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Biomedical subjects

E Sullivan

Publications and source records attributed to E Sullivan.

At least 37 records · Page 2Linked to original sources
PubMed1996

Reducing the amount of cytoplasm available for early embryonic development decreases the quality but not quantity of embryos produced by in vitro fertilization and nuclear transplantation.

The effect of reducing the amount of cytoplasm available for early embryonic development was investigated in embryos produced by in vitro fertilization (IVF) and nuclear transplantation. In Experiment 1, approximately 1/2 or 1/20 of the cytoplasm was removed from bovine embryos at the pronuclear-stage of development. The percentage of embryos developing to the compact morula or blastocyst stage was significantly higher in non-manipulated controls (26%) than in embryos with 1/20 of the cytoplasm removed (16%), and those with 1/2 of the cytoplasm removed (10%; P < 0.05). There was also a significant difference in the average number of cells between blastocysts in which 1/20 of their cytoplasm was removed (67), those with 1/2 of their cytoplasm removed (55), and nonmanipulated controls (77; P < 0.05). In Experiment 2, nuclear transfer embryos were produced in which approximately 1/2 or 1/20 of the cytoplasm was removed during oocyte enucleation. The percentage of embryos developing to the blastocyst stage was 17% for both groups of nuclear transfer embryos compared to 44% for control embryos (P < 0.05). The mean number of cells in blastocysts produced by nuclear transfer in which 1/20 of the cytoplasm was removed during oocyte enucleation (61) was no different than that in control embryos (66), but significantly higher than the mean number of cells in blastocysts produced by nuclear transfer in which 1/2 of the cytoplasm was removed (42; P < 0.05). There was no indication that altering the amount of cytoplasm available for early embryonic development of IVF embryos affected the timing of differentiation events, including those of embryo compaction and blastocyst formation.

Journal Article↗
PubMed1996

Pulmonary vascular pressures of strenuously exercising thoroughbreds after administration of phenylbutazone.

OBJECTIVE: To determine the effects of phenylbutazone administration on heart rate and right atrial and pulmonary vascular pressures in Thoroughbreds during rest and during exercise performed at maximal heart rate. ANIMALS: 7 healthy, exercise-conditioned Thoroughbreds. PROCEDURE: Horses were studied on 3 occasions: without medication [control], after i.v. administration of phenylbutazone (4.4 mg/kg of body weight) at 12-hour intervals for 2 days and a final dose given 1 hour before exercise, and after i.v. administration of phenylbutazone for 2 days in the same manner, but with the final dose given 24 hours before exercise. Horses were studied at rest and during exercise performed at maximal heart rate on a treadmill. Right atrial and pulmonary vascular pressures were measured with catheter-tip manometers referenced at the point of the shoulder. RESULTS: We did not detect significant differences in heart rate or right atrial and pulmonary vascular pressures among values recorded when horses were not given medication and values recorded when phenylbutazone was administered by either regimen. Exercise-induced pulmonary hemorrhage occurred in 6 of the 7 horses regardless of whether phenylbutazone was administered or the dosage regimen used. CONCLUSIONS: In these Thoroughbreds, phenylbutazone treatment did not modify heart rate or right atrial and pulmonary vascular pressures at rest or during exercise capable of eliciting exercise-induced pulmonary hemorrhage. Thus, because phenylbutazone is a potent inhibitor of cyclooxygenase, prostaglandins probably do not play a role in mediating exercise-induced pulmonary hypertension in horses. CLINICAL RELEVANCE: Phenylbutazone administration did not modify the pulmonary capillary hypertension in the strenuously exercising Thoroughbreds, and therefore, is unlikely to alter the prevalence or severity of exercise-induced pulmonary hemorrhage in Thoroughbred race-horses.

Animals↗
PubMed1995

Continuous extrapleural intercostal nerve block with continuous infusion of lidocaine after thoracotomy. A descriptive pilot study.

Continuous extrapleural intercostal block (EPIB) with bupivacaine has been reported to be an effective analgesic technique in patients after thoracotomy. We report a retrospective study of EPIB using a continuous infusion of 1% lidocaine hydrochloride at a dose of 1 mg/kg/h. A posterior parietal pleural pocket was created and cannulated with a 16-g polyethylene catheter. Lidocaine was perfused over a 3-day period following surgery. Patients also had access to morphine sulfate via patient-controlled analgesia. Eighteen consecutive posterolateral thoracotomies (in 17 patients) performed during a 6-month period were reviewed. Serum lidocaine exceeded the toxic level of 5 microgram/mL in only one patient, a 104.5-kg man who had a level of 5.9 micrograms/mL on postoperative day 2 but experienced no clinical toxicity. Pain was evaluated by verbal analog scores (0 = no pain and 10 = worst pain), which averaged 3.02, 3.14, and 2.8 in the 3 days following surgery. Mean total daily MS doses were 24.3, 37.75, and 34.32 mg (range, 0 to 94 mg). Sedation was scored on a 1 to 5 scale. Mean scores were 2.78, 2.56, and 2.6. No patient died or had a major respiratory complication. Continuous EPIB with lidocaine appears to be a promising adjuvant technique in the management of postthoracotomy pain. Effectiveness needs to be confirmed in a prospective randomized study.

Adult↗
PubMed1994

Pathology of Unstable Angina: Analysis of Biopsies Obtained by Directional Coronary Atherectomy.

Background: The transient and generally nonfatal nature of unstable angina has impaired the accumulation of pathologic data and the definition of the pathoanatomy of this syndrome. Methods: Atherectomy specimens from patients enrolled in CAVEAT were examined for the presence of thrombus, foam cells, cholesterol clefts, media, and adventitia. Comparison of the pathologic findings was made according to clinical presentation in the following categories: stable angina, unstable angina, and recent myocardial infarction. Results: Patients with unstable angina had. a slightly higher incidence of thrombus when compared with patients presenting with stable angina (36% vs. 26%, p =.14). Within the unstable angina population some subgroups demonstrated a greater incidence of thrombus, including those whose pain was associated with ECG changes (43%, p =.07). The incidence of thrombus was highest among patients who had a myocardial infarction within 30 days (53%, p =.004) or within 14 days (58%, p =.003). No difference between the patient groups was detected with respect to the other histologic findings. Conclusions: Atherectomy specimens from patients with unstable angina demonstrated a trend toward increasing incidence of thrombus, but this trend did not achieve statistical significance. Specimens from patients with a recent myocardial infarction did not demonstrate a significant increase in the presence of thrombus. While thrombus is a component of the pathophysiology of unstable angina in a significant number of patients, continued study is required to determine the other factors that are responsible.

Journal Article↗
PubMed1993

Developing educational programmes for nurses that meet today's addiction challenges.

Since undergraduate curricula have in the past offered little substance abuse content, bold and innovative educational programmes are necessary to prepare nurses for the addiction challenges of the 1990s. The University of Kansas and the American Nurses' Foundation (ANF) recently addressed the problem when they were jointly funded by the John W. and Effie E. Speas Memorial Trust to present an alcohol and other drug education project targeted to nurses practicing in the local community. 60 nurses in key clinical settings were given an opportunity to receive general information about substance abuse through two, 2-day workshops. The purposes of the project were; (1) to plan and develop materials for an alcohol and other drug abuse (AODA) curriculum for practicing nurses in a variety of clinical areas; (2) to assess the effectiveness of the programme through on-site and post-workshop participant evaluations; (3) and to refine the curriculum and materials according to evaluation data. Results indicated that participants' knowledge of AODA was significantly increased by the workshop. Attitudes also changed in two areas, permissiveness and belief in treatment interventions. Decreased permissiveness toward substance abuse persisted 3 months after the workshop indicating this may be a lasting change. The conclusion is that education can lead to a change in knowledge and attitudes toward substance abuse.

Curriculum↗
PubMed1992

Rabies case in New South Wales, 1990: public health aspects.

OBJECTIVES: To identify the source of rabies in the recent case in New South Wales, and to determine the need for post-exposure rabies prophylaxis among contacts of the patient. DESIGN: Information was obtained by face-to-face interview of the dead girl's family and face-to-face and telephone interviews using a questionnaire of health care workers. Other information was gathered from overseas and local sources through telephone and facsimile contact. RESULTS: The girl had migrated from Vietnam in 1984 to Hong Kong, and from there in 1986 to Australia. No evidence of contact with a rabid animal in Australia or Hong Kong was found. There had also been no organ donations from the girl. Four health care workers were given post-exposure rabies prophylaxis. CONCLUSIONS: Because of the lack of evidence of animal contact in Australia and the fact that extremely long incubation periods for rabies have been documented, it was considered that the most likely source of the rabies virus was North Vietnam. Genetic studies of the virus also supported a South-East Asian source. Nevertheless the presumed incubation period--at least six years and four months--is one of the longest recorded.

Animals↗
PubMed1992

Prospective versus retrospective methods of identifying patients with delirium.

OBJECTIVE: To determine if DSM-III criteria or clinical or discharge diagnoses, reviewed retrospectively, are as accurate an indicator of the presence of delirium as prospective evaluation by a psychiatrist. DESIGN: Selection of delirious patients prospectively by a psychiatrist, followed by retrospective record review of the same patients. SETTING: A referral-based university hospital. PATIENTS: From a sample of 235 consecutive medical patients over age 70, 47 delirious patients were identified prospectively by a research psychiatrist using DSM-III criteria. The medical record of these delirious patients was reviewed after discharge for evidence of delirium. RESULTS: Four patients were assigned ICD-9 codes suggestive of delirium (sensitivity 0.09). Review of physicians' diagnoses correctly identified 8 of 47 (sensitivity 0.17) patients as being delirious or acutely confused. The specific diagnostic criteria necessary to meet a DSM-III diagnosis of delirium could be ascertained from 10 of 47 records (sensitivity 0.21). CONCLUSION: The retrospective medical record review is very imprecise in establishing the diagnosis of delirium. As research in this field moves from descriptive epidemiology to studies of pathogenesis and treatment, prospective designs will be needed.

Abstracting and Indexing↗
PubMed1991

Delirium in the medically ill elderly: operationalizing the DSM-III criteria.

This prospective study determined the incidence and prevalence of delirium in 235 consecutive subjects over age 70 admitted to a general medicine hospital service. The DSM-III criteria for delirium were operationalized. Using accepted screening procedures, patients were referred for evaluation by a psychiatrist who determined whether delirium was present by applying explicit operational definitions to each of the DSM-III criteria. Data on presence and severity of each of the DSM-III symptoms were recorded. Analysis of these data indicates that the DSM-III criteria describe a discrete, recognizable syndrome. However, some of the symptoms are more specific than others in identifying the syndrome in this population.

Aged↗
PubMed1991

The effects of co-dependence on physicians and nurses.

To evaluate the effect on physicians and nurses of being closely involved with one or more chemical dependent persons, a sample of 67 physicians and 133 nurses with chemical dependent significant others was surveyed. The majority reported that the quality of their work was adversely affected by this association. Reduced ability to concentrate, absenteeism, errors, poor judgment, and patient neglect were reported. Most reported their professional education had not prepared them to recognize and assist people with chemical dependence and half thought their professional education negatively influenced their ability to help. About half had attempted to treat the chemical dependent person(s) themselves, sometimes giving medication and occasionally diverting drugs for this purpose. Most said their self-esteem and self-confidence were damaged by these relationships. Over one-third reported being diagnosed as depressed and 12% had attempted suicide. There were few differences between physicians and nurses on the effects of being in a co-dependent relationship(s), although nurses and women were more likely to have chemically dependent parents. Implications for professional education are identified.

Adult↗
PubMed1990

A new platelet function test.

A method for screening EDTA(K3) blood samples for platelet function is described. The general availability of whole blood platelet counters in the clinical laboratory suggested their use to measure platelet aggregation. To simplify the collection and storage of blood samples, a method utilizing EDTA collected blood is described. Addition of calcium and citrate restores platelet function to blood samples even when stored at room temperature for several hours. Thus, the blood sample used to assay RBC, WBC and platelet parameters may also be employed in platelet aggregation. A comparison of this method with aggregometry on 120 subjects indicated a similar response to arachidonate, collagen, ristocetin and ADP.

Adenosine Diphosphate↗
PubMed1990

Using DSM-III criteria to diagnose delirium in elderly general medical patients.

Studies of delirium in general medical populations have used criteria for delirium different from current DSM-III or DSM-IIIR criteria of the American Psychiatric Association, or have used DSM-III or DSM-IIIR criteria without operationalizing the components of these criteria. Therefore this prospective study was conducted to establish an approach to operationalizing DSM-III criteria and to determine the incidence and prevalence of delirium. Two hundred thirty-five consecutive subjects age 70 and over admitted to general medicine underwent daily standardized screening. Patients with low scores on screening tests or clinical evidence suggestive of any psychiatric disorder and controls were seen by a psychiatrist, who determined whether delirium was present by applying explicit operational definitions to each component of the DSM-III criteria for delirium. We conclude that the syndrome of delirium as defined by the American Psychiatric Association is prevalent on admission among elderly on general medical services, but the number of cases developing in the hospital is much less than often stated in the literature.

Aged↗
PubMed1985

Developmental pattern of splenic dysfunction in sickle cell disorders.

Splenic function in sickle hemoglobinopathy syndromes was assessed to determine the developmental pattern of splenic dysfunction. Nonvisualization of the spleen using technetium-99 metastable (99mTc) spleen scans correlated strongly with pocked (vesiculated) RBCs greater than or equal to 3.5%. Cross-sectional analysis of pocked RBC data from 2,086 patients showed differences in the developmental pattern of splenic dysfunction between several disorders. In hemoglobin SS disease (sickle cell anemia) and hemoglobin S beta(0) thalassemia, splenic dysfunction (greater than or equal to 3.5% pocked RBCs) often occurred in the first 6 to 12 months of life. In hemoglobin S beta(+) thalassemia, splenic dysfunction occurred less frequently and later. Splenic dysfunction in hemoglobin SC disease (sickle cell-hemoglobin C) was intermediate. The level of pocked RBCs was inversely associated with fetal hemoglobin (P less than .007) and directly associated with age (P less than or equal to .001). These patterns of splenic dysfunction reflect the known severity of hemolysis and intravascular sickling and are consistent with the epidemiology of severe bacterial meningitis and sepsis in these diseases. Serial measurement of pocked RBCs permits determination of the onset of splenic dysfunction and the time of increased susceptibility to severe bacterial infections.

Age Factors↗