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Biomedical subjects

R R Attia

Publications and source records attributed to R R Attia.

5 recordsLinked to original sources
PubMed1979

Release of vasoactive intestinal peptide in the central nervous system in man.

Recent work has shown that vasoactive intestinal peptide (VIP), one of the many candidate hormones of the gut, also occurs widely in neurones. To determine whether the neuronal peptide may have a neurotransmitter function, we studied changes in immunoreactive VIP in dog plasma and human cerebrospinal fluid after the infusion of choline esterase inhibitors (neostigmine and physostigmine, respectively). Immunoreactive VIP was released in both situations. The systemic changes (in VIP levels) were enhanced five weeks after portacaval shunting in dogs. Our results demonstrate that the immunoreactive VIP level increases as a result of choline esterase inhibitors. The plasma "release" may originate either from peripheral peptidinergic nerve terminals or from APUD cells of the gastroenteropancreatic system. The increase in immunoreactive cerebrospinal fluid VIP may very well originate from central neurons, since the peptide does not apparently cross the blood-brain barrier.

Animals↗
PubMed1976

Myocardial ischemia due to infrarenal aortic cross-clamping during aortic surgery in patients with severe coronary artery disease.

Hemodynamic measurements were performed and ECG recorded before and shortly after infrarenal aortic cross-clamping during operation for abdominal aortic aneurysm in five patients without evidence of heart disease (group I) and in ten patients with severe coronary artery disease (group II). All patients sustained an increase in systemic arterial pressure. Group I demonstrated a decrease in pulmonary artery, pulmonary capillary wedge (PCW), and central venous pressures when the aorta was clamped, whereas group II demonstrated an increase. The difference in response of the groups is significant (P less than 0.05). All three patients who responded to cross-clamping with increases of 7 mm Hg or greater in PCW demonstrated myocardial ischemia during cross-clamping. None of the values measured prior to cross-clamping predicted with certainty the response to cross-clamping. Sodium nitroprusside reversed the elevation of left ventricular filling pressure in all three patients, and in two patients, relieved evidence of myocardial ischemia concurrently. In the third patient, ventricular irritability was abolished by lidocaine and did not recur. We conclude that infrarenal aortic cross-clamping may cause myocardial ischemia in patients with severe coronary artery disease. This ischemia may be predicted by a rise in PCW at the time of cross-clamping, and vasodilator therapy is indicated in such patients.

Aged↗
PubMed1975

Transtracheal ventilation.

Effective percutaneous oxygenation and ventilation can be achieved through the use of transtracheal catheters. A graphic study of pressure-flow requirements through different-sized catheters can serve as a guide for the caliber and driving pressure requirement to obtain optimal oxygen flow.

Acute Disease↗
PubMedDate not supplied

Teaching effectiveness: evaluation of computer-assisted instruction for cardiopulmonary resuscitation.

Computer instruction for cardiopulmonary resuscitation (CPR), using a case-simulation program, was evaluated for its teaching effectiveness. First-month anesthesia residents, divided into two groups, A and B, underwent a cognitive evaluation on their 1st day of arrival and again on their 5th day. Both groups were provided with clear educational objectives and reading materials, a tutor was assigned to each student to answer specific questions. Students in group A, also given computer-assisted instruction (CAI), showed a significantly higher learning than those in group B, who served as controls. That CAI was a highly motivational form of learning was established by later voluntary participation in CAI of all group B students.

Anesthesiology↗