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Biomedical subjects

D Rosenbloom

Publications and source records attributed to D Rosenbloom.

32 records · Page 2Linked to original sources

Effects of aspirin, naloxone and placebo.

This study was designed to examine the effects of aspirin, naloxone and placebo treatment on serum beta-endorphin concentration and joint pain in patients with rheumatoid arthritis (RA). Ten patients with definite or classical RA were studied. All treatments were administered in a randomized sequence. On each study day, the following measurements were carried out at specified time intervals: serum beta-endorphin concentration, serum salicylate concentration and joint pain score on a visual analogue horizontal scale. We conclude that in patients with rheumatoid arthritis suffering from chronic joint pain, serum beta-endorphin does not appear to play a role in pain relief.

Arthritis, Rheumatoid↗

Continuous intravenous heparin compared with intermittent subcutaneous heparin in the initial treatment of proximal-vein thrombosis.

We performed a randomized double-blind trial comparing continuous intravenous heparin with intermittent subcutaneous heparin in the initial treatment of 115 patients with acute proximal deep-vein thrombosis. Intermittent subcutaneous heparin as administered in this trial was inferior to continuous intravenous heparin in preventing recurrent venous thromboembolism. The subcutaneous heparin regimen induced an initial anticoagulant response below the target therapeutic range in the majority of patients and resulted in a high frequency of recurrent venous thromboembolism (11 of 57 patients, 19.3 percent), which was virtually confined to patients with a subtherapeutic anticoagulant response. In contrast, continuous intravenous heparin induced a therapeutic anticoagulant response in the majority of patients and a low frequency of recurrent events (3 of 58 patients, 5.2 percent; P = 0.024); the recurrences were limited to patients with an initial subtherapeutic anticoagulant response. The results of this trial establish the efficacy of intravenous heparin in the treatment of proximal venous thrombosis and suggest a relation between the effectiveness of heparin and the levels of anticoagulation achieved; such a relation could explain the observed failure of the subcutaneous regimen.

Acute Disease↗

Driving ability after intravenous fentanyl or diazepam. A controlled double-blind study.

Uncomfortable or moderately painful radiologic diagnostic and therapeutic procedures are being performed increasingly on outpatients. If sedation and analgesia are used, patients cannot drive themselves home or return rapidly to normal activities. This study compares the effect of fentanyl (100 micrograms), diazepam (7.5 mg), and placebo on driving ability of young volunteers as measured by the thacometer. Speed and accuracy were impaired at 30 and 120 minutes by both drugs, and by fentanyl more than diazepam. This study design may be suitable for the assessment of whether patients can drive safely after other analgesic drugs.

Adult↗

Drugs and exercise.

In this article, we have examined some pharmacologic principles as they apply to drug use by healthy individuals. With the present emphasis on community activities, we have dealt with the impairment of thermoregulation by athletes and fun runners who may take normal over-the-counter medications for a variety of reasons. However, many of these drugs impair thermoregulation. Our additional focus has been on drug abuse, again by healthy people, often striving to enhance their performance. Here we have dealt principally with the anabolic and androgenic steroids and stimulants. Finally, we have reproduced the current list of medications permitted by the International Olympic Committee, but have also offered some suggestions of common medications that may be required by athletes for such illnesses as hay fever, upper respiratory tract infections, and other simple disorders (Table 2). These medications do not contain any ingredients prohibited by the International Olympic Committee regulations. It is important to remember that many of the compound medications often sold over-the-counter contain substances such as caffeine, codeine, and ephedrine, which the unwitting athlete, trainer or coach could prescribe for a legitimate indication but which could, and have in the past, cost such athletes Olympic medals.

Absorption↗

Drug treatment of epilepsy: a review.

Once a decision to treat epilepsy has been made it is necessary to have a thorough knowledge of the benefits, disadvantages, toxic effects, pharmacokinetics and interactions associated with each anticonvulsant. However, by determining the serum concentration and manipulating it within the therapeutic range it should be possible to find a regimen that adequately controls seizures without introducing unnecessary toxic effects. There are special considerations in choosing anticonvulsants to treat epilepsy in pregnancy, febrile convulsions and status epilepticus.

Abnormalities, Drug-Induced↗

Observations on written communications between physicians regarding patients' drug treatment compared with patients' recall.

The authors reviewed the quality of information shared by referring doctors with hospital consultants, in regard to past drug treatment in the cases of 95 consecutive patients with rheumatoid arthritis. Information contained in referral letters was compared with information obtained from patient interviews. It was found that the referral letters often contained little information on drug use and included no information on adverse reactions to drug therapy.

Arthritis, Rheumatoid↗

Anaphylaxis due to thiopental sodium anesthesia.

Anaphylaxis due to an anesthetic is one type of cardiovascular emergency that can occur during general anesthesia. Anaphylactic reactions to muscle relaxants have been documented. Barbiturates, used as sedatives, are well known to produce cutaneous reactions, but anaphylaxis after their ingestion seems to be rare. Generalized allergic reactions to thiopental sodium during anesthesia are mentioned in the product monograph for Penthothal sodium, and rare case reports of anaphylactic reactions to infused thiopental have appeared, generally in the anesthesiology literature. Documentation of the immunologic responses to thiopental sodium has been limited to the demonstration of an allergic reaction to thiopental by skin testing in some cases. This report describes a woman who, after having tolerated thiopental sodium and other general anesthetics, became sensitive to this agent and had a severe acute reaction at the time of induction of general anesthesia.

Adult↗