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J Dougherty

Publications and source records attributed to J Dougherty.

At least 37 records · Page 2Linked to original sources
PubMed1987

Teaching research in the emergency medicine residency curriculum.

Research in emergency medicine is a necessary component for the growth and development of the academic discipline. Although the need exists for competent physician investigators, most graduates of emergency medicine residencies have had little structured education in research design or methodology. This is particularly true in community hospital programs with little funding allocated to research, limited facilities, and few staff members actively involved in research. Our purpose is to describe a research curriculum designed to operate within a community-based residency program. This curriculum identifies a detailed set of educational objectives in research techniques with the expectation that on completion of the residency program, the resident will be able to critically evaluate medical literature and independently design a research project. We have developed a specific plan for meeting these objectives with coordinated seminars, readings, journal clubs, research projects or exhibits, and professional conferences. We suggest some practical methods of motivating residents and attending staff to pursue clinical investigation.

Curriculum↗
PubMed1987

Tagamet-induced acute dystonia.

A 20-year-old woman presented with an apparent acute dystonic reaction after only five doses of cimetidine (Tagamet). The patient was on no other medications with the exception of oral contraceptives. Emergency administration of IV diphenhydramine HCL brought rapid reversal of this acute dystonic reaction without any neurological sequelae. To our knowledge, this is the first reported case of an acute dystonic reaction associated with cimetidine.

Adult↗
PubMed1987

Noninvasive evaluation of knee meniscal tears: preliminary comparison of MR imaging and CT.

One hundred twenty knees were examined prospectively with both axial computed tomography (CT) and magnetic resonance (MR) imaging to compare the value of these techniques in patients with clinical evidence of meniscal tears. Sixty-four of these knees were subsequently evaluated with diagnostic arthroscopy. In this group, CT was superior to MR imaging for meniscus evaluation in 29.7% of the knees, equal to MR in 54.7%, and inferior to MR in 15.6%. Although surface-coil MR imaging shows great promise and has numerous advantages over more conventional techniques, this preliminary experience suggests that, at least with certain imaging equipment and techniques, CT may be slightly more efficacious than 0.5-T MR imaging in meniscus evaluation. However, further comparative studies at higher field strengths are needed before the relative roles of CT and MR imaging can be established.

Adolescent↗
PubMed1986

Congestive heart failure associated with hyperthyroidism in cats.

Hyperthyroidism was diagnosed in 4 cats with congestive heart failure. Dyspnea and anorexia were observed in 3 of the 4 cats. In each cat, a holosystolic left and/or right apical heart murmur was auscultated. In 3 cats, a prominent extra heart sound (gallop rhythm) was auscultated. All cats had a palpably large thyroid lobe(s) and weight loss. The laboratory and ECG changes were similar to those reported for feline hyperthyroidism. Moderate-to-severe pleural effusion and cardiomegaly were detected via radiography in all cats. Some cats had radiographic signs of pulmonary venous engorgement and pulmonary edema. Echocardiography revealed cardiac dilatation and low left ventricular shortening fraction (wall motion) in all cats. Three cats responded initially to cardiac drugs and propylthiouracil or thyroidectomy. One of these died later, presumably from an adverse reaction to propylthiouracil, and the others died from recurrent congestive heart failure (1) or postoperative cardiac arrest (1). One cat did not respond to treatment, and died 2 days after diagnosis.

Animals↗
PubMed1986

Diphenhydramine-induced toxic psychosis.

A 24-year-old man presented to the emergency department with acute anticholinergic symptoms, hallucinations, and bizarre behavior following a large ingestion of diphenhydramine (Benadryl). Because of the large number of nonprescription preparations containing this antihistamine, similar ingestions are becoming increasingly frequent. Minor anticholinergic side effects associated with diphenhydramine are general medical knowledge. The effects of overdosage are less well known. The clinical presentation of toxic psychosis, its differential diagnosis, and its subsequent treatment are discussed.

Adult↗
PubMed1986

Current status of plasmapheresis in toxicology.

Although the elimination of specific toxins by the removal of all plasma constituents is a crude approach, further refinements of the technique should permit safer and more selective detoxification in the future. Currently the mainstay of treatment of intoxicated patients remains careful, aggressive, supportive care. Plasmapheresis should be considered as yet an unproven, hazardous form of therapy for the treatment of intoxication. Its main role should be confined to a research setting in which investigators attempt to develop more advanced and potentially useful apheresis techniques. Membrane plasmapheresis with subsequent on-line treatment of the plasma by sorbent may remove specific plasma solutes. The plasma may be perfused back to the patient without the need to use replacement fluids, thus avoiding many of the side effects of conventional exchange. Bile acids have been removed by circulating plasma over charcoal-coated glass beads, and several toxic substances were shown to be absorbed by perfusion over amberlite resin columns. Another productive area for future research includes the use of plasma exchange therapy for the treatment of acute endogenous intoxications. Recent examples include the treatment of severe preeclampsia, extensive rhabdomyolysis, and life-threatening bleeding in a hemophiliac with inhibitors to clotting factors. Although plasmapheresis in the management of intoxications is still an experimental technique, it may open the door to the treatment of previously intractable syndromes, both medical and toxicologic.

Adult↗
PubMed1986

A geriatrics curriculum for emergency medicine training programs.

The growing number of elderly in the United States will continue to increase the demand for emergency services. Although the emergency medicine core curriculum, as defined by the American College of Emergency Physicians, requires mandatory training in pediatrics, there is no mention of geriatric care. A special body of knowledge regarding normal aging as well as the special presentation of disease in the elderly is required to provide optimum care for the aged patient. We present an integrated geriatric curriculum designed to operate within a three-year emergency medicine residency program. This curriculum identifies specific educational objectives for training in geriatric emergencies that can be summarized as follows: identify those impairments and functional disorders that often complicate diagnosis and therapy; acquire an understanding of how physiologic changes in aging affect normal laboratory and radiologic values; develop knowledge of drug side effects and interactions in this population; understand and treat the group of disease peculiar to the elderly; recognize diseases and injuries that present a different clinical picture in old age; and differentiate and treat common psychosocial emergencies in the elderly. These educational objectives are further defined using a specific interlinked framework of didactic presentations, journal clubs, case conferences, therapeutic audits, formal rotations, and consultants. This format will provide valuable educational experiences for the emergency medicine resident and may strengthen positive attitudes toward geriatric medicine.

Aged↗
PubMed1986

Cathartic-induced magnesium toxicity during overdose management.

A 39-year-old women was admitted to the hospital following a large ingestion of a tricyclic antidepressant. The administration of magnesium citrate in repeated doses with activated charcoal resulted in a striking increase in serum magnesium levels followed by acute neuromuscular deterioration and respiratory depression. The patient required dialysis for control of hypermagnesemia. Her clinical condition improved slowly without further complication and she was discharged to a rehabilitation center.

Adult↗
PubMed1985

Correlation between immunosuppressive activity and translation regulatory activity.

An immunoglobulin negative material from the eluate of an anti-idiotype immunosorbent column [1] exhibited potent immunosuppressive activity. This material also inhibited the translation of globin mRNA in a cell-free reticulocyte lysate system. The translation inhibitory activity of this material was not attributable to nucleases which were separable by a blue-dextran agarose column. Further correlation between immunosuppressive activity and translation inhibitory activity was observed when GTP or GTP analogue was included in experimental systems. These results suggest that the immunosuppressive factor (or factors) may contain a translation inhibitory factor. The biochemical mechanism of immunosuppression is discussed.

Animals↗
PubMed1984

Tumorigenicity of adenovirus-transformed rat cells and expression of class I major histocompatibility antigen.

The expression of class I major histocompatibility antigens was studied in six syngeneic adenovirus 12 (Ad12)-transformed LIS rat cell lines of varying tumorigenicity. The concentration of MHC class I product was estimated by indirect immunofluorescence staining of viable cells in suspension with specific antibody and cytofluorographic analysis, and by sensitivity to killing by allogeneic cytolytic T cells (CTLs) elicited by immunization with spleen cells in vivo and in mixed lymphocyte reactions in vitro. None of the rat cell lines examined was devoid of MHC class I antigen. When compared to syngeneic Ad2-transformed cells or fibroblasts, the average intensity of fluorescence of Ad12-transformed lines was lower, suggesting that the concentration of MHC class I antigen is somewhat lower in Ad12-transformed cells. Sensitivity to killing by both in vivo and in vitro induced allogeneic CTLs, however, was not markedly lower with Ad12-transformed cells and correlation was not found between tumorigenic potential in vivo and sensitivity to allogeneic T-cell killing in vitro.

Adenoviruses, Human↗
PubMed1981

Interferons, double-stranded RNA, and RNA degradation. Isolation and characterization of homogeneous human (2'-5')(a)n synthetase.

(2'-5')(A)n synthetase is one of the mediators of interferon action. If activated by double-stranded RNA it converts ATP into pyrophosphate and (2'-5')(A)n. In turn, (2'-5')(A)n activates a latent endoribonuclease (RNase L) which cleaves single-stranded RNA. We report here the isolation and characterization of a homogeneous human (2'-5')(A)n synthetase. The enzyme was purified from interferon-treated HeLA S3 cells by chromatography of a ribosomal salt wash fraction on DEAE-cellulose, poly(I) . poly(C) agarose, and CM-cellulose. The purified (2'-5')(A)n synthetase can convert over 90% of ATP into (2'-5')(A)n. The enzyme is unstable but can be stabilized by certain nonionic detergents (e.g. Triton X-100). Its apparent Mr = 100,000, as determined by gel electrophoresis in sodium dodecyl sulfate, and about 80,000, as determined by centrifugation through a glycerol gradient. The human (2'-5')(A)n synthetase is similar to the corresponding enzyme from mouse Ehrlich ascites tumor cells, but differs from the latter in size (100,000 versus 105,000 daltons) and in ionic conditions required for maximal activity.

2',5'-Oligoadenylate Synthetase↗
PubMed1981

Pharmacology of narcotic analgesics in the horse: selective blockade of narcotic-induced locomotor activity.

The locomotor responses of horses given morphine and fentanyl were blocked or lessened by administration of naloxone or acepromazine. Naloxone given at the dosage of 0.015 mg/kg completely blocked the locomotor activity induced in horses given fentanyl (0.020 mg/kg of body weight). The locomotor stimulation produced by morphine given at the dosage of 2.4 mg/kg was reduced by 75% of naloxone (0.020 mg/kg). Acepromazine partially blocked the locomotor responses to fentanyl and morphine. This blockade activity reached its peak about 30 minutes after acepromazine was given (IV) and lasted more than 6 hours. Simultaneous administration of acepromazine and morphine was associated with substantial respiratory depression for more than 4 hours after administration of both drugs. In other experiments, fentanyl did not add to the partial locomotor response observed after large doses of pentazocine were given--this being consistent with the concept that pentazocine possesses both antagonist and agonist actions at the narcotic receptor. Furosemide and phenylbutazone, given at usually used clinical doses, had no effect on the locomotor response to fentanyl, indicating that the usual clinical dosages of neither drug exerted stimulant or depressant actions.

Acepromazine↗
PubMed1980

Double-stranded RNA and the enzymology of interferon action.

Extracts from interferon-treated, not virus-infected Ehrlich ascites tumor cells differ in various biochemical characteristics from extracts of control cells. We studied three enzymes whose level is enhanced in cells upon treatment with IF and which are causing some of the differences. (2'-5')(A)n synthetase, an enzyme converting ATP into a series of (2'-5') linked oligoadenylates ((2'-5')(An)) in the presence of dsRNA was purified to homogeneity and characterized. The second enzyme, RNase L, a latent endonuclease, which can be activated by (2'-5')(A)n to cleave single-stranded RNAs, was purified several hundredfold. The activation of this enzyme is reversible and is lost upon removal of (2'-5')(A)n. The activation is not accompanied by a large change in shape of conformation of the enzyme. The third enzyme is a protein kinase which if activated by dsRNA can phosphorylate the peptide chain initiation factor eIF-2 and a protein designated P1 of 67,000 daltons. This enzyme was purified several thousandfold. The most highly purified preparation consists of three proteins with P1 as the most abundant component.

2',5'-Oligoadenylate Synthetase↗
PubMed1979

Familial arthrogrypotic-like hand abnormality and sensorineural deafness.

We describe a family with arthrogrypotic-like hand abnormalities. There were ten affected members in two generations. Three of ten affected persons showed an associated sensorineural hearing loss. The degree of the hand deformities and hearing loss varied in affected individuals. The pattern of inheritance seems to be autosomal dominant with variable expressivity. The findings in this syndrome resemble those reported previously.

Adolescent↗
PubMed1978

A technique to assess fibrinogen, platelet and red cell kinetics in calves with artificial hearts or circulatory assist devices.

1. Normal data for routine hematologic studies including fibrinogen, VIIIAHF, AT III, and circulating platelet aggregates are reported for Holstein calves. 2. Therapy with warfarin, ASA, and dipyridamole does not alter these parameters such as VIIIAHF, AT III, or circulating platelet aggregates. 3. 75SeM can be used as an in vivo label to study the fibrinogen, platelet, and red cell kinetics simultaneously in calves. 4. Decreased VIIIAHF levels and decreased platelet survival are the most sensitive parameters to estimate the activation of coagulation in the animals with circulatory assist devices. 5. The total heart animals seem to have a significant decrease in fibrinogen and VIIIAHF levels as compared to normal and left ventricular assist animals. 6. Despite the use of warfarin and antiplatelet drugs, decreased platelet survival occurred in both the total heart and the left ventricular assist animals. Fibrinogen half life with 75SeM must be interpreted with caution until corrections for pool size, reutilization, and nonpeptide binding have been considered.

Animals↗
PubMed1973

Fixed-interval schedules of intravenous cocaine presentation in rats.

Fixed-interval schedules of intravenous cocaine presentation were examined as a function of injection dose (0.32 to 0.64 mg/kg) and interval duration (200 to 400 sec) in two rats. Cocaine was found to exert a dose-related temporal control over the initiation of responding that was unaffected by the fixed-interval contingency. Fixed-interval pause duration was linearly related to injection dose and was the same duration as the interresponse time found on continuous reinforcement schedules of cocaine presentation. The fixed-interval pause remained constant with changes in interval duration. Characteristic fixed-interval patterns of responding were observed. However, overall response rates were inversely related to injection dose and directly related to interval duration. Running response rates varied unsystematically with both variables. These findings are at variance with results typically found in studies of fixed-interval food and electric shock presentation.

Animals↗