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Biomedical subjects

A Banning

Publications and source records attributed to A Banning.

16 recordsLinked to original sources
PubMed1997

Local delivery of platelets with encapsulated iloprost to balloon injured pig carotid arteries: effect on platelet deposition and neointima formation.

Local delivery of a drug to the arterial wall during angioplasty is an approach which might reduce the incidence of occlusive events such as thrombosis and restenosis, without the risk of systemic side effects. By exploiting their natural primary haemostatic properties, platelets, with encapsulated drugs, can be targeted to a vessel wall injury site and act as a depot for sustained release. The platelet plasma membrane can be reversibly permeabilised by high voltage, short duration electrical pulses (electroporation). Drugs will diffuse into porated platelets and become trapped on resealing. We have studied the effects of autologous platelets, electroloaded with the stable prostacyclin analogue, iloprost on platelet deposition and neointima formation in a pig carotid angioplasty model. Iloprost loaded or control platelets were delivered locally and immediately to the balloon injured site using a double balloon delivery catheter. Acute platelet deposition was measured using 111-Indium, and neointima formation at 21 days post angioplasty was assessed by morphometric analysis. In pigs treated with iloprost loaded platelets, platelet deposition on the artery at 2 hours post injury was dramatically reduced (to approximately monolayer coverage), when compared with arteries from pigs treated with control platelets. In pigs with deeply injured arteries, i.e. with extensively ruptured internal elastic lamina (IEL), platelet deposition was reduced by 88% compared with control arteries (118 +/- 20 x 10(6)/cm vs. 14 +/- 2 x 10(6)/cm, means +/- SI, 2P < 0.001). In minimally injured arteries (IEL intact) a 65% reduction in platelet deposition was observed (55 +/- 24 x 10(6)/cm vs. 19 +/- 3 x 10(6)/cm. 2P < 0.002). A high concentration of free iloprost, delivered to the angioplasty site, with control platelets, had far less effect on platelet deposition, substantiating the advantage of platelet encapsulation. At 21 days post injury, morphometry of the carotid arteries after treatment with iloprost loaded platelets showed significant reductions in intimal area and intimal/medial ratios in minimally injured vessels (P < 0.05) as compared with vessels from pigs treated with control platelets. With deeply injured vessels, the mean differences (control vs. treated) for the same morphometric parameters were not significant. This novel approach of electro-encapsulating drugs within autologous platelets, and using them as highly biocompatible and biodegradable drug targeting vehicles might, with the appropriate choice of encapsulated agent, have potential for reducing the incidence of occlusion after angioplasty and thrombolysis procedures.

Animals↗
PubMed1994

Physiological pacing improves symptoms and increases exercise capacity in the elderly patient.

We evaluated the benefits of physiological pacing in the elderly by recruiting 13 subjects > 75 years of age, already fitted with a physiological pacing system. All had been paced for complete or Mobitz II heart block. Double blind cross over study was performed comparing exercise capacity, measuring distance walked on a 6-min walking test and time taken to climb two flights of stairs; and symptoms, evaluated by an activity of daily living questionnaire, in atrioventricular synchronous and ventricular pacing. Mean distance walked was significantly higher in atrioventricular synchronous than in ventricular pacing (360 +/- 65 m vs. 327 +/- 69 m; P < 0.01). No significant difference was found in the ability to climb stairs but there was a marked improvement in the symptomatic questionnaire score, 19 +/- 5 in physiological pacing increasing to 28 +/- 10 with ventricular. Physiological pacing in the elderly produces an increase in exercise tolerance and improves symptoms; therefore, age alone should not be a contraindication to a physiological system.

Activities of Daily Living↗
PubMed1992

Reaction time in cancer patients receiving peripherally acting analgesics alone or in combination with opioids.

Continuous Reaction Time (CRT) was measured in cancer patients receiving peripherally acting analgesics either alone (n = 16) or in combination with opioids (n = 16). Comparison was performed matching the patients from each group for age and performance status. Statistically significant prolongations of CRT and higher sedation scores were seen in the opioid group, while performance status did not have any influence on CRT.

Acetaminophen↗
PubMed1991

Pain causes in 200 patients referred to a multidisciplinary cancer pain clinic.

Causes of pain were analysed in 200 patients referred to a specialized cancer pain clinic. Pain caused by tumour growth was found in 158 patients, pain secondary to cancer or its treatment in 116 patients and pain unrelated to cancer in 33 patients. Visceral involvement (74 cases), bone metastases (68 cases), soft tissue invasion (56 cases) and nerve/plexus pressure or infiltration (39 cases) were the most frequent causes of pain due to tumour growth. Myogenic pain (68 cases) was the most frequent cause of secondary pain. The patients presented with a multitude of different combinations of causes of pain, the majority having at least two separate causes. Since pain treatment in cancer patients should be determined by its aetiology, a detailed analysis of the pain condition in each patient should form the basis for a rational therapy.

Adolescent↗
PubMed1990

Cerebral effects of long-term oral opioids in cancer patients measured by continuous reaction time.

Cerebral function was studied in a group of 34 cancer patients being treated with stable doses of 30-920 mg morphine/24 h using measurement of continuous reaction time. Sedation visual analog scale, pain visual analog scale and time from last medication were registered. This group was compared to a group of 32 healthy controls taking no opioids. Small but statistically significant prolongations of continuous reaction time were seen in the opioid group. Analgesic dose and sedation visual analog scales were weakly positively correlated to continuous reaction time, but factors other than opioid treatment must influence cancer patients' performance of continuous reaction time.

Administration, Oral↗
PubMed1989

Mother-son incest: confronting a prejudice.

This paper examines the proposition that the incidence of child sexual abuse by female perpetrators is underestimated. This may be due to a culturally based unwillingness to believe that women commit such acts. Female sexual offenders have been little studied and poorly understood. Until recently mother-child incest was considered to be virtually nonexistant and there remains a huge discrepancy in the incidence of male and female offenders. The predisposing factors contributing to this situation are examined for both men and women and an illustrative case history of mother-son incest is used to highlight our prejudices. The tentative conclusions reached are that (1) we underestimate the incidence of sexual abuse of male and female children by women and that (2) the changing roles of men and women in Western societies may lead to an increase in such abuse.

Female↗
PubMed1989

Pain, sedation and reaction time during long-term treatment of cancer patients with oral and epidural opioids.

Continuous reaction times (CRTs) and subjective assessment of pain intensity (PVAS) and sedation (SVAS) were compared in 14 cancer patients during chronic oral opioid therapy (daily doses of morphine: 130-400 mg) and subsequent stable epidural opioid therapy (daily doses of morphine: 32-240 mg). CRTs were also measured in 20 healthy controls. CRT results were summarized using 10%, 50% and 90% percentiles. On the basis of these values a 'variation index' was calculated (90-10%): 50%, describing the spread of the reaction time values. No statistically significant differences were found in PVAS, SVAS and CRT before and after initiation of epidural opioid administration. Calculation of confidence limits of median differences showed absolutely no tendency towards differences in CRT between the treatments. Only 4 patients experienced both increased pain relief and less sedation on epidural opioids. Comparing CRT percentiles of the cancer patients with the controls, differences were found between the control group and the oral opioid group, the latter being statistically significantly slower in the 90% percentiles (P = 0.018) and variation indexes (P = 0.018). In conclusion, no differences were found between CRT values and VAS scores in cancer patients treated with chronic oral opioids versus epidural opioids. Therefore at this dose level of chronic opioid treatment, the advantage of epidural administration seems questionable.

Administration, Oral↗
PubMed1984

Recurrent abdominal pain in children.

Recurrent abdominal pain in the child is a common and difficult problem for practitioners. To resolve whether its origin is organic or psychogenic takes time and patience. Investigation is made more difficult by the fact that parents and doctors are happier if the pain has an organic basis; in the great majority of children it is caused by stress.

Abdomen↗
PubMed1979

The attraction of opposites--an object-relations understanding of family interaction over three generations.

Severely dysfunctional families who manifest diametrically opposed, but complementary characteristics in the marital partners and in their children can be understood and treated in terms of Fairbairn's object-relations theory and the concept of ego-splitting. A family history is presented where these problems can be traced through three generations--both maternal and paternal sets of grandparents, parents and finally the children, boy and girl twins. Therapy was initially family-based and directed at helping the parents remove their projections and foci of differences from their children onto themselves. Later the marital dyad was treated intensively looking at the whole marital relationship, the collusions to maintain the splitting and finally enabling each partner to accept the split-off part of himself as belonging to himself instead of being projected onto his partner.

Adult↗