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Biomedical subjects

B Woodruff

Publications and source records attributed to B Woodruff.

13 recordsLinked to original sources
PubMed1995

Recombinant aprotinin in coronary artery bypass graft operations.

OBJECTIVE: To evaluate the role of recombinant bovine aprotinin in reducing blood loss in coronary artery bypass graft surgery. DESIGN: An open-label, randomized, controlled study evaluating two dosage levels of recombinant aprotinin. SETTING: Two acute care hospitals (Northwestern Memorial Hospital, Chicago, Ill., and the Scott & White Memorial Hospital, Temple, Texas). PATIENTS: Patients undergoing primary and reoperation coronary artery bypass grafting were assigned to groups by means of a computer-generated table of random numbers. Treated (n = 48) and control (n = 36) patients did not differ significantly in age, sex, weight, number of grafts, or preoperative hemoglobin level. INTERVENTIONS: Recombinant aprotinin was given at two dosages. Dosage level 1 consisted of a bolus of 2 mg/kg intravenously immediately after the induction of anesthesia, 1 mg/kg added to each liter of the oxygenator prime, and 0.5 mg.kg-1.hr-1 infused continuously during operation. At dosage level 2, doses were doubled. Intraoperative monitoring of anti-factor Xa activity was performed, and additional doses of heparin were given on the basis of anti-factor Xa results. MAIN OUTCOME MEASURES: Preoperative and postoperative hemoglobin levels, amounts of autotransfusion device and chest tube drainage blood, and transfusions of allogeneic red blood cells. Adverse clinical events (alterations in renal function, graft thrombosis, myocardial infarction, and death) were recorded. RESULTS: Additional heparin was given to 48% patients in the aprotinin group and to 44% of control patients. Overall red blood cell loss (in milliliters, mean +/- standard deviation [SD]) was decreased with aprotinin at dosage level 1 for reoperations (1040 +/- 162 vs 1544 +/- 198, p < 0.01), and at dosage level 2 for all operations (primary operations, 886 +/- 362 vs 1333 +/- 618, p = 0.02; reoperations, 1191 +/- 560 vs 1815 +/- 1116, p = 0.2). Fewer patients in the aprotinin than in the control group had transfusions of donated blood (6/48 vs 12/36, p = 0.02) or reinfusion of chest tube drainage blood (12/48 vs 20/36, p < 0.01). Among patients receiving dosage level 1, there were no myocardial infarctions or deaths. At dosage level 2, one patient had profound bradycardia and died on day 12 and two patients had late graft closures. Two control patients had hypotension after bypass necessitating intraaortic balloon pumps, and one of these patients died. Postoperative increases in blood urea nitrogen and creatinine levels were small in both aprotinin and control groups. No hypersensitivity or other allergic reactions occurred. CONCLUSION: We conclude that, at the dosages given, recombinant bovine aprotinin decreases surgical blood loss and transfusion requirements in patients undergoing coronary artery bypass grafting, but its use requires appropriate monitoring of heparin use during bypass. Whether higher dosages of aprotinin increase the risk of graft thrombosis must be further assessed with a larger patient sample.

Aged↗
PubMed1994

Incidence of posthospitalization proximal deep venous thrombosis after total hip arthroplasty. A pilot study.

The incidence of venous thromboembolic disease after hospitalization for elective total hip arthroplasty (THA) was evaluated in a prospective pilot study of 42 patients. Before discharge from the hospital, all patients were free of deep venous thrombosis (DVT) (bilateral lower extremity ascending venography, 38 patients; duplex ultrasonography, two patients; or a combination of both, two patients). After discharge from the hospital, each patient had bilateral duplex ultrasonography and clinical evaluation monthly for three months. Venography was performed when the noninvasive test suggested the presence of DVT. Four (10.5%) of 38 completed patients (95% confidence interval, 4.4-24.8%) developed proximal DVT after hospitalization. Two episodes occurred during the first month after discharge and two during the second month. Three of the four episodes involved the surgically treated extremity. This pilot experience suggests that a significant risk of DVT continues for at least two months after THA. This observation adds support for the emerging clinical trend to continue DVT prophylaxis for at least two months after hospitalization. Further study regarding the incidence of late DVT and its effective prophylaxis seems warranted.

Adult↗
PubMed1993

High clearance of (S)-warfarin in a warfarin-resistant subject.

A 30 year old black male required a 60 mg daily dose of warfarin to elicit a therapeutic anticoagulant response (normal warfarin dose 2.5-10 mg day-1; maximum 15 mg day-1). Hereditary warfarin resistance was suspected after compliance, diet, concurrent medication and any gastrointestinal disorder were eliminated as contributory causes. The disposition of vitamin K and vitamin K epoxide was examined in the propositus, his two sisters and 13 control black male subjects. Each subject was given an i.v. bolus dose (5 mg) of vitamin K prior to and after 2 weeks of warfarin therapy (5 mg day-1). The oral clearances of (S)- and (R)-warfarin were also measured in each subject during the last day of warfarin therapy. The mean (+/- s.d.) systemic clearance of vitamin K was similar in all subjects before (114 +/- 35 ml min-1) and after (112 +/- 40 ml min-1) warfarin therapy. The mean (+/- s.d.) AUC value for vitamin K epoxide was increased by warfarin treatment (6.5 +/- 5.4 micrograms ml-1 min before and 139 +/- 78 micrograms ml-1 min after) in all subjects. In the propositus, the oral clearance of (S)-warfarin (14.5 ml min-1) and the clearance ratio for (S)/(R)warfarin (2.6) differed by more than 7 standard deviations from the control group (4.3 +/- 1.1 ml min-1 and 1.2 +/- 0.2, respectively). In one sister of the propositus, the stereoselective disposition of warfarin was comparable with that of her brother ((S)-warfarin clearance = 16.2 ml min-1; and (S)/(R)-warfarin clearance ratio = 2.7).

Adult↗
PubMed1991

Strategies for enhancing the consonant to vowel intensity ratio with in the ear hearing aids.

Numerous investigators have suggested that increasing the consonant to vowel intensity ratio (CVR) may improve speech intelligibility. This investigation was designed to determine the extent to which analog circuits, small enough to fit into in the ear hearing aids, can increase the CVR, and whether CVR enhancement is of benefit to hearing-impaired listeners. Real ear CVRs, calculated from real ear recordings of nonsense syllables, were obtained from eight hearing-impaired listeners. Recordings from each listener were obtained through each of four hearing aid circuits: (1) an adaptive high-pass filter; (2) a faster acting adaptive high-pass filter; (3) the fast-acting adaptive high-pass filter with expansion; and (4) an infinite amplitude clipper. The amount of CVR enhancement was compared to performance of the subjects with a NST speech recognition task. Subjects also ranked the four circuits for amount of consonant emphasis provided. Results indicated that the four hearing aid circuits increased the real ear CVR by 4 to 6 dB, relative to unaided. Aided CVR varied, however, across circuits and between fricative and stop consonants. Performance on the NST recognition task was generally consistent with the amount of CVR increase provided. Rank ordering for consonant emphasis was consistent with aided CVR for stop consonants, but not for fricatives.

Equipment Design↗
PubMed1976

Arjo baby bath.

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Baths↗