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Biomedical subjects

E M Grundy

Publications and source records attributed to E M Grundy.

At least 19 recordsLinked to original sources
PubMed2005

Delayed haemolytic transfusion reaction and hyperhaemolysis complicating peri-operative blood transfusion in sickle cell disease.

We present a case of delayed haemolytic transfusion reaction and hyperhaemolysis syndrome in a patient with sickle cell disease. A 32-year-old woman with a history of sickle cell disease was scheduled for total hip replacement. She was transfused pre-operatively and suffered a delayed haemolytic transfusion reaction. Postoperatively the patient continued to haemolyse, despite the use of antigen compatible blood, suggesting that she had developed hyperhaemolysis syndrome following her delayed haemolytic transfusion reaction. Although rare, both conditions must be borne in mind when dealing with patients who have undergone multiple transfusions.

Adult↗
PubMed1996

Population review: (5). The population aged 60 and over.

The elderly population of the UK is currently growing more slowly than in the past, but is becoming older. When the larger post-Second World War birth cohorts reach their sixties this trend will be reversed. In comparison with their predecessors, more of today's elderly have spouses and children. The proportions of divorced people among the elderly, while growing rapidly, are still small. Changes in living arrangements have been substantial. Co-residence between generations has continued to become less, and living alone more common. The number of elderly people with children close at hand has fallen and the proportion of very old people living in institutions has increased. Elderly people are far less likely to be in paid work than in the past, but provide a great deal of the informal care needed by disabled parents and other people aged 65 or over. Mortality rates at older ages have fallen, but the extent of self-reported limiting long-term illness has risen. This may reflect increased awareness of health problems among elderly people. More positively, there are signs that the extent of serious disability has fallen.

Activities of Daily Living↗
PubMed1993

Moves into supported private households among elderly people in England and Wales.

"Data from the Longitudinal Study (LS) of the Office of Population Censuses and Surveys have been used to examine differentials in the proportion of elderly people living in 'independent' households (alone or with only a spouse) in 1971 but in 'supported' households (with relatives or friends) ten years later." The geographical focus is on England and Wales.

Adult↗
PubMed1989

Effects of halothane on somatosensory evoked potentials recorded in the extradural space.

We studied the effects of supplementing anaesthesia with halothane (up to 1.5%, inspired) on the somatosensory evoked potential recorded in the extradural space of six patients before corrective surgery for idiopathic adolescent scoliosis. A further six patients in whom anaesthesia was supplemented with thiopentone acted as a control group. Halothane 1.5% resulted in a significant decrease in overall amplitude (P less than 0.05) from the left leg only. Halothane had no significant effect on overall amplitude, first peak amplitude, second peak amplitude and first peak latency. We conclude that halothane is unlikely to alter the interpretation of somatosensory evoked potentials recorded extradurally during scoliosis surgery. A possible unilateral effect of halothane on the concave side in idiopathic adolescent scoliosis needs further investigation.

Adolescent↗
PubMed1987

Tracheal versus intravenous atropine. A comparison of the effects on heart rate.

Atropine 600 micrograms was given either intravenously or intratracheally and the change in heart rate noted in a double-blind, randomised study of 40 anaesthetised patients. There was no significant difference between the two groups in the maximum increase in heart rate, 20.3 beats/minute in the tracheal compared to 21.4 beats/minute in the intravenous group. However, the maximum increase occurred significantly earlier in the tracheal group, 45.5 seconds after administration compared to 95.5 seconds in the intravenous group (p less than 0.01, 95% confidence interval 36.8-63.2 seconds). This study supports the clinical observation that tracheal and intravenous atropine are equally effective and suggests that the trachea should be the route of choice when a rapid response is required.

Adult↗
PubMed1986

Efferent phrenic nerve activity during induced changes in arterial pressure.

Efferent activity in the phrenic nerve was recorded during induced hypotension and hypertension in anaesthetized, paralysed, artificially ventilated dogs. Changes in arterial pressure were induced with infusions of sodium nitroprusside, noradrenaline and angiotensin II, after which ventilation was adjusted to return the PaCO2 near to control values. The PaO2 was maintained above chemoreceptor threshold throughout. When a steady state was achieved quantitative measurements of phrenic nerve activity were made. In six dogs an increase in mean arterial pressure from 114 to 167 mm Hg caused a mean reduction of phrenic nerve activity of 28%. In six dogs a decrease in mean arterial pressure from 128 to 82 mm Hg caused an increase in phrenic nerve activity of 22%. This shows that the reduction in arterial pressure induced by vasodilator drugs causes a major sustained stimulus to respiration, while increase in arterial pressure causes marked respiratory depression.

Action Potentials↗
PubMed1984

Antagonism of the effects of midazolam on phrenic nerve activity in the dog by Ro 15-1788 and Ro 15-3505.

Experiments were performed on 14 anaesthetized, artifically ventilated dogs, in which efferent activity in the phrenic nerve was recorded and blood-gas tensions, arterial pH and core temperature were controlled. Doses of midazolam between 0.2 mg kg-1 and 2 mg kg-1 abolished phrenic nerve activity for periods between 30 and 90 min. Ro 15-1788 in doses between 0.06 mg kg-1 and 1 mg kg-1 and Ro 15-3505 0.2-2 mg kg-1 reversed the effects of midazolam on phrenic nerve activity. Prior administration of these drugs either abolished or greatly inhibited the action of midazolam. When the preparations were observed for up to 2 h, there was no evidence of return of the action of midazolam, suggesting that both antagonists had a duration of action at least as long as that of midazolam.

Action Potentials↗
PubMed1982

Haemodynamic effects of midazolam and thiopentone during induction of anaesthesia for coronary artery surgery.

The cardiovascular effects of thiopentone 3 mg kg-1 and midazolam 0.3 mg kg-1 were observed during induction of anaesthesia in 16 premedicated patients about to undergo myocardial revascularization. There were no significant changes in either group in cardiac output or central venous pressure. The heart rate in both groups showed an increase at 3 min and thereafter returned to control values. After 3 min, there was a significant decrease in both arterial pressure and peripheral resistance by 12% and 15% (mean values) respectively from control values in the group receiving midazolam, whereas after thiopentone the peripheral resistance increased by approximately 13% and was not affected by a further dose of thiopentone 1 mg kg-1.

Anesthesia, Intravenous↗
PubMed1982

Continuous intravenous infusion of disoprofol (ICI 35868, Diprivan). Comparison with Althesin to cover surgery under local analgesia.

Disoprofol has been used to induce and, by continuous infusion, to maintain a light level of general anaesthesia in 100 patients undergoing surgery with the aid of a regional block. Its effects have been compared with 100 patients anaesthetised in a similar manner with Althesin. Disoprofol proved to be a very satisfactory agent for use by this method and apart from an appreciable incidence of pain on injection the number of complications was small and comparable to those found with Althesin, which caused more involuntary movements. Recovery was particularly rapid and clear-headed following disoprofol, and occurred highly significantly more quickly than after Althesin. Disoprofol, however, will not be marketed in the present formulation which has Cremophor EL as the solubilising agent.

Alfaxalone Alfadolone Mixture↗
PubMed1982

Open heart surgery in a patient with homozygous sickle cell disease.

A child in heart failure with homozygous sickle cell disease underwent corrective surgery on cardiopulmonary bypass. The use of early intra-operative exchange transfusion produced a rapid fall in the level of HbS. Postoperatively she developed falciparum malaria which responded to treatment. She was eventually discharged home to Nigeria 8 weeks after her operation.

Anemia, Sickle Cell↗
PubMed1978

Fracture of a float catheter. A case report.

Fracture of a balloon-tipped flow-directed catheter is described. The circumstances associated with the fracture are discussed, but no definite cause could be determined.

Cardiac Catheterization↗
PubMed1978

Extradural analgesia revisited. A statistical study.

The results of 334 lumbar extradural analgesics, administered in a standard manner, allowed reassessment of some factors influencing the spread of local anaesthetic solution in the extradural space. There was no evidence of increased spread in patients with degenerative vascular disease when compared with a control group free from such disease. The patient's height and age had a small effect on spread. The results contradict the earlier assumption of a direct relationship between the volume of anaesthetic solution injected and the number of segments blocked.

Adult↗
PubMed1978

The Rees system in infants: fresh gas flow and PaCO2.

Fresh gas flow from the anaesthetic machine can be set to determine the low level of PaCO2 that is achieved during anaesthesia using Rees variation of the T-piece. It does not however set the upper limits for PaCO2 which is more reliant upon the minute ventilation. For a PaCO2 of 40 mm Hg, it is suggested that the fresh gas flow from the machine be 220 cc/kg. For small infants, a higher flow rate is necessary.

Adolescent↗
PubMed1977

The effect of assisted ventilation on arterial carbon dioxide.

The effect on the arterial carbon dioxide tension of assisting spontaneously breathing patients under halothane anaesthesia has been studied. A reduction in PaCO2 is usually seen, but it was reduced below 40 torr in only 30 per cent of cases, while a rise was recorded in 20 per cent.

Adolescent↗