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Biomedical subjects

A L Hanson

Publications and source records attributed to A L Hanson.

14 recordsLinked to original sources
PubMed2002

Remifentanil sedation compared with propofol during regional anaesthesia.

BACKGROUND: The short onset and offset of remifentanil may allow for accurate dosing of sedative effect with few side-effects and rapid recovery. In this study remifentanil is compared with propofol for sedation during successful regional anaesthetic blocks. METHODS: After informed consent was given, 125 patients undergoing surgery under spinal or brachial plexus anaesthesia were randomized to receive, either propofol: bolus 500 microg/kg plus initial infusion 50 microgkg/min or remifentanil: bolus 0.5 microg/kg plus initial infusion 0.1 microgkg/min. Study drug infusion rate was titrated throughout the procedure according to level of sedation and side-effects. Pain, discomfort, sedation level and side-effects were recorded at regular intervals until discharge from the post operative care unit (PACU). RESULTS: Two patients in the remifentanil group versus ten in the propofol group were treated for discomfort or pain during surgery (P<0.02). Due to a significantly higher rate of respiratory depression (46% vs. 19% with propofol, P<0.01) the mean remifentanil infusion rate was decreased to 0.078 +/- 0.028 microgkg/min, whereas it was kept stable with propofol. Propofol patients had significantly higher (P<0.05) sedation levels and experienced more frequent amnesia of the procedure. Eleven propofol patients experienced pain at injection site, versus two remifentanil patients (P<0.02). Nausea and vomiting were more frequent in the remifentanil patients during infusion (27% vs. 2% in the propofol group, P<0.001) but similar postoperatively. Time to discharge from PACU was similar in the two groups. CONCLUSION: Propofol results in less respiratory depression and nausea when sedation is needed during a case with a successful regional block. Remifentanil may be considered as an alternative if pain during the procedure is a major concern or if amnesia is contraindicated.

Adolescent↗
PubMed1993

Manic syndrome early and late in the course of HIV.

In a chart review at a hospital's infectious disease AIDS clinic, manic syndromes affected 8% of patients who had AIDS. Of the 14 patients with manic episodes, those without a family or personal history of mood disorder presented later in the course of HIV infection and had a higher prevalence of comorbid dementia.

AIDS Dementia Complex↗
PubMed1988

X-ray fluorescence with synchrotron radiation.

The use of synchrotron radiation for X-ray fluorescence has several advantages over the use of other conventional X-ray sources. The principles of synchrotron radiation and methods for applying synchrotron radiation to the X-ray fluorescence measurements of trace elements are discussed. The Brookhaven National Laboratory X-ray microprobe, facilities dedicated to X-ray fluorescence, and related analytical techniques are discussed. Some examples of trace element analyses in biological materials with synchrotron radiation are presented.

Electron Probe Microanalysis↗
PubMed1986

The need for evaluation of the ultimate impact of continuing pharmaceutical education.

Many governmental agencies and professional associations are using continuing education as the single, and relatively untested, means of ensuring that professionals maintain an acceptable level of knowledge and skills. The ultimate goal of continuing education in the health professions is improved professional performance leading to an improvement in the quality of health care provided. However, there is justifiable concern over the lack of a significant link between participation in continuing education activities and professional competence. This issue is explored and a conceptual framework for the evaluation of continuing pharmaceutical education is presented. The conceptual framework is an evaluation hierarchy which depicts the following four levels of a comprehensive evaluation process: participant satisfaction; changes in knowledge, attitudes, and skills; behavior change in practice setting; and improvement in patient care.

Education, Pharmacy, Continuing↗
PubMed1986

Educating today's students to practice pharmacy in the 21st century: reaction from the perspective of continuing education.

In summary, I have described changes which will occur within continuing education to better prepare the pharmacy school graduate to practice in the 21st century. One level of change deals with an attitude toward lifelong learning which in turn affects the efficiency of continuing education. Although some effort to address this issue currently takes place at the undergraduate level, students in the coming years will witness an increased effort recognizing the importance of lifelong learning with appropriate sensitization and nurturing of self-directed study skills to assist in the lifelong learning process. The second level of change focuses on sophistication within CE and involves a significant change, at least by some providers, in program content which will be more rigorous and tailor-made in the needs of individual practitioners. Through increased efficiency and sophistication, continuing education will be perceived differently in the 21st century. Rather than a current view of continuing education as one of many types of postgraduate education and training, continuing education will be viewed as a learning process which encompasses or includes all other types of postgraduate education and training.

Education, Pharmacy, Continuing↗
PubMed1986

Regional distribution of lead in the brains of lead-intoxicated adult mice.

The susceptibility of adult neural tissues to the detrimental effects of Pb poisoning has prompted the present distributional analysis of lead in the brains of chronically lead-exposed mice. A high-resolution microPIXE method was developed for measuring Pb in whole-brain cryosections derived from chronically lead-exposed mice. Spatial resolutions as small as 20 micron were obtained. Details of the methodology are presented together with procedures for Pb standard preparation and control measures employed to reduce potential errors of Pb assay associated with taking brain sections with steel alloy knives. The unique advantages of making microPIXE Pb determinations in nonpreselected brain anatomic regions using freeze-dried semithick cryosections are reviewed. The study revealed that, in lead-intoxicated mice, there existed wide regional variation in Pb concentration in the ppm range, in 50 micron sagittal or coronal sections. Higher Pb levels were found in discrete brain regions of lead-treated adult mice than in matched control brains. Suggestions for further studies of Pb kinetics using microPIXE methods in adults and immature animals, including components of neural barrier tissues, are reviewed.

Animals↗
PubMed1986

Effect of use-criteria for intravenous administration sets.

Numbers of intravenous administration sets used were studied in a 480-bed hospital before and after criteria for selecting sets were implemented. Criteria for use of eight common administration sets were developed by a committee of nurses and pharmacists. Hospital drug-use review was used as a pattern. Baseline data were collected for seven-day periods on each of five patient-care units; twice daily, one pharmacist recorded the numbers of sets used and determined their compliance with the criteria, which had been established but not disseminated to nurses or implemented. After nurses were instructed on use of the criteria, data were collected for a second seven-day period on each unit. Use of each set type as a percentage of all sets and compliant use of each type as a percentage of all compliant use were calculated. Annual hospitalwide cost savings were predicted from the observed changes in use and the hospital's costs in the six-month period before the study. Significant changes occurred in overall use and in use of individual set types. For each set type, use compliant with the criteria increased. Notable changes included decreased use of volumetric chambers (burettes) and increased relative use of Y maxidrip and Y minidrip sets. Annual savings of more than +20,000 were predicted. Criteria for selection of i.v. administration sets had an effect on set use at this hospital.

Anti-Bacterial Agents↗
PubMed1984

Epidural anesthesia for cesarean section. The effect of morphine-bupivacaine administered epidurally for intra and postoperative pain relief.

Two groups of mothers who underwent elective cesarean section under epidural analgesia, were studied with the aim of comparing the analgesic potency and side effects of two solutions: morphine-bupivacaine and morphine-saline. Each group comprised 100 patients. The intraoperative anesthesia was established with bupivacaine plain, 5 mg/ml, in amount 85-125 mg. Immediately after the infant was delivered, the mothers received a single epidural dose of 3 mg of preservative-free morphine chloride mixed with either 5 ml of 0.25% bupivacaine (Group I) or 0.9% saline (Group II). The intraoperative observations showed "good effect" without need for supplementation of analgesia in 82 mothers in Group I, compared with 61 mothers in Group II (p less than 0.001). The postoperative observations showed that 82 mothers in Group I were satisfied with a single dose of morphine for more than 24 hours, while in Group II the corresponding number was 63 (p less than 0.01). A significant difference in the incidence of nausea and vomiting was found between the groups; 7 of the mothers experienced nausea and 4 vomited in Group I and 17 experienced nausea and 13 vomited in Group II (p less than 0.05, for both variables). Respiratory depression was seen in one mother during surgery immediately after supplementation of morphine-bupivacaine analgesia with ketamine. Other side effects, such as itching, bradycardia and Horner's triad were rare. It may be concluded that a single epidural dose of morphine in bupivacaine will augment intraoperative analgesia and prolong postoperative analgesia. Less favorable results were obtained when morphine in saline was used. Synergism between bupivacaine and morphine is suggested.

Adolescent↗
PubMed1983

Mercury toxicity and dental amalgam.

There is adequate evidence that dental amalgam restorations, during and after placement, results in the release of Hg into the patient's body. Whether the Hg released from amalgam is due to placement procedures, surface abrasion, or later corrosion breakdown, there is evidence that a low level Hg release continues for years. It is generally agreed that if amalgam was introduced today as a restorative material, they would never pass F.D.A. approval. With new and more accurate techniques of measuring Hg levels, especially in tissue and blood, additional studies are necessary to relate blood-Hg levels with dental amalgam restorations. Studies must relate existing restorations as well as the placement of new restorations to body-Hg levels. It is possible that we have accepted a potentially dangerous material as being safe.

Dental Amalgam↗
PubMed1979

Juvenile rickets and hyperparathyroidism in the Arctic fox.

Three of seven Arctic fox kits, Alopex lagopus, trapped on St. Paul Island, Alaska, had evidence of rickets and hyperparathyroidism. Radiographic, morphologic and histologic examination confirmed the diagnosis. The disease was presumed to be a juvenile-onset disease due to calcium-deficient intake following weaning. The possibility of insufficient exposure to sunlight could not be determined. No other abnormalities (e.g., genitourinary) were found. Skeletal involvement was quite varied. All growth plates exhibited columnar hyperplasia compatible with rickets, while the metaphyses showed decreased trabeculation and cortical thinning compatible with osteodystrophia fibrosa. One fox had bilateral metaphyseal fractures through this osteodystrophic bone.

Alaska↗
PubMedDate not supplied

An X-ray microprobe facility using synchrotron radiation.

An X-ray microprobe for trace elemental analysis at micrometer spatial resolutions, using synchrotron radiation (SR), is under development. The facility consists of two beamlines, one including a 1:1 focusing mirror and the other an 8:1 ellipsoidal mirror. At present, "white light" is used for excitation of the characteristic X-ray fluorescence lines. Sensitivities in thin biological samples are in the range of 2-20 fg in 100 microns2 areas in 5 min irradiation times. Scanning techniques, as well as microtomography and chemical speciation, are discussed. Application to a specific biomedical study is included.

Animals↗
PubMedDate not supplied

Psychiatric care for patients with HIV infection. The varying perspectives.

This article reviews the literature on the classification and treatment of psychiatric morbidity associated with infection from the human immunodeficiency virus (HIV). The psychiatric disorders seen in HIV-infected patients are formulated by using one of the following four perspectives as treatment guides: 1) the syndromal or disease perspective, 2) the dispositional or personality perspective, 3) the behavioral or addictive perspective, and 4) the life story perspective.

Antipsychotic Agents↗