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Biomedical subjects

P Duke

Publications and source records attributed to P Duke.

14 recordsLinked to original sources
PubMed2001

The efficacy and resource utilization of remifentanil and fentanyl in fast-track coronary artery bypass graft surgery: a prospective randomized, double-blinded controlled, multi-center trial.

UNLABELLED: We compared (a) the perioperative complications; (b) times to eligibility for, and actual time of the following: extubation, less intense monitoring, intensive care unit (ICU), and hospital discharge; and (c) resource utilization of nursing ratio for patients receiving either a typical fentanyl/isoflurane/propofol regimen or a remifentanil/isoflurane/propofol regimen for fast-track cardiac anesthesia in 304 adults by using a prospective randomized, double-blinded, double-dummy trial. There were no differences in demographic data, or perioperative mortality and morbidity between the two study groups. The mini-mental status examination at postoperative Days 1 to 3 were similar between the two groups. The eligible and actual times for extubation, less intense monitoring, ICU discharge, and hospital discharge were not significantly different. Further analyses revealed no differences in times for extubation and resource utilization after stratification by preoperative risk scores, age, and country. The nurse/patient ratio was similar between the remifentanil/isoflurane/propofol and fentanyl/isoflu-rane/propofol groups during the initial ICU phase and less intense monitoring phase. Increasing preoperative risk scores and older age (>70 yr) were associated with longer times until extubation (eligible), ICU discharge (eligible and actual), and hospital discharge (eligible and actual). Times until extubation (eligible and actual) and less intense monitoring (eligible) were significantly shorter in Canadian patients than United States' patients. However, there was no difference in hospital length of stay in Canadian and United States' patients. We conclude that both anesthesia techniques permit early and similar times until tracheal extubation, less intense monitoring, ICU and hospital discharge, and reduced resource utilization after coronary artery bypass graft surgery. IMPLICATIONS: An ultra-short opioid technique was compared with a standard fast-track small-dose opioid technique in coronary artery bypass graft patients in a prospective randomized, double-blinded controlled study. The postoperative recovery and resource utilization, including stratification of preoperative risk score, age, and country, were analyzed.

Aged↗
PubMed2001

A pilot clinical evaluation of a new injection denture base system.

The purpose of this pilot study was to determine if clinically acceptable complete denture prostheses can be consistently fabricated with a new injection system. In the first part of this investigation, 14 patients requiring complete denture fabrication had one prosthesis made with the new injection system and one made with the compression-pack technique. Polish, porosity, and esthetics were evaluated by one of three investigators at the placement visit. The percentage of the intaglio surface in contact with the mucosa before adjustment was also measured. One week after placement, the patients were questioned regarding the prostheses' stability, the presence of any undesirable taste, and overall satisfaction. The second portion of the study involved materials property testing of flexural strength and Izod toughness of conventionally packed and injection-packed specimens processed by the fast cycle or the long cycle. In every case, acceptable results were obtained for the resin's polishability, its lack of porosity, esthetics, stability, lack of unpleasant taste, and overall patient satisfaction with the prostheses. No difference in clinical adaptation was observed. These results indicated that no clinical difference was detectable between the conventionally packed and injection-packed denture bases by the investigators or patients in this study. Physical property testing indicates that the differences between groups may be more affected by the polymerization cycle used than the way that the resin was placed in the mold space.

Acrylic Resins↗
PubMed2000

Study of the physical properties of type IV gypsum, resin-containing, and epoxy die materials.

STATEMENT OF PROBLEM: Little published information is available comparing the properties of recently developed resin-modified gypsum and epoxy resin die materials, which are claimed to be superior to conventional type IV gypsum die materials. PURPOSE: This study compared the properties of 3 new die materials and 2 conventional type IV gypsum products. METHODS AND MATERIAL: The linear dimensional change, detail reproduction, surface hardness, abrasion resistance, and transverse strength of 2 recently introduced, resin-modified gypsum die materials (Resinrock and Milestone), a new epoxy resin die material (Epoxy-Die), and 2 conventional type IV gypsum die materials (Silky-Rock and Die-Stone) were studied. RESULTS: All gypsum products expanded, whereas the epoxy resin material contracted during setting. The epoxy resin exhibited much better detail reproduction, abrasion resistance, and transverse strength than the gypsum materials, which were similar in these properties. A conventional type IV gypsum exhibited the highest surface hardness, whereas the epoxy resin had the lowest value. CONCLUSION: The resin-modified gypsum products were not significantly superior to the conventional type IV gypsum die materials. In general, the epoxy resin exhibited the best properties of the materials studied; however, its setting shrinkage may necessitate alterations in technique to achieve well-adapted castings.

Analysis of Variance↗
PubMed1990

Effectiveness of intradermal hepatitis B immunization of hospital staff.

Three doses of hepatitis B vaccine were administered via an intradermal route to 316 health service staff. One month after the final dose, 89.9% of subjects had antibodies to hepatitis B surface antigen at levels of 10 IU/l or greater. A programme of hepatitis B immunization based upon the intradermal route is substantially less expensive than one using an intramuscular technique, and can enable health authorities to provide protection for increased numbers of staff without diverting resources from other programmes of health care.

Adult↗
PubMed1989

A prospective evaluation of 68 patients suffering blunt chest trauma for evidence of cardiac injury.

The prevalence and significance of cardiac injury following blunt chest trauma is largely unknown. Although electrocardiography (ECG) and creatinine phosphokinase isoenzyme (CPK-MB) determination have traditionally been used in determining cardiac injury, recent developments in two-dimensional echocardiography (ECHO) as a noninvasive diagnostic tool have led to its use in detecting structural cardiac damage following trauma. In an attempt to determine the occurrence and consequences of cardiac injury we prospectively evaluated 68 patients at one institution using ECHO, serial ECG, and serial CPK-MB determinations in the first 3 days following hospital admission. Patients were selected who had evidence of blunt chest injury on examination or by mechanism of injury. The mean age of the 68 patients was 36.3 +/- 19.6 years and the mean Injury Severity Score, 21.5 +/- 11.6. Forty-nine patients (72%) were found to have an abnormal ECHO, ECG, or CPK-MB (greater than 3%). Eighteen patients (26%) had abnormal ECHOs consisting of seven right ventricular contusions, three left ventricular contusions, three contusions of both chambers, four pericardial effusions, and one small ventricular septal defect. Only three contusions were associated with elevated CPK-MB and seven with abnormal ECGs. Abnormalities of ECG included 18 patients with S-T, T wave changes, axis shifts (11 patients), and bundle branch or hemiblocks (10 patients). No patient died or experienced serious morbidity as a result of their cardiac injury, including 12 patients who underwent surgical procedures with general anesthesia within 30 days of admission.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1981

Sexual development, age, and dating: a comparison of biological and social influences upon one set of behaviors.

Data from the U.S. National Health Examination Survey of 12-17-year-old youths were used to determine whether the development of the social behavior of dating is more closely linked to the level of sexual maturation or to the progression through age grades without reference to sexual maturation. Regression analyses and partial correlations show that individuals levels of sexual maturation add very little to the explained variance in dating after age had been taken into account. It appears that social pressures, based on behavior considered typical and appropriate at various ages, determines the onset of dating in adolescents. Individual rates of sexual maturation that deviate from the norm for that age have little impact on dating. These findings show how social standards can reduce dramatically the impact of individual biological processes on institutionalized forms of behavior.

Adolescent↗
PubMed1980

Pubertal changes in daytime sleepiness.

Nineteen children (8 girls, 11 boys) were evaluated in a total of 47 three-day sessions across three summers. Children were ranked according to Tanner's stages of secondary sexual characteristics. Nocturnal sleep was recorded from 2200 to 0800 hr each night. Multiple sleep latency tests were given at 2 hr intervals from 0930 each day. Nocturnal sleep time and REM sleep time remained constant across Tanner stages. Slow wave sleep time declined progressively across Tanner stages, with a 40% reduction from prepuberty to maturity. Daytime sleepiness was significantly greater in subjects at Tanner stages 3 and 4 than at Tanner stages 1 and 2. Subjects at Tanner stage 5 tended to be as sleepy as Tanner stage 3 and 4 subjects but did not differ significantly from the less mature subjects. No gender differences were found in daytime sleepiness for children at similar Tanner stages. More mature children were significantly sleepier at 1330 and 1530 than in the late afternoon and evening.

Adolescent↗
PubMed1979

Effects of lanthanum on the heart sarcolemmal ATPase and calcium binding activities.

Effects of lanthanum on Ca2+-ATPase, Mg2+-ATPase, Na+-K+-ATPase, and calcium binding activities were studied in rat heart sarcolemma. Ten to 100 micrometers lanthanum depressed significantly the Ca2+-ATPase activity and 50--200 micrometers lanthanum inhibited the calcium binding activity. Lineweaver-Burk plots of the Ca2+-ATPase activity showed that the inhibition by lanthanum was competitive with calcium concentration. Neither Mg2+-ATPase nor Na+-K+-ATPase activities were affected by lanthanum when the assay medium contained 1 mM EDTA; however, in the absence of EDTA, these enzyme activities were significantly decreased by 10--100 micrometers lanthanum. Rat hearts perfused with HEPES buffer containing 0.5 mM lanthanum showed electron-dense deposits restricted to the outer cell surface and the sarcolemma obtained from these hearts also had the deposits, indicating that the membrane fraction isolated by the hypotonic shock--LiBr treatment method is of sarcolemmal origin. The Ca2+-ATPase activity of the sarcolemma isolated from lanthanum-perfused hearts, unlike the Mg2+-ATPase, Na+-K+-ATPase, and calcium binding activities, was significantly less than the control value. From these observations it is suggested that lanthanum may influence calcium movement across the sarcolemma by affecting sarcolemmal ATPase and calcium binding activities.

Adenosine Triphosphatases↗
PubMed1975

Submucous fibrosis.

The first recorded case of submucous fibrosis in a Chinese woman in Papua New Guinea is described. The essential clinical and pathological characteristics of the condition are presented and a scheme of management suggested. The pre-cancerous nature of the disease and the need for early diagnosis and regular review of affected patients are stressed.

Adult↗