PubMed Health⌕ Search

Biomedical subjects

A R Kelly

Publications and source records attributed to A R Kelly.

12 recordsLinked to original sources
PubMed1986

Pneumocystis pneumonia in a patient with normal chest roentgenograms and normal arterial blood gas values.

For unknown reasons, manifestations of even heavy opportunistic infection in AIDS patients may be chronic and subtle. We have presented the second fully reported case of an AIDS patient with symptomatic Pneumocystis carinii pneumonia in whom the usual screening tests of blood gases and chest roentgenography were normal to all observers. Diffusing capacity for carbon monoxide can be an early and sensitive indication of PCP.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Determination of valproic acid in plasma or serum by solid-phase column extraction and gas-liquid chromatography.

A simple, fast, sensitive, and inexpensive method is described for routine therapeutic monitoring of both total and free valproic acid (VPA) at therapeutic concentrations in seizure patients. The method uses solid-phase (Bond Elut) columns for the preliminary extraction of 100 microliters plasma or serum and gas-liquid chromatography (GLC) analysis, using 10% Carbowax 6000 on a Chromosorb WAW 80/100 column and alpha-methyl-alpha-ethylcaproic acid as an internal standard. The extraction efficiency for VPA at a concentration of 70 micrograms/ml is 98 +/- 4%. The calibration curve is linear in the range of 1.0-280 microliters/ml. The detection limit of VPA is 1.0 micrograms/ml. Syva enzyme multiplied immunoassay technique (EMIT) Free-Level filters were used in the analysis of free VPA from plasma. The described Bond Elut X GLC (BE X GLC) method was used to determine total drug concentrations in 56 VPA-treated patients, and the results were compared with those obtained by conventional liquid-liquid extraction X GLC analysis. The 44 sera involved were also analyzed by EMIT. In addition, BE X GLC was compared with the Abbott TDx system on an additional 21 specimens. Statistical agreement was excellent between BE X GLC and TDx, but poor between BE X GLC and liquid-liquid extraction X GLC. Agreement with the EMIT method was intermediate.

Chromatography, Gas↗
PubMed1984

An evaluation of a new patient compliance index using plasma propranolol levels.

Propranolol levels in plasma were studied in relation to dose prescribed in order to assess poor compliance with antihypertensive treatment. Fifty consecutive ambulatory patients (36-81 years) having hypertension, including 19 with azotemia, were investigated. Patient interviews using questionnaires and chart reviews were used to evaluate compliance. A composite Compliance Index was calculated for each patient. Individual oral doses of propranolol ranged from 20 to 160 mg. Subsequent plasma levels were determined by high performance liquid chromatography. Good correlation between last oral dose (mg) per body weight (kg) and log plasma propranolol levels were observed in patients whose compliance indices were above the mean for this sample (r = 0.74, p less than 0.01), when blood pressure control was satisfactory (r = 0.66) or excellent (r = 0.78), and when serum creatinines were greater than or equal to 1.4 (r = 0.76, p less than 0.001). Poor correlations between dose and propranolol levels suggest poor compliance with treatment.

Adult↗
PubMed1984

Endotracheal bretylium tosylate in a canine model.

This study was conducted to determine whether bretylium tosylate (BT) is effectively and safely absorbed through the endotracheal route in the canine model. Eleven adult mongrel dogs were anesthetized with pentobarbital, were orally intubated, and had continuous blood pressure and electrocardiographic monitoring. Four dogs received 5 mg/kg BT, three dogs received 10 mg/kg BT, two dogs received 20 mg/kg BT, and two control dogs were given volumes of normal saline equal to those given the 5- and 10-mg/kg groups. Each dog received the same dose of BT both endotracheally and intravenously, but in a random order and on different dates. Following each drug administration arterial blood was drawn at various intervals over two hours and sent for immediate gas analysis; serum samples were frozen for future determination of BT levels. Regardless of the amounts delivered, the peak levels of BT in the arterial blood following administration by the endotracheal route were consistently low (4.13 micrograms/mL to 14.00 micrograms/mL) when compared to those levels following intravenously administered BT (120 micrograms/mL to 268 micrograms/mL) (all P less than .002 for the 5- and 10-mg/kg groups). No depot effect was observed during a two-hour period. The arterial blood gases did not change significantly following the administration of BT by the endotracheal route in the 5- and 10-mg/kg groups, and sections of these autopsied dog lungs showed no apparent pathologic changes.

Animals↗
PubMed1981

Chronic training with static and dynamic exercise: cardiovascular adaptation, and response to exercise.

To determine the acute and chronic effects of static and dynamic exercise upon the cardiovascular system, two groups of athletes were studied and compared to untrained control individuals. Thus, 12 long distance runners (LDR) and 17 competitive weight lifters (CWL) were compared to 10 light controls (LC) and 14 heavy controls (HC). The echocardiographically measured left ventricular mass (LVM) was shown to be increased in both groups of athletes. When this mass was related to lean body mass, the LDR demonstrated a significantly increased LVM, whereas the CWL had a LVM similar to that of the HC. During static handgrip exercise, the LDR maintained a relative bradycardia and, consequently, a lower calculated double product when compared to the LC, whereas the CWL reacted similarly to the HC. Further, the LDR demonstrated higher end-diastolic and higher end-systolic volume indices than the LC during static exercise. The exercising stroke volume index and the cardiac index were, however, not significantly different in the LDR compared to the LC. In contrast to the LDR, the cardiovascular dynamics of the CWL changed in a manner very similar to that of the HC during static exercise. This information suggests, therefore, that endurance training alters both the absolute and relative left ventricular mass and the response of the cardiovascular system to static exercise. On the other hand, static exercise training increases the absolute but not the relative left ventricular mass. Also, the immediate hemodynamic response to static exercise is similar in athletes who train with this form of exercise compared to untrained control subjects.

Adult↗
PubMed1980

Echocardiographic left ventricular masses in distance runners and weight lifters.

Sixty individuals including 17 competitive weight lifters (CWL), 12 competitive long-distance runners (LDR), 7 amateus (noncompetitive) weight lifters (AWL), 14 heavy controls (HC), and 10 light controls (LC) were studied at supine rest with echocardiographic determination of the left venticular mass (LVM) by the Penn convention. Lean body mass (LBM) was estimated by the Wilmore-Behnke method. The absolute LVM (mean +/- SE) was increased in the two competitive athlete groups compared to controls (LDR: 195 +/- 12; CWL: 190 +/- 10 vs. LC: 122 +/- 10; HC: 151 +/- 9 g). The AWL had a mass (174 +/- 20 g) intermediate between the LDR-CWL and the HC-LC groups. A significant (P = 0.033) correlation of LVM was found with LBM although the correlation coefficient was low (r = 0.276). Normalizing LVM by LBM revealed a significantly higher mass for LDR compared to all other groups but equalized CWL and HC (LDR: 3.2 +/- 0.2; CWL: 2.5 +/- 0.1; AWL: 2.5 +/- 0.2; HC: 2.3 +/- 0.2; LC: 2.0 +/- 0.2 g). These data suggest that training for competitive long-distance running (dynamic training) elevates LVM compared to nonathletic controls and CWL. On the other hand, training for weight lifting (static training) increases absolute LVM but only to the extent that LBM is increased.

Adult↗
PubMed1980

Cardiovascular responses to static exercise in distance runners and weight lifters.

Sixty individuals including 17 competitive weight lifters (CWL), 12 competitive long-distance runners (LDR), 7 amateur (noncompetitive) weight lifters (AWL), 14 heavy controls (HC), and 10 light controls (LC) were studied at supine rest and during static exercise at 40% of maximal voluntary contraction. Blood pressures were similar in all groups at rest (R) and exercise (EX), but the heart rate (HR) and calculated double product (DP) of the LDR were lower at rest (HR: 53 +/- 2.9 beats/min, DP: 6,346 +/- 402) and at fatigue (HR: 78 +/- 5.4 beats/min. DP: 12,739 +/- 1,011) compared to the control group (R-HR: 69 +/- 2.2 beats/min, DP: 8,553 +/- 372; EX-HR: 97 +/- 3.5 beats/min, DP: 16,345 +/- 836). The LDR demonstrated higher end-diastolic volume index (EDVI) and higher end-systolic volume index (ESVI) at rest (EDVI: 84 +/- 3.7, ESVI: 31 +/- 2.7 ml/m2) and at the time of fatigue (EDVI: 90 +/- 5, ESVI: 37 +/- 2.7 ml/m2) compared to the LC group (R-EDVI: 61 +/- 4.4, ESVI: 22 +/- 2.2; EX-EDVI: 75 +/- 3.4, ESVI: 27 +/- 3.2 ml/m2). The CWL, AWL, and control groups had similar HR, DP, and cardiac volumes at rest and during exercise. These data suggest that competitive endurance (dynamic exercise) training alters the cardiovascular response to static exercise. On the other hand, weight lifting (static exercise) training does not alter the cardiovascular response to static exercise.

Adult↗
PubMedDate not supplied

Alcohol and the auditory brain-stem response, brain temperature, and blood alcohol curves: explanation of a paradox.

A previous study found temperature-independent effects of alcohol upon the auditory brain-stem response (ABR): another found only temperature-dependent effects. To understand these paradoxical results, we measured the ABR and brain temperature in unrestrained rats before and after 3 alcohol doses (0.5, 2.5 and 5.0 g/kg). In a separate experiment, blood ethanol concentration (BEC) curves were determined for the same 3 alcohol doses. Integration of dose- and time-related effects of alcohol upon the ABR, brain temperature, and BEC suggested that alcohol has both temperature-dependent and temperature-independent effects, which vary according to dose and BEC curve phase. Temperature-dependent effects are likely during a BEC curve falling phase with a steep slope, following a high alcohol dose. Temperature-independent effects are likely during a BEC curve falling phase with a flatter slope, when BEC is still high following a moderate alcohol dose, or during a BEC curve rising phase soon after alcohol administration. The two previous studies with contradictory results each used procedural combinations likely to produce their respective results. Although both research groups administered similar alcohol doses, their alcohol solutions, administration routes, and time of ABR recording differed; consequently, they probably recorded ABR during different portions of BEC curve falling phases, which differed in slope. In view of the complex interactions among alcohol effects, BEC curve phase, temperature, and the ABR, we recommend temperature measurement during alcohol-ABR studies.

Analysis of Variance↗