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Biomedical subjects

D J Haines

Publications and source records attributed to D J Haines.

6 recordsLinked to original sources
PubMed1992

The effects of flumazenil on alertness and hypoxia in elderly patients after ERCP.

It is not known whether hypoxia, associated with upper gastrointestinal endoscopic procedures when midazolam sedation is used without narcotics, persists into the post-procedure recovery period. Thirty consecutive patients aged over 60 years, undergoing ERCP using midazolam sedation alone, were monitored clinically and by pulse oximetry before, during and for 2 hours after the procedure. They were randomized prospectively to receive either 0.5 mg flumazenil or normal saline on extubation. Results show that patients were most hypoxic in the first 30 minutes after the procedure and that mean oxygen saturation had not returned to pre-sedation values by 2 hours. Treatment with flumazenil increased alertness 2 minutes after the procedure, and was associated with a significantly higher arterial oxygen saturation at 15 minutes.

Aged↗
PubMed1992

Does nasal oxygen reduce the cardiorespiratory problems experienced by elderly patients undergoing endoscopic retrograde cholangiopancreatography?

Elderly patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) have an increased risk of sedation related complications during the procedure. To determine whether nasal oxygen supplementation (2 l/min) reduces these risks, half of 66 patients aged over 60 undergoing ERCP using minimal midazolam sedation alone were randomised to receive nasal oxygen. The arterial oxygen saturation and pulse rate of all patients were monitored by pulse oximetry before and during the procedure. Only three patients in the oxygen supplemented group (n = 33) required any form of intervention for hypoxia compared with six in the control group (n = 33). Comparison of mean arterial oxygen saturation between the groups showed significantly higher levels in the nasal oxygen group throughout the procedure. Pulse rate comparisons showed no significant difference from control group values, both groups had short periods of significant tachycardia. We conclude that minimal sedation with midazolam alone still produces hypoxia during ERCP in a substantial number of elderly patients. Nasal oxygen supplementation increases the level of patient oxygenation and reduces the need for intervention, but does not reduce tachycardia in the elderly patient. Because hyoscine may be a significant factor contributing to the tachycardia, sparing rather than routine use of this agent is advisable.

Administration, Intranasal↗
PubMed1990

Mucosal peptide hydrolase and brush-border marker enzyme activities in three regions of the small intestine of rats with experimental uraemia.

1. The activities of nine peptide hydrolases and three non-peptidase brush-border marker enzymes have been quantified in crude homogenates prepared from the proximal, mild and distal regions of small-intestinal mucosa for sham-operated (n = 9) and uraemic (n = 14) rats. Abnormalities in enzyme activities were observed in all regions studied in the uraemic group, although no reduction in food intake occurred. 2. The proximal region of the small intestine from uraemic rats showed a general fall in enzyme activities associated with the brush-border. This fall was combined with a decline in mucosal protein content. In contrast, the mid and distal regions showed increased activity against the dipeptide tyrosyl-glycine. 3. It is proposed that the fall in brush-border enzyme activities in the proximal small intestine of uraemic rats is a response to the increased water intake associated with this, and presumably other, rat models of uraemia. The increased enzyme activity against tyrosyl-glycine found in the mid and distal regions of the small intestine of uraemic rats may be caused by an increased small-intestinal transit rate, but could be an attempt to maximize tyrosine absorption in response to decreased plasma tyrosine levels. 4. This study casts doubt on specific activities being the most useful units of enzyme activity, when measured in crude homogenates prepared from the proximal small intestine of uraemic rats. It also demonstrates that enzyme activities measured at a single site in the small intestine of uraemic rats may not be representative of the enzymatic changes occurring in the small-intestinal mucosa as a whole.

Animals↗
PubMed1989

Experimental uraemia with associated plasma amino acid abnormalities but without retarded food intake and weight gain.

A rat model of moderate uraemia is described in which uraemic animals attain normal food intake and weight gain. Despite the low levels of the induced uraemia, which has been well defined, changes in plasma amino acid concentrations associated with experimental uraemia still occur. It appears from this study that a reduction in food intake is not a major factor in the aetiology of the plasma amino acid changes seen in uraemia and that the model may prove useful in future studies of experimental chronic renal failure.

Amino Acids↗
PubMed1978

The measurement of complement as an aid in diagnosis: 1. Nephritis and collagen disease.

A selection of patients with nephritis and collagen diseases were studied for complement abnormalities. This communication briefly reviews the current comcepts of complement physiology, details standard assay used in this laboratory and describes clinical examples where these tests have provided significant clinical information. Quantitative measurements of individual components, the presence of circulating immune complexes, and the demonstration of in vivo C3 cleavage products were assessed simultaneously. The importance of measuring cleavage products and immune complexes is stressed. Clinical examples are given where misleading or erroneous interpretation of results might have occurred if these tests had not been performed.

Adolescent↗