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Biomedical subjects

B A Tolliver

Publications and source records attributed to B A Tolliver.

7 recordsLinked to original sources
PubMed1998

Patient-controlled anesthesia for colonoscopy using propofol: results of a pilot study.

BACKGROUND: We studied the feasibility of using patient-controlled anesthesia (PCA) for conscious sedation during colonoscopy. METHODS: Patients having elective colonoscopy had medications delivered in bolus fashion by PCA pump (Abbot Lifecare Provider 5500 Infusion System). Four patients received propofol as 20 mg/dose boluses, and four patients received propofol in a 0.3 mg/kg/dose. Twelve patients received propofol at 0.2 mg/kg/dose with alfentanil at 4 microg/kg/dose. RESULTS: There were no clinically unacceptable changes in continuously monitored blood pressure, pulse rate, ECG, or respiratory rate. There were no adverse effects from the sedation and no complications due to colonoscopy. Recovery time was rapid, but recall persisted in most subjects. Pain and overall discomfort in patients given propofol only were rated as moderate by most subjects. CONCLUSION: Patient-controlled anesthesia is feasible for use in endoscopic sedation. Propofol alone did not allow adequate pain relief, but propofol and alfentanil together seemed to provide good control of pain.

Adolescent↗
PubMed1997

The alternate iron transport pathway: mobilferrin and integrin in reticulocytes.

Iron transport in reticulocytes is known to occur via the well-described transferrin-receptor-endosome pathway. An alternative pathway for iron transport independent of transferrin has been postulated in reticulocytes and other cells. Transport of iron into reticulocytes from ferric citrate solutions was shown to be saturable and independent of transferrin. During transport of iron from ferric citrate, both cell surface integrins, and a soluble protein, mobilferrin, were labelled. This demonstrated that the reticulocyte transferrin independent pathway for iron transport involved integrins and mobilferrin similar to intestinal absorptive cells. This pathway would be expected to transport iron into cells under conditions of iron overload and was capable of providing iron for haemoglobin synthesis. Mobilferrin was also radiolabelled when radioiron labelled transferrin was incubated with reticulocytes and this occurred with a different time course than was observed following reticulocyte exposure to radiolabelled ferric citrate. This suggested that mobilferrin may serve as an intermediary in both pathways.

Animals↗
PubMed1997

Elevated tumor-associated antigen CA 19-9 in a patient with an enlarged pancreas: does it always imply malignancy?

Carbohydrate antigen 19-9 (CA 19-9) has been used as a serum tumor marker for adenocarcinoma of the upper gastrointestinal tract, particularly primary adenocarcinoma of the pancreas. This tumor marker has also been used to differentiate benign from malignant diseases of the pancreas. However, significant elevations of CA 19-9 levels in the absence of pancreatic malignancy have also been reported. This case illustrates a marked elevation of CA 19-9 due to an infectious process in a patient with a pancreatic mass suggestive of malignancy.

Adult↗
PubMed1996

Does lactose maldigestion really play a role in the irritable bowel?

Patients who met International Congress of Gastroenterology criteria for irritable bowel syndrome (IBS) and had breath hydrogen lactose testing were interviewed to determine whether detection of lactose maldigestion (LM) had an impact on their symptoms. Of 199 patients initially evaluated, 161 (81%) were contacted and asked to rate their symptoms. At baseline, 47 (29%) of the IBS group had LM. Before testing, 23 (49%) were aware that ingestion of lactose-containing food was associated with their gastrointestinal symptoms. Lactose-maldigesting IBS subjects (IBSLM, n = 47) and those who had IBS and no LM (n = 114) were similar in terms of age, sex, and ethnic background. Interviews performed 41 +/- 1.1 (SEM) months after baseline evaluation revealed no significant differences in abdominal pain, altered bowel habits, bloating/distension, mucus, and relief with defecation among those with IBS or LMIBS. Overall symptoms resolved, improved, did not change, or worsened in a manner not statistically different between IBS and IBSLM groups. IBSLM subjects (a) felt that identifying LM helped them gain awareness of food-symptom relationships (78.7%), (b) experienced some improvement in symptoms (83%), (c) were avoiding lactose foods (87.2%), or (d) used lactase enzyme supplements (38.3%). Identifying LM did not significantly affect rated variables.

Breath Tests↗
PubMed1995

Zenker's bezoar.

Zenker's diverticulum has been associated with a variety of symptoms such as dysphagia, regurgitation, aspiration, halitosis, and occasionally cough. In this case, a large Zenker's diverticulum containing a bezoar caused a persistent, debilitating cough presumably due to compression of adjacent neck structures.

Bezoars↗
PubMed1994

Evaluation of patients who meet clinical criteria for irritable bowel syndrome.

OBJECTIVE: To determine which test would yield the most useful clinical data in evaluation of irritable bowel syndrome (IBS). METHODS: One hundred ninety-six patients who met the International Congress of Gastroenterology criteria for irritable bowel syndrome were prospectively evaluated with hematological, biochemical, and metabolic laboratory testing, as well as a structural evaluation of the colon. RESULTS: complete blood count, sedimentation rate (ESR), serum chemistries, thyroid profile, and urinalysis were normal or yielded no useful clinical information. Stool examinations for parasites were also normal. Structural evaluations (barium enema, x-ray, and flexible sigmoidoscopy or colonoscopy) revealed abnormalities, including colon cancer (1), polyps (9), colitis (1), melanosis coli (2), diverticulosis (17), and hemorrhoids (11). Forty-eight subjects (25.8%) had lactose maldigestion confirmed by H2 breath lactose testing. Prior to formal testing, 25 (52%) of these subjects were unaware of the relationship between lactose-containing foods and their symptoms. CONCLUSIONS: 1) ESR, thyroid profiles, and parasite examinations had no diagnostic yield in this study and, without specific clinical indication from history and physical examination, should not be part of the "routine" IBS evaluation. 2) Lactose hydrogen breath testing is encouraged for patients with and without milk intolerance who present with IBS.

Adolescent↗