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Biomedical subjects

A Garrison

Publications and source records attributed to A Garrison.

7 recordsLinked to original sources

A prospective assessment of mortality in chronic spinal cord injury.

STUDY DESIGN: Prospective mortality study. OBJECTIVE: To assess the relationship between comorbid medical conditions and other health-related factors to mortality in chronic spinal cord injury (SCI). SETTING: Boston, MA, USA. METHODS: Between 1994 and 2000, 361 males >/=1 year after injury completed a respiratory health questionnaire and underwent pulmonary function testing. Cause-specific mortality was assessed over a median of 55.6 months (range 0.33-74.4 months) through 12/31/2000 using the National Death Index. RESULTS: At entry, mean (+/-SD) age was 50.6+/-15.0 years (range 23-87) and years since injury was 17.5+/-12.8 years (range 1.0-56.5). Mortality was elevated (observed/expected deaths=37/25.1; SMR=1.47; 95% CI=1.04-2.03) compared to US rates. Risk factors for death were diabetes (RR=2.62; 95% CI=1.19-5.77), heart disease (RR=3.66; 95% CI=1.77-7.78), reduced pulmonary function, and smoking. The most common underlying and contributing causes of death were diseases of the circulatory system (ICD-9 390-459) in 40%, and of the respiratory system in 24% (ICD-9 460-519). CONCLUSIONS: These results suggest that much of the excess mortality in chronic SCI is related to potentially treatable factors. Recognition and treatment of cardiovascular disease, diabetes, and lung disease, together with smoking cessation may substantially reduce mortality in chronic SCI.

Adult↗

Circulatory responses to progressive exercise: insights from positional differences.

The influence of body position on cardiac responses to progressive exercise was examined in 13 healthy circumpubertal boys. The subjects (mean age 12.5 +/- 1.4 y) performed a progressive cycle test with an identical protocol in the sitting and supine positions. Stroke volume and left ventricular dimensions were assessed with Doppler and two-dimensional echocardiography, respectively. During supine exercise, no changes were seen in stroke volume or left ventricular preload (end-diastolic dimension) with increasing exercise intensity. At rest, mean values for stroke volume and cardiac output were 16.4 % and 27.1 % lower, respectively, with subjects upright compared to supine. With upright exercise these variables rose to become insignificantly different than supine values. Stroke volume while cycling upright rose by 29 % by the second workload but remained stable at higher work intensities. The initial increase in stroke volume observed only when cycling upright presumably reflects mobilization of dependent blood in the lower extremities. The mechanisms governing cardiac responses to exercise when supine and upright are otherwise identical.

Adolescent↗

Antipyretic therapy in patients with sepsis.

Sepsis is a clinical syndrome characterized by a systemic inflammatory response to infection. Mortality rates in sepsis have remained high, despite recent advances in our understanding of the immunological mechanisms that cause sepsis. Fever, a nonspecific acute-phase response, has been associated with improved survival and shortened disease duration in some infections. This article reviews the biological effects of fever and the influence of antipyretic therapy on the outcome in sepsis in experimental models and in humans and offers clinical recommendations for antipyretic therapy in early and late stages of the disorder.

Analgesics, Non-Narcotic↗