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Biomedical subjects

D R Gray

Publications and source records attributed to D R Gray.

26 records · Page 2Linked to original sources
PubMed1979

Clinical pharmacists as allied health care providers to psychiatric patients.

The effect of clinical pharmacy services on the quality and economy of health care provided to psychiatric patients at a Veterans Administration outpatient clinic was evaluated. Twenty-one patients were selected from the Day Treatment Center, of these, 19 patients completed the study. In providing health care to these psychiatric patients, the clinical pharmacist used a systemized approach including data gathering, evaluation, plan of action, and follow-up. In addition, medication groups and weekly staff meetings were incorporated into the patient treatment plan. Following a 3-month study period, the impact of clinical pharmacy services was evaluated. The provision of allied health care to psychiatric patients by clinical pharmacists resulted in a decreased incidence and severity of adverse drug effects, fewer drug use problems, a reduction in the total number of drugs prescribed, improved patient drug knowledge, and reduced expenditures for health care without compromising the patient's mental functioning.

California↗
PubMed1978

Physical child abuse: a review of all cases seen at Sacramento Medical Center in 1975.

This report presents physical, socioeconomic, demographic and follow-up information on all 18 cases of physical child abuse seen at the Sacramento Medical Center in 1975. Of the 18 abused children, 16 were initially discharged to Children's Protective Service; 13 were placed in foster homes. There were 17 alleged abusers; all were arrested; 12 came to trial; 8 were convicted. Preventive programs offer a less expensive approach and deserve the highest priority.

California↗
PubMed1975

Electrophysiologic properties of perhexiline.

Perhexiline maleate (Pexid), a promising clinical antiarrhythmic and antianginal drug, was evaluated for its electrophysiologic effects on the entire conduction system of the intact canine heart throughout a wide range of therapeutic and potentially toxic doses. Intracardiac conduction times were measured by bipolar intramyocardial and transvenous endocardial electrodes before and following the intravenous administration of each dose of perhexiline maleate, 3 mg/kg every 30 min for a total of 4 doses in 7 open-chest anesthetized dogs. Eight animals served as controls in which similar operative technique and electrophysiologic variables were recorded after infusion of the maleate diluent. In addition, the effects of perhexiline on atrial and ventricular thresholds to electrical stimulation were recorded, as well as the QRS and QT intervals, sinus rate, and rhythm disorders. It was observed that perhexiline did not significantly (p greater than .05) alter sinus rate, QT interval, QRS duration, PR interval, intra-atrial conduction time, atrioventricular nodal conduction time, and His-Purkinje conduction velocity. The drug did not affect the cardiac threshold to electrical stimulation of less than 0.1 ma. No ectopic atrial or ventricular activity emerged during the accumulated influence of the agent. From this study, it is concluded that perhexiline does not exert deleterious actions on the conduction system of the intact canine heart. In view of the negligible toxic effects and its efficacy in treating ventricular tachyarrhythmias in patients, the drug deserves further clinical evaluation.

Animals↗
PubMedDate not supplied

Cost-justification of a clinical pharmacist-managed anticoagulation clinic.

A cost-benefit evaluation of a clinical pharmacist-managed anticoagulation clinic (AC) was performed. Outpatient and hospital records were examined for 26 patients in the treatment group with an AC clinic and 26 patients in the control group. Therapeutic prothrombin times were maintained within the treatment group to a significantly greater extent than within the control group (p less than 0.001). The AC was successful in preventing hospitalizations resulting from hemorrhage or thromboembolism (p less than 0.01). The abnormal prothrombin times on admission in the control group correlated with hemorrhagic and thromboembolic admissions (p less than 0.05, p less than 0.005, respectively). Patients were hospitalized 3.22 days and .048 days per patient-treatment-year in the control and treatment groups, respectively. The net savings in reduced hospitalization costs per year in the treatment group was $211776. The benefit:cost ratio (B:C) was 6.55, suggesting the program is socially valuable. This clinical pharmacist-managed AC was effective in maintaining therapeutic prothrombin times, and reducing the incidence of hospitalization resulting from anticoagulation complications, and can be cost-justified based on a cost-benefit analysis.

California↗
PubMedDate not supplied

Fish oil as an adjuvant in the treatment of hypertension.

STUDY OBJECTIVE: To evaluate the effects of omega-3 fatty acids on blood pressure control and lipid levels. DESIGN: Double-blind, placebo-controlled, randomized study. SETTING: Veterans Affairs Medical Center teaching hospital. PATIENTS: Twenty-one men whose blood pressure was not optimally controlled with antihypertensive agents, who met the inclusion criteria. INTERVENTIONS: Patients were randomized to receive either fish oil (4.5 g omega-3 fatty acids/day) or placebo. MEASUREMENTS AND MAIN RESULTS: Blood pressure readings were taken at baseline, and 4 and 8 weeks. Sitting systolic and diastolic blood pressures were significantly reduced in the fish oil group at both week 4 (148/97 to 132/90, p <0.05) and week 8 (148/97 to 134/91, p <0.05). Sitting diastolic blood pressure was significantly reduced in the placebo group at week 8 (94 to 88, p <0.05). There was no difference in percentage change of sitting systolic and diastolic pressures at week 8 comparing the placebo group (-6.4% and -6.3%, respectively) and the fish oil group (-8.8% and -6.6%, respectively). Triglyceride levels (-40.9%, p <0.05) and platelet counts (-8.7%, p <0.05) were significantly reduced at 4 weeks, and low-density lipoprotein (LDL) cholesterol levels were significantly increased both at 4 and 8 weeks (13.5% and 19.1%, respectively) in the fish oil group. CONCLUSION: Adjunctive fish oil supplementation did not substantially augment blood pressure lowering in treated hypertensive men with suboptimally controlled blood pressure. Effects on plasma lipid values were mixed, with an increase in LDL cholesterol and a decrease in plasma triglyceride levels.

Adolescent↗
PubMedDate not supplied

Effect of pharmaceutical care on optimum colestipol treatment in elderly hypercholesterolemic veterans.

We conducted a prospective trial to determine whether a formal, integrated pharmaceutical care plan can enhance patient acceptance and compliance with colestipol therapy and improve outcomes. Forty patients with hypercholesterolemia were equally divided and assigned to either a usual care or pharmaceutical care group. In the pharmaceutical care group compared with the usual care group, after 52 weeks, colestipol therapy resulted in a greater reduction in total cholesterol (12.5% vs 7.3%), low-density lipoprotein cholesterol (LDL-C; 16% vs 9.4%), and LDL-C:high-density lipoprotein cholesterol (HDL-C) ratio (24.4% vs 12.2%, p < 0.05). The percentage of patients who achieved their LDL-C goal at week 52 was much greater in the pharmaceutical care group (29.4%) than in the usual care group (5.0%, p < 0.05). Co-management by a physician and a pharmacist of hypercholesterolemic veterans treated with colestipol can enhance patient acceptance of the drug, LDL-C reduction, and achievement of therapeutic goals.

Aged↗