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Biomedical subjects

J E Fairfield

Publications and source records attributed to J E Fairfield.

9 recordsLinked to original sources
PubMed1996

Prehospital deaths in the Yorkshire Health Region.

OBJECTIVES: To estimate the proportion of prehospital deaths in a British population of trauma victims which may be preventable, and to investigate the effect of death at the scene and death in transit on potential survivorship. METHODS: Blinded review, by four specialists with an interest in trauma, of necropsy results and details of age, sex, and mechanism of injury for prehospital trauma deaths in the Yorkshire Health Region in a 12 month period. RESULTS: Complete records were traced on 305 of 337 trauma deaths, 190 being recorded as dead on arrival of emergency services and 115 dead on arrival at hospital. In the group declared dead at the scene, three of the four assessors considered 93% of deaths to have been inevitable and only 2% as potential survivors (25% of this group sustaining inevitably fatal injuries such as brain avulsion or decapitation). In the group dead on arrival 81% were felt to be inevitable deaths and 5% potential survivors. CONCLUSIONS: There seems to be less scope for salvage of victims of trauma death in a British population than has been recorded in America, possibly due to a higher proportion of blunt trauma deaths here. Those who die in transit consist of a less severely injured group with a higher potential for survival.

Accidents↗
PubMed1991

Haemodynamic effects of propofol: induction with 2.5 mg kg-1.

Serial measurements of haemodynamic variables were performed at 1-min intervals in nine ASA I, unpremedicated patients before and for 5 min after induction of anaesthesia with propofol 2.5 mg kg-1. End-tidal carbon dioxide concentration was maintained within the normal range. Stroke volume and left ventricular function were measured by Doppler and cross-sectional echocardiography at the aortic valve. Systemic arterial pressure was measured by automated oscillotonometry and heart rate by electrocardiograph. Stroke volume, cardiac output, systemic vascular resistance, left ventricular stroke work and rate-pressure product were calculated. There was a decrease at all time points in systolic, mean and diastolic arterial pressure. There was an initial increase in heart rate and cardiac output, with a subsequent decrease to less than baseline. There was an initial decrease in systemic vascular resistance followed by partial recovery, and a delayed decrease in left ventricular function as measured by peak aortic blood flow velocity and acceleration.

Adult↗
PubMed1991

Oxygen delivery systems--a comparison of two devices.

Two low-volume, variable performance oxygen delivery systems were compared in conscious spontaneously breathing volunteers. Oropharyngeal oxygen concentrations were measured during periods of nose and mouth breathing. The systems were studied at oxygen flow rates of 2 or 4 litres/minute. The performance of both systems was similar under the test conditions but the nasal catheter is preferable in terms of cost.

Anesthesia Recovery Period↗
PubMed1991

Induction and recovery characteristics of desflurane in day case patients: a comparison with propofol.

Desflurane is an ether halogenated exclusively with fluorine. It has a blood/gas partition coefficient of 0.42 (cf. isoflurane 1.40 and nitrous oxide 0.46). This characteristic suggests that it should provide both a fast induction of anaesthesia and a rapid recovery from anaesthesia. To assess this, 60 patients were entered into a study and allocated at random to one of four groups receiving either desflurane or propofol for induction and maintenance of anaesthesia. Desflurane caused loss of consciousness in approximately 2 minutes during gaseous inductions. The psychomotor scores in the patients who received propofol for induction and maintenance of anaesthesia were significantly worse compared with those who were given desflurane for either induction and maintenance or for maintenance only. There was also a tendency for other recovery parameters to be faster in the patients receiving desflurane although this did not reach statistical significance. This suggests that desflurane would be a suitable agent for day case anaesthesia providing for a rapid recovery.

Adolescent↗
PubMed1990

Insulin protects cognitive function in experimental stroke.

There is evidence from in vitro systems that the extent of neuronal loss in acute central nervous system ischaemia can be reduced by manoeuvres which restrict availability of glucose to the ischaemic area. Experiments were designed to test whether hypoglycaemia induced with insulin is associated with improved behavioural outcome in a recovery model of stroke. Rats learned a maze task as a test of working memory, believed to be subserved by the hippocampus, and then had a period of cerebral ischaemia, followed by reperfusion. After an interval of 14 days they were tested on the same maze, where lesioned animals had very significant (p less than 0.0001) impairment of working memory, whereas lesioned and treated (2.0 u/kg-1 insulin, minimum single plasma glucose value: 3.1 mmol/l-1) animals were indistinguishable from control animals. It is concluded that a striking degree of protection can be obtained with levels of mild hypoglycaemia which may be acceptable and practicable for use in humans.

Animals↗
PubMed1987

Detection of IgG subclass-specific anti-IgE antibodies in normal and atopic individuals.

Atopic dermatitis and atopic asthma patients were shown to have elevated IgG anti-IgE levels compared with those of controls. When the pattern of IgG subclass anti-IgE activity was studied, further differences between the three groups became apparent. Adults with atopic dermatitis had elevated IgG1 and IgG4 anti-IgE compared with those of controls but no corresponding increase in the IgG2 or IgG3 subclasses. For Sri Lankan children with atopic asthma and a high incidence of Nematoda infection, elevated anti-IgE was restricted to the IgG1 subclass. While IgG1 anti-IgE proved to be the predominant subclass for both atopic groups, IgG2 anti-IgE was the major subclass among controls.

Adult↗