PubMed Health⌕ Search

Biomedical subjects

A F Kirkpatrick

Publications and source records attributed to A F Kirkpatrick.

At least 19 recordsLinked to original sources
PubMed1998

A protocol-contract for opioid use in patients with chronic pain not due to malignancy.

The legal, psychosocial, and medical factors that we believe have contributed to the success of our protocol-contract in prescribing opioids to patients with chronic pain not due to malignancy are outlined. These factors may be applicable to the treatment of a variety of chronic nonmalignant pain syndromes such as postherpetic neuralgia or human immunodeficiency virus/acquired immunodeficiency syndrome. The intended target audience of this paper is the physician (primary care, chronic pain specialist) who is involved in prescribing opioids for the treatment of chronic, nonmalignant pain.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Role of the USA in shortage of food and medicine in Cuba.

For over 30 years an embargo by the USA has restricted Cuba's ability to purchase foods and medicines. In 1992, the USA enacted the Cuban Democracy Act (CDA), which "exempted" the sale of medicines from the embargo. However, the implementation of the CDA's requirements and the intensification of the embargo as a result of the passage of the Helms-Burton Act in March, 1996, have undermined the purpose of the medicine exemption. The resultant lack of food and medicine to Cuba contributed to the worst epidemic of neurological disease this century. The Inter-American Commission on Human Rights of the Organization of American States has informed the US Government that such activities violate international law and has requested that the US take immediate steps to exempt food and medicine from the embargo.

Commerce↗
PubMed1994

The time has come to lift the economic embargo against Cuba.

The United States embargo against Cuba, which makes trade illegal, contributes to that country's death and disease. The policy is obsolete, counterproductive and should be changed to bring peace between the two nations and help restore the health of the Cuban people. Along with the ban on trade is the ban on traveling. The United States' controls contradict the most fundamental values upon which this country stands. Despite current restrictions, physicians can travel to Cuba and they should in order to observe the island's system for themselves.

Aged↗
PubMed1986

The inhibitory effect of esmolol on human plasmacholinesterase.

Esmolol, a new cardioselective beta adrenergic blocker inhibits plasmacholinesterase activity in vitro. The concentration of esmolol hydrochloride that inhibits by 50 per cent the hydrolysis of 50.0 mumol.L-1 benzoylcholine hydrochloride by 1:200 diluted, heparinized pooled plasma of six healthy volunteers at 37 degrees C and 240 nm, determined by the ultraviolet spectrophotometric method of Kalow, was 50 mumol.L-1. Esmolol's primary metabolite, 3-[4-(2-hydroxy-3-(isopropylamino)propoxy)-phenyl]propionic acid, had an I50 = 190 mumol.L-1. The benzoylcholine hydrolysis rates in the plasma of ten patients who received an esmolol infusion of 500 micrograms.kg-1.min-1 for 4 minutes were 58.6 +/- 6.2 mumol.hr-1.ml-1 (mean +/- SE) before and 55.1 +/- 6.6 mumol.hr-1.ml-1 after the infusion. The benzoylcholine hydrolysis rates in the plasma of ten patients who received an esmolol infusion of 500 micrograms.kg-1.min-1 for two minutes and 200 micrograms.kg-1.min-1 for an additional two minutes were 70.2 +/- 8.9 mumol.hr-1.ml-1 before and 69.1 +/- 9.5 mumol.hr-1.ml-1 after the infusion. The pre- and post-infusion plasmacholinesterase activities were not significantly different. Since plasmacholinesterase is responsible for the hydrolysis of succinylcholine and that of the ester-type local anaesthetics this lack of in vivo interaction of esmolol with the hydrolysis of these drugs should be further confirmed by experiments with these combinations in man.

Anesthesia↗
PubMed1985

Ultra-long-duration local anesthesia produced by injection of lecithin-coated methoxyflurane microdroplets.

This study was designed to evaluate a new drug delivery system. The authors undertook to determine if microdroplets prepared by encapsulating volatile anesthetics with a membrane of lecithin could be used for local anesthesia. Local anesthesia was determined by monitoring the response of the rat to tail clamping and electrical stimulation of the skin following the intradermal injection of the microdroplets. Microdroplets were prepared from isoflurane, enflurane, halothane, methoxyflurane, diethyl ether, chloroform, and heptane. Although all microdroplet preparations produced local anesthesia, only methoxyflurane microdroplets produced an ultra-long duration of local anesthesia (approximately 24 h). Further characterization of the methoxyflurane microdroplets revealed two important differences from conventional local anesthetics. First, the local anesthetic effect of methoxyflurane reached a plateau that did not change significantly for 20 h while the injection of lidocaine and bupivacaine resulted in a peak effect that returned to baseline within 1 and 3 h, respectively. Second, the anesthetic effect of methoxyflurane remained essentially localized to the site of injection, while the anesthetic effect of lidocaine and bupivacaine migrated 15 cm in less than 1 h. The toxicity and safety of methoxyflurane were evaluated. When administered over the dosage range 1-16% (v/v) intradermally, or by injections into muscle, or by repeat injections every 4 days for 16 days, all animals regained their pretreatment response to painful stimulations, and there was no evidence of gross injury to tissue. Deliberate intravenous injection of 0.8 ml of 6.7% (v/v) methoxyflurane microdroplets had no apparent anesthetic or toxic effect. The present study demonstrates that methoxyflurane microdroplets produce an anesthetic effect that is highly localized, stable in intensity, ultra-long in duration, and reversible.

Anesthesia, Local↗