Biomedical subjects

G J Stuart

Publications and source records attributed to G J Stuart.

21 records · Page 2Linked to original sources

PubMed1986

Continuous intravenous morphine infusions for terminal pain control: a retrospective review.

The continuous intravenous infusion of morphine may control terminal cancer pain unrelieved by conventional narcotic therapy. A retrospective review was conducted of the medical records of 79 terminal cancer patients who received a total of 84 intravenous morphine infusions. Data were recorded on morphine dosage, pain control, adverse effects, duration of infusion, and concomitant medication requirements. Infusion duration varied from less than 24 hours to 162 days (median: 7 days). Morphine dosage ranged from 0.5 to 300 mg/h. All patients experienced an improvement in baseline pain control; however, 54 percent required additional medication to enhance analgesia. Serious adverse effects, including marked sedation, hallucinations, diaphoresis, and respiratory depression, were recorded in 14 patients. These effects may be a reason for reducing the dose. Guidelines for the use of continuous intravenous morphine infusions are presented. Accurate pain assessment, morphine dosage calculation, and monitoring of adverse effects are essential to insure the safe and effective use of these infusions.

British Columbia↗

PubMed1985

The initial burst of impulses in responses of toad muscle spindles during stretch.

The responses of muscle spindles in the iliofibularis muscle of the cane toad Bufo marinus were examined during constant velocity stretch of the passive muscle. Spindles were found to show an 'initial burst' of high frequency impulses at the onset of stretch. Associated with the initial burst was a steep passive tension rise in the whole muscle, the short-range elastic component (Hill, 1968), called here the passive stiffness. The size of the initial burst was found to depend on muscle length in a similar way as whole-muscle tetanic tension. Repetitive stretch was found to reduce both the initial burst and passive stiffness. The time taken for both to return to their control values was 3 and 10 s respectively. If immediately following repetitive stretch the muscle, and hence the spindle, was held stretched for 3 s, the initial burst in response to a subsequent stretch from a shorter length remained reduced in size for 300 s. The depression could be reversed by a brief period of fusimotor stimulation. Hypertonic Ringer solutions were found to increase the initial burst and passive stiffness, while both were reduced in hypotonic solutions. Low concentrations of caffeine (1.5 mM) produced a similar decrease in both the initial burst and the passive stiffness. Calcium-free Ringer solution left the stiffness unchanged, and increased the whole dynamic response of the spindle. Metabolic exhaustion and poisoning of the muscle caused the initial burst to increase while decreasing the active tension. It is concluded that the initial burst is an intrafusal manifestation of the passive short-range stiffness of extrafusal muscle which is thought to be due to the formation of stable cross-bridges between the actin and myosin filaments of myofibrils.

Action Potentials↗

PubMedDate not supplied

OCIS: 15 years' experience with patient-centered computing.

In the mid-1970s, the medical and administrative staff of the Oncology Center at Johns Hopkins Hospital recognized a need for a computer-based clinical decision-support system that organized patients' information according to the care continuum, rather than as a series of event-specific data. This is especially important in cancer patients, because of the long periods in which they receive complex medical treatment and the enormous amounts of data generated by extremely ill patients with multiple interrelated diseases. During development of the Oncology Clinical Information System (OCIS), it became apparent that administrative services, research systems, ancillary functions (such as drug and blood product ordering), and financial processes should be integrated with the basic patient-oriented database. With the structured approach used in applications development, new modules were added as the need for additional functions arose. The system has since been moved to a modern network environment with the capacity for client-server processing.

Artificial Intelligence↗