Search PubMed⌕ Search

Biomedical subjects

T Vargish

Publications and source records attributed to T Vargish.

At least 55 records · Page 3Linked to original sources
PubMed1983

Duodenal trauma in the rural setting.

During the past 15 years, 21 patients with duodenal injuries were treated at the University of Iowa Hospitals and Clinics. The major cause of injury (66.6%) was blunt abdominal trauma. Eighteen patients (85.7%) underwent celiotomy. Only one patient (4.7%) had an isolated duodenal injury. In most cases, a careful exploration of the periduodenal area and lesser sac was necessary to diagnose and treat the injury. No one specific procedure was used in these patients. The use of Penrose drains did not prevent abscess formation in three of nine patients. Overall mortality was 23.8 per cent, but most deaths were related to other serious injuries. Only one death (4.7%) was directly related to the duodenal injury. In the rural setting, duodenal injuries are rare, but when they occur they are frequently the result of blunt trauma. These injuries are commonly associated with other obvious problems and may be easily overlooked. Because the preoperative diagnosis is difficult, careful intraoperative examination of the entire duodenum is mandatory.

Adult↗
PubMed1982

Naltrexone improves survival rate and cardiovascular function in canine hemorrhagic shock.

The possible involvement of opiate receptors in the cardiovascular depression associated with hypovolemic shock was investigated. Opiate receptor blockade with naltrexone increased mean arterial pressure, cardiac output, stroke volume and left ventricular contractility in dogs bled to a mean arterial pressure of 45 mm Hg. Naltrexone also increased survival rate. At high doses, naltrexone adversely affected cardiac performance which may outweigh its advantages of greater potency and putatively longer action than naloxone, at least in the dog. Similar actions with another opiate antagonist gives further proof for endogenous opiate involvement in the cardiovascular pathophysiology of hypovolemic shock.

Animals↗
PubMed1982

Naloxone without transfusion prolongs survival and enhances cardiovascular function in hypovolemic shock.

The hypothesis that opiate receptors are involved in the cardiovascular pathophysiology of hypovolemic shock was tested by using the opiate receptor antagonist naloxone. Naloxone increased mean arterial pressure, cardiac output, stroke volume and left ventricular dP/dtmax in a canine hemorrhagic shock model. Naloxone treatment also prolonged survival time. All these responses were dose-dependent and were independent of blood reinfusion. It is concluded that endorphins activated by stress act on opiate receptors to bring about some of the cardiovascular abnormalities in hypovolemic shock.

Animals↗
PubMed1981

Opiate receptors and endorphins in the pathophysiology of hemorrhagic shock.

We investigated the hypothesis that endorphins released by stress act on opiate receptors to depress cardiovascular function during hemorrhagic shock. Anesthetized adult mongrel dogs were bled into a heparinized reservoir to achieve a mean arterial pressure (MAP) of 45 mm Hg. The reservoir was adjusted to maintain MAP for 1 hour and then clamped for 1 hour, at the end of which time the shed blood was reinfused. While the reservoir was clamped we treated the animals with an intravenous bolus followed by 3-hour infusion of either 0.9% NaCl (as control) or the specific opiate receptor antagonist naloxone at three dose regimens (0.5, 1, or 2 mg/kg plus 0.5, 1, or 2 mg/kg . hr). Naloxone produced dose-dependent increases in MAP, cardiac output, stroke volume, and left ventricular contractility. Survival at 72 hours was related to the dose of naloxone used. None of six dogs treated at 0 mg/kg . hr survived, one of six survived at 0.5 mg/kg . hr, four of five at 1 mg/kg . hr, and five of five at 2 mg/kg . hr. Since naloxone has minimal effect on cardiovascular function in nonshocked dogs, these results implicate opiate receptors and perhaps endorphins in the cardiovascular pathophysiology of hemorrhagic shock.

Animals↗
PubMed1980

Naloxone reversal of hypovolemic shock in dogs.

The endogenous opiate ligand, beta-endorphin, is released during stress. We tested the hypothesis that endorphins may be involved in the pathophysiology of hemorrhagic shock by using the opiate receptor blocking agent, naloxone. Two groups of five anesthetized dogs were instrumented to monitor cardiovascular performance and subjected to a protocol in which they were bled into a reservoir to lower mean arterial pressure to 45 mmHg and maintained at that pressure for one hour. At that time the reservoir was clamped and on group of dogs received an intravenous bolus of naloxone (2 mg/kg) and an infusion at 2 mg/kg-hr. These dogs demonstrated a prompt increase in arterial pressure, left ventricular dp/dtmax and cardiac output. The shed blood was returned at t = 2 hr and drug infusion continued for 2 hours. The control group of dogs received saline in equivalent volume. The control dogs died within 30 minutes of clamping the reservoir while all five treated dogs survived beyond 72 hours (P less than 0.02). These data suggest the involvement of endorphins acting on opiate receptors as part of the pathophysiology in this shock model.

Animals↗
PubMed1978

A randomized prospective evaluation of orally administered antibiotics in operations on the colon.

In this randomized, prospective study of 91 patients undergoing operations on the colon, we found that neomycin, neomycin-phthalylsulfathiazole and neomycin-erythromycin base all provided adequate intestinal antisepsis. Wound infection rates for all groups were also similar and close to the national average for operations on the colon. A detailed analysis of the wound infections in our series revealed that 60 per cent of these infections were from organisms different from those found on the colonic mucosa. This evidence indicates the possible advantage of parenteral antibiotic therapy to achieve adequate tissue levels of antibiotics not presently possible with orally administered agents.

Administration, Oral↗
PubMed1977

Canine kidney preservation: comparison of "intracellular", "extracellular," and high molecular weight dextran flushing solutions.

The effects of modified Collins-2 solution, adjusted lactated Ringer's solution, and a solution containing dextran 70 on kidney preservation and red blood cell (RBC) washout in dogs were evaluated. Excised kidneys were stored on ice for 24 hours and then reimplanted, at which time the contralateral kidney was removed. RBC washout from the preserved kidneys was measured at the time of initial cold flush. For 20 days after transplantation, serial measurements were made of serum creatinine, blood urea nitrogen, creatinine clearance, serum and urine osmolality, blood pH, and dog weight. No one solution cleared RBCs from the kidneys better than the other solutions. Renal function was significantly better in transplanted kidneys flushed and preserved with the Collins-2 solution than that in kidneys flushed and preserved with the other two solutions. There was generally no significant difference in function between kidneys preserved with dextran and those preserved with lactated Ringer's solution. Our findings suggest that the electrolyte composition of the flush solution may be more important than maintaining a high osmolality in the flush solution in the preservation of renal function during 24 hours' cold storage.

Animals↗