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Biomedical subjects

A A Spence

Publications and source records attributed to A A Spence.

At least 19 recordsLinked to original sources
PubMed1991

Nitrous oxide and formiminoglutamic acid: excretion in surgical patients and anaesthetists.

We have investigated the possible toxicity of nitrous oxide on vitamin B12 and its sequelae upon folic acid metabolism using the urine formiminoglutamic acid excretion test, an index of the functional state of folate metabolism. Ten control subjects not exposed to nitrous oxide and five patients receiving limb surgery under local anaesthesia excreted normal amounts of formiminoglutamic acid in urine for 6 days. Fifty patients received nitrous oxide anaesthesia for similar surgery and, of these, 22 had a dose-dependent increase in excretion on the first 2 days after operation. There were large individual variations. Exposure to 70% nitrous oxide appeared to cause abnormal metabolism of folate when exposure was greater than 90 min. Ten anaesthetists demonstrated normal excretion of formiminoglutamic acid; their exposure to nitrous oxide was typical of that in other studies of theatre environmental pollution.

Adult↗
PubMed1991

Cross-sectional study of complications of inhalational anaesthesia in 16,995 patients.

Patients undergoing anaesthesia in which halothane, enflurane or isoflurane were used, were surveyed with reference to 16 unwanted effects selected by the nominal group method. A simple record card was completed at the time of anaesthetic administration. The overall incidence of complications was 13.9%. One complication was reported in 10.8% of the cases, and more than one in 3.1%. Complications were more frequent in the obese, the elderly and those patients receiving isoflurane, but in view of the small overall use of this agent, the anaesthetists involved may still have been on a learning curve.

Adolescent↗
PubMed1991

Pain after surgery.

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Analgesics, Opioid↗
PubMed1990

Comparison of candidates who passed or failed the final (Part Three) examination for the F.F.A.R.C.S. (Eng.) in 1988.

All 484 candidates for the 1988 Fellowship in Anaesthesia (Part Three) were surveyed to investigate any differences between successful and unsuccessful candidates in study techniques, work and domestic factors, and examination history that might lead to better guidance to those preparing for the examination and an improvement in the current success rate of less than 30%. Candidates' views were sought also on the examination process. The response rate was 67%. Forty-two percent of respondents passed the examination. Forty-seven percent of successful and 55% of unsuccessful candidates considered their clinical workload was excessive. Successful candidates reported better departmental support, more systematic and adequate preparation, and a better knowledge of the scope of the examination. Unsuccessful candidates were more likely to have had a personal or family crisis or change in job which impeded their preparation for the examination. Almost 50% of all respondents were unhappy with the method of announcing results.

Achievement↗
PubMed1990

Comparison of i.m. ketorolac trometamol and morphine sulphate for pain relief after cholecystectomy.

I.m. ketorolac trometamol 30 mg was compared with morphine sulphate 10 mg after cholecystectomy in a double-blind, multiple dose, randomized study of 100 patients. Assessments of pain were made immediately after operation (day 1), and the next morning (day 2). Pain intensity (verbal response score and visual analogue scale) was recorded before injection and then over a 6-h period. Pain relief was assessed also. The effect of ketorolac on operative blood loss and platelet function was examined. Time to commencing oral intake and the duration of administration of i.v. fluids were recorded. Adverse events were noted. Ketorolac produced significantly less analgesia than morphine on day 1, but on day 2 the two drugs produced a similar effect. Blood loss was not increased by ketorolac, although platelet function was impaired. Repeated i.m. administration of ketorolac did not produce any serious adverse effects.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1979

Reports by anaesthetists to procurators-fiscal: analysis of "anaesthetic deaths" over 10 years in four Scottish teaching hospitals.

Review of 489 "anaesthetic deaths" reported to procurators-fiscal over 10 years disclosed only 30 that were thought to justify such reporting. Most of the remainder occurred in patients so desperately ill at the time of operation that death was expected. Postmortem examinations ordered by the Crown authorities in nearly all cases were probably largely unrewarding and mostly unnecessary. The results suggest that the present regulation on reporting should be revised to focus more attention on the few deaths that occur in patients who have no apparent contraindication to anaesthesia or operation.

Adult↗
PubMed1979

Fatty acid positional specificity in phospholipids of L1210 leukemia and normal mouse lymphocytes.

The positional distribution of fatty acids in the choline and ethanolamine phosphoglycerides of the L1210 murine leukemia cells was determined and compared to that of normal mouse lymphocytes. The major phospholipids of both cell types had appreciable degrees of positional specificity as evident from the higher percentage of saturated fatty acids in position 1 and of polyunsaturated fatty acids in position 2. The L1210 cells had less arachidonate and more linoleate in position 2 of choline and ethanolamine phosphoglycerides as compared to the normal lymphocytes. However, there were similar proportions of saturated, monoenoic and polyenoic fatty acids in positions 1 and 2 of the phospholipids of the L1210 leukemia cells and the lymphocytes, These data demonstrate that fatty acid positional specificity is retained in the major phospholipids of this rapidly growing tumor.

Animals↗
PubMed1979

A modification of the MGA 200 mass spectrometer to enable measurement of anaesthetic gas mixtures.

The measurement of anaesthetic gas mixtures with a mass spectrometer is complicated by the overlap of fragmentation products of the anaesthetics with the normal respiratory gas. For the MGA 200 quadrupole instrument the problem has been overcome by incorporating simple circuitry which, for an appropriate mass number, sums the concentrations of the unwanted fragments and subtracts them from the total output for the particular channel; this provides an accurate and stable system (within +/- 1% f.s.d.) over at least 24 h.

Anesthetics↗
PubMed1979

Glycopyrrolate as a premedicant: comparison with atropine.

A double-blind comparison of glycopyrrolate with atropine as the anticholinergic component of premedication was made in 200 patients undergoing minor or intermediate surgical procedures. Glycopyrrolate was associated with a smaller increase in heart rate, but there was no difference between the drugs in respect of cardiac arrhythmia, change in arterial pressure, control of secretions in the upper respiratory tract, frequency of nausea and vomiting after operation or subjective well-being of the patients.

Adolescent↗
PubMed1977

Occupational hazards for operating room-based physicians. Analysis of data from the United States and the United Kingdom.

Comparative analysis of data from three large retrospective surveys in the United States and the United Kingdom reaffirms an increased incidence of spontaneous abortion among female physicians working in the operating room. The live-born children of female physicians exposed in the operating room also had substantially more congenital abnormalities. Male anesthetists, compared with nonanesthetist physicians, had an increased incidence of hepatic disease; there was also an increased frequency of congenital abnormality in their children. The incidence of spontaneous abortion in wives of male anesthetists and in the rate of cancer among exposed male anesthetists was similar to control. Despite differences in survey methods and analysis, there was remarkable agreement in conclusions to be drawn from the independent studies.

Abnormalities, Drug-Induced↗