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Biomedical subjects

D Beckman

Publications and source records attributed to D Beckman.

13 recordsLinked to original sources
PubMed2001

Divalproex sodium in sex offenders with bipolar disorders and comorbid paraphilias: an open retrospective study.

BACKGROUND: This study evaluated divalproex response in sex offenders with a bipolar disorder. METHODS: We reviewed the records of all sex offenders who participated in a residential rehabilitative program who received divalproex for treatment of a bipolar disorder. Patients' mood symptoms and, when present, comorbid paraphilic symptoms, were retrospectively assessed using the CGI severity scale. RESULTS: Sex offenders displayed significant improvement in manic symptoms with divalproex treatment. However, there was no significant improvement in paraphilic symptoms in the subset of patients admitting to these symptoms. CONCLUSION: Divalproex may be effective for manic symptoms in sex offenders with a bipolar disorder. However, for bipolar sex offenders with comorbid paraphilias, the drug may not be effective for paraphilic symptoms. LIMITATIONS: This study was limited by its retrospective, open-label design, lack of systematic means of assessing manic and paraphilic symptoms, and small sample size. CLINICAL RELEVANCE: Divalproex may be a helpful adjunct in the treatment of the subset of sex offenders who have a bipolar disorder.

Adolescent↗
PubMed1996

Utilization of intravenous immunoglobulin to ameliorate alloantibodies in a highly sensitized patient with a cardiac assist device awaiting heart transplantation. Fluorescence-activated cell sorter analysis.

Surgery surrounding the use of mechanical assistance in cardiac transplant candidates often leads to multiple blood/platelet transfusions and subsequent development of alloantibodies. This is a case report of a 50-year-old male patient who had received blood transfusions during coronary bypass grafting 9 years earlier. He presented in acute and chronic heart failure and, despite therapy, became moribund with multisystem organ failure. His ejection fraction was 10%. A Novacor ventricular assist device was implanted on May 19, 1995 (day 0). The patient received 44 U of blood and 20 U of platelets. Although his percent reactive antibodies (PRA) were negative before surgery by fluorescence-activated cell sorter analysis, the PRA 3 days after implantation of the ventricular assist device was 80%; it increased to 100% by day 7. In an attempt to decrease the PRA, intravenous immunoglobulin was given at 3-week intervals. The PRA became negative and the patient received a donor heart that was negative by fluorescence-activated cell sorter cross-match on day 64. On days 69-72, a dramatic increase in alloantibody activity was promptly reversed with additional intravenous immunoglobulin. Currently at posttransplant month 12, the patient shows no humoral, cellular, or vascular evidence of rejection.

Blood Transfusion↗
PubMed1995

The use of tranexamic acid to reduce postoperative bleeding following cardiac surgery: a double-blind randomized trial.

Bleeding during the first 24 hours following cardiac surgery using cardio-pulmonary bypass (CPB) is a serious complication. Attempts to modify the degree of postoperative bleeding with pharmacologic therapy have met with limited success. Tranexamic acid, a potent inhibitor of plasminogen, may decrease the amount of mediastinal bleeding following surgery utilizing CPB. We assigned 30 patients who were about to undergo cardiac surgery to a double-blind randomized trial. The treatment group received tranexamic acid, given intravenously as 10 mg/kg over 30 minutes, at the time of skin incision, followed by a 1 mg/kg/hr infusion for 12 hours. The control group received a placebo (saline) of equal volume. Measurements of shed mediastinal blood and transfused homologous blood were made at 6, 12, and 24 hours postoperatively. Mediastinal blood loss in the treatment and control groups was 382 mL versus 594 mL at 6 hours (P = 0.08), 502 mL versus 848 mL at 12 hours (P = 0.04), and 711 mL versus 1160 mL at 24 hours (P = 0.02). The mean transfusion volumes after 24 hours were 356 mL in the treatment group and 528 mL in the placebo group (P = NS). Prophylactic tranexamic acid infusion decreases mediastinal blood loss following cardiopulmonary assisted cardiac surgery.

Blood Transfusion↗
PubMed1985

Heart transplantation at a private institution: a two year experience.

Since October 1982, 45 patients were referred and 15 underwent orthotopic heart transplantations. Eleven patients are presently alive. The donor heart ischemic time averaged 104 minutes for locally procured hearts and 183 minutes for hearts harvested in distant cities. Ninety-three percent of the patients survived the perioperative period. Survival rate at six months was 84%, at one and two years 72% and 52%, respectively. The one year survivors spent 80% of their time out of the hospital. The average cost for the transplant admission was $58,023. Four patients died 11 days, 57 days, 8 and 12 months after the operation. During the first three months there were 0.75 rejection episodes, 1.13 infections and 1.40 other complications per patient. We conclude that heart transplantation can be successfully carried out at a private institution, with excellent survival rates and at reasonable costs. In spite of progress, infection and rejection still account for most of the mortality and morbidity.

Adolescent↗
PubMed1984

Hypokalemia and massive transfusion.

To investigate the etiology of the hypokalemia that is more commonly associated with massive transfusions than hyperkalemia, we determined the plasma potassium concentrations of 26 stored packed cell preparations and reviewed a series of 15 patients who received massive transfusions with whole blood or packed cells. Our results confirm that stored packed cell preparations, like stored whole blood preparations, are hyperkalemic, and suggest that metabolic alkalosis, catecholamine release, and hemorrhagic shock are important factors in the development of hypokalemia associated with massive blood transfusions. In view of the association of hypokalemia and hyperkalemia with massive transfusion, plasma potassium levels should be carefully monitored in patients receiving massive transfusions.

Adult↗
PubMed1981

Rat trophoblastic cell antigenicity.

Trophoblast cells were isolated from the trophoblast giant cell (TGC) layer associated with the rat parietal yolk sac and from the chorioplacenta. Antisera to these cells were produced in the rabbit and analysed with several test systems. Anti-TGC sera reacted with Reichert's membrane (RM), TGC, and chorioplacental trophoblast cells (CTC) by immunodiffusion, and immunofluorescent localization showed that antisera produced against both preparations of trophoblast cells reacted with antigens present in RM and the maternal and renal glomeruli. There was no localization in the trophoblast cells themselves. The abortifacient effects of trophoblastic antisera, which were previously reported, were not found to be due to antisera produced to specific antigens of the trophoblastic preparations which were utilized. In fact the only abortigenic effect observed could be eliminated if the TGC antisera were absorbed with RM. There are several possibilities to explain the presence of antigens in the TGC and CTC which cross-react with RM, and these are discussed, but it is important to recognize that, in the rat, the preparations of antisera to TGC and CTC may produce abortigenic and embryotoxic effects by their actions not on the chorioplacenta, but on the yolk sac placentae. Both the previous reports of embryotoxicity of trophoblastic antisera and our own findings only raise many new questions that have obviously not been answered by this study. But these studies make it quite apparent that any immunological, embryotoxic or teratological studies in the rodent that deal with antigens of the chorioplacenta must include simultaneous immunological and biological studies involving the yolk sac placentae, since dysfunction in either of these placentae can result in various types of reproductive failure.

Animals↗
PubMed1975

[Studies on the metabolism of oestrone and oestradiol-17 beta in the kidneys of minipigs of different ages and sexes (author's transl)].

After incubation of [4-14C]oestrone (E1) with kidney cortex slices of minipigs, [4-14C]oestradiol-17 beta (E2) and small amounts of a polar metabolite were detected in the ether-soluble fraction. E1, E2 and polar metabolites were found in the protein-bound fraction. The water-soluble fraction contained E1-3-glucuronide (80% of total glucuronides), E2-3-glucuronide and trace amounts of the 3-monoglucuronide of oestriol (E3). When E2 was used as substrate, the main product formed was E1; it was detected in both the ether-soluble and protein-bound fractions. E1-3-Glucuronide was the main metabolite in the water-soluble fraction, which also contained some E2-3-Glucuronide. In male minipigs, the mast, the rate of conversion of E1 and E2 as well as the formation of glucuronides were significantly greater in fertile females than in infertile females. Whereas no sex difference was observed in the metabolism of oestrogens in kidneys of infertile minipigs, the rate of oxidoreduction and glucuronidation was more pronounced in fertile female animals than in the corresponding males. The present results suggest that, in the kidneys of minipigs, the ratio of E1 to E2 is shifted towards the former; furthermore, by a comparatively rapid metabolism of the oestrogenic hormone, the renal tissue contributes to the maintenance of hormonal equilibrium.

Aging↗
PubMed1973

Temperature-sensitive nonsense mutations in essential genes of Escherichia coli.

Cells containing nonsense mutations in essential genes have been isolated in a strain of Escherichia coli that carried the su4(ts) gene which specifies a temperature-sensitive tyrosine transfer ribonucleic acid. Such cells are unable to form colonies at temperatures which inactivate this suppressor transfer ribonucleic acid. A screening procedure for the identification of mutants that carry temperature-sensitive nonsense mutations in essential genes is described, and certain properties of two such mutants are reported.

Chromosome Mapping↗