Biomedical subjects

S Pugh

Publications and source records attributed to S Pugh.

59 records · Page 4Linked to original sources

PubMed1981

Correlation of antibiotic usage with an antibiotic policy in a urological ward.

An antibiotic policy for a urological ward was largely implemented by restrictive antibiotic sensitivity reporting, and indications for prophylaxis were derived from the feature of 40 episodes of bacteraemia associated with urological procedure. Of 510 patients admitted to this ward, 30-8 per cent received antibiotics. Of 187 antibiotic courses, 53 per cent were for treatment and 43 per cent for prophylaxis. The stated indications were considered dubious in 28 per cent of courses of treatment and irrational in 13 per cent of courses of prophylaxis. Of 1368 days of antibiotic use, co-trimoxazole and amoxycillin/ampicillin accounted for 84.6 per cent, and gentamicin for 5.6 per cent. The modal duration of courses of co-trimoxazole, amoxycillin/ampicillin, and gentamicin were 5, 5 and 1 days respectively. Antibiotics whose sensitivities were not reported were rarely used, and there was no prescription of cephradine, cefoxitin, cefuroxime or amikacin. In general, antibiotic administration corresponded well with policy guidelines.

Amoxicillin↗

PubMed1976

Abnormal lymphocyte function is secondary to drug-induced autoimmunity.

Abnormal lymphocyte function has been frequently reported in patients with connective tissue diseases but its significance has been uncertain. Sequential studies of lymphocyte function were carried out in patients receiving the beta-adrenergic blocking drug practolol (Eraldin) both before and during the development of autoimmune complications. No evidence was obtained that abnormal lymphocyte function presaged the onset of autoimmunity, and when these tests did show deficient responses these could be correlated with disease activity in general.

Adult↗

PubMedDate not supplied

Mechanism of action of Roter (bismuth subnitrate) in patients with duodenal ulcer disease and healthy volunteers.

The effects of Roter (compound bismuth subnitrate) on antacid activity and mucosal prostaglandin E2 (PGE2) synthesis were variously investigated in patients with duodenal ulcer disease and healthy volunteers. Roter had a significant but small antacid activity with a buffering capacity of 10.9 mmol per tablet. In healthy volunteers, this was assessed by 24 h gastric pH monitoring on matched days with and without Roter treatment. The percentage of time that gastric pH was above 3 and the time after a standard meal that the pH was above 3, were both significantly increased by treatment with Roter (II tds post-cibal) (P less than 0.01). Endogenous PGE2 synthesis was measured in endoscopic duodenal biopsies taken both before and after Roter treatment in patients with acute untreated duodenal ulceration. There was a significant deficiency of mucosal PGE2 synthesis in untreated patients compared with controls (P less than 0.005). However, following 4 weeks' treatment with Roter, there was a 90% rate of healing accompanied by a significant increase in PGE2 synthesis (P less than 0.05) up to control levels. These findings suggest that Roter heals by the combined effects of a modest antacid neutralizing capacity and the ability to restore mucosal prostaglandins to normal levels, thereby mediating prostaglandin-dependent defence mechanisms.

Adult↗

PubMedDate not supplied

Effective endothelialization of polyurethane surfaces. Response to shear stress and platelet adhesion.

Biomer and Mitrathane are thromboresistant polyurethane ureas that are suitable for coating artificial valves. Degeneration of the surface coatings, however, does occur over time, and in experimental animal studies adherent thrombi have been observed as a complication. In this study, morphometric techniques applied to scanning electron microscopy were used to assess whether vascular endothelial cells harvested from jugular veins of fetal lambs could be grown to confluence on these polyurethane surfaces, whether the monolayer would remain intact under conditions of shear stress (104 dynes/cm2), and whether this would result in decreased platelet adherence of sheep platelets relative to nonendothelialized surfaces. The results have shown that both Biomer and Mitrathane could be endothelialized: 88.8 +/- 5.1% of the Biomer surface consisted of intact confluent endothelial cells, as did 95.45 +/- 1.7% of the Mitrathane surface. After 6 hr of shear stress, a significant reduction in this feature was observed (p = 0.02), but both materials still maintained a high percentage of confluent endothelial cells (78.65% for Biomer and 85.58% for Mitrathane). After 48 hr of shear stress, however, the percent confluence was similar to control values, which suggested new cell growth. Endothelialized Biomer compared with Mitrathane had fewer adherent single platelets, or small or large aggregates (p = 0.001, p = 0.01, and p = 0.05, respectively); this feature was not affected by shear stress. Whereas endothelialization of the surface clearly decreased platelet adherence on Mitrathane (p = 0.01), only a trend was seen with Biomer. These studies therefore show that endothelialization of these polyurethane surfaces is feasible.

Animals↗

PubMedDate not supplied

The inotropic and hemodynamic effects of intravenous milrinone when reflex adrenergic stimulation is suppressed by beta-adrenergic blockade.

Milrinone is an inotropic and vasodilator agent proven to be effective in the treatment of heart failure. This study evaluated whether milrinone produces inotropic and hemodynamic effects independent of reflex adrenergic stimulation. Eleven stable heart failure patients (New York Heart Association class II to III) undergoing cardiac catheterization received intravenous (i.v.) milrinone (50 micrograms/kg for 10 minutes followed by 0.5 micrograms/kg/min for 50 minutes) during beta-adrenergic blockade. After beta-blockade with a 50-mg oral dose of metoprolol, heart rate decreased by a mean of 16.6%. The peak inotropic response to i.v. milrinone measured using the maximum rate of rise of left ventricular pressure (LV dP/dt) was fully developed at 20 minutes. Mean absolute inotropic response of LV dP/dt from baseline was statistically significant at 10, 20, 30, and 40 minutes (P < 0.05). Mean percentage increase in cardiac index from baseline was statistically significant at 20 and 30 minutes, and mean absolute decline from baseline for pulmonary capillary wedge pressure was statistically significant at 20 and 40 minutes (P < 0.05). The inotropic and hemodynamic effects of i.v. milrinone were thus preserved during beta-adrenergic blockade. This finding is consistent with a mechanism of action of i.v. milrinone--myocardial phosphodiesterase inhibition--that is independent of reflex adrenergic stimulation.

Adrenergic beta-Antagonists↗