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Biomedical subjects

M J Barnard

Publications and source records attributed to M J Barnard.

6 recordsLinked to original sources
PubMed1993

Acute circulatory support.

Numerous drugs can increase cardiac output, thereby improving tissue oxygen delivery, but often they do this at the expense of increasing myocardial oxygen demand. This may be critical when cardiac function is substantially impaired or ischaemia is the precipitating cause. Using polypharmacy to substantially improve cardiovascular status requires detailed knowledge of the pharmacodynamics and interactions of the available agents so that they may be tailored to the individual patient. In some settings combinations of inotropes and vasodilators may be desirable to minimise cardiac workload. In other instances vasopressors may be necessary to urgently restore a minimum perfusion pressure. This paper reviews the use of this group of drugs as well as the mechanical assist devices that may be used when drugs fail.

Acute Disease↗
PubMed1990

Comparison of albumin excretion rate obtained with different times of collection.

This study was undertaken to assess the usefulness of different techniques for determination of albumin excretion rate (AER). Ninety patients with type I (insulin-dependent) diabetes mellitus and 45 with type II (non-insulin-dependent) diabetes mellitus, with AER/24 h of less than 200 micrograms/min, were included. All patients were free of major systemic complications of diabetes and overt kidney disease (mean serum creatinine 1.1 +/- 0.1 mg/dl, range 0.4-1.2 mg/dl). We compared timed day, night, and 24-h specimens, as well as timed spot specimens during water-induced diuresis. Most patients with type I (75 of 90) and type II (30 of 45) diabetes had AER less than 20 micrograms/min and showed significant differences in AER that were dependent on the collection time. Differences were diminished or absent with AER less than 20 micrograms/min. Sensitivity, specificity, and prediction rates of AER in different specimens were evaluated against 24-h AER. Use of albumin concentrations and albumin-creatinine ratios did not improve test performance in comparison with AER. Sampling time and the overall rate of AER influenced measurement of urinary albumin excretion. Day or 24-h AER is most useful to determine the presence of abnormal AER. AER and albumin concentration in spot samples are of limited use for initial screening and frequently require day or 24-h specimens of AER for confirmation. Day or 24-h AER should be used for long-term follow-up of the diabetic patient.

Adolescent↗