1
|
Paige D, Anderson J. M166 SUBCUTANEOUS C1-INHIBITOR PROPHYLAXIS FACILITATES CONTINUITY OF CARE IN WOMEN OF CHILDBEARING AGE WITH HEREDITARY ANGIOEDEMA. Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
2
|
Jones JD, Sinder BP, Paige D, Soki FN, Koh AJ, Thiele S, Shiozawa Y, Hofbauer LC, Daignault S, Roca H, McCauley LK. Trabectedin Reduces Skeletal Prostate Cancer Tumor Size in Association with Effects on M2 Macrophages and Efferocytosis. Neoplasia 2018; 21:172-184. [PMID: 30591422 PMCID: PMC6314218 DOI: 10.1016/j.neo.2018.11.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 11/07/2018] [Accepted: 11/09/2018] [Indexed: 12/30/2022] Open
Abstract
Macrophages play a dual role in regulating tumor progression. They can either reduce tumor growth by secreting antitumorigenic factors or promote tumor progression by secreting a variety of soluble factors. The purpose of this study was to define the monocyte/macrophage population prevalent in skeletal tumors, explore a mechanism employed in supporting prostate cancer (PCa) skeletal metastasis, and examine a novel therapeutic target. Phagocytic CD68+ cells were found to correlate with Gleason score in human PCa samples, and M2-like macrophages (F4/80+CD206+) were identified in PCa bone resident tumors in mice. Induced M2-like macrophages in vitro were more proficient at phagocytosis (efferocytosis) of apoptotic tumor cells than M1-like macrophages. Moreover, soluble factors released from efferocytic versus nonefferocytic macrophages increased PC-3 prostate cancer cell numbers in vitro. Trabectedin exposure reduced M2-like (F4/80+CD206+) macrophages in vivo. Trabectedin administration after PC-3 cell intracardiac inoculation reduced skeletal metastatic tumor growth. Preventative pretreatment with trabectedin 7 days prior to PC-3 cell injection resulted in reduced M2-like macrophages in the marrow and reduced skeletal tumor size. Together, these findings suggest that M2-like monocytes and macrophages promote PCa skeletal metastasis and that trabectedin represents a candidate therapeutic target.
Collapse
Affiliation(s)
- J D Jones
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - B P Sinder
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - D Paige
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - F N Soki
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - A J Koh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - S Thiele
- Department of Endocrinology, Diabetes, and Bone Disease, Technische Universität Dresden Medical Center, Dresden, Germany; German Cancer Consortium (DKTK), partner site Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Y Shiozawa
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI; Department of Cancer Biology and Comprehensive Cancer Center, Wake Forest University School of Medicine, Winston-Salem, NC
| | - L C Hofbauer
- Department of Endocrinology, Diabetes, and Bone Disease, Technische Universität Dresden Medical Center, Dresden, Germany; German Cancer Consortium (DKTK), partner site Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - S Daignault
- Department of Biostatistics, Center for Cancer Biostatistics, University of Michigan, Ann Arbor, MI
| | - H Roca
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - L K McCauley
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI; Department of Pathology, University of Michigan Medical School, Ann Arbor, MI.
| |
Collapse
|
3
|
Wolf S, Goiriz R, Dhairyawan R, Paige D, Rizvi H, Haroon A, Montoto S. Brentuximab vedotin in multifocal cutaneous anaplastic large cell lymphoma in a patient with human immunodeficiency virus following Hodgkin lymphoma. Clin Exp Dermatol 2018; 44:562-564. [PMID: 30430604 DOI: 10.1111/ced.13824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2018] [Indexed: 01/10/2023]
Affiliation(s)
- S Wolf
- Department of Haemato-Oncology, Barts Health NHS Trust, London, UK
| | - R Goiriz
- Department of Dermatology, Barts Health NHS Trust, London, UK
| | - R Dhairyawan
- Department of Infection and Immunity, Barts Health NHS Trust, London, UK
| | - D Paige
- Department of Dermatology, Barts Health NHS Trust, London, UK
| | - H Rizvi
- Department of Pathology, Barts Health NHS Trust, London, UK
| | - A Haroon
- Department of Imaging, Barts Health NHS Trust, London, UK
| | - S Montoto
- Department of Haemato-Oncology, Barts Health NHS Trust, London, UK
| |
Collapse
|
4
|
El-Guebaly L, Wilson P, Paige D. Initial Activation Assessment for ARIES Compact Stellarator Power Plant. Fusion Science and Technology 2017. [DOI: 10.13182/fst05-a726] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- L. El-Guebaly
- University of Wisconsin, Fusion Technology Institute, 1500 Engineering Dr., Madison, WI
| | - P. Wilson
- University of Wisconsin, Fusion Technology Institute, 1500 Engineering Dr., Madison, WI
| | - D. Paige
- University of Wisconsin, Fusion Technology Institute, 1500 Engineering Dr., Madison, WI
| | | |
Collapse
|
5
|
El-Guebaly L, Wilson P, Paige D, Team A, Team ZP. Evolution of Clearance Standards and Implications for Radwaste Management of Fusion Power Plants. Fusion Science and Technology 2017. [DOI: 10.13182/fst06-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- L. El-Guebaly
- University of Wisconsin-Madison, Fusion Technology Institute 1500 Engineering Drive, Madison, Wisconsin 53706
| | - P. Wilson
- University of Wisconsin-Madison, Fusion Technology Institute 1500 Engineering Drive, Madison, Wisconsin 53706
| | - D. Paige
- University of Wisconsin-Madison, Fusion Technology Institute 1500 Engineering Drive, Madison, Wisconsin 53706
| | - Aries Team
- University of Wisconsin-Madison, Fusion Technology Institute 1500 Engineering Drive, Madison, Wisconsin 53706
| | - Z-Pinch Team
- University of Wisconsin-Madison, Fusion Technology Institute 1500 Engineering Drive, Madison, Wisconsin 53706
| |
Collapse
|
6
|
Affiliation(s)
- A. J. Ryan
- Department of Dermatology; The Royal London Hospital; Barts Health NHS Trust; London UK
| | - R. Cerio
- Department of Dermatology; The Royal London Hospital; Barts Health NHS Trust; London UK
| | - D. Paige
- Department of Dermatology; The Royal London Hospital; Barts Health NHS Trust; London UK
| | - P. Goldsmith
- Department of Dermatology; The Royal London Hospital; Barts Health NHS Trust; London UK
| |
Collapse
|
7
|
Hartley AJ, Hourihan M, Paige D, Williams A. Are specialist-led genital dermatology clinics a valuable and necessary part of sexual health service provision in the UK? Sex Transm Infect 2013; 89:379. [PMID: 23858498 DOI: 10.1136/sextrans-2013-051239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
8
|
Hartley A, Paige D, Buchanan J, Hourihan M, Adlington R. P171 A case of extensive oral and penile ulceration. Br J Vener Dis 2012. [DOI: 10.1136/sextrans-2012-050601c.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
9
|
Affiliation(s)
- E Campalani
- Department of Dermatology, Barts and The London NHS Trust, Royal London Hospital, London, UK.
| | | | | |
Collapse
|
10
|
Sinclair C, O’Toole E, Paige D, El Bashir H, Robinson J, Dobson R, Lench N, Stevens H, Hitman G, Booy R, Mein C, Kelsell D. Filaggrin mutations are associated with ichthyosis vulgaris in the Bangladeshi population. Br J Dermatol 2009; 160:1113-5. [DOI: 10.1111/j.1365-2133.2009.09050.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
11
|
|
12
|
Abstract
The immuno-osseous dysplasias are a rare group of conditions in which short-limbed dwarfism is associated with an immune defect. The best known of these is cartilage hair hypoplasia. However, several reports of other distinct conditions exist, which have been arbitrarily classified on the basis of the immune defect. We present a child with a previously unreported combination of immune and skeletal abnormalities in whom there was an unusual and distinctive skin appearance associated with defective cutaneous elastic fibers. These cutaneous features suggest a unifying link with other immuno-osseous dysplasia but the combination of immune and skeletal defects exposes weaknesses in the current method of classification.
Collapse
Affiliation(s)
- V Hubbard
- Department of Dermatology, Bart's and the Royal London Hospitals NHS Trust, London, UK.
| | | | | | | | | |
Collapse
|
13
|
Mak R, Paige D, Leigh I, Kelsell D, O’toole E. Two siblings with harlequin ichthyosis, clinical and molecular findings. Ann Dermatol Venereol 2006. [DOI: 10.1016/s0151-9638(06)77585-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
14
|
Harwood CA, Stevens JC, Orton D, Bull RC, Paige D, Lessing MPA, Mortimer PS, Marsden RA, Cerio R. Chronic meningococcaemia: a forgotten meningococcal disease. Br J Dermatol 2005; 153:669-71. [PMID: 16120166 DOI: 10.1111/j.1365-2133.2005.06771.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
15
|
Sevarino FB, Paige D, Sinatra RS, Silverman DG. Postoperative analgesia with parenteral opioids: does continuous delivery utilizing a transdermal opioid preparation affect analgesic efficacy or patient safety? J Clin Anesth 1997; 9:173-8. [PMID: 9172021 DOI: 10.1016/s0952-8180(97)00043-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
STUDY OBJECTIVES To compare, in patients who underwent major orthopedic surgical procedures, the efficacy of intravenous (IV) patient-controlled analgesia (PCA) with morphine combined with continuous administration of two doses of fentanyl or placebo via transdermal therapeutic system with fentanyl (TTSF) patches. DESIGN Randomized, double-blind, placebo-controlled study. SETTING University teaching hospital. PATIENTS 62 patients aged 18 to 65 years, presenting for elective orthopedic surgery and general anesthesia. INTERVENTIONS Patients were randomized to one of three groups: group 1 received two placebo patches; group 2 received a 20 cm2 active patch delivering 50 micrograms/hr of fentanyl and a 30 cm2 placebo patch; group 3 received a 30 cm2 active patch delivering 75 micrograms/hr of fentanyl and a 20 cm2 placebo patch. All patches were placed approximately two hours prior to induction of general anesthesia. General anesthesia was induced with thiopental, intubation facilitated by the use of vecuronium or pancuronium, and anesthesia was maintained with isoflurane in an oxygen/nitrous oxide mixture (O2/N2O). Following surgery, IV morphine was provided using IV PCA with 1.5 mg of morphine with a 6-minute lockout and a 4-hour maximum dosage of 30 mg. MEASUREMENTS AND MAIN RESULTS The time and dosage of morphine administered was recorded. Vital signs, pain intensity at rest, level of sedation, and arterial oxygen saturation (SpO2) were measured at intervals throughout the 72-hour study period and at 6 and 12 hours following patch removal. The presence of side effects was noted. Visual analog pain scores throughout the 72 hours of the study were not significantly different among groups. Patients receiving active TTSF required less IV PCA morphine at all time intervals. However, total opioid consumption was comparable among groups. The incidence of side effects was similar in all groups. CONCLUSIONS There is no significant advantage to the routine use of continuous transdermal opioid delivery in patients receiving IV PCA after major orthopedic surgery.
Collapse
Affiliation(s)
- F B Sevarino
- Department of Anesthesiology, Yale University School of Medicine, New Haven, CT 06520-8051, USA
| | | | | | | |
Collapse
|
16
|
|
17
|
Abstract
STUDY OBJECTIVE To examine the safety and analgesic efficacy of sufentanil administered via either epidural or intravenous (i.v.) patient-controlled analgesia (PCA) in patients recovering from gynecologic surgery. DESIGN Randomized, double-blind comparison. SETTING Patient care unit at a university medical center. PATIENTS 29 healthy women presenting for major intraabdominal gynecologic surgery with epidural anesthesia who requested postoperative PCA. INTERVENTIONS Following completion of surgery performed using epidural anesthesia with 2% lidocaine and i.v sedation, patients were assigned to one of three treatment groups: Group 1-epidural PCA (EPCA) with sufentanil: 0.3 microgram/kg bolus followed by 8 micrograms/hr infusion plus epidural PCA boluses of 4 micrograms every 6 min as needed; Group 2-i.v. PCA with sufentanil: 0.3 microgram/kg bolus followed by 8 micrograms/hr infusion plus IV PCA boluses of 4 micrograms every 6 min as needed; or Group 3-i.v. PCA with morphine: 0.1 mg/kg bolus followed by 0.5 mg/hr infusion plus i.v. PCA boluses of 1 mg every 6 min as needed. MEASUREMENTS AND MAIN RESULTS Patients were observed at regular intervals during a 24-hour evaluation period. Visual analog scale (VAS) scores were used to assess analgesia and satisfaction with therapy. Pulmonary function was assessed by monitoring respiratory rate, oxygen (O2) saturation, and forced expiratory flow. Total opioid dose delivered and the presence/severity of side effects was also collected. Sufentanil plasma levels were measured in a subset of eight patients. Patients receiving either EPCA or i.v. PCA sufentanil experienced equivalent analgesia that was more rapid in onset than i.v. PCA morphine. Total dose administered and plasma concentration of drug were similar in both sufentanil groups; however, a greater number of patients in the i.v. delivery group experienced clinically significant O2 desaturation. CONCLUSIONS The main advantage of EPCA sufentanil in this postsurgical setting was its ability to provide a more rapid onset of analgesia than traditional i.v. PCA with morphine while offering greater safety than i.v. sufentanil.
Collapse
Affiliation(s)
- R S Sinatra
- Yale University School of Medicine, Department of Anesthesiology, New Haven, Connecticut 06510, USA
| | | | | |
Collapse
|
18
|
Sevarino FB, Sinatra RS, Paige D, Silverman DG. Intravenous ketorolac as an adjunct to patient-controlled analgesia (PCA) for management of postgynecologic surgical pain. J Clin Anesth 1994; 6:23-7. [PMID: 8142094 DOI: 10.1016/0952-8180(94)90113-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
STUDY OBJECTIVE To determine whether intravenous (IV) doses of ketorolac tromethamine provide safe and effective augmentation of postsurgical analgesia for patients using IV patient-controlled analgesia (PCA) with morphine. DESIGN Randomized, double-blind, placebo-controlled, dose-response evaluation. SETTING Patient care unit at a university medical center. PATIENTS 62 ASA physical status I-III females recovering from intra-abdominal gynecologic surgery with general anesthesia who requested postoperative PCA. INTERVENTIONS Following initial pain assessment in the recovery room, patients were randomized to receive either IV saline (placebo) followed by IV saline every 6 hours (Group 1); IV ketorolac 30 mg loading dose followed by IV ketorolac 15 mg every 6 hours (Group 2); or IV ketorolac 60 mg loading dose followed by IV ketorolac 30 mg every 6 hours (Group 3). All patients were provided IV PCA, which was programmed to provide 1.2 mg of morphine with a 6-minute lockout interval. MEASUREMENTS AND MAIN RESULTS Visual analog scale (VAS) resting pain and satisfaction scores were measured every 2 to 12 hours. Cumulative PCA with morphine and the frequency and severity of side effects also were assessed. IV ketorolac showed no clinically significant side effects. Group 2 patients experienced significant reductions in VAS resting pain scores (p < 0.05), and a trend toward decreased morphine self-administration in both active groups was noted. Group 2 and Group 3 patients reported greater satisfaction with postsurgical analgesia than Group 1 patients. (p < 0.05). CONCLUSIONS IV ketorolac used as an analgesic adjunct provided safe and effective augmentation of PCA with morphine in patients recovering from intra-abdominal gynecologic surgery.
Collapse
Affiliation(s)
- F B Sevarino
- Department of Anesthesiology, Yale University School of Medicine, New Haven, CT 06510
| | | | | | | |
Collapse
|
19
|
Chung KS, Sinatra RS, Halevy JD, Paige D, Silverman DG. A comparison of fentanyl, esmolol, and their combination for blunting the haemodynamic responses during rapid-sequence induction. Can J Anaesth 1992; 39:774-9. [PMID: 1363221 DOI: 10.1007/bf03008287] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
The purpose of this randomized, double-blind study was to compare the ability of a combination of fentanyl and esmolol to blunt the haemodynamic effects of intubation with that of either agent alone. Patients received fentanyl or saline four minutes before, and esmolol or saline two minutes before rapid-sequence induction of anaesthesia. The F2 group (n = 24) received fentanyl 2 micrograms.kg-1, the E2 group (n = 24) received esmolol 2 mg.kg-1, the F2/E2 group (n = 25) received a combination of fentanyl 2 micrograms.kg-1 and esmolol 2 mg.kg-1, and the F5 group (n = 26) received fentanyl 5 micrograms.kg-1. Following tracheal intubation, the maximum percent change from baseline heart rate was less in the F2/E2 and F5 groups (12% and 16% respectively) than in the E2 group (34%)(P < 0.05). The maximum percent changes from baseline systolic blood pressure in the F2/E2 and F5 groups (15% and 6% respectively) were less than in the F2 and E2 groups (24% and 33% respectively) (P < 0.05). The combination of a low dose of fentanyl and esmolol provides an alternative to a higher dose of fentanyl for blunting the haemodynamic responses to laryngoscopy and tracheal intubation during rapid-sequence induction in healthy patients.
Collapse
Affiliation(s)
- K S Chung
- Department of Anesthesiology, Yale University School of Medicine, New Haven, CT 06510
| | | | | | | | | |
Collapse
|
20
|
Sevarino FB, Naulty JS, Sinatra R, Chin ML, Paige D, Conry K, Silverman DG. Transdermal fentanyl for postoperative pain management in patients recovering from abdominal gynecologic surgery. Anesthesiology 1992; 77:463-6. [PMID: 1519784 DOI: 10.1097/00000542-199209000-00010] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The current placebo-controlled double-blinded study was undertaken to assess the safety and efficacy, as well as the potential clinical role, of the transdermal therapeutic system (TTS) of fentanyl delivery in the postoperative setting. TTS patches releasing 25 micrograms.h-1 or 50 micrograms.h-1 or placebo were applied to 95 women 1 h before abdominal gynecologic surgery during general anesthesia. Postoperatively, patients self-administered intravenous morphine as required using patient-controlled analgesia with a 1-mg incremental dose and a 6-min lockout interval. Each was assessed upon admission to the postanesthesia care unit and at intervals over the following 72 h with respect to vital signs, visual analogue scale pain and satisfaction scores, side effects, and cumulative morphine use. Data were analyzed using analysis of variance, Kruskal-Wallis, and chi-square. P less than 0.05 was considered significant. There were no demographic differences among groups. Beginning 32 h after TTS application, a statistically significant morphine-sparing effect was seen with the 50 micrograms.h-1 patch. There were no significant differences among groups with regard to visual analogue scale pain scores at rest, patient satisfaction, or the incidence of side effects; a significant reduction in pain upon movement was noted at 24 h in patients treated with TTS 50 micrograms.h-1. This finding constituted the only benefit noted with this form of analgesic therapy in the present investigation.
Collapse
Affiliation(s)
- F B Sevarino
- Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut 06510
| | | | | | | | | | | | | |
Collapse
|
21
|
Sevarino FB, Paige D, Sinatra RS, Preble L, Silverman DG. TRANSDERMAL FENTANYL AS AN ADJUNCT TO PCA MORPHINE FOR POSTOPERATIVE ORTHOPEDIC PAIN. Anesthesiology 1992. [DOI: 10.1097/00000542-199209001-00884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
22
|
Sevarino FB, Sinatra RS, Paige D, Ning T, Brull SJ, Silverman DG. The efficacy of intramuscular ketorolac in combination with intravenous PCA morphine for postoperative pain relief. J Clin Anesth 1992; 4:285-8. [PMID: 1419009 DOI: 10.1016/0952-8180(92)90130-s] [Citation(s) in RCA: 56] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
STUDY OBJECTIVE To examine the efficacy of intramuscular (IM) ketorolac used in combination with intravenous (IV) patient-controlled analgesia (PCA) morphine for postoperative pain relief following intra-abdominal gynecologic surgery. DESIGN Randomized, double-blind, placebo-controlled study. SETTING Patient care unit at a university medical center. PATIENTS Thirty-five healthy women undergoing intra-abdominal gynecologic surgery who requested postoperative PCA. INTERVENTIONS Postoperatively, all patients received IV PCA morphine, with the PCA device programmed to deliver a maximum of 1 mg every 6 minutes (maximum of 30 mg over 4 hours). In addition, patients received one of three regimens: (1) IM saline every 6 hours; (2) IM ketorolac 30 mg while in the postanesthesia care unit (PACU), followed by 15 mg every 6 hours; or (3) IM ketorolac 60 mg while in the PACU, followed by 30 mg every 6 hours. MEASUREMENTS AND MAIN RESULTS Patients were assessed at regular intervals. Visual analog scale (VAS) scores were used to assess analgesia and patient satisfaction with therapy. Data on morphine usage were obtained from the PCA device, and the frequency and severity of adverse effects were assessed for the presence or absence of side effects. Cumulative morphine dosages were lower (p less than 0.05) in both ketorolac groups at 12, 18, and 24 hours. VAS scores and the frequency of side effects did not differ significantly among groups. CONCLUSIONS IM ketorolac significantly decreased PCA morphine requirements. The analgesic effects of the two drugs appear to be additive.
Collapse
Affiliation(s)
- F B Sevarino
- Department of Anesthesiology, Yale University School of Medicine, New Haven, CT 06510
| | | | | | | | | | | |
Collapse
|
23
|
Silverman DG, Freilich J, Sevarino FB, Paige D, Preble L, O'Connor TZ. Influence of promethazine on symptom-therapy scores for nausea during patient-controlled analgesia with morphine. Anesth Analg 1992; 74:735-8. [PMID: 1567042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We assessed whether adding promethazine to the syringe containing morphine for patient-controlled analgesia (PCA) decreases nausea after gynecologic surgery. Patients were assigned randomly to receive PCA (morphine 1.5 mg, 6-min lockout interval) with or without promethazine (0.625 mg/PCA dose, providing an average of 17.6 mg/24 h). Assessments included a visual analogue scale (VAS) for nausea (0 = none, 10 = worst possible) at scheduled times, rescue therapy requirements, and a maximum symptom-therapy score that provided an aggregate assessment of nausea intensity, duration, and response to rescue therapy (0 = no nausea; 1 = mild; 2 = moderate, requiring droperidol; 3 = severe or persistent, requiring droperidol; 4 = requiring droperidol+transdermal scopolamine; 5 = unrelieved). Nausea scores on the visual analogue scale at 2, 6, 8, and 24 h and use of rescue droperidol identified no significant differences between the groups. However, symptom-therapy scores differed significantly, with median values of 0 and 2, respectively, for the promethazine-treated and control groups. We conclude that simultaneous titration of morphine and promethazine decreases nausea associated with PCA therapy; the difference may best be appreciated with use of the combined symptom-therapy score.
Collapse
Affiliation(s)
- D G Silverman
- Department of Anesthesiology, Yale University School of Medicine, New Haven, CT 06510
| | | | | | | | | | | |
Collapse
|
24
|
Abstract
The relations among race, family income, and low birth weight were examined using information obtained from the National Longitudinal Survey of Youth, which conducted yearly interviews with a nationally representative sample of young women identified in the late 1970s. Data were available for these women and their offspring from 1979 through 1988. Maternal education, maternal age, age/parity risk, marital status, and smoking during pregnancy served as covariates in cross-sectional and longitudinal analyses. The risk of low birth weight among births to black women and white women who were poor was at similarly high levels regardless of whether poverty was determined prior to study entrance or during the study period. Longitudinal analyses showed an exceptionally large increase in risk of low birth weight among children born to women whose prior pregnancy ended in a low-birth-weight infant. These two findings emphasize the importance of factors antecedent to the pregnancy in the genesis of low birth weight.
Collapse
Affiliation(s)
- B Starfield
- Department of Health Policy and Management, Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD 21205
| | | | | | | | | | | | | |
Collapse
|
25
|
Criddle RS, Fontana AJ, Rank DR, Paige D, Hansen LD, Breidenbach RW. Simultaneous measurement of metabolic heat rate, CO2 production, and O2 consumption by microcalorimetry. Anal Biochem 1991; 194:413-7. [PMID: 1907437 DOI: 10.1016/0003-2697(91)90250-w] [Citation(s) in RCA: 78] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
This study describes methods and equipment for measurement of metabolic heat rates of cells and tissues under conditions that provide simultaneous determinations of the flux rates of both O2 and CO2. Isothermal measurement of metabolic heats are conducted in a sealed ampule. A trapping solution is employed to absorb metabolic CO2. Absorption of CO2 produces heat at a rate proportional to the rate of CO2 production. Under these conditions, O2 consumption by the tissue results in a decrease in the partial pressure of O2 within the sealed ampule. The decrease in pressure can be monitored with a pressure sensor and related to O2 consumption rates. The combined measurements of heat rates, CO2, and O2 fluxes provide important information on bioenergetic efficiency of cell metabolism. These data can also suggest possible shifts in metabolic pathways or substrate sources as cells develop, or are exposed to effectors, inhibitors, and environmental factors.
Collapse
Affiliation(s)
- R S Criddle
- Department of Biochemistry and Biophysics, University of California, Davis 95616
| | | | | | | | | | | |
Collapse
|
26
|
Sinatra RS, Sevarino FB, Chung JH, Graf G, Paige D, Takla V, Silverman DG. Comparison of epidurally administered sufentanil, morphine, and sufentanil-morphine combination for postoperative analgesia. Anesth Analg 1991; 72:522-7. [PMID: 1826073 DOI: 10.1213/00000539-199104000-00018] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Postoperative analgesia provided by epidurally administered sufentanil and/or morphine was evaluated in 45 patients recovering from major gynecologic surgery. At the first complaint of pain in the Postanesthesia Care Unit, patients received a single epidural bolus of 30 micrograms sufentanil (group A), 5 mg morphine (group B), or 30 micrograms sufentanil plus 3 mg morphine (group C) in a randomized blinded fashion. Analgesic efficacy was assessed throughout the 24-h study period with 10-cm visual analog scales. The need for additional postoperative analgesia (patient-controlled analgesia, 1 mg of morphine every 6 min as necessary) and the incidence of adverse effects were also assessed. Patients receiving sufentanil (groups A and C) had significantly faster onset of analgesia than did patients given morphine alone (group B, P less than 0.05). Group B subjects experienced the longest duration of analgesia (B vs A and C, P less than 0.05) and required significantly less patient-controlled analgesia (morphine) than patients in group A (P less than 0.05). No patient developed clinically significant respiratory depression or excessive sedation, and there were no intergroup differences in incidence of pruritus or nausea (P value not significant). The data indicate that a mixture of sufentanil and morphine provides either a more rapid onset of epidural analgesia or reduced patient-controlled analgesia narcotic requirement than respective doses of each agent administered alone.
Collapse
Affiliation(s)
- R S Sinatra
- Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut 06510
| | | | | | | | | | | | | |
Collapse
|
27
|
Kumanyika SK, Huffman SL, Bradshaw ME, Waller H, Ross A, Serdula M, Paige D. Stature and weight status of children in an urban kindergarten population. Pediatrics 1990; 85:783-90. [PMID: 2330240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
To assess the prevalence of growth problems among school entrants in an urban population who were not preselected on poverty or other nutritional risk criteria, we analyzed height and weight measurements for 5170 4- and 5-year-old children (91.9% black, 5.5% white, and 2.6% Hispanic) who enrolled in District of Columbia public school kindergartens in the Fall of 1985. Compared to the National Center for Health Statistics reference, the white girls and boys were of average height, Hispanic girls were of average height, and Hispanic boys were shorter than average. The black girls and boys were taller than average. In light of published evidence for black-white differences in the timing and duration of growth, we tentatively attributed this tall stature to advanced skeletal maturation of the black children relative to the predominantly white United States population growth standards. Underweight was virtually absent in this population. Excess overweight was noted in all sex-racial/ethnic subgroups, particularly among Hispanic children. However, the extent to which overweight (high weight-for-height percentile) represents obesity in kindergarten-aged children and in different racial/ethnic groups needs clarification before the implications of the finding of excess overweight can be fully understood. Overall, the growth of these children was on a par with the National Center for Health Statistics growth reference population.
Collapse
Affiliation(s)
- S K Kumanyika
- Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland
| | | | | | | | | | | | | |
Collapse
|
28
|
Oard JH, Paige D, Dvorak J. Chimeric gene expression using maize intron in cultured cells of breadwheat. Plant Cell Rep 1989; 8:156-160. [PMID: 24233093 DOI: 10.1007/bf00716830] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/1988] [Revised: 04/17/1989] [Indexed: 06/02/2023]
Abstract
High voltage electrical pulses were used to introduce the CAT reporter gene into cultured protoplasts of breadwheat,Triticum aestivum. Four DNA constructs harboring the CAT gene and the 35S or mannipine synthase promoter were tested for levels of CAT activity 40-45 hr after electroporation of protoplasts. One construct, containing a maize intron sequence between 35S and CAT sequences, conferred 30 to 185 fold greater CAT activity over the other three constructs. Data from these experiments suggest that a maize intron or sequences with similar effects may be required in DNA constructs for efficient heterologous gene expression in cultured cells of breadwheat.
Collapse
Affiliation(s)
- J H Oard
- Department of Agronomy and Range Science, University of California-Davis, 95616, Davis, CA, USA
| | | | | |
Collapse
|
29
|
Breidenbach RW, Paige D. Guidelines for Controlled Environments Controlled Environment Guidelines for Plant Research T. W. Tibbitts T. T. Kozlowski. Bioscience 1981. [DOI: 10.2307/1308409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
30
|
Abstract
We studied 166 hospitalized male patients to determine the clinical importance of tolerance-test-determined "lactose intolerance," assumed to affect most of the world's adults. Abnormal lactose tolerance tests were found in 81% of 98 blacks, 12% of 59 whites of Scandinavian or Northwestern European extraction, and three of nine non-European whites. Seventy-two per cent of the "lactose-intolerant" subjects had previously realized that milk drinking could induce abdominal and bowel symptoms. Two hundred and forty milliliters of low-fat milk produced gaseousness or cramps in 59% of 44 "lactose-intolerant" men, and 68% were symptomatic with the equivalent amount of lactose. None of 18 "lactose-tolerant" men noted symptoms with milk or lactose. Refusal to drink 240 ml of low-fat milk served with meals correlated significantly with "lactose-intolerance": 31.4% versus 12.9% among "lactose-tolerant" patients. "Lactose intolerance" is common in adults and is a clinically relevant problem.
Collapse
|