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Biomedical subjects

R E Tobey

Publications and source records attributed to R E Tobey.

16 recordsLinked to original sources
PubMed1992

A comparative study of the effects of intranasal triamcinolone acetonide aerosol (ITAA) and prednisone on adrenocortical function.

A comparison of adrenocortical function before and after treatment with either intranasal triamcinolone acetonide aerosol (ITAA), prednisone, or placebo was done. Sixty-two male subjects with allergic rhinitis were treated for 6 weeks with either ITAA (220 or 440 micrograms/day), oral prednisone (10 mg/day), or placebo in double-blind, parallel-group fashion. Adrenocortical function was assessed by 6-hour cosyntropin stimulation before and at the end of the treatment period. The placebo-treated and two ITAA-treated groups produced no changes in adrenocortical function with treatment, and the ITAA-treated groups were not different from the placebo-treated group with mean +/- SEM changes in stimulated plasma cortisol (micrograms per deciliter) as follows: placebo, -2.68 +/- 1.77; ITAA 220 micrograms, -2.69 +/- 1.18; ITAA 440 micrograms, -2.96 +/- 1.81. The prednisone-treated group had a mean reduction in adrenocortical function (mean +/- SEM change in stimulated plasma cortisol of -19.8 +/- 1.77 micrograms/dl) that was significant (p less than 0.0001) compared with that of the placebo-treated group. The results of this study indicate that 6 weeks of treatment with 220 micrograms/day or 440 micrograms/day of ITAA has no effect on adrenocortical function, but prednisone, at a dosage of 10 mg/day for 6 weeks, produces partial adrenocortical suppression.

Administration, Intranasal↗
PubMed1979

Ketamine and thiopental sleep responses in guinea pigs in hyperbaric helium-oxygen.

One-hundred twenty three guinea pigs, randomly divided into four groups, were exposed to the following normoxic environments: Group I, 1 atmosphere absolute (ATA) air; Group II, 1 ATA helium-oxygen (heliox); Group III, 20 ATA heliox; and Group IV, 31 ATA heliox. Each group was divided into five subgroups; each subgroup received a different and graduated intravenous dose of ketamine in one of these environments. An additional 172 guinea pigs were exposed either to 1 ATA air or 31 ATA heliox and given thiopental. The duration of sleep, determined by failure of the animals to right themselves, was then used to construct dose-response curves for the two drugs in the hyperbaric environments. Results demonstrated less pressure antagonism of anesthesia with ketamine than with thiopental. For both drugs, pressure not only increased the dose required to induce sleep but also decreased the duration of sleep, when it occurred, by as much as 50% compared to effects of the same doses at surface pressure.

Anesthesia↗
PubMed1976

Hydroxocobalamin therapy of cyanide intoxication in guinea pigs.

The efficacy of hydroxocobalamin (vitamin B12a) as a specific, nontoxic antidote in acute cyanide poisoning was tested. Guinea pigs receiving lethal intravenous NaCN injections were treated with either vitamin B12a or saline solution. There was a statistically significant antidotal effect of the vitamin. No toxic effect was observed with large doses of the vitamin.

Animals↗
PubMed1976

Nitroprusside-induced cyanide poisoning: antidotal effect of hydroxocobalamin.

Sodium nitroprusside was investigated as a potential source of cyanide poisoning, Whole-blood cyanide determinations were performed on arterial samples from baboons receiving nitroprusside while anesthetized. There was a statistically significant increase in cyanide levels, as well as development of tachyphylaxis and severe metabolic acidosis. Hydroxocobalamin (vitamin B12a) infused simultaneously with nitroprusside significantly lessened the increase in cyanide levels and eliminated the development of metabolic acidosis. Nitroprusside can cause cyanide intoxication in the baboon, and hydroxocobalamin appears to be an effective antidote.

Acid-Base Equilibrium↗
PubMed1976

Onset of succinylcholine-induced hyperkalemia following denervation.

Denervation injuries in baboons were used to define the time course of the hyperkalemic response to succinylcholine. Half-peak increase in serum potassium (2.78 mEq/l) occurred 8.4 days following injury. Peak increase (5.5 mEq/l) appeared 14 days after injury. However, changes in potassium levels begin as early as four days after injury. Succinylcholine or other depolarizing muscle relaxants should not be used after the fourth day following an injury or denervation that involves two or more limbs.

Animals↗
PubMed1975

Diphenylhydantoin and lidocaine modification of A-V conduction in halothane-anesthetized dogs.

The effect of halothane on A-V conduction was evaluated in gods during atrial pacing using the technique of His-bundle electrocardiography. In addition, the effects of lidocaine and diphenylkydantoin (DPH) on A-V conuction were examined during halothane anesthesia. Effects of these drugs on three subintervals of A-V conduction were compared. These included the -H (stimulus atifact of His-bundle deflection-atrioventricular conduction), H-Q (His-budnle deflection onset of QRS complex-His-Purkinje conduction), and H-S intervals(His-bundle delfection to end of QRS COmplex-total intraventricular conduction). Linear regression best described the relationship between duration of interval (P-H, H-V,and H-S) and heart rate during incremental increases in the atrial paced rate. Data from these experiments were fitted to a multiple lenear regression model that predicted the effect of increasing concentrations of halothan, lidocaine, and DPH on slope and intercept coefficients. In creasing concentrations of halothan ( 30 and 45 mg/100 ml arterial). Both lidocaine and DPH further depressed conduction at all levels of halothan anesthesia. The P-H interval was particularly sensitive todrug effefts. This may represent potentiation of the normal slowing of conduction through the AVnode in response to incremental increases in heart rate (fatigue response.) We conclude thatboth lidocaine and DPH fail to reverse the depressant effect of halothane on A-V conduction. This may explain their ineffectiveness in treating certain types of arrhythmias during halothane anesthesia.

Anesthesia, Inhalation↗
PubMedDate not supplied

Anesthetic considerations in patients with gas gangrene.

Anesthesia for a patient with gas gangrene presents a challenge for the anesthesiologist, since it is an uncommon disease requiring emergency treatment. The authors, faced with such a challenge and finding little guidance in the literature, have proposed modalities of anesthetic management based on pathophysiology, symptomatology, and the reported experience of others. In addition to choice of anesthetic agents, problems reviewed include shock, hypovolemia, tachycardia, fever, anemia, renal dysfunction, pulmonary insufficiency, and contamination. Factors relating to anesthesia during hyperbaric-O2 therapy are also reviewed.

Adjuvants, Anesthesia↗
PubMedDate not supplied

Hepatitis and operating-room personnel: an approach to diagnosis and management.

Hepatitis represents a common problem in operating room (OR) personnel. The differential diagnosis is usually narrowed to viral hepatitis versus halothane-associated hepatitis. While specific immunologic technics are available to diagnose viral hepatitis, halothane hepatitis cannot presently be unequivocally diagnosed with available clinical, biochemical, immunologic, or pathologic technics. Suggestions for management of OR personnel with hepatitis can only be based on insufficient evidence at present. The authors have initiated a prospective study to help clarify this situation.

Acute Disease↗