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Biomedical subjects

R Ruff

Publications and source records attributed to R Ruff.

7 recordsLinked to original sources

Hemodynamic effects of a lorazepam-fentanyl anesthetic induction for coronary artery bypass surgery.

Previous anesthetic induction techniques using the combination of a benzodiazepine (midazolam or diazepam) and fentanyl have been reported to produce marked hypotension. In this study, anesthesia was induced with a combination of lorazepam and fentanyl in patients undergoing coronary artery bypass graft surgery. In 10 patients, anesthesia was induced using an exponentially declining continuous infusion of lorazepam equivalent to a total infused dose of 0.1 mg/kg over 15 minutes, which was supplemented at 10 minutes by fentanyl, 75 micrograms/kg, given as an infusion over 5 minutes. In 8 additional patients, anesthesia was induced with an exponentially declining infusion of fentanyl to a total dose of 75 micrograms/kg over 15 minutes, which was supplemented at 10 minutes by lorazepam, 0.1 mg/kg, given as an infusion over 5 minutes. Hemodynamics were recorded during a 20-minute observation period. One patient in each group required treatment for bradycardia during the initial drug infusion (before the second drug was added). Four additional patients in the group receiving lorazepam followed by fentanyl required treatment for bradycardia or hypotension within 10 minutes of the beginning of the fentanyl infusion. When an infusion of lorazepam was added to the fentanyl infusion, hemodynamics remained stable; however, the reverse order produced a high level of bradycardia and hypotension.

Anesthesia, Intravenous

Comparison of different methods for detecting human immune deficiency virus in human immunodeficiency virus-seropositive hemophiliacs.

Since the detection of antibodies against the human immune deficiency virus (HIV) does not definitely prove HIV infection in hemophiliacs, virus detection was attempted by virus isolation from the peripheral blood monocytes (PBL), by demonstration of p24 antigen and decline of p24 antibody, and by detection of viral DNA by the polymerase chain reaction (PCR). Virus isolation was optimized by immediate coculture of PBL and by replacement of the reverse transcriptase test by the p24 antigen test, whereas the elimination of CD8+ lymphocytes proved to be unnecessary. Virus detection was dependent on the clinical stage of the illness. Virus isolation in 70 of 211 patients (33%) was more sensitive than detection of p24 antigen or decline of p24 antibody. PCR was performed in 25 patients and indicated infection in all of 15 isolation-positive cases and in 6 of 10 patients from whom virus was not isolated. Changes from negative to positive virus culture and from a weakly fusiogenic to a highly fusiogenic isolate were often accompanied by a progression of the disease. The results suggest that reactivation of HIV occurs when immune deficiency has become manifest. Apparently virus isolation detects only the virus already reactivated in vivo, whereas the PCR may also detect latent virus.

Antibodies, Viral

Familial 'sleep apnea plus' syndrome: report of a family.

We describe a familial disorder consisting of sleep apnea, anosmia, colorblindness, partial complex seizures, and cognitive dysfunction. The phenotypic expression of the syndrome suggests an autosomal dominant inheritance with incomplete penetrance.

Adult