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31.
32.
Effects of inotropes on human leucocyte numbers, neutrophil function and lymphocyte subtypes 总被引:1,自引:1,他引:0
Burns A. M.; Keogan M.; Donaldson M.; Brown D. L.; Park G. R. 《British journal of anaesthesia》1997,78(5):530-535
We have investigated the effects of inotropes with different adrenergic
receptor specificity on differential white cell count, lymphocyte subtypes
and neutrophil function in healthy volunteers. Six healthy, male volunteers
were enrolled into this randomized, placebo-controlled pilot study. Each
volunteer was studied on four separate occasions during a 2-h infusion of
various agents, and for 2 h after stopping the infusion. The agents
investigated were adrenaline 0.1 microgram kg-1 min-1, dobutamine 5
micrograms kg-1 min-1, dopexamine 2 micrograms kg-1 min-1 and 5% glucose
0.5 ml kg-1 h-1. Venous blood was sampled at 0, 30, 120 and 240 min.
Haemodynamic monitoring was continued throughout the study. Full blood
count, white cell differential count and enumeration of lymphocyte subtypes
were performed. Neutrophil function tests included chemoluminescence, and
assessment of neutrophil chemotaxis, phagocytosis and adhesion. The
Wilcoxon signed rank test was used to compare differences between placebo
and active drugs at each time compared with baseline. There was a
significant increase in white cell count, lymphocyte count and neutrophil
count with adrenaline, and a small but significant decrease in these
variables with dobutamine and dopexamine. These changes were also apparent
for absolute CD3+, CD4+ and CD8+ lymphocyte counts. Neutrophil respiratory
burst in response to f-methionyl-leucyl-phenylalanine increased
significantly only with adrenaline at 30 min (P = 0.046). There were no
other significant changes in tests of neutrophil function. Infusion of
inotropes was associated with changes in white cell numbers, lymphocyte
subtypes and neutrophil respiratory burst. In healthy volunteers,
adrenaline had effects different from those of dobutamine and dopexamine.
The clinical relevance of such effects requires further investigation in
critically ill patients.
相似文献
33.
OBJECTIVES. The authors assessed the effects of varying one extracellular component (fibrinogen concentration) and one cellular component (hematocrit) on magnetic resonance (MR) T1 and T2 relaxation times of in vitro blood clots. METHODS. Blood from six male subjects was collected into sodium citrate anticoagulant (3.8%) and the whole blood was separated into platelet-rich plasma and packed erythrocytes. Subsequently, in vitro blood clots were made from varying concentrations of fibrinogen (1, 10, and 100 microM) in Tyrode's solution and washed, packed erythrocytes (hematocrit levels: 0%, 10%, 40%, and 80%). T1 and T2 measurements were completed at 20 MHz within 8 hours of initiating clotting. RESULTS. Significant shortening of MR relaxation times occurred with increasing fibrinogen concentration for hematocrit values of 0% and 10%. Extracellular fibrinogen concentration did not contribute significantly to variation in relaxation times at hematocrit values of 40% and 80%. For any given fibrinogen level, significant shortening occurred in T1 and T2 values for each successive increase in hematocrit values. CONCLUSIONS. Both extracellular (fibrinogen) and cellular (erythrocyte concentration) factors are significant determinants of thrombus T1 and T2 relaxation times. 相似文献
34.
Robert J. Town Douglas Wholey Roger Feldman Lawton R. Burns 《Health services research》2007,42(1P1):219-238
Objective. This paper analyzes whether the rise in managed care during the 1990s caused the increase in hospital concentration.
Data Sources. We assemble data from the American Hospital Association, InterStudy and government censuses from 1990 to 2000.
Study Design. We employ linear regression analyses on long differenced data to estimate the impact of managed care penetration on hospital consolidation. Instrumental variable analogs of these regressions are also analyzed to control for potential endogeneity.
Data Collection. All data are from secondary sources merged at the level of the Health Care Services Area.
Principle Findings. In 1990, the mean population-weighted hospital Herfindahl–Hirschman index (HHI) in a Health Services Area was .19. By 2000, the HHI had risen to .26. Most of this increase in hospital concentration is due to hospital consolidation. Over the same time frame HMO penetration increased three fold. However, our regression analysis strongly implies that the rise of managed care did not cause the hospital consolidation wave. This finding is robust to a number of different specifications. 相似文献
Data Sources. We assemble data from the American Hospital Association, InterStudy and government censuses from 1990 to 2000.
Study Design. We employ linear regression analyses on long differenced data to estimate the impact of managed care penetration on hospital consolidation. Instrumental variable analogs of these regressions are also analyzed to control for potential endogeneity.
Data Collection. All data are from secondary sources merged at the level of the Health Care Services Area.
Principle Findings. In 1990, the mean population-weighted hospital Herfindahl–Hirschman index (HHI) in a Health Services Area was .19. By 2000, the HHI had risen to .26. Most of this increase in hospital concentration is due to hospital consolidation. Over the same time frame HMO penetration increased three fold. However, our regression analysis strongly implies that the rise of managed care did not cause the hospital consolidation wave. This finding is robust to a number of different specifications. 相似文献
35.
The effects of patient, hospital, and physician characteristics on length of stay and mortality 总被引:14,自引:0,他引:14
This article compares the ability of hospital and physician characteristics to explain variations in length of stay and mortality, controlling for factors associated with severity of illness. The analysis is based on 54,571 discharges, covering 11 medical and five surgical conditions, from nonfederal general hospitals in one state during 1988. Results suggest that both hospital and physician characteristics are important predictors of both outcome measures. Contrary to previous research, the volume of patients with the same condition treated by the hospital increases both length of stay and mortality. The volume of patients with the same condition treated by the physician increases length of stay among patients with medical conditions, decreases length of stay among those with surgical conditions, and decreases mortality. One interesting finding is that the medical school attended by the physician influences the patient's length of stay. Findings are interpreted in light of research evidence on factors affecting medical outcomes and recent federal efforts to improve quality of care. 相似文献
36.
R Snyder J Bishop G Brodie W Burns A Coates J Levi D Raghavan M Schwarz M Tattersall D Thomson 《Cancer treatment reports》1987,71(3):273-276
Epirubicin was studied in a phase I setting to find the maximum tolerated dose when given weekly for 3 of 4 weeks. Forty-one evaluable patients were treated in groups at doses increasing from 20 to 45 mg/m2. The highest dose level produced the maximum degree of myelosuppression (lowest neutrophil count, 1.9 X 10(9)/L; range, 0-3.7) recorded on Day 22. This was well-tolerated in this group of mainly pretreated patients. Nonhematologic side effects were minimal. This dose schedule allows a greater dose per unit time to be administered than other recommended schedules for epirubicin. 相似文献
37.
38.
A portable system for measuring cutaneous thresholds for warming and cooling. 总被引:5,自引:3,他引:2 下载免费PDF全文
C J Fowler M B Carroll D Burns N Howe K Robinson 《Journal of neurology, neurosurgery, and psychiatry》1987,50(9):1211-1215
Measurement of cutaneous thermal thresholds is a valuable technique for detecting small fibre neuropathy. A robust and portable microcomputer controlled system, which separately measures thresholds for warming and cooling, is described. Thresholds at three sites have been measured; the cheek, the dorsum of the hand and the sole of the foot. Regional variability and a correlation with age have been found, indicating the sensitivity of this system. 相似文献
39.
John Polich Tim Burns Floyd E. Bloom 《Alcoholism, clinical and experimental research》1988,12(2):248-254
P300 event-related brain potentials (ERPs) were obtained from 20 pairs of male and 20 pairs of female undergraduate subjects. One member of each pair reported having a father who was alcoholic (FHP), the other reported no known alcoholic biological relative (FHN). Pair members were matched on age, height, weight, grade point average, and personal drinking history. Three auditory tasks which differed in stimulus discrimination difficulty were presented to each subject. All tasks employed 20% target and 80% standard tones with the subject required to move their index finger whenever a target stimulus was detected. No significant differences in P300 amplitude or latency were obtained between the family history subject groups, although female FHP subjects tended to have smaller P300 amplitudes than their FHN counterparts. P300 amplitude decreased with increases in the amount of self-reported alcohol consumed for FHP subjects but significantly so only for the most difficult task situation. The results suggest that the relationship between the P300 ERP and the inheritability of alcoholism is not yet clear and may be subject to modulation by task requirements, population differences, and subject sex. 相似文献
40.
The patient''s appraisal of the cosmetic result of segmental mastectomy in benign and malignant breast disease. 总被引:1,自引:0,他引:1 下载免费PDF全文
Women's appraisal of the cosmetic result and their psychosocial adjustment after a standardized segmental mastectomy for benign or malignant breast disease was analyzed on the basis of a mailed questionnaire, which was satisfactorily answered by 263 (92%) of 285 women operated on consecutively. The overall result was favorable: 96.5% of the patients found the new appearance of their breast very good (30.7%), good (44.0%), or acceptable (21.8%). Women with a benign diagnosis ran a two-fold higher risk of being discontented with the new appearance of the breast than those with breast cancer. Complications of radiation therapy, preoperative concern that the breasts are important for the appearance, and anxiousness about the cosmetic result were associated with a significantly elevated risk of being less satisfied with the outcome. The main finding that it is possible to perform a locally radical operation that is highly acceptable to the woman is relevant to the surgical management of potentially malignant mammographic lesions and also to the scientific strategies for future evaluation of breast-conserving treatment modes in malignant disease. 相似文献