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Biomedical subjects

B Thompson

Publications and source records attributed to B Thompson.

At least 145 records · Page 8Linked to original sources
PubMed1986

Efficacy of single-agent therapy with azlocillin, ticarcillin, and amikacin and beta-lactam/amikacin combinations for treatment of Pseudomonas aeruginosa bacteremia in granulocytopenic rats.

The efficacy of azlocillin, ticarcillin, and amikacin as single agents and the penicillin/amikacin combinations for treatment of Pseudomonas aeruginosa bacteremia during cyclophosphamide-induced severe neutropenia in a rat model were assessed. Equivalent antibiotic dosing was based on the time rat serum antibiotic levels were above the minimal bactericidal concentration for the challenge organism. Antibiotic therapy was administered for 62 hours after bacterial challenge. Antimicrobial efficacy was based on the rate of bacteremia, the emergence of resistant organisms during therapy, life-table survival analysis, and rat survival seventy-two hours after bacterial challenge. For infection with a P. aeruginosa strain susceptible to all study antibiotics, therapy with azlocillin and ticarcillin (given so as to be equipotent) were equivalent, as judged by bacteremia rates or rat survival. However, combination therapy prevented the emergence of organisms resistant to azlocillin, but not to ticarcillin. Amikacin-containing combinations were more effective than single-agent regimens.

Agranulocytosis↗
PubMed1986

A new evaluation method for instructors of advanced cardiac life support.

This study evaluated the ability of a specific educational program to teach instructors of advanced cardiac life support (ACLS) how to identify errors committed by team leaders of cardiac arrest simulations. The design compared experimental and control groups for differences in identification of critical performance errors, grade assignments and errors specifically emphasized in the educational program. The group receiving the educational program documented more critical performance errors (1.70 vs. 1.10, P = 0.006), made more correct grade assignments (2.35 vs. 2.0, P = 0.026), and identified more errors that were emphasized in the educational program (3.61 vs. 2.25, P = 0.0001) than the control group. The data strongly suggests that the educational program accounted for the observed differences.

Educational Measurement↗
PubMed1986

Bystander/first responder CPR: ten years experience in a paramedic system.

The effectiveness of bystander CPR recently has been challenged. We undertook a ten-year retrospective review of our prehospital experience with witnessed cardiorespiratory arrest to ascertain save rates in patients receiving and not receiving CPR before paramedic advanced life support (ALS). Traumatic and poisoning arrests and children less than 18 years old were excluded. A total of 1,905 patients presenting to a paramedic system from November 1, 1973, to October 31, 1983, were bystander-witnessed arrests and attempted paramedic resuscitations. Four hundred five paramedic-witnessed arrests were excluded. One hundred eighty-two of 1,248 (14.6%) who had CPR initiated before paramedic ALS arrival were saves, compared to 38 of 252 (15%) who had no CPR initiated until paramedic arrival (P = NS). A save was defined as a patient discharged from the hospital. The respective save rates for coarse ventricular fibrillation were 148 of 628 (23.6%) (CPR before paramedic arrival) vs 35 of 151 (CPR delayed until paramedic arrival) (23.2%); electromechanical dissociation (EMD), 11 of 209 (5.3%) vs 0 of 38; asystole, 19 of 401 (4.7%) vs 3 of 61 (4.9%); and ventricular tachycardia, four of ten (40%) vs 0 of two. In this prehospital system, bystander/first responder CPR was found not to improve hospital discharge rates except in patients with initially documented rhythm of EMD.

Adult↗
PubMed1986

Inhibition of esterase activity and an undercounting of circulating monocytes in a population of production workers.

A cross-sectional review of routine employee health status examinations has identified an undercounting of circulating monocytes associated with an inhibition of a surface monocyte esterase, alpha-naphthyl butyrate esterase. It is postulated that this inhibition is associated with an organophosphate used in the production process. Correlation with routine measures of health status are presented.

Adult↗
PubMed1986

Further studies on the prevalence of isolated sleep paralysis in black subjects.

In a previous study, one of the authors (C.C.B.) found isolated sleep paralysis was common in blacks. In this study, conducted by interviews, a recurrent pattern (one or more episodes per month) of isolated sleep paralysis episodes in blacks was described by at least 25 percent of the afflicted sample studied. Frequent episodes were associated with stress, and subjects with isolated sleep paralysis had an unusually high prevalence of panic disorder (15.5 percent). The genetic transmission of sleep paralysis was studied in a large black family, and in addition to stressful environmental factors being associated with the condition, there appears to be a dominant genetic factor associated with the predisposition for developing sleep paralysis. The implications of these findings for stress, anxiety, sleep, and psychophysiologic disorders are discussed.

Adult↗
PubMed1985

The effectiveness of calcium chloride in refractory electromechanical dissociation.

The effectiveness of calcium in electromechanical dissociation (EMD) has been challenged. Retrospective studies have been contradictory. To determine its effectiveness a prospective, randomized, blinded study comparing calcium chloride and saline in refractory EMD was carried out in the pre-hospital setting from October 1982 to October 1983. Only patients who had received epinephrine and bicarbonate and were refractory were entered in the study. All trauma and pediatric arrests were excluded. Ninety patients presented in refractory EMD. Overall, eight of 48 who received calcium were resuscitated successfully in the field; two of 42 who received saline were resuscitated successfully (P less than .07). A successful resuscitation was defined as the conveyance of a patient with a pulse and a rhythm to an emergency department. Patients were analyzed for age, sex, and witnessing of arrest. There was no statistical difference in demographic data. When the group of EMD patients was broken down into subgroups based on the width of QRS, it was noted that patients with a QRS width less than 0.12 did not respond to calcium, whereas the successfully resuscitated in the group with widened QRS or ischemic changes (N = 70) was eight of 39, compared with one of 31 not receiving calcium (P less than .028). Only one patient who was resuscitated successfully was discharged from the hospital alive. Calcium has been shown to be effective in the cardiac resuscitation of patients in refractory EMD. There may be a subset of patients with widened QRS complexes or ischemic changes who will benefit to a greater extent from the use of calcium chloride.

Adult↗
PubMed1985

Lack of effectiveness of calcium chloride in refractory asystole.

The effectiveness of calcium chloride in asystole has been challenged; retrospective studies have not supported its use. We conducted a prospective, randomized, blinded study comparing the effectiveness of calcium chloride with saline in the prehospital paramedic setting. Seventy-three patients who had received epinephrine, bicarbonate, and atropine and were in refractory asystole were included in the study, which was conducted from October 1982 to October 1983. Traumatic and pediatric arrests were excluded. The successful resuscitation rate was three of 39 in the calcium group versus one of 34 in the saline group (P less than .37). A successful resuscitation was defined as the conveyance of a patient with a pulse and a rhythm to an emergency department. Groups were analyzed for sex, age, and witnessed arrests. There was no statistically significant difference between the groups. No patient who was resuscitated successfully in the field was discharged from the hospital alive. We conclude that calcium chloride is not of value in resuscitating patients from refractory asystole in the prehospital cardiac arrest setting.

Aged↗
PubMed1985

Comparative activities of piperacillin, ceftazidime, and amikacin, alone and in all possible combinations, against experimental Pseudomonas aeruginosa infections in neutropenic rats.

This study compared the efficacy of therapy with the double beta-lactam combination of ceftazidime plus piperacillin with that of single-agent therapy with ceftazidime, piperacillin, or amikacin alone and with that of two aminoglycoside-beta-lactam combinations against Pseudomonas aeruginosa peritonitis and bacteremia in neutropenic rats. Rats made severely granulocytopenic with cyclophosphamide became bacteremic secondary to peritonitis which was induced by intraperitoneal challenge with P. aeruginosa. Antibiotic therapy with single agents (amikacin, 20 mg/kg of body weight, intramuscularly; ceftazidime, 20 mg/kg of body weight, subcutaneously; piperacillin, 200 mg/kg of body weight, intramuscularly) or with the various combinations of agents was begun 2 h after bacterial challenge and was continued every 6 to 8 h for 62 h. Therapeutic efficacy was judged on the basis of survival 72 h after bacterial challenge, rate of mortality, incidence of bacteremia, and the emergence of resistant organisms. Based on these criteria, therapy with the double beta-lactam combination had no advantage over single-agent therapy and was in all cases clearly inferior to beta-lactam-aminoglycoside combinations.

Amikacin↗
PubMed1985

Characterization and maturation of alveolar macrophages procured from BCG-induced pulmonary granulomas.

Pulmonary macrophages from BCG-induced granulomas were separated according to their densities into six fractions by the use of discontinuous gradients of Percoll. A comparative study of distribution profiles of lavaged rabbit alveolar cells obtained 16 or 28 days after vaccination revealed that 16 days after vaccination there were small numbers of low-density cells (fractions 1 and 2) and large numbers of high-density cells (fractions 4 and 5). In contrast, 28 days after vaccination there was a marked increase in the numbers of macrophages in fractions 1 and 2 and relatively small numbers of high-density cells in fractions 4 and 5. Macrophages of fractions 1 and 2 (densities of 1.030-1.050) were large and mature in appearance and expressed low levels of acid phosphatase and beta-glucuronidase. Although macrophages in fraction 1 commonly showed signs of degeneration, they were the most active in terms of reducing nitroblue tetrazolium (NBT). Macrophages of fractions 3 and 4 (densities of 1.050-1.068) were smaller, appeared intact and fully mature, showed no signs of degeneration, and expressed the highest levels of the above enzymes, although their ability to reduce NBT was less than that in cells from fractions 1 and 2. The cells of fractions 5 and 6 (densities of 1.068-1.074) were small, expressed low levels of the above enzymes, and their ability to reduce NBT was minimal. These results indicate that density may be a reliable correlate of the maturity of macrophages harvested from BCG-induced granulomas.

Acid Phosphatase↗
PubMed1985

Prevalence of coma in black subjects.

Coma, commonly known as "being unconscious" or "out cold," is a state of consciousness characterized by a total inability to perceive incoming stimuli. A retrospective phenomenologic study found that 10 of 36 control, 19 of 36 precare, and 20 of 36 aftercare subjects (49 of 108, or 45.4 percent) had experienced coma at least once during their lives. The implications of these findings are discussed.

Black People↗
PubMed1985

Altered states of consciousness profile: an Afro-centric intrapsychic evaluation tool.

In an effort to develop an Afro-centric intrapsychic evaluation tool, the Community Mental Health Council, Inc., Altered States of Consciousness Research Team, developed a structured interview used to quantify and qualify the 17 states of consciousness(1) that occurred in black control, precare, and aftercare subjects. Differences were noted in the three groups as to the incidence, prevalence, and quality of the various states of consciousness. It was also noted that the profile obtained from the interviews yielded a sharp clinical picture of the subjects' total intrapsychic propensities.

Africa↗
PubMed1985

A comparison of conventional radiography and computed tomography in the evaluation of spiral fractures of the tibia.

Spiral fractures of the distal third of the tibial shaft can have problems of malunion or non-union that may be related to inability to assess the quality of the initial reduction of the fracture. We created typical two-fragment torsional tibial fractures in cadaver bones. The fracture fragments were mounted in a specially constructed jig that allowed simulation of various malreduction positions including varus and valgus angulation, antecurvatum, recurvatum, malrotation, and shortening. Anteroposterior and lateral radiographs and computed tomographic scans of the specimens were made. Measurements of the fracture gap were made at defined distances along the fractures, directly on the specimens as well as on the radiographs and computed tomographic scans. Excellent correlation was obtained between measurements of the gap on the specimens and on the computed tomographic scans, but plain radiographic measurements in thirty of thirty-four instances underestimated the true width of the gap. When shortening was introduced larger maximum gaps (of as much as eighteen millimeters) as well as greater discrepancies between measurements on the scans and plain radiographs were seen. The sizes of the fracture gaps were also greater for a given degree of shortening when the pitch of the spiral fracture was greater.

Cadaver↗