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Biomedical subjects

S Gabriel

Publications and source records attributed to S Gabriel.

108 records · Page 6Linked to original sources
PubMed1976

Measurement of cardiac output by impedance cardiography in patients with myocardial infarction. Comparative evaluation of impedance and dye dilution methods.

The cardiac output was measured simultaneously by the impedance cardiography and dye dilution methods in 10 patients with acute myocardial infarction 2-3 weeks after admission to the Coronary Care Unit. The impedance cardiac output was on the average 9.7% higher than the dye dilution cardiac output. The reproducibility of impedance cardiac output 4.1%, compared with 5.1% for the dye dilution method. The study showed a satisfactory reliability of impedance in predicting the relative changed of cardiac output in response to tilting from the supine to the 30 degrees head-up position, to a 10 degrees head-down position, and to the intravenous administration of propranolol.

Acute Disease↗
PubMedDate not supplied

Immunity to schistosomiasis in animals: an update.

The present paper reviews the available literature on the development of immunity to animal Schistosoma infections. The majority of the studies on animal schistosomiasis were performed in cattle and pigs and only Schistosoma mattheei, S. bovis and S. japonicum received particular attention, mainly because of their recognized veterinary significance or zoonotic aspect. Although it is an accepted fact that acquired resistance to Schistosoma is of major importance in the regulation of infection intensity in the field, almost nothing is yet known of either the nature of the antigens or of the immune mechanisms involved. The recent studies on immunity development focus in particular on the occurrence of maternal to foetal transfer of immunological substances related to animal Schistosoma infections and possible effects of these transfers on the immunity development of the foetus/newborn. Since congenital infections for Schistosoma species other than S. japonicum are extremely rare, the most plausible route for foetal contact is the transplacental or postnatal transfer of immunological substances. Prenatal transfers of specific antibodies and antigens via placental lesions and postnatal transfers via the colostrum were observed in cattle and pigs, and subsequent modifications of the immune response of the newborn were observed. Placental lesions induced by Schistosoma eggs could allow other pathogens to cross the placenta.

Animals↗
PubMedDate not supplied

Assessing values for health: numeracy matters.

BACKGROUND: Patients' values are fundamental to decision models, cost-effectiveness analyses, and pharmacoeconomic analyses. The standard methods used to assess how patients value different health states are inherently quantitative. People without strong quantitative skills (i.e., low numeracy) may not be able to complete these tasks in a meaningful way. METHODS: To determine whether the validity of utility assessments depends on the respondent's level of numeracy, the authors conducted in-person interviews and written surveys and assessed utility for the current health for 96 women volunteers. Numeracy was measured using a previously validated 3-item scale. The authors examined the correlation between self-reported health and utility for current health (assessed using the standard gamble, time trade-off, and visual analog techniques) across levels of numeracy. For half of the women, the authors also assessed standard gamble utility for 3 imagined health states (breast cancer, heart disease, and osteoporosis) and asked how much the women feared each disease. RESULTS: Respondent ages ranged from 50 to 79 years (mean = 63), all were high school graduates, and 52% had a college or postgraduate degree. Twenty-six percent answered 0 or only 1 of the numeracy questions correctly, 37% answered 2 correctly, and 37% answered all 3 correctly. Among women with the lowest level of numeracy, the correlation between utility for current health and self-reported health was in the wrong direction (i.e., worse health valued higher than better health): for standard gamble, Spearman r=-0.16, P = 0.44;for time trade-off, Spearman r=-0.13, P=0.54. Among the most numerate women, the authors observed a fair to moderate positive correlation with both standard gamble (Spearman r=0.22, P=0.19) and time trade-off (Spearman r=0.50, P=0.002). In contrast, using the visual analog scale, the authors observed a substantial correlation in the expected direction at all levels of numeracy (Spearman r= 0.82, 0.50, and 0.60 for women answering 0-1, 2, and 3 numeracy questions, respectively; all Ps < or = 0.003). With regard to the imagined health states, the most feared disease had the lowest utility for 35% of the women with the lowest numeracy compared to 76% of the women with the highest numeracy (P=0.03). CONCLUSIONS: The validity of standard utility assessments is related to the subject's facility with numbers. Limited numeracy may be an important barrier to meaningfully assessing patients' values using the standard gamble and time trade-off techniques.

Aged↗
PubMedDate not supplied

Cost consequence analysis of fondaparinux versus enoxaparin in the prevention of venous thromboembolism after major orthopaedic surgery in Belgium.

Fondaparinux, a selective inhibitor of activated factor X, has been shown to reduce further the risk of venous thromboembolism (VTE) in major orthopaedic surgery compared to the low molecular weight heparin enoxaparin, when both were applied for 7 days after surgery. To compare the expected costs and clinical outcomes of fondaparinux with enoxaparin applied for 7 days after surgery, we conducted a cost-consequence analysis in patients undergoing major orthopaedic surgery, i.e. total hip replacement, total knee replacement and hip fracture repair. Our decision model included endpoints relevant in routine clinical practice and the natural history of VTE over a long term period of 5 years. Costs for prevention, diagnosis and treatment of VTE and its complications were estimated from the Belgian health care payer perspective. Analyses were conducted for different time horizons and for the three indications, separately, and then combined. Overall, our results indicated that the initial investment in fondaparinux (cost per day: 10.39 euros versus 3.74 euros for enoxaparin) was soon compensated by savings due to avoided VTE events, with cost neutrality being achieved after 90 days and further savings being incurred over longer time periods mainly due to avoided post-thrombotic syndromes. These findings were most pronounced in patients undergoing hip fracture repair. Sensitivity analyses showed these findings to be robust for the three indications separately, and combined. We conclude that our analysis of health and economic consequences over a long term period, demonstrates the value for money of fondaparinux versus enoxaparin for the prevention of VTE events after total hip replacement, total knee replacement and hip fracture repair.

Anticoagulants↗
PubMedDate not supplied

Comparison of two commercial brands of microcrystalline cellulose for extrusion-spheronization.

Two commercial brands of microcrystalline cellulose, the widely used Avicel PH-101 and the newly available Pharmacel 101, were compared for aqueous extrusion-spheronization of a model mix with lactose. Based on the results of multi-level experiments employing pellet size analysis by sieving and sphericity determination by image analysis, Avicel was shown to be less adversely affected by variation in added water or speed of spheronization. Physicochemical testing of powder samples from both brands was carried out using laser particle sized analysis, density determinations, differential scanning calorimetry and X-ray diffraction studies. The results indicated that the improved ease of processing with Avicel may be related to its smaller particle size with less aggregates, improved flow, lower depolymerization temperature range and absence of traces of cellulose II in its cellulose I content.

Calorimetry, Differential Scanning↗
PubMedDate not supplied

How effectively do you function in a cardiac arrest? A creative program approach to code skills.

Novice and experienced nurses are consistently concerned about their knowledge, skills and abilities to function appropriately in arrest situations. The clinical teachers at Mount Sinai Hospital in Toronto have established an innovative, creative, practical and cost-effective workshop that addresses nurses' code skills. The 500 evaluations received from nurses who have attended the workshops show the program is a resounding success. The 4-hour workshop concentrates on the nurses' role during cardiac arrests in four key areas: leadership, drug administration, suctioning, and airway management. The program is complete with goals and objectives, props, specific evaluation forms, and a take-home examination. The hands-on component of the workshop allows the application of new information under close observation and supervision of knowledgeable and skilled clinical teachers.

Cardiopulmonary Resuscitation↗
PubMedDate not supplied

Laparoscopic cholecystectomy.

Traditional gall bladder surgery results in an abdominal incision requiring management of pain, possible ileus, a hospital stay of 5 to 7 days, and a six week recovery period. This type of surgery carries with it the risks of both surgery and anaesthesia and can have a high monetary cost for both the patient and the hospital. Laparoscopic cholecystectomy results in four, 1 to 3 cm incisions, that appear to produce less pain and no ileus. Hospitalization is 24 to 48 hours and complete recovery and return to work can occur within two weeks. This surgery is a safe and economical alternative to traditional surgical methods.

Cholecystectomy↗
PubMedDate not supplied

Metabolism, disposition, and pharmacokinetics of a potent anticonvulsant, 4-amino-N-(2,6-dimethylphenyl)benzamide (LY201116), in rats.

The metabolism, disposition, and pharmacokinetics of 4-amino-N-(2,6-dimethylphenyl)benzamide (LY201116) have been studied in rats. 14C-LY201116 was well absorbed (approximately 94%) from the gastrointestinal tract following oral administration. Of the dose administered, 64.5% was excreted in the urine and 29% in the bile; with the majority being excreted during the first 24 hr. Peak plasma levels of LY201116 were observed at 0.75 hr, whereas peak plasma concentrations of radioactivity were seen at 2 hr after dosing. Maximum levels of radioactivity were observed at 2 hr in all of the tissues studied. The elimination of radioactivity from the tissues was monophasic with a mean half-life of 3.4 hr. Biotransformation of LY201116 in rats was investigated by quantitating and isolating metabolites from urine and plasma. The major route of metabolism was N-acetylation to form 4-(acetylamino)-N-(2,6-dimethylphenyl)benzamide (ADMP), and subsequent hydroxylation to form 4-(acetylamino)-N-(2-hydroxymethyl-6-methylphenyl)benzamide (HADMP). Two hr after oral dosing with 14C-LY201116, ADMP and HADMP comprised 92% of the total radioactivity in the plasma. The major urinary metabolite, accounting for 63% of the radioactivity in the urine, was HADMP. The elimination of LY201116 from the systemic circulation following iv administration was monophasic, with a terminal t1/2 of 9.4 min. The volume of distribution was 911 ml/kg and the plasma clearance was 66.9 ml/min/kg.

Animals↗
PubMedDate not supplied

[Specific soluble cell-wall antigens of "Candida tropicalis" demonstrated by crossed immunoelectrophoresis (author's transl)].

In the present study, soluble cytoplasmic extracts of Candida albicans and C. tropicalis were prepared and showed respectively 67 and 47 precipitates in crossed immunoelectrophoresis performed with a commerical goat anti-C. albicans immunserum. Purified cell walls of C. tropicalis have been prepared, and corresponding antiserum was got in rabbits. Although important cross-reacting antigens exist between soluble cytoplasmic extracts of C. albicans and C. tropicalis, the C. tropicalis cell wall antiserum precipitated antigens in crossed immunoelectrophoresis only in C. tropicalis soluble cytoplasmic extracts. The present study: - confirms that C. albicans shared 70% of the antigens with C. tropicalis; - demonstrates that soluble cytoplasmic antigens prepared by homogenization of yeasts contain cell wall constituents; - allows us to prepare a specific immune serum for C. tropicalis.

Animals↗