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Biomedical subjects

G Varghese

Publications and source records attributed to G Varghese.

At least 37 records · Page 2Linked to original sources
PubMed1993

International comparative study of cefepime and ceftazidime in the treatment of serious bacterial infections.

In this randomized multicentre study, we compared the safety and efficacy of cefepime, 2.0 g bd i.v., with that of ceftazidime, 2.0 g tid i.v., as initial treatment of adult patients with serious infections of bacterial aetiology. Three hundred and forty-eight patients were entered into the study, 173 received cefepime and 175 ceftazidime. The treatment groups were comparable with respect to demographic characteristics, including the types of infection (cefepime/ceftazidime: urinary tract, 55/72; lower respiratory tract, 83/74; skin and soft tissue, 23/14; septicaemia, 81/81; and others, 15/5). Gram-positive bacteria were identified as pathogens on 86 occasions (cefepime/ceftazidime: 48/41), including 20 Staphylococcus aureus isolates (13/7) and 27 Streptococcus pneumoniae isolates (14/13). Gram-negative bacilli were isolated on 261 occasions (126/135), and included 219 Enterobacteriaceae (cefepime/ceftazidime: 108/111) and 34 strains of Pseudomonas aeruginosa (14/20). An intention-to-treat analysis revealed satisfactory clinical response rates of 80% and 79% for the cefepime and ceftazidime groups, respectively, and bacteriological eradication rates of 85% and 88% for the cefepime and ceftazidime groups, respectively. Of patients with microbiologically documented infections, 86% (84 of 98) treated with cefepime and 87% (94 of 108) treated with ceftazidime responded satisfactorily. Thirty-two patients (19%) treated with cefepime and 26 (15%) treated with ceftazidime died. Thirty-six patients in the cefepime group and 23 in the ceftazidime group experienced adverse events; therapy was discontinued prematurely in four and two patients in the cefepime and ceftazidime groups, respectively. Of the patients experiencing adverse events, 22 (13%) treated with cefepime developed intolerance at the injection site, compared with 11 (6%) treated with ceftazidime (P = 0.045). In conclusion, twice-daily cefepime (2 g bd) is at least as effective as ceftazidime (2 g tid), as initial empirical therapy for serious bacterial infections in non-neutropenic patients.

Adolescent↗
PubMed1992

Inhaled steroids in patients with bronchiectasis.

The effect of inhaled beclomethasone diproprionate (1500 micrograms day-1) on symptoms, pulmonary function and sputum production was examined in a double-blind, placebo-controlled, cross-over study in 20 patients with bronchiectasis. An 18% reduction in daily sputum production (P less than 0.003) was observed on treatment with inhaled steroid compared to placebo. A small, significant, improvement in morning peak expiratory flow rate (P less than 0.03) and forced expiratory volume in 1 s (P less than 0.03) was seen but the absolute changes are unlikely to be of clinical importance. Symptom scores for cough improved significantly (P less than 0.02). Inhaled steroids may have a role in the management of bronchiectasis by reducing cough and sputum production.

Administration, Inhalation↗
PubMed1992

Fibromatosis on the dorsum of the nose.

An extremely rare case of fibromatosis in a 25-year-old Indian male is reported. The clinical examination and pre-operative findings were suggestive of a benign neoplasm, probably of neurogenic origin. The mass was well circumscribed and could be shelled out en masse. Histopathological examination showed it to be fibromatosis. An external rhinoplasty approach enabled a complete wide excision to be performed without any resulting cosmetic defect.

Adult↗
PubMed1992

Respiratory responses and blood sugar level of the crab, Barytelphusa cunicularis (Westwood), exposed to mercury, copper and zinc.

Barytelphusa cunicularis (Westwood), a freshwater crab was exposed to mercuric chloride, copper sulphate and zinc sulphate from 0 to 12 hr and the oxygen consumption of the animal was measured in order to study the stress caused by these heavy metals. Normal oxygen consumption was affected by the three heavy metals. Similarly, crabs exposed to sublethal concentrations of the same pollutants for 24, 48, 72 and 96 hr showed an elevation in the blood sugar level with a maximum increase at 48 hr. The results indicate a switch towards glycolysis in order to overcome the anaerobic stress caused by the heavy metals.

Animals↗
PubMed1991

Utilization of circulating glutathione by nodular and cancerous intact rat liver.

The relationship of the rate of extraction of circulating glutathione (GSH) to the level of activity of gamma-glutamyltransferase (GGT) of hepatocytes of nodular and of cancer-bearing livers was studied in rats perfused in situ via the portal vein. Fischer adult male rats with many nodules (10 rats) or few (nine rats) liver nodules and four rats with hepatomas were compared as to their ability to remove GSH (10 microM) from the perfusate. The rate of extraction of infused GSH was directly proportional to the numbers of GGT(+)-hepatocytes in the liver tissue, inhibitable completely by adding the GGT inhibitor serine borate at 6-8 mM in the perfusate, and significantly enhanced in all rats by adding the gamma-glutamyl acceptor glycyl-glycine to the perfusate. These results suggest that nodules and cancers are able to remove GSH much more efficiently from the circulation than the surrounding liver tissue and that their enhanced GSH utilization is directly dependent on their GGT activity, which is present at much higher levels than in the surrounding tissues. The increases in GGT activity in nodule hepatocytes and enhanced ability to utilize GSH could be critical factors in the response to resistance selection of chemical hepatocarcinogenesis.

Animals↗
PubMed1991

Nonarticular complication of heterotopic ossification: a clinical review.

Heterotopic ossification (HO) is a complication in neurologic lesions such as head injury and spinal cord injury. Limitation of range of motion and ankylosis as results of HO are well documented. In this report, ten instances of nonarticular complications after development of HO are described. There were three instances of vascular compression, five instances of ulnar nerve compression at the elbow, and two instances of suspected lymphedema. Clinical findings and radiographic evidence of these complications are described. Clinicians should be aware of these complications when HO is diagnosed. In addition, HO should be considered in the differential diagnosis of deep venous thrombosis in spinal cord injured and head injured patients.

Adolescent↗
PubMed1990

Role of hepatic gamma-glutamyltransferase in the degradation of circulating glutathione: studies in the intact guinea pig perfused liver.

The role of hepatic gamma-glutamyltransferase in the breakdown of circulating glutathione was studied in the perfused guinea pig liver. Hepatic gamma-glutamyltransferase activity in the guinea pig is sevenfold higher than in the rat and is comparable to its activity in man. Guinea pig livers were found to remove, in a single pass, 50% to 90% of glutathione (10 to 50 mumol/L) added to the portal perfusate. Removal of portal glutathione was totally dependent on the activity of gamma-glutamyltransferase and led to the near quantitative appearance of cysteinyl-glycine and cysteine in the caval perfusate. Glutathione removal by the intact liver followed saturation with a Michaelis constant (Km) of 59 mumol/L for glutathione and a maximum velocity of 235 nmol glutathione/min/gm of liver weight. The capacity of the guinea pig liver to remove circulating glutathione was estimated to be sevenfold to 10-fold higher than its net rate of output of glutathione into the circulation. Inhibition of gamma-glutamyltransferase activity in the perfused liver led to threefold to sixfold increases in the hepatic output of glutathione into the circulation, indicating that more than two thirds of glutathione transported extracellularly is broken down. Data obtained demonstrate a major role of hepatic gamma-glutamyltransferase, both in the removal of portally carried glutathione and in the degradation of glutathione molecules released by the liver itself into the sinusoids. These findings suggest the existence of an intraorgan transport of glutathione in the liver, whereby periportal cells could provide glutathione precursors to pericentral cells.

Animals↗
PubMed1989

Effect of ethanol on splanchnic hemodynamics in awake and unrestrained rats with portal hypertension.

Alcoholic liver disease is frequently accompanied by portal hypertension. We have previously shown that alcohol intake in awake, unrestrained rats is followed by an increase in portal tributary blood flow. In this study, the effect of ethanol on splanchnic hemodynamics in rats with portal hypertension was analyzed. Portal hypertension was induced by partial ligation of the portal vein. This procedure resulted in an increase in portal tributary and hepatic arterial blood flows compared to sham-operated animals. Ethanol (2 gm per kg, oral) increased portal tributary blood flow in both sham-operated and portal vein-ligated rats (sham + water = 37.6 +/- 1.4; sham + ethanol = 63.1 +/- 1.9; p less than 0.01; partial portal vein stenosis + water = 53.2 +/- 3.3; partial portal vein stenosis + ethanol = 69.5 +/- 2.2 ml.kg-1.min-1; p less than 0.01). In sham-operated rats, hepatic artery blood flow was unchanged following ethanol (sham + water = 6.6 +/- 0.7; sham + ethanol = 7.1 +/- 1.0 ml.kg-1.min-1), whereas in portal vein-ligated rats, flow was increased (partial portal vein stenosis + water = 13.7 +/- 1.4; partial portal vein stenosis + ethanol = 19.8 +/- 1.1 ml.kg-1.min-1; p less than 0.025). The adenosine receptor blocker 8-phenyltheophylline suppressed only the ethanol-induced increase in both portal tributary and hepatic artery blood flows in portal vein-ligated rats. The increases in hepatic artery and portal tributary blood flows observed in portal vein-ligated rats without ethanol were not influenced by 8-phenyltheophylline.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine↗
PubMed1988

Pulmonary involvement in ulcerative colitis.

Pulmonary involvement in ulcerative colitis usually presents as a rapidly progressive cough with copious amounts of sputum. Although it is rare, distressing symptoms may be relieved by inhaled steroids in 50-60% of cases. Three case reports are presented along with a review of the features of 28 other cases.

Adult↗
PubMed1987

Basolateral gamma-glutamyl transferase ectoactivity in rat liver: effects of chronic alcohol consumption.

Chronic alcohol consumption is known to increase hepatic gamma-glutamyl transferase (GGT) activity. The biological significance of this change has, however, remained unknown. Using a recently described methodology which allows the determination of basolateral ectoenzyme GGT activity (Ble-GGT) in perfused rat liver (Speisky et al, 1985), we have investigated the effects of chronic alcohol consumption on Ble-GGT and on its participation in the utilization of circulating glutathione (GSH). Ble-GGT was markedly increased (40-75%) by chronic alcohol consumption. The ecto-activity strongly correlated with total GGT activity, measured in whole liver homogenates from ethanol-fed animals (r = 0.898, p less than 0.001). Ble-GGT was found to catalyze the utilization of significant amounts of circulating GSH (7.4-14.7 nmol/min/100 g B.W.). Chronic ethanol treatment led to marked increases (111%) in the hydrolysis of circulating GSH, which highly correlated (r = 0.958, p less than 0.001) with total liver GGT activity. An increased Ble-GGT activity following chronic alcohol consumption might constitute a mechanism to increase the hepatic availability of GSH precursors.

Alcohol Drinking↗
PubMed1986

Spinal cord injuries following electrical accidents.

Injuries from high tension electrical current result in approximately 1000 deaths per year and account for 3% of all major thermal injuries in the United States. Even though the complications from electrical injury can affect almost every organ system in the body, a neurological complication is perhaps the most common non-lethal one. 116 cases of electrical accidents among 1206 burn patients admitted to Kansas University Medical Center were reviewed. There were 5 cases of spinal cord injury which were detected from a few days up to four weeks from the injury. All had incomplete lesions. Two of them had quadriparesis, and 3 paraparesis. Clinical manifestations included motor and sensory involvement, predominantly motor. Possible mechanisms for the spinal cord damage include heating effect, electrogenic changes and vascular damage. Spinal cord injury following an electrical accident is more frequently encountered than is generally recognized.

Accidents↗