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Biomedical subjects

B A Anderson

Publications and source records attributed to B A Anderson.

At least 19 recordsLinked to original sources
PubMed1999

Compromised antioxidant status and persistent oxidative stress in lung transplant recipients.

Oxidative stress may be a key feature, and hence important determinant, of tissue injury and allograft rejection in lung transplant recipients. To investigate this, we determined the antioxidant status (urate, ascorbate, thiols and alpha-tocopherol) and lipid peroxidation status (malondialdehyde) in bronchoalveolar lavage (BAL) fluid and blood serum of 19 consecutive lung transplant recipients 2 weeks and 1, 2, 3, 6, and 12 months post-surgery. BAL fluid and blood samples from 23 control subjects and blood from 8 patients two days before transplantation were obtained for comparison. Before surgery, the antioxidant status of patients was poor as serum ascorbate and total thiol concentrations were significantly (p < 0.05) lower than control subjects. Two weeks post-surgery, ascorbate and total thiol concentrations were still low and urate concentrations had fallen compared to control subjects (p < 0.01). At this time, BAL fluid urate concentration was higher (p < 0.01), ascorbate concentration was lower (p < 0.01) and reduced glutathione concentrations were similar to control subjects. MDA, a product of lipid peroxidation, was higher (p < 0.01) in both BAL fluid and serum obtained from transplant patients compared to control subjects. During the first 12 months post-surgery, little improvement in antioxidant status or extent of lipid peroxidation was seen in transplant recipients. Regression analysis indicated no difference in serum or BAL fluid antioxidant status in patients with acute rejection compared to those without. In conclusion, lung transplant recipients have a compromised antioxidant status before surgery and it remains poor for at least the first year following the operation. In addition, these patients have elevated MDA concentrations in both their lung lining fluid and blood over most of this time. Oxidative stress is not, however, a sufficiently sensitive endpoint to predict tissue rejection in this group.

Adult↗
PubMed1996

High-dose thiopentone for open-chamber cardiac surgery: a retrospective review.

PURPOSE: High-dose thiopentone has been reported to reduce the incidence of neurological dysfunction after open-chamber cardiac surgery. However, this technique delays tracheal extubation and increases requirements for inotropic support after cardiopulmonary bypass. As a quality assurance measure to determine the safety of high-dose thiopentone, we reviewed the records of all patients undergoing elective, open-chamber surgery at our institution between 1st March, 1987 and 31st Dec, 1989. METHODS: The charts of 236 patients were reviewed retrospectively, and 227 met our inclusion criteria. The perioperative characteristics of patients anaesthetized with thiopentone (Group T, n = 80) were compared with those of patients anaesthetized with opioids (Group O, n = 147). RESULTS: Anaesthetic technique was chosen by the attending anaesthetist. in Group T (n = 80) thiopentone 38.1 +/- 11.8 mg.kg-1 was infused to produce electroencephalographic burst-suppression during bypass. Moderate hypothermia and arterial line filtration were used during bypass. The groups did not differ with respect to demographics, type of surgery, or conduct of bypass. There were no strokes in Group T and 4 in Group O (P = NS). The time to extubation was prolonged in Group T compared with Group O (39 +/- 51 vs 27 +/- 24 h, P = 0.014), as was the duration of stay in intensive care (66 +/- 56 vs 51 +/- 29 h, P = 0.010). Thiopentone did not increase the need for inotropic or mechanical support after bypass. In-hospital mortality was lower in Group T than in Group O (1.2% vs 9.5%, P = 0.034). CONCLUSION: High-dose thiopentone delays extubation after open-chamber procedures. However, the technique appears safe, and further prospective investigation is justifiable.

Anesthesia, Intravenous↗
PubMed1995

Dual inhibition of angiotensin-converting enzyme and neutral endopeptidase in rats with hypertension.

Angiotensin converting enzyme (ACE) and neutral endopeptidase (NEP), are two mechanistically similar enzymes involved in the metabolism of several vasoactive peptides. Selective inhibitors of ACE are effective antihypertensive agents in high-renin, renovascular rats and normal-renin, spontaneously hypertensive rats (SHR), but are not effective in the low-renin, deoxycorticosterone acetate (DOCA)-salt hypertensive rats. In contrast, NEP inhibitors are only effective in the low-renin model of hypertension. Treatment with a combination of selective inhibitors or with a dual inhibitor of both enzymes produces an antihypertensive response regardless of basal plasma renin activity. In this study, we compared the activities of MDL 100,173, a novel subnanomolar inhibitor of both ACE and NEP, with those of equimolar doses of captopril, a selective ACE inhibitor, following intravenous administration in these three rat models of hypertension. Treatment with MDL 100,173 significantly lowered blood pressure compared to vehicle treatment in all three models, whereas captopril treatment lowered blood pressure in the renovascular and SHR models only. Administration of MDL 100,173 also significantly elevated diuresis and natriuresis compared to either vehicle or captopril treatment in the SHR and DOCA-salt rats. Urinary excretion of atrial natriuretic peptide (ANP) was increased by MDL 100,173 treatment in all three models of hypertension. Treatment with captopril did not alter urine, sodium, or ANP excretion in any of the models. However, plasma-renin activity was elevated by both MDL 100,173 and captopril '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' ''''''''

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1995

Characteristics of substance-abusing veterans attempting suicide: a national study.

Demographic, diagnostic, and service utilization characteristics of veterans diagnosed with suicide attempt, substance dependence, both, or neither at discharge from Department of Veterans Affairs (DVA) hospitals in fiscal year 1994 (FY94) were compared using the DVA's discharge abstract database. Four groups of veterans were studied: (1) substance-abusing suicidal inpatients (n = 1,459), (2) substance-abusing nonsuicidal inpatients (n = 123,808), (3) nonsubstance-abusing suicidal inpatients (n = 632), and (4) nonsubstance-abusing nonsuicidal inpatients (n = 402,906). Substance-abusing suicidal veterans had higher rates of substance abuse than substance-abusing nonsuicidal veterans. Substance-abusing suicidal veterans had a higher mean number of inpatient treatment episodes and a larger proportion of discharges against medical advice than the other three inpatient groups. Psychiatric and substance use disorders are more prevalent among substance-abusing suicidal veterans than among veterans with only substance use disorders or suicidal conduct.

Adult↗
PubMed1994

Cost-effectiveness of home relaxation training for tension headaches.

Taped home relaxation training was evaluated in a single-case replication design across three patients suffering from tension headaches. Data from daily headache diaries indicated that headache frequency decreased substantially for two of the patients. For the third patient who reported almost continual headache pain, intensity was reduced by over 50%. When compared with results of our previous research taped home relaxation training appeared as effective as (and therefore, more cost-effective than) live clinic relaxation training.

Adolescent↗
PubMed1994

Oral sumatriptan: effect of a second dose, and incidence and treatment of headache recurrences.

Oral sumatriptan in a dose of 100 mg aborts about 60% of migraine attacks within 2 h, but the headache may recur within 24 h. We investigated: (i) the incidence of headache recurrence after oral sumatriptan (ii) whether a second tablet of sumatriptan at 2 h increases initial efficacy and/or (iii) prevents headache recurrence and (iv) whether a further tablet of sumatriptan treats headache recurrence. In a randomized parallel-group clinical trial, 1246 patients treated one to three migraine attacks (with or without aura), with 100 mg oral sumatriptan. Two hours later they all took a double-blind randomized second table of sumatriptan (group I) or placebo (group II). Patients who initially improved, but then experienced headache recurrence took a further double-blind randomized tablet of sumatriptan or placebo. Proportions of patients who improved from moderate/severe headache to mild/none were similar in groups I and III at 2 h (55 vs 56%) and 4 h (80 vs 77%). Incidences of headache recurrence (moderate/severe-any grade of headache) and median times to headache recurrence were also similar: 22-32% at 16 h in group I and 25-33% at 16.5 h in group II. Sumatriptan was superior to placebo in treating headache recurrence: 74 vs 49% (p = 0.017) in group I and 70 vs 30% (p = 0.0001) in group II. Thus, one-fourth of patients experience headache recurrence at about 16 h after successful treatment of a migraine attack with 100 mg oral sumatriptan. A second tablet of sumatriptan at 2 h does not increase initial efficacy and neither prevents nor delays headache recurrence.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1994

A retrospective study of the diagnostic accuracy of a community hospital-based PET center for the detection of coronary artery disease using rubidium-82.

UNLABELLED: A retrospective analysis has been carried out to determine the diagnostic accuracy of PET of the heart with 82Rb at a community hospital based center. METHODS: Utilization statistics were derived from a total of 1460 patients scanned for the first 36 mo of the center's operation. Diagnostic accuracy for detection of coronary artery disease (CAD) was assessed using three readers blinded to the clinical information. A total of 287 rest and dipyridamole-stress scans of patients who had coronary angiograms within 6 mo of the PET scan were selected by the computer for this study. Each rest/stress scan was read by at least two of the three readers. RESULTS: The average sensitivity for all three readers was 87% for greater than 67% diameter stenosis and the average specificity was 88% for myocardial regions perfused by normal coronary arteries. The average accuracy was 88% for patients with greater than 67% diameter stenosis. Sensitivity and accuracy improved to 92% and 91% respectively for stenosis greater than 90% in diameter. CONCLUSION: These results compare well with published results from major hospital-based centers and the recently published results from a private PET center in Georgia.

Coronary Angiography↗
PubMed1994

The validity of survey responses on abortion: evidence from Estonia.

This paper presents results of a validation survey of abortion conducted in Tallinn, Estonia in April and May 1992. The sample was drawn from patient records in a maternity hospital. Women who had an abortion in that hospital in 1991 were asked about recent abortions as part of a survey about women's health. More than 80% of the respondents reported having a recent abortion. Some respondents misreported their abortion as a miscarriage. Moreover, some variation in reporting was associated with respondents' characteristics. Ethnic Estonians were less likely to report their abortion than were Russians, women over age 40 were less likely to report the abortion than younger women, and women who had the abortion late in the first trimester were less likely to report that abortion. There was some evidence that unmarried women were less likely than married women to report their abortion, and that women who had borne three or more children were less likely to report their abortion than women who had borne fewer children. These differences probably stem from the extent to which pregnancy or abortion is considered stigmatizing for women in different situations.

Abortion, Legal↗
PubMed1993

Endoscopic carpal tunnel release. A new approach to carpal tunnel syndrome.

Endoscopic carpal tunnel decompression is a new and effective way of relieving CTS. It shortens the recovery period and the length of time required to resume normal postoperative activity. The majority of our patients have experienced relief of symptoms and, in instances where the opposite hand was affected by CTS, have returned for that hand to be surgically repaired. Because there is less trauma with this method, and because of the patient's rapid recovery, it is common to perform bilateral releases. It is thought that patients who require surgical intervention will choose to have the procedure done sooner because of the availability of endoscopy, thereby decreasing the incidence of entrapment neuropathy that occurs late in the CTS process.

Carpal Tunnel Syndrome↗
PubMed1993

Eosinophilic leukaemia with trisomy 8 and double gammopathy.

Prolonged eosinophilia of unknown cause has generally been described as the hypereosinophilic syndrome, and is characterised by peripheral blood and bone marrow infiltration and frequent multisystem disease. The nature of this disorder has been questioned, and the clinical features are quite variable, suggesting its heterogeneity and probable neoplastic aetiology. A patient with severe eosinophilia, karyotype abnormalities, serum gammopathy and massive organ disease is reported. The clinical course was aggressive despite cytoreduction of eosinophils and terminated in multisystem failure. These findings are consistent with a diagnosis of eosinophilic leukaemia, and it is suggested that chromosome and cell culture studies might be useful in the early diagnosis of this controversial entity.

Aged↗
PubMed1992

Treatment integrity of relaxation training for tension headaches.

Treatment integrity procedures, generally lacking in previous research, were employed for evaluation of relaxation training for tension headaches. Treatment integrity is the extent to which the therapist implements the relaxation procedure as described, and the degree to which the patients comply with the therapist's instructions. Objective compliance with the home practice of relaxation training was assessed using a microcomputer-based method which required the patient to squeeze a hand control when instructed to tense a muscle. A single-case replication design with three tension headache patients was used. The dependent variables were taken from patients' self-reported daily headache data. Results indicate that: (a) the therapist accurately adhered to the relaxation training protocol; (b) headache frequency decreased in all patients from baseline to 1-year follow-up (improvements ranged from 72.7% to 98.2%); and (c) improvement was greater with higher compliance.

Adult↗
PubMed1992

A simple measure of fertility control.

We describe a simple measure of fertility control: the proportion of all births from the age-specific fertility schedule that occurs among women by age 35. This measure has broad applicability because it does not require information on marital fertility rates. When both the proportion of births by age 35 and the most commonly used measure of fertility control, m, are calculated for a population over time, they are correlated very highly. Because of increasing levels of nonmarital fertility in several developed countries, measures of fertility control that are based on marital fertility are less appropriate now than in the past.

Adult↗
PubMed1991

Probucol reduces myocardial dysfunction during reperfusion after short-term ischemia in rabbit heart.

The effects of probucol, a lipophilic antioxidant, on the myocardial dysfunction (stunning) observed during reperfusion after 15-min ischemia in rabbit heart were studied. Rabbits received food with or without 1% probucol for 3 weeks. They were then anesthetized and prepared for recording of myocardial segment shortening, arterial blood pressure (BP), left ventricular pressure (LVP), rate of development of LVP (dP/dt), and a lead II ECG. Regional myocardial ischemia was produced by acute occlusion of the first marginal branch of the left coronary artery. Myocardial segment shortening was depressed after reperfusion in control rabbits. In comparison, myocardial segment shortening was significantly greater in probucol-treated rabbits than in control rabbits during reperfusion, indicating a beneficial effect. No hemodynamic or ECG changes measured could explain this difference. The number of premature ventricular contractions was reduced in the probucol-treated group, although the incidence of ventricular tachycardia (VT) and ventricular fibrillation (VF) were not. Concentrations of probucol in serum and heart of five rabbits were 15.0 +/- 1.2 micrograms/ml and 17.5 +/- 2.5 micrograms/g (mean +/- SEM), respectively. Only probucol concentrations in the serum were positively correlated with the improvement in myocardial segment shortening (r = 0.91, p = 0.03). We conclude that a clinically relevant serum concentration of probucol reduces ischemia-induced myocardial stunning in the rabbit.

Animals↗
PubMed1991

Protection against postischemic myocardial dysfunction in anesthetized rabbits with scavengers of oxygen-derived free radicals: superoxide dismutase plus catalase, N-2-mercaptopropionyl glycine and captopril.

Postischemic myocardial dysfunction in canine myocardium has been reported to be reduced by scavengers of oxygen-derived free radicals. One potential source of oxygen-derived free radicals in canine myocardium is xanthine oxidase, but human and rabbit myocardium either lack or possess very low levels of this enzyme. Therefore, the effects of scavengers of oxygen-derived free radicals on postischemic myocardial dysfunction produced by 15 min of ischemia and 3 h of reperfusion were evaluated in vivo in the rabbit. Superoxide dismutase (SOD) (45,000 U/kg) and catalase (55,000 U/kg) were given into the left atrium 10 min before ischemia, and followed by an additional 45,000 U/kg of SOD and 55,000 U/kg of catalase given over 85 min. This treatment reduced postischemic myocardial dysfunction, as did sulfhydryl-containing free radical scavengers N-2-mercaptopropionyl glycine (4 mg/kg, i.v.) and captopril (3 mg/kg, i.v.) given 5 min before and 60 min after reperfusion. SOD given alone at the same dose was ineffective, as was enalaprilat (0.3 mg/kg, i.v.), an angiotensin-converting enzyme inhibitor that does not scavenge oxygen-derived free radicals. Thus, postischemic myocardial dysfunction was reduced by scavengers of oxygen-derived free radicals in vivo in a species that is deficient in myocardial xanthine oxidase. This suggests that oxygen-derived free radicals derived from a source other than xanthine oxidase play a role in postischemic myocardial dysfunction.

Anesthesia↗
PubMed1990

Predictors of stroke outcome using objective measurement scales.

We set out to determine if rehabilitation variables predicted the motor and functional outcomes of stroke patients. Using the Modified Motor Assessment Scale (motor status) and the Barthel Index (functional status), we tested 50 stroke patients less than or equal to 3 days, 1 week, and 1 month after their stroke and at discharge from the hospital. Both measures are reliable and valid. We used the Spearman correlation coefficient (r) and stepwise regression analysis to analyze the data. Balanced sitting and bladder control scores at 1 week correlated significantly with motor score at discharge (r = 0.83), Barthel Index score at discharge (r = 0.82), and walking score at discharge (r = 0.80). The combined arm score at 1 month correlated significantly with the combined arm score at discharge (r = 0.94). Regression equations using the scores at 1 month produced the highest r2 values (range 0.76-0.95) in predicting the Barthel Index, motor, walking, and arm recovery scores at discharge. The correlation coefficients and the regression equations have uses in both research and clinical settings. We suggest that these objective predictors of recovery be used as adjuncts in prioritizing and directing the rehabilitation management of patients with stroke.

Adult↗
PubMed1989

Differentiating multiple personality disorder and complex partial seizures.

A number of reports have suggested that some cases of multiple personality disorder might be due to temporal lobe epileptic discharges. We have administered a structured interview, the Dissociative Disorders Interview Schedule, to 20 subjects with multiple personality disorder, 20 with complex partial seizures, and 28 neurologic controls. Subjects also completed the Dissociative Experiences Scale. Results show that multiple personality can be differentiated from complex partial seizures on a large number of items. The seizure patients did not differ from controls. The data indicate that the phenomenologies of these two disorders are distinct, and, therefore, there is little reason to assume a common etiology.

Adult↗