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Biomedical subjects

G Collins

Publications and source records attributed to G Collins.

At least 55 records · Page 3Linked to original sources
PubMed1989

Prediction of early recurrent myocardial ischemia and coronary reocclusion after successful thrombolysis: a qualitative and quantitative angiographic study.

To determine the association of qualitative and quantitative measurements of the myocardial infarct-related coronary narrowing with subsequent recurrent ischemia/reocclusion after successful thrombolysis, 47 patients treated with high-dose (150 mg) tissue plasminogen activator over 6 to 8 hours were studied in the setting of acute myocardial infarction. No patient underwent emergent coronary angioplasty. All patients had Thrombolysis in Myocardial Infarction (TIMI) grade 2 flow or higher at the baseline (90-minute) angiogram; 31 patients had a protocol 24-hour catheterization as well. Eighteen patients had recurrent ischemia/reocclusion whereas 29 had an uneventful hospital course. There was no significant difference in baseline clinical characteristics between the 2 groups. Twenty-five (86%) of those with an uneventful course had TIMI grade 3 flow at baseline angiogram compared with 56% of patients with recurrent events. No significant difference in angiographic morphologic characteristics was found between the 2 groups at baseline catheterization. At 24 hours, however, none of the patients who subsequently had recurrent events had a concentric narrowing, while 13 (58%) of them had a complex morphology. In contrast, quantitative parameters of minimal lumen diameter, percent area stenosis and percent diameter stenosis at baseline and 24 hours were not significantly different between those who did and did not have recurrent ischemia/reocclusion. These findings suggest that the degree and quality of coronary flow at baseline catheterization are more important determinants of sustained patency and event-free hospitalization than are quantitative dimensions or coronary morphology. In addition, narrowings that fail to become concentric within the first 24 hours are more likely to be associated with subsequent ischemia or reocclusion during the early periinfarct period.

Aged↗
PubMed1989

Electrocardiographic left ventricular hypertrophy and effects of antihypertensive drug therapy in hypertensive participants in the Multiple Risk Factor Intervention Trial.

Data are reported on electrocardiographic left ventricular hypertrophy (ECG LVH) among 8,012 men classified as hypertensive at baseline in the Multiple Risk Factor Intervention Trial. Compared with those allocated to the usual care (UC) control group, men allocated to the special intervention (SI) group experienced a mean reduction of 4 mm Hg in diastolic blood pressure and 7 mm Hg in systolic blood pressure, over 6 years of follow-up. There were 378 new cases of ECG LVH during follow-up; the incidence in the SI group was about 23% less than that in the UC group (4.2 vs 5.4% 2P less than 0.01). Among the 189 men with ECG LVH at baseline, those in the SI group experienced about 24% more annual follow-up visits at which they were free of ECG LVH (4.6 vs 3.7 visits; 2P less than 0.01). This reduced incidence and increased reversal of ECG LVH in the SI group compared with that in the UC group was consistent with significant overall reductions (2P less than 0.001) among SI men in mean wave amplitude in those leads in which voltage is correlated with left ventricular mass (T wave in V1, R wave in aVL and S wave in V3). In SI and UC groups combined, the presence of ECG LVH either at baseline or at follow-up was associated with several-fold increases in death from cardiovascular diseases in general, and death from coronary artery disease in particular.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

A comparison of fluoxetine imipramine and placebo in patients with bipolar depressive disorder.

This was a 6-week, double-blind comparison of fluoxetine, imipramine, and placebo in 89 patients with bipolar depression. Using the criteria of greater than or equal to 50% improvement in the HAMD-total score after at least 3 weeks on study drug, endpoint analysis showed 86% of the fluoxetine-treated patients improved compared with 57% of the imipramine-treated and 38% of the placebo-treated patients. Significantly fewer fluoxetine-treated patients discontinued due to adverse events than did imipramine-treated patients (7% vs. 30%, respectively).

Adolescent↗
PubMed1988

Perfusion balloon catheter.

An autoperfusion balloon catheter was developed to allow passive myocardial perfusion during balloon inflation, through a central lumen and multiple side holes in the shaft proximal and distal to the balloon. This report reviews preliminary experimental animal data and initial human clinical experience with this device. In our first study with this device, the duration of inflation in dogs was compared with the maximal duration of inflation using a standard angioplasty catheter. Coronary arteriography was performed to demonstrate distal coronary blood flow through the perfusion balloon catheter. Electrocardiographic recordings and repeated left ventriculograms were performed to detect evidence of ischemia during standard and perfusion and balloon catheter inflations. The average inflation time was 3 +/- 1 minute for the standard catheter and 37 +/- 10 minutes for the perfusion catheter. Each dog had evidence of severe myocardial ischemia during standard inflation, yet none of the animals had ST-segment elevation, ventricular arrhythmia or wall motion abnormality during dilatation with the perfusion catheter. In a second experiment, the effect of prolonged balloon inflations (30 minutes) on intimal hyperplasia was evaluated in the rabbit model. Results of this study showed reduction of intimal and medial hyperplasia after 4 weeks in iliac arteries in rabbits treated with prolonged inflations compared with the contralateral vessel in rabbits treated with standard angioplasty. Initial clinical results from patients treated with this new catheter are presented. The availability of an effective autoperfusion catheter should allow for testing the hypothesis that prolonged inflations could alter the acute angioplasty success rate and long-term restenosis rate.

Angioplasty, Balloon↗
PubMed1988

Clinical and immunological studies of cadaveric renal transplant recipients given total-lymphoid irradiation and maintained on low-dose prednisone.

Twenty-five recipients of cadaveric renal transplants were given total lymphoid irradiation (TLI), perioperative antithymocyte globulin, and low-dose prednisone as the sole maintenance immunosuppressive drug. Nine patients were diabetic, and follow-up was between 19 and 37 months. One-year graft and patient survival was 76% and 87%, respectively, Serious complications included four deaths from cardiovascular disorders, and two deaths from viral infections. Studies of peripheral blood T cell subsets showed a prolonged reduction in the absolute number of helper (Leu-3+) cells, and a rapid recovery of cytotoxic/suppressor (Leu-2+) cells. Analysis of the latter subset, using the monoclonal antibody 9.3, showed that the ratio of suppressor/cytotoxic cells was approximately 10:1. The normal ratio is 1:1. The mean mixed leukocyte reaction remained below 30% of the pre-TLI value for 6 months, and approached 80% at two years. Similar kinetics were observed in the proliferative response to mitogens. The results show that maintenance immunosuppressive drug therapy can be reduced after TLI as compared with conventional drug regimens that use prednisone in combination with cyclosporine and/or azathioprine.

Adult↗
PubMed1987

Preload-independent index of contractility for the assessment of left ventricular function.

We describe a method for the assessment of myocardial contractile force; it is based on the measurement of left ventricular pressure P and its first derivative dP/dt at two well-defined points on the isovolumic pressure curve. The slope Vs relating rise of dP/dt to rise of P is a measure of contractile element velocity. Vs values for normal children and adults, varying in body surface area from 0.18 to 2.14 m2 and in age from 1 day to 60 years, were in close agreement, indicating that this parameter is substantially independent of heart size. Ten children with myocardial disease all had lower Vs values than any of 24 children with normal left ventricular function. Within each of these two groups, the increase of dP/dt during isovolumic contraction was highly correlated with the increase of P, but the regression line for the normal group had a significantly steeper slope than that for the impaired group. The near zero intercepts of the two regression lines on both delta P and the delta dP/dt axes gave additional evidence that alterations of preload did not affect Vs.

Adolescent↗
PubMed1985

Treatment of cadaveric renal transplant recipients with total lymphoid irradiation, antithymocyte globulin, and low-dose prednisone.

The ability of preoperative total lymphoid irradiation (TLI) to reduce the need for chronic immunosuppression after cadaveric renal transplantation was examined in 25 recipients who were given a brief course of antithymocyte globulin (ATG) postoperatively with daily low-dose prednisone (0.1-0.2 mg/kg) as the sole maintenance immunosuppressive drug. Patients were selected for the study on the basis of their low levels of cytotoxic antibodies. Grafts were not HLA-matched, and the mean interval between completion of TLI and transplantation was 9 days. During an observation period of up to 25 months, 2 grafts were lost because of rejection. There were two deaths due to disseminated viral infections and two to late cardiovascular complications. At the last observation point, the mean serum creatinine of the 19 patients with functioning grafts was 1.5 mg/dl, and the mean dose of prednisone was 10.2 mg/day. 10 of these patients did not have a rejection episode. Comparison of patients given TLI with a group given cyclosporin at the same institution showed similar graft survival but better graft function in the TLI group.

Adult↗
PubMed1983

Allergy to inhaled egg material.

The use of a spray system to coat meat rolls with egg solution resulted in the development of asthmatic type symptoms in eight of thirteen workers exposed to the spray. Symptoms were severe in five workers, less severe in two, and one worker experienced vague symptoms. Even though precipitins were present in nine of the workers there were no pyrexial episodes nor influenza-like symptoms occurring some hours after inhaling the egg material to suggest extrinsic allergic alveolitis. All sera with precipitins reacted against an antigen in egg yolk, two sera only to this antigen but no precipitins to ovalbumin were detected. Lung function, X-ray and haematology provided no evidence that the inhalation of egg had lasting detrimental effects. There was no correlation between clinical response, skin testing, IgE levels and precipitins, hence, for each individual none of these parameters is predictive. However, collectively the results show sensitization and this has been confirmed by lack of symptoms when a different method of coating the pastry was adopted.

Adult↗
PubMed1981

An investigation of operating theatre staff exposed to humidifier fever antigens.

Sixty staff working in a hospital operating theatre, where a case of humidifier fever had been identified, were studied together with 49 subjects working in other parts of the hospital. They each had a blood test for serology, a skin test, and a chest radiograph and completed a questionnaire. The theatre staff also had pulmonary function tests. The theatre humidifier was found to contain several organisms including amoebae and antigens cross-reacting highly with those implicated in previous outbreaks of humidifier fever. Of the 60 exposed subjects, 25 had developed antibodies, nine had probable symptoms of humidifier fever, and six possible symptoms. There was a strong association between symptoms and antibodies (p = 6 x 10(-5) by Fisher's exact test). The development of antibodies was also related to duration of exposure in the theatre (p less than 0.01 by X2 test for trend) and inversely to smoking (p = 0.0073 by Fisher's exact test) but not to history of atopy. Because of the presence of antigens and because certain biocides added were ineffective in controlling antigenic build-up the humidifier was switched off. Eight months later specific IgG levels in the theatre staff sera, estimated by an enzyme-linked immunosorbent assay technique, had fallen on average by 25%. Inhalation challenge with humidifier water was performed in eight subjects. Four subjects reacted to the challenge, including both those with antibodies and previous symptoms.

Air Conditioning↗
PubMed1981

The Cleveland NIAAA prospective alcohol-in-pregnancy study: the first year.

Data from 2,913 antepartum gravidas screened for alcohol problems during the first year of a large prospective study designed to relate antenatal drinking behavior to infant outcome have been analyzed. The Michigan Alcoholism Screening Test (MAST) appears to separate two populations of pregnant patients. Differences between positive and negative MAST responders indicate variables, such as ethnicity, previous pregnancies, nutrition and cigarette smoking, which will require control when infant outcome data are evaluated. Positive MAST responders were found to be more likely to drink alcohol, to drink greater volumes and to drink more frequently than matched negative responders. They obtained a smaller proportion of their alcohol intake from wine and were more likely to drink a combination of beer, wine and/or liquor than the negative responders. The positive responders significantly decreased their alcohol intake as pregnancy progressed, while negative responders did not, suggesting the possibility that abstinence oriented therapy may be helpful. Problems with quantitating alcohol intake by humans and strategies for separating chronic and acute alcohol effects are discussed.

Adult↗
PubMed1980

The role of equipment having accidental or indirect contact with the carcase in the spread of Salmonella in an abattoir.

Counts of salmonellae were performed by the most probable number technique on steels, aprons, scabbards and on structures within the abattoir with which carcases made accidental contact. Counts on steels ranged from 0-153 salmonellae per steel; aprons from 0-14 per 100 cm2; scabbards from 0-greater than 3667 per scabbard; and carcase bump points from 0-40 per 100 cm2. Contamination rates were highest for the equipment of workers whose job functions brought them in contact with the hide.

Abattoirs↗
PubMed1980

Salmonellae on posts, hand-rails and hands in a beef abattoir.

Counts of salmonellae were done by the most probable number technique on samples collected from the hands of abattoir workers as well as on samples from hand-rails and posts regularly touched by the workers. Salmonellae were isolated from the hands of 52% of the workers who handled the hide. They had the highest average counts with counts ranging from 0 to greater than 3663 salmonellae. The remaining workers on the slaughter floor and those in the boning room had generally lower counts with contamination rates of 28% and 45% respectively. Only 3 of the 100 samples collected from the hand-rails and posts contained salmonellae. The average count was 0.11 per 100 cm2.

Abattoirs↗
PubMed1979

Bacteriological aspects of the disposal of manure from beef cattle.

Manure, collected from cattle housed in yards, was spread on experimental plots at the rate of 120 tonnes per hectare per annum. The manure was applied to 2 plots at 6-monthly intervals while a further 2 plots received monthly applications. Samples of manure soil, run-off and ground waters were examined for their counts of total aerobic bacteria, coliforms, faecal coliforms and for the presence of salmonellae. Comparison of the bacterial counts from samples from the test plots to those of the control plots showed that no change occurred in the levels of coliforms or faecal coliforms over the 3 years of manure application. One hundred and fifty-seven isolations of salmonella were made from the soil and water samples, but only 51 could be attributed to the manure. No difference was observed in the effects of different application frequencies.

Animals↗
PubMed1979

The use of minor tranquilizers in a community mental health center.

A study of 306 adult psychiatric outpatients visiting a CMHC during one month revealed that 55 per cent of those patients received a psychotropic medication and 45 per cent of the medication recipients used a minor tranquilizer as all or part of their treatment regimen. The most common diagnosis for patients receiving minor tranquilizers was depressive neurosis. The tranquilizers were prescribed in relatively high doses, and 57 of the 77 patients who recieved them had taken the drugs continuously for at least six months. The study also revealed that polypharmacy was widely practiced. The authors' suggestions for improving the quality of pharmacotherapy in a CMHC include instituting peer review of prescribing and recordkeeping practices and monitoring the effectiveness of medications through the application of quantitative mood scales at regular intervals.

Adult↗