass. In all patients MAPs indicated typical ischaemic changes. The high sensitivity of the method enables the study to be completed quickly and without hazard to the patient. The technique provides a new means to assess local ischaemia, the viability of specific areas of myocardium, and the efficiency of individual grafts during surgery.

Action Potentials↗
PubMed1986

Cerebral consequences of cardiopulmonary bypass.

55 patients undergoing coronary-artery bypass surgery (CABS) and a comparison group of 20 patients having thoracic or major vascular surgery were investigated preoperatively and 8 days and 8 weeks postoperatively for changes in neuropsychological status, psychiatric state, cerebral blood flow, and neurological signs, this last being assessed also at 24 h. Major persisting neurological changes were rare, but minor abnormalities were significantly more common after CABS than after thoracic or vascular surgery. Neuropsychological deficits were common at 8 days in both CABS and comparison groups, and in about a third of all patients persisted at 8 weeks. Cerebral blood flow was reduced at 8 days in some CABS patients, but this was not significant for the group. Pre-existing cerebrovascular disease was not predictive, but low perfusion pressure and long bypass time were associated with postoperative deficits.

Adult↗
PubMed1986

A scoring method (ASEPSIS) for postoperative wound infections for use in clinical trials of antibiotic prophylaxis.

To compare antibiotic regimens for their effectiveness in preventing or treating wound sepsis, well-defined criteria for outcome are needed. A method of assessing wound healing has been devised that defines carefully the characteristics to be considered and how they are to be awarded points. Objective criteria are also included in the assessment. Points are given for the need for Additional treatment, the presence of Serous discharge, Erythema, Purulent exudate, and Separation of the deep tissues, the Isolation of bacteria, and the duration of inpatient Stay (ASEPSIS).

Anti-Bacterial Agents↗
PubMed1986

A clinical trial of teicoplanin compared with a combination of flucloxacillin and tobramycin as antibiotic prophylaxis for cardiac surgery: the use of a scoring method to assess the incidence of wound infection.

A prospective randomized clinical trial is in progress to compare the efficacy of teicoplanin with flucloxacillin and tobramycin in the prevention of endocarditis and wound infection following cardiac surgery. To date, 198 patients have completed the trial, of whom 95 have received teicoplanin and 103 flucloxacillin and tobramycin. One patient developed prosthetic valve endocarditis 3 months after surgery covered by flucloxacillin and tobramycin. There was no significant difference in the incidence of sternal wound infection (P = 0.15). Severe sternal sepsis occurred in four patients in the teicoplanin group and two in the flucloxacillin/tobramycin group. There were more postoperative urinary tract infections among those given teicoplanin (15 of 95 patients compared to six of 103 patients P less than 0.05). The trial continues.

Anti-Bacterial Agents↗
PubMed1986

Changes in pressor hormone concentrations in association with coronary artery surgery. Renin and vasopressin responses.

In 10 patients undergoing routine coronary artery surgery, plasma renin activity and vasopressin concentration were measured at intervals before the induction of anaesthesia, and for 6 h after bypass. In three patients plasma renin activity was increased, but the increases followed no particular pattern. Vasopressin concentrations increased in all 10 patients, but the changes were not significantly correlated with the postoperative arterial hypertension that was seen in seven of the patients.

Adult↗
PubMed1986

Changes in plasma vasopressin concentration in association with coronary artery surgery or thymectomy.

Plasma vasopressin concentrations in 14 patients undergoing coronary artery surgery were compared with those in eight patients undergoing thymectomy. Vasopressin concentrations increased similarly in both groups on sternotomy. A second, and more marked increase was noted in the patients requiring cardiopulmonary bypass. Haemodynamic stimuli could be responsible in both groups and might explain both the similarities and the differences between the groups.

Adult↗
PubMed1986

Antibiotic prophylaxis in cardiothoracic surgery in the United Kingdom: current practice.

A survey was conducted of the current practice of antibiotic prophylaxis in cardiac surgery throughout the United Kingdom. Most surgeons (84%) use a regimen covering a broad spectrum of bacterial species that is continued for two to three days after the operation. The most used regimens are a combination of beta lactamase resistant penicillin with an aminoglycoside (44%) or a single broad spectrum cephalosporin (30%). Just 16% of surgeons preferred a narrow spectrum regimen effective against only the Gram positive organisms commonly responsible for postoperative infection in these patients. Antibiotic prophylaxis has been adopted by all cardiac surgeons in the United Kingdom but is sometimes continued longer than is indicated by the clinical or experimental evidence.

Aminoglycosides↗
PubMed1986

Left recurrent laryngeal nerve palsy as the presenting feature of sarcoidosis.

We report a case of sarcoidosis in which the presenting features were hoarseness of voice, hilar lymphadenopathy and paralysis of the left recurrent laryngeal nerve. Sarcoidosis does not usually enter into the differential diagnosis in this situation, which almost invariably implies the presence of malignant disease, particularly either lymphoma or bronchial carcinoma.

Adult↗
PubMed1986

Measurement of potassium concentration on-line with an ion-specific electrode during hemodialysis.

Patients requiring hemodialysis for end-stage renal disease are vulnerable to wide fluctuations in plasma potassium concentration [K+]p. Dialysis of K+ can result in rapid and large changes of [K+]p and result in significant morbidity. Since blood is routinely diverted extracorporeally to the dialyzer, the measurement of [K+]p could be made 'on-line' in this circuit with an ion-selective electrode (ISE) with negligible additional risk. Valinomycin/tetraphenylborate embedded in polyvinylchloride (PVC) electrodes of high K:Na selectivity were manufactured in our laboratory. The electrodes were calibrated in vitro and placed in a T diverter tube upstream from the dialyzer. Intermittently small amounts of blood were diverted to flow past the electrode allowing measurement of the electrical potential developed between the ISE half cell and a Ag:AgCl electrode placed 4 mm from the valinomycin membrane which could be read as [K+]p ISE. Blood flowing through the T diverter was then collected in glass tubes for measurement of [K+]p by flame photometry. Forty-six comparative measurements were made for 6 patients who had given informed consent for study. Least squares regression analysis for all observations gave a correlation coefficient of 0.95 and a regression equation of y = 1.1 X -0.39. Only six samples were discrepant by 0.5 mmol/l, and all of these had [K+]p greater than 5.0 mmol/l where the ISE measurements were less precise. Although the correlation of the two techniques was less than perfect, the ISE shows potential utility for monitoring trends of [K+]p instantaneously during hemodialysis.

Electrodes↗