PubMed Health⌕ Search

Biomedical subjects

Thomas W Allen

Publications and source records attributed to Thomas W Allen.

6 recordsLinked to original sources

Prediction of volatile anesthetic binding sites in proteins.

Computational methods designed to predict and visualize ligand protein binding interactions were used to characterize volatile anesthetic (VA) binding sites and unoccupied pockets within the known structures of VAs bound to serum albumin, luciferase, and apoferritin. We found that both the number of protein atoms and methyl hydrogen, which are within approximately 8 A of a potential ligand binding site, are significantly greater in protein pockets where VAs bind. This computational approach was applied to structures of calmodulin (CaM), which have not been determined in complex with a VA. It predicted that VAs bind to [Ca(2+)](4)-CaM, but not to apo-CaM, which we confirmed with isothermal titration calorimetry. The VA binding sites predicted for the structures of [Ca(2+)](4)-CaM are located in hydrophobic pockets that form when the Ca(2+) binding sites in CaM are saturated. The binding of VAs to these hydrophobic pockets is supported by evidence that halothane predominantly makes contact with aliphatic resonances in [Ca(2+)](4)-CaM (nuclear Overhauser effect) and increases the Ca(2+) affinity of CaM (fluorescence spectroscopy). Our computational analysis and experiments indicate that binding of VA to proteins is consistent with the hydrophobic effect and the Meyer-Overton rule.

Anesthetics, Inhalation↗

Sideline management of asthma.

The timely, efficient, and effective sideline management of asthma must be grounded on an understanding of the disease processes, awareness of evidence-based therapeutic intervention, and thorough knowledge of the individual athlete's medical history and current physical condition. There is accumulating evidence that exercise-induced airway narrowing, if unrecognized or inadequately treated, can progress to a severe life-threatening status and should always be viewed as a potential medical emergency. A widening range of therapeutic measures is currently available to prevent and to treat exercise asthma, and treatment must be tailored to the individual circumstances to optimize response.

Journal Article↗

Sideline management of asthma.

The timely, efficient, and effective sideline management of asthma must be based on an understanding of the disease processes, awareness of evidence-based therapeutic intervention, and thorough knowledge of the individual athlete's past and present medical history. There is accumulating evidence that exercise-induced airway narrowing, if unrecognized or inadequately treated, can progress to a severe life-threatening status and should always be viewed as a potential medical emergency. A widening range of therapeutic measures is currently available to prevent and treat exercise asthma, and treatment must be tailored to the individual circumstances in order to optimize response.

Asthma, Exercise-Induced↗

Return to play following exercise-induced bronchoconstriction.

OBJECTIVE: To review evidence-based support for return to play criteria following acute exercise-induced bronchoconstriction. DATA SOURCES: Electronic databases Ovid Medline and PubMed were searched for papers relating to exercise related asthma and bronchoconstriction and return to play criteria. Additional references from the bibliographies of retrieved articles were also reviewed. DATA SYNTHESIS: There is clear evidence that exercise-induced airways narrowing is increasing in prevalence among athletes from school children to Olympians to professionals, yet there have been no studies specifically addressing return to play criteria. Although deaths from exercise associated bronchoconstriction were previously thought to be rare, recent reports of such deaths call for increased awareness by physicians, athletic trainers, and coaches of the potential fatal consequences of unrecognized episodes or of inadequate treatment. CONCLUSIONS: No agreed-upon protocol for safe return to play following an acute episode of exercise induced bronchoconstriction has been published. A specific detailed protocol for return to play would assist physicians and other heath professionals to determine with greater confidence that an athlete is fully recovered and can safely return to play.

Asthma, Exercise-Induced↗

Backfill for iliac-crest donor sites: a prospective, randomized study of coralline hydroxyapatite.

We report on a prospective randomized study of coralline hydroxyapatite (CH) used as backfill for iliac-crest donor sites. Autogenous iliac-crest bone graft is routinely harvested for spinal fusion. Donor-site morbidity is underappreciated; the presumption is that donor sites regenerate. In this study, we assessed the biological viability of the backfill CH (Pro OsteonTM Implant 500 Hydroxyapatite Bone Void Filler; Interpore, Irvine, Calif) and compared donor-site morbidity after harvest. Twelve patients (11 men, 1 woman) were enrolled: 5 in the backfill group and 7 in the no-backfill group. As part of routine evaluations done preoperatively and 6 weeks, 3 months, 6 months, and 1 year postoperatively, plain radiographs and computed tomography (CT) scans were used to assess bone ingrowth, and technetium bone scans were used to assess biological activity. Postoperative pain analysis was also done. Ten patients (9 men, 1 woman) completed the study. Of the 4 completers in the backfill group, 3 (75%) showed bony ingrowth on plain radiographs and CT scans at 1 year; the fourth patient showed bony ingrowth only on plain radiographs. All 4 patients showed biological activity on bone scans and reported mild pain to no pain. Of the 6 completers in the no-backfill group, 1 (17%) showed bony ingrowth on plain radiographs and CT scans. No patient showed biological activity on bone scans at 1 year. CH aids in iliac-crest healing after bone-graft harvesting by acting as a biological osteoconductive matrix. Postoperative pain at the bone-graft site is potentially reduced. More studies of larger numbers of patients are needed to assess the true long-term benefits of this material in a clinical setting.

Adult↗