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Biomedical subjects

J R Barrie

Publications and source records attributed to J R Barrie.

At least 19 recordsLinked to original sources
PubMed2005

The problem of trachoma within an onchocerciasis-endemic zone in Kaduna: need for a multilateral approach?

INTRODUCTION: Within the mesoendemic onchocerciasis belt of Kaduna State, Northern Nigeria, there were other causes of ocular morbidity as well. We investigated the contribution of trachoma. METHODS: A total of 6831 individuals were examined for eye disease, including signs of trachoma. RESULTS: The overall prevalence of trachoma was 4.5% (577 eyes of 310 individuals), making it the second most common cause (1 in 5) of ocular morbidity after cataracts. Of the 577 eyes, 405 (70.2%) had cicatrizing disease while the rest had active disease. Overall, the prevalence of TF was 1.1% (1.3% in those < 10 years of age), TI 0.2%, TS 3%, CO 0.5% and TT 1.1% (4.3% and 3.5% in subjects aged > 55 and > 40 years, respectively). The prevalence of trachoma increased with age. The overall prevalence of blindness in the whole population was 2.7%. Trachoma accounted for 11% of this. On the other hand, onchocerciasis accounted for 3.1% of the overall ocular morbidity (less than trachoma) and 39% of the blindness. CONCLUSIONS: There appears to be a clear need to retrain middle cadre ivermectin workers in trachoma rapid assessment and SAFE strategy intervention methods in order to further impact blindness prevention in these 'onchocerciasis-endemic' zones.

Adolescent↗
PubMed2002

Radiographic findings in 20 patients with Hantavirus pulmonary syndrome correlated with clinical outcome.

OBJECTIVE: Hantavirus is a rare rodent-borne pathogen responsible for the Hantavirus pulmonary syndrome. The objective of this study was to review the clinical and radiographic findings of patients presenting with Hantavirus pulmonary syndrome in northern Alberta, Canada. MATERIALS AND METHODS: We retrospectively reviewed the cases of 20 patients who presented with Hantavirus pulmonary syndrome from 1989 to 1999. RESULTS: Two patterns of presentation were identified. One group (13/20 patients) presented with fulminant clinical and radiographic findings and required intensive care support. Six (46%) of the 13 died within a few days of presentation. Some presented in respiratory failure with bilateral parenchymal infiltrates or a rapid progression from mild bilateral interstitial changes to bilateral interstitial and alveolar infiltrates with pleural effusions. The radiographic findings paralleled these clinical symptoms. The second group (7/20) consisted of patients whose clinical course was more limited, as were their corresponding radiographic findings. These patients had a limited hospital stay, and only minimal changes were identified on radiographs. None of the second group of patients died. CONCLUSION: Clearly, in our study, the patients with Hantavirus pulmonary syndrome presented as two groups: those with the fulminant form of the illness and those with the limited type. Of the patients we studied, the group with the fulminant form presented with severe clinical symptoms and radiographic signs of pulmonary disease and had a 46% mortality rate. The group with the limited form presented with mild clinical symptoms and minimal radiographic changes and had no mortalities.

Adolescent↗
PubMed1994

Respiratory sinus arrhythmia: comparison with EEG indices during isoflurane anaesthesia at 0.65 and 1.2 MAC.

Respiratory sinus arrhythmia (RSA) is a cyclical variation in heart rate during breathing, where the heart rate increases during inspiration and decreases during expiration. RSA and the electroencephalogram (EEG) were monitored in 10 patients undergoing elective surgery with isoflurane and nitrous oxide in oxygen anaesthesia after induction with propofol. All patients were subject to controlled ventilation and recovery from competitive neuromuscular block was facilitated by neostigmine and glycopyrronium (seven patients) or atropine (three patients). Median and spectral edge (95%) frequencies of the raw EEG were derived off-line. RSA and EEG indices were obtained during preinduction (baseline), induction, incision, 0.65 and 1.2 MAC of isoflurane maintenance during surgery and recovery. Significant decreases in the level of RSA, median and spectral edge frequencies were observed during induction and significant increases in all indices were observed at recovery in all patients. Significant decreases in the median and spectral edge EEG frequencies occurred in patients treated with atropine both to counteract bradycardia after propofol induction and at antagonism of neuromuscular block (n = 3), compared with patients treated with glycopyrronium (n = 7). In contrast, the level of RSA did not decrease significantly with atropine. It is concluded that measurements of RSA could form the basis of a useful index of anaesthetic depth during isoflurane anaesthesia, even during the use of pharmacologically appropriate doses of atropine. However, any effects of atropine on the raw EEG and on indices derived from the EEG, should be characterized further so that these effects are not confused with changes in anaesthetic depth.

Adult↗
PubMed1994

Efficiency of the Carden "Ventmasta" in A and D modes during controlled ventilation in children.

We have determined the efficiencies of the enclosed Mapleson A and Mapleson D modes of the Carden "Ventmasta" ventilator during controlled ventilation in 19 anaesthetized children. In addition, we determined the suitability for the A mode of the fresh gas formula, VF = 0.6 x weight0.5. Efficiency was assessed in terms of the fraction of fresh gas delivered to the alveoli. When the minute volume to fresh gas flow ratio exceeded 1.5, fractional delivery of fresh gas was 23% greater in the A mode than in the D mode (0.74 vs 0.60) (P < 0.0001). Under the same conditions, mean end-tidal carbon dioxide concentration in 27 children undergoing ventilation in the A mode with VF = 0.6 x weight0.5 was 4.6% (range 3.5-5.4%). We conclude that the Carden system is up to 23% more efficient in the A mode than in the D mode, and that under the conditions of this study, normocapnia or mild hypocapnia was produced accurately using the formula VF = 0.6 x weight0.5.

Adolescent↗
PubMed1994

Determination of the onset of rebreathing in an enclosed afferent reservoir breathing system in anaesthetized, spontaneously breathing adults: a comparison of three methods.

We used three methods to determine the onset of rebreathing in the Ohmeda enclosed afferent reservoir breathing system and compared the results with the previously published rebreathing characteristics of this system. Of the methods studied, expiratory limb capnography proved unsuitable for determining the onset of rebreathing in this system. Inspiratory limb capnography and minimum inspired carbon dioxide at the mouth did enable the onset of rebreathing to be determined. However the fresh gas flow:minute volume ratio at which rebreathing occurred as determined by these criteria was less than that determined by the Kain and Nunn criteria and thus offer no clinical advantage over the latter.

Adult↗
PubMed1993

Fresh gas requirements of an enclosed afferent reservoir breathing system in anaesthetized, spontaneously breathing adults.

Using two methods of determining the onset of rebreathing, we have determined the minimum fresh gas flow rate (VF) of the Ohmeda enclosed afferent reservoir breathing system (EAR) in anaesthetized, spontaneously breathing adults. Rebreathing as defined by the Kain and Nunn criteria did not occur when the VF/VE ratio was greater than 0.70. A mathematical model was used to calculate the degree of rebreathing at each VF. From this model, rebreathing did not occur when VF was 0.86 VE or more and this value of VF/VE is considered appropriate to eliminate rebreathing in clinical practice.

Aged↗
PubMed1993

Respiratory sinus arrhythmia: an index of light anaesthesia.

This study was designed to test if changes in the degree of respiratory sinus arrhythmia (RSA) can be used as an index of light anaesthesia. An on-line, real-time data logging system was used to record simultaneously the EEG and ECG waveforms from 10 patients undergoing routine surgery using i.v. propofol (Diprivan) anaesthesia. The degree of RSA was determined in real-time. The median frequency of the EEG was derived off-line and correlated with the degree of RSA. Time series analysis was performed on the derived indices off-line. Significant changes in the degree of RSA occurred in response to changes in propofol infusion in all patients; these changes corresponded also to changes in the median frequency of the EEG. Heart rate and ventilatory frequency are measured routinely during surgery and it is suggested that on-line monitoring of RSA, derived from these standard signals, provides a more convenient and objective index of lightening anaesthesia than either EEG analysis or classical estimates of anaesthetic depth based on arterial pressure or heart rate.

Adult↗
PubMed1993

Training in neonatal resuscitation: the views of junior paediatricians.

Senior house officers and registrars in one region were asked whether they received any training in neonatal resuscitation in this region and what they thought of it. Training in neonatal resuscitation is variable and often falls short of the guidelines of the Royal College of Physicians of London. The majority of the respondents were dissatisfied with the extent and the level of supervision of their training. The structure and content of training in this subject needs to be reviewed.

Attitude of Health Personnel↗
PubMed1992

Ciprofloxacin levels in a patient undergoing veno-venous haemodiafiltration.

Haemofiltration is a popular technique for removal of fluid and small to medium size molecules in critically ill patients. Whilst there is often good information on drug disposition in chronic renal failure, there is a lack of information available to guide Intensivists on how to prescribe drugs in patients in acute renal failure undergoing haemofiltration or haemodiafiltration.

Acute Kidney Injury↗