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Biomedical subjects

P Breslin

Publications and source records attributed to P Breslin.

9 recordsLinked to original sources
PubMed2001

Effectiveness of surveillance of infrainguinal grafts.

OBJECTIVE: To audit the surveillance programme of infrainguinal vein graft in a tertiary vascular unit, and find out how effective it was in preventing occlusion of grafts. DESIGN: Retrospective study. SETTING: Teaching hospital, Scotland. SUBJECTS: 59 consecutive patients who had 61 vein grafts between 1996 and 1998 for critical limb ischaemia. INTERVENTIONS: Grafts scanned at 3-monthly intervals for at least a year, and clinical review. MAIN OUTCOME MEASURES: Survival with an intact limb and patency of the graft. RESULTS: 52 of the 59 patients (90%) were alive at the time of follow up, and 55 of the 61 involved limbs (90%) were intact. Median follow up was 660 days (range 180-1995). 23 stenoses were detected by the surveillance programme. 17 grafts were revised, all of which were patent at follow up, and 8 other grafts occluded requiring 6 major amputations. One-year cumulative primary, primary-assisted, and secondary patency, and limb salvage rates were 63%, 88%, 88%, and 90% respectively. CONCLUSIONS: Surveillance of infrainguinal grafts by duplex scanning is effective and has resulted in high rates of limb salvage and secondary patency in patients who presented with critical ischaemia.

Aged↗
PubMed1995

Insonation and impedance analysis in graft surveillance.

Seventy consecutive patients with infrainguinal bypass grafts entered a 1-year graft surveillance programme involving colour duplex scanning, direct graft insonation and computer-assisted impedance analysis. Graft patients with a positive duplex scan, high frequencies on graft insonation or an impedance value above 0.50 subsequently underwent arteriography. Sixteen patients were excluded before the initial surveillance visit. The 54 remaining patients with grafts (30 vein, 24 synthetic) underwent a total of 137 surveillance visits, with 21 grafts confirmed to be 'at risk'. The sensitivity of an impedance value above 0.55 in identifying these grafts was 86 per cent, rising to 95 per cent when combined with graft insonation. Duplex scanning did not identify any abnormalities in 11 grafts that were either shown by arteriography to be 'at risk' or occluded before arteriography. Impedance measurement and graft insonation are simple screening techniques with a high sensitivity (when combined), which identify 'at risk' infrainguinal grafts. Positive graft insonation or an impedance value over 0.55 will identify all 'at risk' vein grafts while minimizing the number of unnecessary arteriograms.

Angiography↗
PubMed1988

Taste reactivity as a dependent measure of the rapid formation of conditioned taste aversion: a tool for the neural analysis of taste-visceral associations.

Several explanations may account for deficits in the ability of animals to form taste aversions following neural manipulations. These encompass impairments in conditioned stimulus (CS) and unconditioned stimulus (US) processing, conditioned response (CR) measurement, and expression, memory, and taste-visceral integration. A behavioral procedure that aids in the distinction between some of these possibilities is presented. In Experiment 1, 10 rats received seven intraoral (IO) infusions of sucrose (30 s, 0.55 ml) spaced every 5 min starting immediately after the injection of 3.0 mEq/kg of lithium chloride (LiCl). Control rats (n = 12) were treated identically except that they were injected with sodium chloride (NaCl). Oromotor and somatic taste reactivity behaviors were videotaped and analyzed. Lithium-injected rats systematically decreased their ingestive taste reactivity behavior over time, whereas aversive behavior increased. Control rats maintained high and stable levels of ingestive responding and demonstrated virtually no aversive behavior over the 30-min period following sodium injection. Rats were tested several days later for the presence of a conditioned taste aversion (CTA). Rats previously injected with lithium during sucrose infusions demonstrated significantly more aversive behavior than the control group, which demonstrated none. There were no differences in the level of ingestive behavior displayed by the two groups on the CTA test. Experiment 3 revealed that when similarly treated rats were tested for a CTA while in a lithium-induced state, a difference in the ingestive behavior between the two groups was observed. In Experiment 2, naive rats were injected with either NaCl or LiCl but did not receive their first sucrose infusion until 20 min later. These rats also received sucrose infusions at 25 and 30 min postinjection. There were no differences in the taste reactivity behavior displayed by lithium- or sodium-injected rats during any of the sucrose infusions. Collectively, these findings indicate that rats dramatically change their oromotor responses to sucrose during the period following LiCl administration, provided that the infusions start immediately after injection. Furthermore, this time-related behavioral change is predominantly attributable to associative processes. This paradigm can be useful in distinguishing between neural manipulations that affect the establishment of taste-visceral associations from others that affect the animal's ability to retain such associations over the commonly employed 24-hr conditioning-test interval.

Afferent Pathways↗
PubMed1988

Proportionate mortality study of US Army and US Marine Corps veterans of the Vietnam War.

The patterns of mortality among 24,235 US Army and Marine Corps Vietnam veterans were compared with that of 26,685 non-Vietnam veterans using standardized proportional mortality ratios. The veterans were a random sample of deceased Vietnam-era veterans identified in a Veterans Administration computerized benefit file. Military service information was obtained from military personnel records, and cause of death information from death certificates. Statistically significant excess deaths were observed among Army Vietnam veterans for motor vehicle accidents, non-motor vehicle accidents, and accidental poisonings. Similar findings have been reported in other studies of Vietnam veterans. Suicides were not elevated among Vietnam veterans. The Marine Corps Vietnam veterans appeared to have an increased mortality from lung cancer and non-Hodgkin's lymphoma. Although exposure to several environmental factors may be speculated, this study did not investigate possible etiologic factors for these elevated malignancies.

Accidents↗
PubMed1987

Soft tissue sarcoma and military service in Vietnam: a case-control study.

A case-control study was conducted in men who were of draftable age during the Vietnam conflict to examine the association of soft tissue sarcomas (STSs) with military service in Vietnam as well as other host and environmental risk factors. A total of 217 STS cases selected from the Armed Forces Institute of Pathology were compared to 599 controls for Vietnam service, occupational and nonoccupational exposure to various chemicals, occupational history, medical history, and life-style (smoking, alcohol, coffee, etc.). Military service information was verified by a review of the patient's military personnel records. Other information was ascertained from a telephone interview with either subjects or their next of kin. Cases and controls were stratified on the basis of the hospital type (civilian, Veterans Administration, and military); the Mantel-Haenszel estimate of the odds ratio (OR), adjusted for the effects of the stratification variable, was calculated. Vietnam veterans in general did not have an increased risk of STS when compared to those men who had never been in Vietnam (OR, 0.85; 95% confidence interval, 0.54-1.36). Subgroups of Vietnam veterans who had higher estimated opportunities for Agent Orange exposure seemed to be at greater risk of STSs when their counterparts in Vietnam were taken as a reference group. However, this risk was not statistically significant.

2,4,5-Trichlorophenoxyacetic Acid↗