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Biomedical subjects

M Fagan

Publications and source records attributed to M Fagan.

17 recordsLinked to original sources
PubMed2001

Gluteal necrotizing myofascitis: an unusual delayed complication of abdominal sacrocolpopexy.

Persistent low back pain developed in a 51-year-old woman after she had undergone abdominal sacrocolpopexy. Four months postoperatively, necrotizing myofascitis developed in her gluteal muscles. The infected mesh, which had eroded into the vagina, was removed. Cultures of the infected mesh and abscesses grew common vaginal flora, including Gardnerella vaginalis and Actinomyces.

Back Pain↗
PubMed2000

[Withdrawal syndrome after the use of serotonin reuptake inhibitors].

BACKGROUND: The use of serotonin reuptake inhibitors in the treatment of depression has increased significantly over the years since their introduction in Norway in the early 1990s. Reports of side effects have paralleled the increased use; one side effect is the withdrawal syndrome associated with serotonin reuptake inhibitors. MATERIAL AND METHODS: This article reports on two patients who discontinued paroxetine and experienced unusual shock-like symptoms consistent with this syndrome. RESULTS: There are numerous reports documenting withdrawal reactions caused by these antidepressants. Recently the first controlled studies have been published. INTERPRETATION: This syndrome is not well known and differs from the withdrawal syndrome caused by tricyclic antidepressants.

Adult↗
PubMed1998

[Use of new antidepressive agents in general practice].

There is much discussion about the use of the new antidepressant drugs. Some advocate a more liberal use while others criticize overprescribing. Our study examines the indication, dosage and length of treatment in five family practices. Records of 208 patients prescribed one of three new antidepressants in 1995 were reviewed. 90% had depression or anxiety while 10% received medication for pain or for other symptoms. Dosage and median length of treatment were in accordance with recommended guidelines. However, a number of patients discontinue their medication within a month of start of treatment. The study did not examine the reason for this, but side effects or lack of effect are possible explanations. 36 patients were treated for a year or longer and we raise the question whether abstinence-like symptoms or the physicians prescribing practice can explain this finding. The article also examines the increased sale of the new antidepressants in Norway and in Aust-Agder county specifically, the county in Norway with the largest per capita sale of these drugs.

Antidepressive Agents, Second-Generation↗
PubMed1995

Aprotinin reduces the need for blood products during liver transplantation.

BACKGROUND: Bleeding complications and blood product consumption have been a major concern during liver transplantation. Prevention of plasminogen activation and fibrinolysis by aprotinin administration has been shown to reduce perioperative bleeding during operations associated with high blood-product consumption. PATIENTS AND METHODS: Use of blood-products (packed red cells, frozen plasma, platelets, and cryoprecipitate) was analyzed both during the three stages of orthotopic liver transplantation and during total hospitalization of the 26 patients transplanted without aprotinin and the subsequent 40 patients with aprotinin. A similar analysis was performed for 15 patients immediately before and after the introduction of aprotinin to eliminate the "learning curve" effect for liver transplantation. The effect of epsilon-amino-caproic acid was analyzed as 13 patients received neither epsilon-aminocaproic acid nor aprotinin and 13 patients received epsilon-aminocaproic acid but not aprotinin. RESULTS: There was a significant reduction in total hospital use of cryoprecipitate, frozen plasma, platelets, and red cells in the aprotinin-treated patients. This reduction was seen during the anhepatic and reperfusion stages of liver transplantation. There was no difference in blood product consumption between the groups who were or were not treated with epsilon-aminocaproic acid. CONCLUSION: Aprotinin significantly reduces the need for red cell, frozen plasma, platelet, and cryoprecipitate transfusion use during orthotopic liver transplantation, and appears to be more efficacious than epsilon-aminocaproic acid.

Adolescent↗
PubMed1991

Intracellular study of calcium-related events in cat magnocellular neuroendocrine cells.

1. Magnocellular neuroendocrine cells (MNCs) in the supraoptic nucleus (SON) of mammals synthesize vasopressin or oxytocin and release these hormones systemically from their neurohypophysial axon terminals. In the rat, release is facilitated by bursts of action potentials generated by the MNC. However MNC units in the intact cat discharge more slowly and do not display the repetitive bursts (phasic firing) that promote vasopressin secretion. The reasons why these cat endocrine neurones differ so dramatically in their firing behaviour from the rat model were examined using intracellular recording. 2. Cat and rat MNCs displayed similar mean resting potentials approximating -60 mV, and were usually linear in their voltage-current relationship in the hyperpolarizing direction. However cat MNCs displayed a higher mean cell input resistance (301 M omega; n = 56) than those of rat (150 M omega; n = 105). 3. Calcium influx to cat MNCs during firing appeared comparable to rat based on (a) the similar range of action potential broadening observed during a spike train, (b) the shoulder on the action potential's falling phase which was blocked in low-Ca2+ saline, and (c) the ability to evoke tetrodotoxin (TTX)-insensitive spiking and non-synaptic depolarizing potentials, both calcium-mediated events observed in the rat. 4. In cat MNCs, a depolarizing current pulse (100-500 ms; 0.1-0.3 nA) elicited a train of action potentials followed by a prominent after-hyperpolarization (AHP) several times the duration of its counterpart in the rat. The AHP reversed near the equilibrium potential for K+, was not voltage dependent and represented an increased membrane conductance. It was suppressed in low-Ca2+ saline and completely eliminated by the calcium-activated potassium current (IK(Ca)) blockers apamin (100 nM) or d-tubocurarine (50-200 microM). Both blockers decreased spike frequency adaptation but did not induce bursting. Therefore the cat AHP probably represents a Ca(2+)-activated K+ conductance with a similar blocker sensitivity to its briefer counterpart in the rat MNC. 5. The spike hyperpolarizing after-potentials (HAPs) in cat were more than twice the mean amplitude and several times the duration of HAPs in rat. Cat HAPs were qualitatively similar to their rat counterparts, remaining unaffected by apamin or tubocurarine. The intrinsic currents responsible for the AHP and HAP appear to generate the stronger activity-dependent inhibition displayed by cat MNCs. 6. Twenty-one of fifty-two cat MNCs displayed an inward rectification at membrane potentials more negative than -70 mV ([K+]o = 6.24 mM), causing a depolarizing 'sag' in the voltage trajectory lasting 100-200 ms which was TTX resistant.(ABSTRACT TRUNCATED AT 400 WORDS)

Action Potentials↗
PubMed1990

A technique for controlling the membrane potential of neurons during unit recording.

While extracellular unit recordings are technically easier to perform than intracellular recordings, the latter permits control of neuron excitability by changing the membrane potential with steady current passed across the recording micropipette. Utilizing an intracellular amplifier with bridge circuit for the passage of low current (1-10 nA), we show that an extracellular recording micropipette of high resistance (5-20 M omega) can be used in a similar fashion while monitoring single unit activity in the rat brain. This procedure allows fine control of two neuronal mechanisms which are voltage-sensitive: action potential discharge and regenerative bursting. Control of a neuron's membrane potential expands the capabilities of unit recording in the study of evoked synaptic input and bursting behaviour. It can also facilitate classification of neurons based on their firing characteristics.

Animals↗
PubMed1989

[Hypoglycemic hemiparesis. A case report].

Hypoglycemia can result in a transient hemiplegia mimicking a minor cerebral vascular accident. With the widespread use of oral hypoglycemics and insulin this unexpected presentation of hypoglycemia is now being reported more frequently in the medical literature. This article describes a case of hypoglycemic hemiparesis and illustrates the need to consider this diagnosis, especially when the diabetic patient presents with stroke-like symptoms.

Aged↗
PubMed1989

Seizure susceptibility and the osmotic state.

In some unknown manner, water uptake by brain cells (hyposmolality) promotes generalized seizure in humans and experimental animals, whereas cell dehydration (hyperosmolality) protects against it. We have replicated both scenarios in slices of hippocampus undergoing electrographic seizures. Surprisingly, a shift in osmolality does not change the excitability of individual neurons but rather, it alters the degree to which neurons interact. Hyposmolality enhances both excitatory synaptic transmission in neocortex and field (ephaptic) effects, the latter arising when cortical cells fire as a population. We propose that these increased excitatory interactions promote the synchrony that characterizes epileptiform activity.

Action Potentials↗