PubMed Health⌕ Search

Biomedical subjects

R Boys

Publications and source records attributed to R Boys.

10 recordsLinked to original sources
PubMed2006

Improved sedation for oral surgery by combining nitrous oxide and intravenous Midazolam: a randomized, controlled trial.

The objective is to investigate whether sedation techniques for oral surgery can be improved by combining the use of inhalation of nitrous oxide/oxygen with intravenous Midazolam. Prospective, randomized controlled clinical trial: Patients requiring extractions or surgery were randomly allocated to subgroups receiving either intravenous Midazolam or nitrous oxide/oxygen or a combined technique using nitrous oxide/oxygen and intravenous Midazolam. Safety parameters, amount of sedative agents administered, recovery time and co-operation scores were recorded. Patients receiving the combined sedation technique were initially titrated with 10% nitrous oxide, increasing by increments of 10% up to a maximum of 40% nitrous oxide and 60% oxygen. Midazolam was then titrated (initially 2 mg wait 2 min with increments of 1mg every minute until appropriately sedated) whilst still administering 40% nitrous oxide. When a combined technique of N(2)O/O(2) and Midazolam was used there was a statistically significant reduction in the amount of Midazolam required to achieve effective sedation (P<0.001), an overall significant reduction in recovery time (P<0.001) and a significant improvement in co-operation (P<0.01) and arterial oxygen saturation (P<0.001). This combined technique was found to be safe and reliable, requiring reduced doses of Midazolam and demonstrable improvement in patient recovery and co-operation.

Adolescent↗
PubMed1992

Can we predict the persistence of depression?

Fifty-five patients with primary major depression were followed up prospectively from time of onset of the index illness episode until recovery. The course of depression in hospital-treated patients was protracted, with a median length of episode of one year. Two factors significantly predicted persistence of symptoms: interval between onset and receipt of treatment, and premorbid neuroticism, which accounted for 55% of the variance in length of episode.

Adult↗
PubMed1992

A numerical prognostic index for clinical use in identification of poor-risk patients with Hodgkin's disease at diagnosis. The Scotland and Newcastle Lymphoma Group (SNLG) Therapy Working Party.

The aim of this study was to assess the feasibility of using objective data obtained at the time of diagnosis of Hodgkin's disease to predict those patients who were likely to die of progressive disease within four years. Ninety-two consecutive patients from one centre (Newcastle upon Tyne) were used to construct a numerical index based on disease stage (Ann Arbor), age, haemoglobin and absolute lymphocyte count. Weight was assigned according to a predictive value from univariate and multivariate analyses based on survival. The index produced was then validated on a separate patient set (455) from other centres within the Scotland and Newcastle Lymphoma Group (SNLG) on whom the same prospective information was available. The index produced provided a useful separation of those patients destined to die of disease. In 101 patients with index > 0.5, 62 (61.4%) were dead at four years, whereas with index < 0.5, 61 (18%) of 336 patients were dead at four years. The index includes Ann Arbor stage but possesses additional practical prognostic value which allows identification of patients with early stage destined to die of disease. Of 149 patients with Stage IA and IIA disease 15 patients had index > 0.5, and 10 (60%) have died, whereas the remaining patients had survival of 90% and 85% respectively. This numerical index has now been strengthened by an added factor for bulk disease > 10 cms and in the SNLG it has replaced Ann Arbor staging for selection of patients requiring aggressive therapy. A randomized study of chemotherapy versus chemotherapy plus autotransplant in first remission using high dose melphalan and VP16 is currently in progress.

Bone Marrow Transplantation↗
PubMed1991

A numerical prognostic index for clinical use in identification of poor-risk patients with Hodgkin's disease at diagnosis. Scotland and Newcastle Lymphoma Group (SNLG) Therapy Working Party.

The aim of this study was to assess the feasibility of using objective data obtained at diagnosis of Hodgkin's disease to predict those patients who were likely to die of progressive disease within 4 years of diagnosis. 92 consecutive patients from one centre (Newcastle upon Tyne) were used to construct a numerical index based on disease stage (Ann Arbor), age, haemoglobin and absolute lymphocyte count. Weight was assigned according to a predictive value in univariate and multivariate analyses based on survival. The index produced was then validated on a separate patient set (455) from other centres within the Scotland and Newcastle Lymphoma Group (SNLG) on whom the same prospective information was available. The index produced provided a useful separation of those patients destined to die of disease. Of 101 patients with index higher than 0.5, 62 (61.4%) were dead at 4 years, whereas with index lower than 0.5, 61 (18%) of 336 patients were dead at 4 years. The index includes Ann Arbor stage but possesses additional practical prognostic value which allows identification of patients with early stage destined to die of disease. Of 149 patients with stage IA and IIA disease 15 patients had index higher than 0.5, and 10 (60%) have died, whereas the remaining patients had survival of 90% and 85% respectively. This numerical index is applicable to all patients at diagnosis and in the SNLG population gives better predictive survival at 4 years than stage alone, and provides a basis for selecting patients for more aggressive therapy.

Adolescent↗
PubMed1989

Changes in cardiac output during epidural anaesthesia for caesarean section.

Serial haemodynamic investigations were performed in 20 women who had epidural anaesthesia before elective Caesarean section. Cardiac output was measured by Doppler and cross-sectional echocardiography at the aortic valve. Measurements were performed after preloading the circulation with Ringer lactate solution (mean volume 805 ml) and then 10, 20, 30 and 40 minutes after administration of 0.5% bupivacaine. Preloading increased mean stroke volume from 84 to 94 ml and mean cardiac output from 7.01 to 7.70 litres/minute. Relative to basal values, mean arterial pressure decreased in all subjects after administration of bupivacaine (mean - 14%, range - 1 to - 33%). Five subjects were given ephedrine because of hypotension. In three of these subjects hypotension was associated with a marked decrease in cardiac output. No significant changes in arterial blood pressure or cardiac output were demonstrated relative to basal values in the remaining 15 subjects. Ephedrine induced consistent increases in blood pressure and cardiac output.

Adult↗
PubMed1989

Haemodynamic changes associated with caesarean section under epidural anaesthesia.

Serial haemodynamic investigations were performed in 15 women delivered by elective caesarean section under epidural anaesthesia at 38-40 weeks gestation. Cardiac output was measured by Doppler and cross-sectional echocardiography at the aortic valve. No haemodynamic changes were demonstrable after attainment of surgical anaesthesia (T5 or above). Stroke volume increased 13% after delivery of the placenta and remained elevated until the end of the operation at which time cardiac output was 11% above pre-operative values. Stroke volume and cardiac output fell during the first postoperative day. Heart rate remained elevated at pre-operative values for 48 h after delivery. There was a fall in heart rate and cardiac output between the second and the sixth days after delivery. By 2 weeks after delivery cardiac output was 28% lower than pre-operative values. Compared with pre-operative values, diastolic blood pressure was lower on the first and second postnatal days.

Adult↗
PubMed1989

Extrapyramidal reactions to metoclopramide and prochlorperazine.

We have investigated prospectively the incidence of extrapyramidal events amongst patients receiving 'first' prescriptions for metoclopramide (n = 2557) and prochlorperazine (n = 2811) from general practitioners in the Northern Region using community pharmacists to capture prescriptions. There were 12 reports of acute dystonic-dyskinetic events following metoclopramide and the incidence of this reaction was significantly greater in those under 30 years than in those 30 years and over. Following prochlorperazine there were eight reports of Parkinsonism in patients whose ages were known; seven were over 60 years. The incidence in those over 60 years was significantly higher than in those less than 60 years.

Adolescent↗
PubMed1984

Effects of chronic administration of D-amphetamine on PGO wave activity in the cat.

The effects of depletion of serotonin by the chronic administration of amphetamine (twice daily, 7.5 mg/kg per injection on days 1-6; 15 mg/kg per injection on the remaining days, i.p.) for 10-14 days on ponto-geniculo-occipital (PGO) waves was examined in cats. While the regimen of pretreatment with amphetamine produced comparable decreases in the content of central serotonin (i.e. 40-70%) to those observed in other studies (i.e. with reserpine, p-chlorophenylalanine, methiothepin) of ponto-geniculo-occipital wave activity, no ponto-geniculo-occipital waves of the rapid-eye-movement sleep type were observed during waking after chronic treatment with amphetamine. These results are discussed within the context of the "serotonin gating" hypothesis of the generation of ponto-geniculo-occipital waves, an hypothesis which states that ponto-geniculo-occipital waves emerge into waking when a critical level of the depletion of serotonin is reached, thus opening the "gate" for ponto-geniculo-occipital waves to enter waking states. The present authors suggest that a gradual depletion of serotonin, such as occurs following the chronic administration of amphetamine, will not elicit ponto-geniculo-occipital waves into waking, whereas a rapid depletion of serotonin, such as occurs following treatment with reserpine, results in the emergence of ponto-geniculo-occipital waves into walking.

Animals↗
PubMed1984

Evidence for a directional correspondence between eye movements and dream imagery in REM sleep.

We examined the relationship between eye movement direction in REM sleep recorded by electrooculograph (EOG) and gaze direction in dream imagery. In a double-blind protocol, carefully screened and trained subjects were awakened subsequent to direct coupled EOG activity that was either predominantly horizontal or vertical. Following a target eye movement that fulfilled predetermined amplitude and directional criteria, a brief period of ocular quiescence was allowed to transpire before the subject was awakened. The dream narratives and EOG activity occurring prior to the REM awakenings were each reduced to a series of quantitatively scaled ratings. Analyses of variance demonstrated that when the confidence level of the experimenters' prediction is taken into account, statistically significant relationships exist between the number and direction of shifts of gaze in the dream report and scaled measurements of the corresponding EOG. When given dream narratives and the corresponding EOG recordings in sets of four, judges were unable to match them correctly better than by chance. However, in the above matching, judges significantly paired the dream narratives with EOG recordings that were in the same axis of gaze.

Adult↗