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Biomedical subjects

D Knapp

Publications and source records attributed to D Knapp.

At least 37 records · Page 2Linked to original sources
PubMed1992

Evaluating drug prescribing in a large, ambulatory population: application of an embedded expert system.

DUR is a process of problem detection and intervention designed to improve the quality and economy of drug prescribing. Retrospective DUR attempts to detect and address patterns of prescribing that might be indicative of inappropriate therapy. When the process is extended to a largely ambulatory population such as Medicaid beneficiaries, a number of complications are introduced due to the large numbers of patients and sparsity of data. In order to examine the impact of implementing a Medicaid DUR program, we developed a system that would apply screening criteria to prescription claims. It has been used to screen prescribing of groups of two antihypertensive drugs in the 1990 Maryland Medicaid population for 177,409 Medicaid eligible individuals. Potentially significant problems were detected with respect to dosing, duplication of therapeutic agents and drug interactions. The system represents, we believe, a significant improvement in the ability to detect and report prescribing decisions by increasing the specificity of the detection system. By the application of this system to a set of real-world data, we have demonstrated that it is feasible to implement such a system and derive results that are potentially useful in reducing the incidence of inappropriate physician decision-making.

Ambulatory Care Information Systems↗
PubMed1988

Intraspinal epidermoid cyst in a dog.

A 2-year-old female Rottweiler was examined because of progressive gait deficits consistent with transverse myelopathy between the T2 and L3 spinal cord segments. Myelography confirmed an intramedullary spinal cord lesion between T13 and L1, so the dog was euthanatized. At necropsy, an intramedullary epidermoid cyst was confirmed in the T13 and L1 spinal cord segments. The epidermoid cyst probably resulted from a congenital cause.

Animals↗
PubMed1987

National adverse drug reaction surveillance: 1985.

The Food and Drug Administration received about 37,000 adverse drug reaction reports in 1985. Seventy-one percent of the reports involved toxic reactions to usual doses of drugs and were sent by medical care professionals directly to the Food and Drug Administration or to pharmaceutical manufacturers. In terms of severity, 2% of reports involved death while 21% involved hospitalization. The highest proportions of hospitalization or death were found for reports describing cardiovascular, hematologic, or respiratory effects. Nearly half of the reported deaths were in patients more than 59 years of age. The majority of reports described an adverse drug reaction occurring within two weeks of initial exposure to the suspected drug. Adverse drug reaction reporting by physicians is crucial to ensuring that pharmaceutical products are used appropriately.

Adult↗
PubMed1987

Effect of age and training on aerobic capacity and body composition of master athletes.

Maximum oxygen uptake (VO2max) and body composition have been shown to deteriorate with age. How much of the decline is attributable to aging and how much is affected by reduced physical activity is not known. The purpose of this investigation was to determine the aerobic capacity and body composition of 24 master track athletes and to evaluate the relationship to age and maintenance of training over a 10-yr period. The subjects (50-82 yr of age) were retested after a 10.1-yr follow-up (T2). All continued their aerobic training, but only 11 were still highly competitive (COMP) and continued to train at the same intensity. The other 13 athletes studied became noncompetitive (post-COMP) and reduced their training intensity. The results showed the COMP group to maintain its VO2max and maximum O2 pulse while the post-COMP group showed a significant decline (54.2-53.3 vs. 52.5-45.9 ml X kg-1 X min-1; 20.7-20.8 vs. 22.4-20.0 ml/beat from test one (T1) to T2 for the COMP vs. post-COMP groups, respectively). Maximum heart rate declined 7 beats/min for both groups. Body composition showed no difference between groups from T1 to T2. For both groups body weight declined slightly (70.0-68.9 kg), percent fat increased significantly (13.1-15.1%), and fat-free weight decreased significantly (61.0-59.0 kg). Thus, when training was maintained, aerobic capacity remained unchanged over the follow-up period. Body composition changed for both groups and may have been related to aging and/or the type of training performed.

Aged↗
PubMed1978

Trichophyton simii infection in the United States not traceable to India.

To our knowledge, this communication reports the first case of Trichophyton simii infection in the United States not traceable to India, The patient was a 40-year-old Nigerian male student who had not been out of the United States for more than three years. He had never been in India or had contact with animals or poultry. A brief review of the literature is included.

Adult↗