Biomedical subjects

D Shafron

Publications and source records attributed to D Shafron.

5 recordsLinked to original sources

PubMed1990

Utilization and effectiveness of autologous blood donation for arthroplastic surgery.

Autologous blood predeposit before elective surgery is a rapidly expanding transfusion practice. The authors have conducted a 3-year analysis of an autologous blood predeposit program to assess its impact on orthopaedic joint surgery. The authors conclude: autologous blood donation has resulted in a reduction of homologous blood transfusions in patients undergoing elective hip and knee procedures from 73% to 18% and from 71% to 12%, respectively. In addition, autologous blood preoperative donation in elective orthopaedic joint surgery has increased dramatically, so that while previously this practice was considered underutilized, autologous blood as an alternative to homologous blood transfusion now represents a standard of practice for elective orthopaedic joint arthroplasty at University Hospitals of Cleveland.

Arthroplasty↗

PubMed1990

The impact of preoperative autologous blood donation on orthopaedic surgical practice.

We have conducted a retrospective 3-year analysis of our autologous blood donation program to assess its impact on orthopaedic surgery. We conclude: (1) utilization has increased from less than 5% of eligible patients in the first audit interval to nearly 50% in the last audit interval; (2) in the last audit interval, autologous blood donation resulted in a reduction of homologous blood transfusion from 41% in nonautologous blood patients to 14% in autologous blood donors; (3) increasingly conservative transfusion practice is seen for all patients undergoing elective orthopaedic surgery; (4) regional blood centers are responding to increasing requests for autologous blood with programs that are effective in attracting autologous blood donors; (5) on the basis of utilization and efficacy, preoperative autologous blood donation as an alternative to homologous blood transfusion now represents a standard of practice for elective orthopaedic surgery.

Blood Transfusion, Autologous↗

PubMed1989

Onset and duration of neuromuscular blockade following high-dose vecuronium administration.

To determine the onset time and duration of high doses of vecuronium, 40 ASA Physical Status 1 and 2 patients were randomly assigned to receive either 100, 200, 300, or 400 micrograms/kg of vecuronium bromide for muscle relaxation during elective general surgery. Neuromuscular blockade was continuously quantitated by recording the electromyographic response to stimulation of the ulnar nerve train-of-four. The rate of onset of neuromuscular blockade, endotracheal intubating conditions, duration of neuromuscular blockade, and hemodynamic effects of vecuronium at each dose were evaluated and compared. The time from vecuronium administration to complete abolition of twitch tension (T1 = 0%) decreased from 208 +/- 41 to 106 +/- 35 s as the vecuronium dose was increased from 100 to 400 micrograms/kg (P less than 0.01). Corresponding times to endotracheal intubation (T1 less than 20%) also decreased from 183 +/- 24 to 96 +/- 31 s with increasing doses (P less than 0.01). Recovery time (T1 = 25%) increased from 37 +/- 13 to 138 +/- 24 min with increasing doses (P less than 0.01). No significant hemodynamic differences between the four groups were observed. Endotracheal intubating conditions were good or excellent in all patients. High doses of vecuronium may, therefore, be a useful alternative to succinylcholine when a rapid onset of neuromuscular blockade is required.

Anesthesia, General↗

PubMed1989

Evaluation of pentamorphone in humans: a new potent opiate.

We evaluated the analgesic properties of 14-beta-n-pentylaminomorphinone (pentamorphone), a new morphinan derivative, in 23 male volunteers divided into 6 groups who were given either placebo (1 per group) or 0.015, 0.03, 0.06, 0.12, 0.24, 0.48 microgram.kg-1 pentamorphone intravenously. Analgesia was evaluated by the maximal tolerance to a spring-loaded rod on the tibia and manubrium. Analgesic assessments and arterial blood samples were taken prior to and at set time intervals following drug administration. Pentamorphone produced a linear increase in pain tolerance with increasing dose as well as a dose-dependent depression of ventilation. Pentamorphone had no effect on blood pressure or heart rate in the doses used. Plasma histamine levels at 5 minutes were not elevated with any of the dosages. Pentamorphone appears to be an analgesic with clinically tolerable side effects in the range 0.12 to 0.24 microgram.kg-1 that merits further evaluation under clinical conditions.

Analgesics↗

PubMed1988

Direct evidence that complex experience increases capillary branching and surface area in visual cortex of young rats.

Rats housed in complex environments with toys and other rats generate new synapses, and the expanding neuropil tends to spread apart existing blood vessels. Previous work demonstrated that weanling rats kept in complex environments had more closely packed capillaries, suggesting that new capillaries had sprouted into the newly added neuropil. The present study directly investigates the issue of new branching by using india ink perfusions of weanling rats kept for 30 days in a complex environment (EC), paired in standard caging (SC), or individual cages (IC) to examine the density of capillary branch points and the capillary surface area per unit tissue volume. EC rats had a greater density of branch points than the SC and IC littermates, a finding consistent with increased capillary sprouting. Capillary surface area per unit tissue volume and the number of branch points per unit of capillary surface area were also higher for EC rats. This suggests that blood vessels of EC rats branch off more often than those of animals kept in more standard conditions, and provides further evidence that complex experience can increase angiogenesis in cerebral cortex of postweanling rats.

Animals↗