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Biomedical subjects

M Caruana

Publications and source records attributed to M Caruana.

12 recordsLinked to original sources
PubMed1999

Isolation of human hepatocytes after hepatic warm and cold ischemia: a practical approach using University of Wisconsin solution.

A method is described for isolating human hepatocytes from tissue fragments after warm and cold ischemia as experienced during hepatic resections. Cells with a high trypan blue dye exclusion and good culture characteristics were isolated by employing an initial tissue perfusion with UW solution. The method could facilitate transfer of liver tissues between distant centers for cell isolation studies.

Adenosine↗
PubMed1989

Once daily nisoldipine in hypertension: cuff and ambulatory intra-arterial blood pressure.

Cuff blood pressure data has suggested that the calcium channel antagonist nisoldipine has full twenty four hour efficacy. To test this, 24 h ambulatory intra-arterial blood pressure monitoring was performed on 18 untreated hypertensive subjects (12 men, 6 women) (cuff blood pressure greater than 150/95 mm Hg) before and after chronic treatment with 10-20 mg oral nisoldipine taken daily at 08.00 h. Twelve patients completed the study, six being withdrawn, four because of side-effects. After baseline intra-arterial monitoring patients were started on 10 mg nisoldipine daily. Response was assessed by cuff pressures taken 24 h after dosing at fortnightly intervals, and if not controlled (less than 150/95 or at least 10 mm Hg reduction in diastolic BP) the dose was increased to 20 mg. All patients received at least six weeks' therapy before the second intra-arterial blood pressure monitoring. There was a slight but insignificant reduction in mean daytime heart rate of 3 beats.min-1. Mean significant reduction in daytime systolic and diastolic BP was 19 mm Hg and 13 mm Hg respectively but there was no significant mean night-time reduction. By comparison 8 out of 12 patients were apparently controlled more than 24 h post dose according to cuff pressures. This study suggests that this formulation of nisoldipine does not control blood pressure over a full 24-h period, and emphasises the importance of 24 h ambulatory monitoring in assesing the efficacy of once-daily antihypertensive agents.

Adult↗
PubMed1988

Radionuclide measurements of diastolic function for assessing early left ventricular abnormalities in the hypertensive patient.

Three measurements of diastolic filling were compared in 29 patients with essential hypertension and 27 age matched normotensive controls. Systolic function was normal in all but one of the patients. The mean (1SD) first one third filling fraction (a measurement of early diastolic filling) was significantly lower in the hypertensive groups (0.27 (0.24] than in the control group (0.45 (0.16)). The hypertensive group was subdivided into those with electrocardiographic abnormalities and those without. In the subgroup with a normal electrocardiogram the mean (1SD) first one third filling fraction measurement (0.28 (0.16)) was significantly lower than in the control group. In the subgroup with an abnormal electrocardiogram, the first one third filling fraction was even lower (0.24 (0.9)). In addition, the time to peak filling rate (213 (56) ms) was significantly longer in the subgroup with the abnormal electrocardiogram than in the control group (164 (45) ms). However, the interobserver reproducibility of the time to peak filling measurement was poor. The peak filling rate was low in the subgroup with an abnormal electrocardiogram, but not significantly different from the normal controls. The discriminatory value of the three diastolic measurements did not improve with exercise. These results showed an early diastolic filling abnormality in essential hypertension that did not appear to be caused by disease of the large coronary vessels as it was present in patients with normal wall motion and a normal exercise electrocardiogram. The occurrence of diastolic abnormalities when systolic function is still normal may mark an early stage in the development of hypertensive heart failure, at a time when the process is still potentially reversible.

Adult↗
PubMed1987

Assessment of 'once daily' verapamil for the treatment of hypertension using ambulatory, intra-arterial blood pressure recording.

A new, slow release formulation of verapamil, "verapamil o.d." was administered to 12 patients with essential hypertension. Drug administration was started at a dose of 240 mg and increased to 480 mg after 2 weeks of treatment if the cuff blood pressure response was unsatisfactory. The drug reduced the daytime intra-arterial blood pressure significantly from 180.7/106.8 mm Hg to 157.3/89.4 mm Hg. The daytime heart rate fell from 88.1 to 71.8 beats/min. The night-time blood pressure decreased from 155.7/87.2 mm Hg to 140.5/75.3 mm Hg. The nocturnal heart rate decreased from 62.8 to 57 beats/min. Hourly plots of mean systolic and diastolic pressure showed a significant reduction of systolic pressure for 21 of 24 h and of diastolic pressure for all 24 h following a single morning dose. The drug modified the absolute blood pressure and heart-rate response during both forms of exercise, but did not alter the magnitude or rate of blood pressure change. The tilt-test produced no evidence of postural hypotension. Only one patient experienced any side effects whilst taking the drug. These results indicate good 24-h blood pressure control and reduced exercise blood pressure levels during treatment with this new formulation of verapamil. The reduced frequency of drug administration should improve patient compliance with treatment of hypertension.

Adult↗
PubMed1986

A comprehensive clinical validation of the nuclear stethoscope.

Five studies were conducted to examine the degree of variability to be expected during the use of the non-imaging nuclear probe (BIOS Inc.) under a variety of clinical conditions. Comparison of the ejection fraction (EF) readings between the nuclear probe and a gamma camera showed good agreement, with the nuclear probe tending to underestimate lower, and overestimate higher camera EF values [mean (S.D.) difference, 0.84% (6.06)]. A comparison of two nuclear probes showed a small mean (S.D.) difference of EF readings of 0.063% (2.26). EF readings obtained in normal subjects 6 weeks apart were reproducible and differed by a mean (S.D.) of 0.23% (4.42). The administration of placebo to 10 normal subjects followed by sequential measurements for 4 h produced EF changes large enough to mimic a clinical effect, the largest hourly change observed being 5.4%, indicating the need for strict placebo control in interventional experiments. Data on four patients with heart failure showed small non-significant EF changes in the 1 h after placebo administration but a wide intra-subject range of ejection time and time to peak filling measurements. This highlights the problem of accurate, reproducible cursor placement in such patients. The nuclear probe is a portable, low cost instrument which produces accurate EF measurements when compared with the gamma camera.

Adolescent↗
PubMedDate not supplied

Intrahospital transport of the critically ill adult: a research review and implications.

Transporting the critically ill adult from the relative stability of the critical care environment to a testing site or new area is a nursing responsibility. Yet current research about the risks and benefits of intrahospital transport is at times conflicting. This article provides an analysis of available research on the critical elements involved in intrahospital transport and suggests recommendations for clinical practice.

Algorithms↗
PubMedDate not supplied

Effects of tiapamil, a new calcium channel blocker, on ambulatory intraarterial blood pressure and exercise-induced changes in blood pressure.

The duration and magnitude of effect of a new calcium-channel blocker, tiapamil, given twice daily, was studied in 17 hypertensive patients using ambulatory intraarterial blood pressure recording. The drug produced moderate reductions of blood pressure throughout the 24-h cycle with slight reduction of effect before each dose. Ten patients reported side effects, and one withdrew as a result of these. Tiapamil attenuated the blood pressure rise during dynamic cycle ergometry but had no effect on the increase during isometric hand grip. We conclude that tiapamil is similar to existing calcium-channel blocking agents in lowering the blood pressure, but it does not appear to influence the response to isometric exercise in this dose.

Adult↗
PubMedDate not supplied

Male breast cancer: report of 2 cases and review of the literature.

Male breast cancer is rare and accounts for 1% of all breast cancers. The authors report two cases of male breast cancer at Stage III and review the literature. A Madden mastectomy with axillary clearance was performed. Patients were given adjuvant chemotherapy and started on tamoxifen. At one year follow-up the patients are alive and free from disease. Modified radical mastectomy is the preferred surgical approach for localized disease. Adjuvant hormonal therapy with tamoxifen is recommended as first-line treatment. Adjuvant chemotherapy has a role in node-positive cancer and locally advanced disease. Men should be made more aware of the disease and multicentric clinical trials encouraged to ensure an appropriate treatment on the basis of prospectively collected data.

Aged↗