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Biomedical subjects

J A Reichert

Publications and source records attributed to J A Reichert.

10 recordsLinked to original sources
PubMed2001

Peripheral and preemptive opioid antinociception in a mouse visceral pain model.

Recent studies suggest that opioids can produce analgesia through peripheral mechanisms following inflammation of peripheral tissue. This study examined whether opioids administered prior to inflammation can produce antinociception by peripheral mechanisms in a model of visceral pain. Mice were injected intraperitoneally (i.p.) with 1% acetic acid to evoke abdominal writhing, a standard model of visceral pain. The number of writhes that occurred during 30 min after acetic acid were determined. Intraperitoneal injection of morphine sulfate (60, 90, 100 or 120 microg/0.3 ml) or the peripherally acting opioid loperamide (0.12, 0.36, 1.2 or 3.6 mg/0.3 ml) given 5 min after acetic acid decreased writhing in a dose-dependent fashion. Morphine (100 microg) produced an 70% attenuation in the number of writhes while loperamide (1.2 mg) decreased writhing by 56%. These antinociceptive effects were blocked by pretreatment with the opioid receptor antagonists naloxone (10 mg/kg) and its quarternary version naloxone methiodide (10 mg/kg). To determine whether opioids produced preemptive antinociception via peripheral mechanisms, mice received i.p. injections of morphine (1, 5, and 10 microg/0.3 ml) or vehicle 5 min before acetic acid. Doses of 5 and 10 microg morphine inhibited the number of writhes by 51 and 93%, respectively. The highest dose (10 microg) was ineffective when given intravenously 5 min before acetic acid, suggesting that antinociception following i.p. administration was acting via peripheral mechanisms. These data demonstrate that low doses of opioids, given before or after acetic acid, produce visceral antinociception through peripheral mechanisms. This may be clinically relevant for the management of postoperative abdominal pain.

Acetic Acid↗
PubMed1997

Sterilization for family planning in a Third World country.

Outpatient laparoscopy procedures have made sterilization possible for millions of women in developing countries. This report describes the experience of a team of doctors, nurses, and support staff that performed 107 laparoscopic tubal sterilizations during on eight-day sojourn in a remote north-central area of Nicaragua. Minimal analgesia (oral ibuprofen) and anesthesia (1% lidocaine) were used since most of the patients walked to and from the hospital-some up to 15 miles. Because the Nicaraguan government's support for birth-control programs is unreliable and because illegal abortion is the leading cause of maternal mortality in Nicaragua, this safe, minimally invasive surgical method is the favored means of birth control.

Adult↗
PubMed1993

Species differences in nucleotide pool levels of 2',3'-dideoxycytidine: a possible explanation for species-specific toxicity.

The nucleoside analogue, 2',3'-dideoxycytidine (ddC), a potent inhibitor of human immunodeficiency virus reverse transcriptase (in its anabolized triphosphorylated form), mediates virologic and immunologic improvements in AIDS patients. Clinical studies using ddC have shown various ddC-related toxicities, the most pronounced being a dose-limiting peripheral neuropathy. The dose responsiveness and manifestation of the ddC-related neuropathy vary among species, with greatest sensitivity in human > monkey > rabbit whereas mice and rats are insensitive to ddC-related neuropathy. This study has examined nucleotide pool sizes of ddCTP and its constituents (ddC, ddCMP, ddCDP) in cultured fibroblasts (human, rabbit, mouse) and freshly isolated peripheral lymphocytes (monkey, rabbit, rat, and mouse). Cells were treated with 10 microM [3H]ddC and nucleotide pool sizes analyzed by HPLC. The formation of nucleotide pools increased during the 24-hr assay period. Fibroblast pool formation of phosphorylated metabolites was significantly greater in human > rabbit > mouse. Lymphocytes demonstrated a similar pattern with monkey > rabbit > mouse = rat. Total ddC anabolite pools were also found to be significantly smaller (p < 0.05) in rodent lymphocytes than in those of rabbit or monkey, and rodent fibroblasts were smaller than those of human or rabbit (p < 0.05). These findings indicate that nucleoside phosphorylation and intracellular levels of phosphorylated metabolites may play an important role in determining species sensitivity and manifestation of ddC-related toxicity.

Animals↗
PubMed1993

Amyotrophic lateral sclerosis in pregnancy.

BACKGROUND: Amyotrophic lateral sclerosis is rare in the obstetric population; only one case has been described in the last 18 years. Two pregnant women with this disease were observed within a 1-year period in Minneapolis. CASES: A twin pregnancy was diagnosed in a woman during hospital admission for evaluation of a pure lower motor neuron degenerative process. The disease was rapidly progressive, with maternal death occurring 6 weeks after the delivery of healthy twins at 34 weeks' gestation. A second patient with amyotrophic lateral sclerosis conceived in the early stages of respirator dependency; her disease remained stable throughout the pregnancy, and she delivered at 33 weeks. The neonates had a good outcome in both cases. CONCLUSION: Amyotrophic lateral sclerosis, though rare in pregnancy, does occur and can result in good neonatal outcome. Maternal disease does not regress during pregnancy and may worsen under the increased respiratory and weight-bearing demands; whether this represents actual disease progression cannot be determined definitely. Labor management should include pulse oximetry determination and is facilitated by lack of disease involvement of the uterine sensory and motor nerves and a lack of resistance of the pelvic floor musculature.

Adult↗
PubMed1976

Fitz-Hugh-Curtis syndrome. A laparoscopic approach.

Four of our patients had classical Fitz-Hugh-Curtis syndrome. Persistent right upper-gradrant pain prompted extensive medical evaluation; anibiotic therapy fialed to relieve the symptoms. In each case, laparoscopy proved to be an ideal method for obtaining definitive diagnosis and therapy. Typical perihepatic violin-string adhesions were cauterized and divided under direct vision with dramatic resolution of symptoms.

Adult↗
PubMedDate not supplied

Changes in attitudes toward cesarean birth.

OBJECTIVE: To compare the findings of three studies of women's responses to planned and unplanned cesarean birth. DESIGN: Descriptive. SETTING: Private obstetric practices, childbirth education classes, and hospital postpartum units. PARTICIPANTS: Study 1: 24 women who had cesarean deliveries between 1973 and 1980; Study 2: 15 women who delivered in 1981-82; Study 3: 173 women who delivered in 1989-90. MAIN OUTCOME MEASURE: Qualitative data were obtained by an investigator-developed open-ended questionnaire that was mailed to participants after cesarean delivery. RESULTS: The findings from the three studies indicate that the dominant responses to cesarean birth are happiness and excitement about the newborn, accompanied by disappointment about having to have a cesarean delivery. The women in Study 1 expressed the highest proportion of ineffective responses and the lowest proportion of adaptive responses (p = .003), whereas the women in Studies 2 and 3 expressed approximately equal percentages of adaptive and ineffective responses. Women who had unplanned cesarean deliveries had a lower percentage of adaptive responses and a higher percentage of ineffective responses than those who had planned cesarean deliveries (p < .05). Women who had regional anesthesia had more adaptive responses than those who had general anesthesia (p = .0217). CONCLUSION: The findings suggest that women who deliver by cesarean section require continued attention and sensitive care that takes into account their special needs for information, for the presence of their partners throughout the birth experience, and for sustained contact with their newborn.

Adaptation, Psychological↗