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Biomedical subjects

E Field

Publications and source records attributed to E Field.

At least 19 recordsLinked to original sources
PubMed2004

Endoscopic repair of gastrostomy after inadvertent removal of percutaneous endoscopic gastrostomy tube.

Percutaneous endoscopic gastrostomy (PEG) tube placement has become the preferred method of enteral feeding for many patients. Neurologic disease and cancer are the most frequent indications for PEG tube placement. PEG tubes are also becoming more frequent in trauma patients for early initiation of enteral feeding. Inadvertent PEG tube removal is a well-known complication of PEG tubes. Patients undergoing PEG tube placement are frequently malnourished and in poor general medical condition, making them relatively high risk for surgical intervention. In the past, after early inadvertent PEG removal, patients underwent laparotomy for surgical repair of the gastrostomy site. Recently, laparoscopic replacement of the PEG tube has been described. We present a new technique of endoscopic repair of the gastrostomy site with hemoclip placement followed by later PEG tube placement.

Endoscopy, Gastrointestinal↗
PubMed2000

A pilot study: stability of psychiatric diagnoses over 6 months in burning mouth syndrome.

Ten people with burning mouth syndrome (BMS) were interviewed by a psychiatrist using the Schedules of Clinical Assessment in Neuropsychiatry (SCAN) at initial presentation and at 6-month follow-up. A range of psychiatric disorders from the neurotic spectrum was identified using the International Classification of Diseases (ICD-10) criteria, but the diagnoses were unstable. Six of the ten individuals received a psychiatric diagnosis, suggesting that the prevalence of psychiatric morbidity is high in this common dental syndrome. Psychiatric aspects of BMS require further investigation.

Anxiety Disorders↗
PubMed1997

Ability to reproduce head position after whiplash injury.

STUDY DESIGN: A two-group design with repeated measures. OBJECTIVES: To determine if there is loss of the ability to reproduce target position of the cervical spine individuals who have sustained a whiplash injury. SUMMARY OF BACKGROUND DATA: The ability to sense position is a prerequisite for functional movement. Injury may have a deleterious effect on this ability, resulting in inaccurate positioning of the head and neck with respect to the body coordinates and to the environment. METHODS: Eleven subjects with history of whiplash injury (age, 42 +/- 8.7 years) and 11 age-matched asymptomatic subjects (age, 43 +/- 3.1 years) participated in the study. Effects of whiplash injury on the ability to replicate a target position of the head were assessed. Maximum rotation of the neck and ability to reproduce the target angle were measured using a standard cervical range-of-motion device. Subjects' perception of "neutral" position was also assessed. RESULTS: Analysis of variance indicated the whiplash subjects were less accurate in reproducing the target angle than were control subjects. These whiplash subjects tended to overshoot the target. In addition, the subjects in the whiplash group were often inaccurate in their assessment of neutral position. CONCLUSIONS: Subjects who have experienced a whiplash injury demonstrate a deficit in their ability to reproduce a target position of the neck. These data are consistent with the hypothesis that these subjects possess an inaccurate perception of head position secondary to their injury. This study has implications for the rehabilitation of individuals with whiplash injury.

Adult↗
PubMed1996

Fluticasone propionate aqueous nasal spray compared with terfenadine tablets in the treatment of seasonal allergic rhinitis.

BACKGROUND: Comparative studies with topical corticosteroids and antihistamines for treatment of allergic rhinitis have not always demonstrated clear distinctions between the two on the basis of therapeutic efficacy. OBJECTIVE: This study was designed to compare the efficacy and tolerability of fluticasone propionate aqueous nasal spray with those of terfenadine in the treatment of seasonal allergic rhinitis. METHODS: Three hundred forty-eight patients with allergic rhinitis were given fluticasone propionate aqueous nasal spray (200 micrograms once daily), terfenadine tablets (60 mg twice daily), or placebo for 4 weeks in a multicenter, randomized, double-blind, double-dummy, parallel-group study. RESULTS: Clinician-rated total nasal symptom scores after 1, 2, 3, and 4 weeks of therapy and patient-rated total nasal symptom scores throughout treatment were significantly (p <0.05) lower in the fluticasone propionate group compared with the terfenadine group or the placebo group. Terfenadine was not statistically different from placebo on the basis of clinician-related nasal symptom scores, except for sneezing. Total nasal airflow, measured by rhinomanometry, significantly (p <0.05) improved in the fluticasone propionate group compared with the terfenadine group or the placebo group. More fluticasone propionate-treated patients compared with placebo-treated patients had reduced nasal mucosal eosinophil counts after 4 weeks of therapy (p <0.05). No serious or unusual drug-related adverse events were reported. Morning plasma cortisol concentrations after 4 weeks of therapy did not differ among groups. CONCLUSION: Fluticasone propionate aqueous nasal spray is more effective than terfenadine tablets for treatment of seasonal allergic rhinitis.

Administration, Intranasal↗
PubMed1994

Once daily intranasal fluticasone propionate is effective for perennial allergic rhinitis.

The efficacy of intranasal fluticasone propionate 200 micrograms once daily or 100 micrograms twice daily in treating perennial allergic rhinitis was evaluated in a randomized, double-blind, placebo-controlled study of 24 weeks' duration in 365 patients. Clinician-rated and patient-rated total nasal symptom severity scores were improved within 1 week of treatment with either regimen of fluticasone propionate and improvement was maintained over the 24-week treatment period. Clinician-rated overall evaluation indicated a significantly better response in the two fluticasone propionate groups compared with the placebo group. All efficacy evaluations indicated no difference in response between the fluticasone propionate 200 micrograms once-daily and 100 micrograms twice-daily groups. Patients in both fluticasone propionate groups had significantly less nasal obstruction upon awakening than the placebo group at all assessment periods. Fewer patients in either fluticasone propionate group used antihistamine rescue medication compared with the placebo group. The percentage of patients with nasal eosinophils and basophils at the end of the 24-week treatment period was significantly lower in both fluticasone propionate groups compared with the placebo group. Safety evaluations indicated that intranasal fluticasone propionate was as safe as placebo when given as 200 micrograms once daily or 100 micrograms twice daily. The incidence of drug-related adverse events was similar among the fluticasone propionate and placebo groups except for the incidence of epistaxis and blood in nasal mucus which was somewhat higher in the fluticasone propionate twice-daily group. There was no changes in the opthalmic examinations to suggest corticosteriod-induced posterior subcapsular cataract formation.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Intranasal↗
PubMed1991

Infant botulism: a review of 12 years' experience at the Children's Hospital of Philadelphia.

Fifty-seven patients with infant botulism were cared for at The Children's Hospital of Philadelphia between 1976 and 1987. The ages of the children ranged from 18 days to slightly more than 7 months. The average duration of hospitalization was 44 +/- 34 days, with the average intensive care unit stay lasting 29 +/- 25 days (54 of 57 patients). The majority (77%) of the patients were ultimately intubated and mechanically ventilated (68%). The principal indication for intubation was loss of protective airway reflexes and not hypercarbia or hypoxemia. In those patients who required mechanical ventilation the average duration was 23 +/- 22 days, with the 10 most severely affected patients (greater than or equal to 28 days of mechanical ventilation) averaging 53 +/- 25 days. Excluding patients ventilated for more than a month, those who underwent tracheostomy were hospitalized nearly twice as long as those who were managed by nasotracheal intubation only (33.5 days vs 63.2 days). The use of continuous nasogastric feedings has supplied most infants with sufficient enteral feedings to avoid weight loss and the need for central intravenous alimentation.

Botulism↗
PubMed1990

Delayed sexual maturation during prepubertal cannabinoid treatment: importance of the timing of treatment.

Treatment of prepubertal female rats with delta-9-tetrahydrocannabinol (THC) delays first estrus and ovulation. The present study was conducted to determine if treatments initiated at different prepubertal ages would be equally effective in delaying sexual maturation and if changes in prepubertal hormone secretion accompanied the delay. Treatments with THC (10 mg/kg) or vehicle were initiated at 24, 27 or 30 days of age and continued until first estrus was detected by vaginal smears. In one experiment, serum luteinizing hormone (LH) and prolactin (PRL) were measured at 24, 27 or 30 days of age after different durations of treatment. First estrus was delayed (4.8 +/- 1.1 days) when THC treatment started at 27 days of age, but not when treatment started at 24 or 30 days of age. Serum LH was reduced after 1 or 4, but not 7, days of treatment; however, LH suppression was associated with pubertal delay only when it occurred at 27 to 30 days of age. Serum PRL, which increased with age, was suppressed after 1 day of THC treatment at 27 or 30 days of age, but only the former was associated with delayed puberty. Suppression was not evident at 24 days of age after 1 day of THC, or at other ages after treatment for longer than 1 day. These results define a narrow interval, encompassing the ages of 27 to 30 days, during which THC exposure resulted in pubertal delay. Such treatment reduced serum LH and PRL levels, but reductions also occurred with treatments that did not result in maturational delay. The relationship of hormone suppression to the delay thus remains unclear, although the timing of suppression might be a factor.

Analysis of Variance↗
PubMed1988

Opioid inhibition of luteinizing hormone release declines with age and acyclicity in female rats.

The current study assesses changes in opioid inhibition of LH secretion with age in female rats. We administered naloxone (NAL; 2 mg/kg, iv) to regularly cycling estrous rats of three age groups and measured serum LH in serial samples drawn from intraatrial catheters before and after treatment. The serum LH rise 10 min after NAL treatment in 4- to 6-month-old rats was significantly reduced (P less than 0.01) compared with that in 1.5- to 3-month-old animals, and no LH response was observed in 8- to 11-month-old rats. On early proestrus, LH secretion was also reduced 10 min after NAL treatment in older vs. younger rats, but all groups demonstrated belated LH rises 1 h after treatment during proestrus. Persistent estrous (PE) rats released less LH after NAL treatment than age-matched estrous rats (P less than 0.025). Higher dose NAL treatment did not increase LH release in estrous or PE rats. These results support the hypothesis that opioid inhibition of LH secretion diminishes with age in cycling rats. Furthermore, opioid tone is a function of estrous state as well as age. PE rats have lower opioid tone than cycling animals of the same age. Our findings suggest a possible role of diminished opiate tone in reproductive senescence.

Aging↗
PubMed1987

Endocrine consequences of perinatal methadone exposure.

In summary, we have shown that marked acute responses as well as persistent changes in hypothalamopituitary responsivity to opiate challenge result from perinatal opioid addiction. We have also shown that different endocrine systems and opioid receptor subtypes develop at different rates, and that the responses of these systems depend upon the relative timing of the treatment regimen and the functional development of the particular opioid system involved. It should be emphasized that these studies have investigated only a single developmental window. The additional critical question of how opioid neuron function is affected by treatment during the period of active neuronal differentiation has not yet been answered. However, these studies do demonstrate the utility of this neuroendocrine model in assessing opioid function following chronic treatment regimens. By using neuroendocrine function as an end point, multiple systems can be studied simultaneously in the same animal. This has a particular advantage in studying the effects of chronic drug exposure on the developing nervous system, because hormone secretion is an easily quantifiable and early maturing functional index which can be used to identify vulnerable (and resistant) systems. Endogenous opioid systems appear to be particularly important in neuroendocrine regulation during the early phase of development, when other neural controls have not yet matured. Our preliminary results suggest that specific opioid systems that mature early may be especially important in the specific neuroendocrine effects of perinatal opiate addiction.

Aging↗
PubMed1986

Blockade of first ovulation in pubertal rats by delta-9-tetrahydrocannabinol: requirement for advanced treatment due to early initiation of the critical period.

Successful blockade of ovulation in pubertal rats by delta-9-tetrahydrocannabinol (THC) required earlier treatment during proestrus than was required in adults under the same conditions. Only 1 of 8 adult rats ovulated after treatment with THC (10 mg/kg body weight, i.p.) at 1400 h proestrus, whereas 77% of pubertal rats released full sets of ova following similar treatment during proestrus of the first or second vaginal cycle. When treatment of pubertal rats was advanced to 1300 h, only 2 of 10 THC-treated rats exhibited full ovulation, an incidence significantly lower than the 80% ovulation rate observed in vehicle-treated animals (p less than 0.05). To determine whether the requirement for earlier THC treatment in pubertal rats was related specifically to THC or reflected possible age-associated differences in timing of the critical period, the ovulation-blocking efficacy of atropine sulfate (ATR) was tested in pubertal rats for comparison with that of THC. The serum concentrations of luteinizing hormone (LH) during the first proestrus (1200-1900 h) were determined in pubertal rats that remained untreated. The incidence of ovulation in rats treated with ATR (350 mg/kg, s.c.) at 1400 h proestrus was not significantly reduced from that in vehicle-treated rats; however, after ATR treatment at 1300 h, only 2 of 11 animals released full sets of ova whereas all vehicle-treated rats ovulated (p less than 0.025). The mean serum LH concentration in untreated pubertal rats was not significantly increased over baseline at 1300 h proestrus, but was markedly elevated by 1400 h (1009 +/- 375 ng/ml; p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1986

Tolerance to the luteinizing hormone and prolactin suppressive effects of delta-9-tetrahydrocannabinol develops during chronic prepubertal treatment of female rats.

To determine if prepubertal female rats develop tolerance to the hormone suppressive action of delta-9-tetrahydrocannabinol (THC), we tested the ability of THC (10 mg/kg i.p.) to block luteinizing hormone (LH) and prolactin (PRL) surges acutely at first proestrus in animals that were treated repetitively with THC before puberty. Rats were pretreated with 10 mg THC/kg b.wt. twice daily beginning at 27 days of age and the blocking efficacy of THC treatment at first proestrus was compared to that in animals that were previously untreated or were pretreated only with drug vehicle. Vaginae were opened at 30 days of age to permit identification of first proestrus by vaginal smears, and serial blood samples for LH and PRL radioimmunoassays were collected before and after treatment at proestrus. In previously untreated or vehicle-pretreated animals, THC treatment at 1300 hr on the day of first proestrus inhibited the afternoon surges of LH and PRL, whereas hormone surges occurred in control animals injected with only vehicle at 1300 hr proestrus (P less than .05). In contrast, animals pretreated with THC exhibited marked LH and PRL surges whether treated at 1300 hr proestrus with THC or vehicle. Among animals receiving only vehicle at proestrus, there was no difference in serum LH concentrations or in timing of the LH surge between the group pretreated with THC and the group pretreated with vehicle. These results are consistent with the hypothesis that ovulation eventually occurs in the pubertal rat treated chronically with THC because tolerance develops to its gonadotropin suppressive effects.

Animals↗
PubMed1985

Efficacy of total lymphoid irradiation in intractable rheumatoid arthritis. A double-blind, randomized trial.

Twenty-six patients participated in a randomized, double-blind study of the efficacy of total lymphoid irradiation in the treatment of intractable rheumatoid arthritis. All 26 patients, for whom therapy with gold compounds and penicillamine had failed, would ordinarily have been considered candidates for cytotoxic or antimetabolite drug therapy. Thirteen patients randomly assigned to receive full-dose total lymphoid irradiation (2000 rad) and 11 patients assigned to receive control low-dose total lymphoid irradiation (200 rad) completed radiotherapy. Alleviation of joint disease activity was significantly greater in the high-dose group as judged by morning stiffness, joint tenderness, and functional assessment (global composite score) at 3 and 6 months after radiotherapy. The high-dose group had a marked reduction in both T-lymphocyte function and numbers, but this finding was not observed in the low-dose group. Complications seen in the high-dose but not low-dose group included transient neutropenia, thrombocytopenia, pericarditis, and pleurisy.

Adult↗
PubMed1985

Treatment of intractable lupus nephritis with total lymphoid irradiation.

Ten patients with lupus nephritis and marked proteinuria (3.9 g or more/d) that did not respond adequately to treatment with prednisone alone or prednisone in combination with azathioprine were treated with total lymphoid irradiation in an uncontrolled feasibility study. Within 6 weeks after the start of total lymphoid irradiation, the serum albumin level rose in all patients in association with a reduction in the serum level of anti-DNA antibodies, an increase in the serum complement level, or both. Improvement in these variables persisted in eight patients followed for more than 1 year, with the stabilization or reduction of the serum creatinine level. Urinary leakage of albumin was substantially reduced in all patients. Side effects associated with radiotherapy included transient constitutional complaints in ten patients, transient blood element depressions in three, localized viral and bacterial infections in four, and ovarian failure in one. The results suggest that total lymphoid irradiation may provide an alternative to cytotoxic drugs in the treatment of lupus nephritis.

Adult↗
PubMed1984

Delayed sexual maturation in the female rat during chronic exposure to delta-9-tetrahydrocannabinol.

delta-9-Tetrahydrocannabinol (THC), the major psychoactive component of marihuana, retarded sexual maturation in the pubertal female rat as indicated by a delayed appearance of estrus and ovulation. Twice daily intraperitoneal injections of 10 mg THC/kg body weight from 27 days of age until the first day of full vaginal cornification delayed the onset of estrus and the occurrence of the first ovulation by an average of 4.3 +/- 0.9 (S.E.M.) days in comparison with pair-fed, vehicle-treated animals (p less than 0.001). Ovulation during the first estrus occurred in 92% of the animals in each treatment group without a difference in the average number of ova ovulated. The delayed sexual maturation in animals treated with THC could not be attributed to reduced body weight gain since body weights in THC- and vehicle-treated groups were equivalent when vehicle-treated animals came into estrus. Delayed ovulation in THC-treated animals did not merely reflect the repeated blockade of ovulation from otherwise competent follicles in that the onset of vaginal cornification was delayed to a comparable extent. Rather, the data suggest retarded development of ovarian follicles, possibly as a result of pituitary suppression. It is noteworthy that, although delayed, both vaginal cornification and ovulation occurred in spite of continued THC treatment, suggesting the development of drug tolerance.

Animals↗
PubMed1981

Bioavailability, efficacy, and tolerance of two sustained-release theophylline dosage forms in adult patients with bronchial asthma.

Twenty otherwise health adults with a diagnosis of reversible obstructive airways disease were treated for one month in a single-blind crossover study with approximately equivalent doses of Elixophyllin SR capsules or Theo-Dur tablets. Both products provided evidence of efficacy by improvement in pulmonary function tests, and both were well tolerated. There were no significant differences between the two products with regard to bioavailability, efficacy, or tolerance. Both dosage forms appeared to have similar kinetic properties within the context of the study.

Adolescent↗