Annals of the New York Academy of Sciences
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Ann. N. Y. Acad. Sci. · Apr 1999
Comparative StudyMonitoring regional lung ventilation by functional electrical impedance tomography during assisted ventilation.
A new approach in discriminating the regional air volume changes in the lungs associated with either spontaneous or mechanical ventilation during assisted ventilation is presented. Impedance data are obtained by conventional electrical impedance tomography (EIT). ⋯ EIT measurements performed in an infant during synchronized intermittent mandatory ventilation were evaluated with this method and indicated that the specific local lung volume swings related to spontaneous and mechanical inhalations can be separated and imaged as tomograms. This noninvasive approach may become useful in optimizing the ventilatory pattern during advanced forms of artificial ventilation and may help the clinician in the therapy management of individual patients.
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Ann. N. Y. Acad. Sci. · Jan 1999
Randomized Controlled Trial Clinical TrialA double-blind, placebo-controlled study of the safety, tolerability and pharmacokinetics of CP-101,606 in patients with a mild or moderate traumatic brain injury.
CP-101,606 is a postsynaptic antagonist of the glutamate-mediated NR2B subunit of the N-methyl-D-aspartate (NMDA) receptor. When administered intravenously (i.v.) at the time of injury, CP-101,606 is neuroprotective in animal models of traumatic brain injury (TBI) and ischemia. Minimal adverse effects have been observed in normal human volunteers given i.v. doses of up to 3 mg/kg/hr for 72 hours. ⋯ A Neurobehavioral Rating Scale, used to detect personality changes and behavioral disturbances, indicated that all subjects showed an improvement from their postinjury, predosing baseline but did not significantly differ from each other with respect to type of head injury and/or treatment with drug or placebo. Modified Kurtzke Scoring also showed a similar pattern of improvement irrespective of type of head injury or drug/placebo treatment. This study suggests that CP-101,606, infused for up to 72 hours has no psychotropic effects and is well-tolerated in patients who have sustained a mild or moderate TBI or hemorrhagic stroke.
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Ann. N. Y. Acad. Sci. · Jan 1999
ReviewSocioeconomic status and health. Policy implications in research, public health, and medical care.
The role of public policy in research, public health, and medical care is discussed as well as the extent to which public policy has been informed by increased knowledge about the relationship between SES and health and to what extent policy has affected SES-related health disparities. Observations on current healthcare policy and recommendations for the future are offered.
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Ann. N. Y. Acad. Sci. · Jan 1999
Clinical TrialAn open-label study of CP-101,606 in subjects with a severe traumatic head injury or spontaneous intracerebral hemorrhage.
CP-101,606 is a postsynaptic antagonist of N-methyl-D-aspartate (NMDA) receptors bearing the NR2B subunit. When administered intravenously (i.v.), it decreases the effects of traumatic brain injury (TBI) and focal ischemia in animal models. Therapeutic plasma concentrations (200 ng/ml) in animals, have been well tolerated in healthy human volunteers. ⋯ CSF concentrations were slightly higher than that in plasma by the end of infusion suggesting good penetration of CP-101,606 into the CSF. Outcome in the severe TBI patients, as measured by the Glasgow Outcome Score at six months, suggested that a two-hour infusion yielded a range of scores similar to contemporary patients with a severe TBI treated at our hospital while the outcomes of the patients treated with either a 24- or 72-hour infusion were better on average. Thus, these results indicate that CP-101,606 infused for up to 72 hours is well tolerated, penetrates the CSF and brain, and may improve outcome in the brain-injured patient.