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Biomedical subjects

D S Rich

Publications and source records attributed to D S Rich.

51 records · Page 3Linked to original sources
PubMed1984

Two methods for estimating body surface area in adult amputees.

Two methods for estimating body surface area (BSA) in adult amputees were developed. BSA in sq m was determined in 42 healthy, nonamputee men and women by summing the surface areas of individual body parts obtained using geometric measurements (BSAmeas) and by an equation using height and weight (BSAcalc). Linear regression analysis was used to determine correlations between BSAmeas and BSAcalc and between BSAmeas and surface-area measurements of individual body parts (SApart). The percentages of total BSA contributed by individual body parts in each subject were determined by the ratio of SApart to BSAmeas, and these percentages were compared with the corresponding percentages for body parts using the "Rule of Nines." BSAcalc and BSAmeas were significantly correlated, as were SApart and BSAmeas. Regression analysis of SApart versus BSAmeas yielded an equation for each measured body part that allowed calculation of SApart without direct measurement. SApart expressed as a percentage of total BSA differed from the percentage of BSA used in the "Rule of Nines" by a mean of 12.4-32% depending on the body part. Two methods of estimating BSA in amputees were proposed based on deduction of the surface area of the amputated part (calculated from the regression equation for SApart or as a percentage of total BSA) from total BSAcalc in adult amputees. The two methods developed in this study for estimating BSA may be useful in determining drug dosages in adult amputees and may provide more accurate information in burn therapy. Further studies are needed to validate the clinical application of these methods.

Adult↗
PubMed1984

Total condylar knee arthroplasty for valgus and combined valgus-flexion deformity of the knee.

Total condylar knee arthroplasty was performed on 64 knees with fixed valgus or valgus/flexion deformities. The technique for release of tight lateral and posterior structures is important to balance the ligament. Clinical results were rated good and excellent in 95% of the knees. Four patients with excessive flexion deformities required 6 weeks of cast bracing in the immediate postoperative period for instabilities caused by an imbalance in the spacing in flexion and extension. In no joint in the entire series did stability deteriorate with time. There were no patellar complications or nerve palsies noted. Radiographic evaluation revealed well-fixed components in 92% of the arthroplasties. None has required revision for mechanical loosening to date. With proper technique the total condylar prosthesis can be employed in knees with valgus or valgus/flexion deformities to give predictably good results. The total condylar III prosthesis may be required in severe combined deformities for added stability.

Adult↗
PubMed1981

Evaluation of a computerized digoxin pharmacokinetic consultation service.

A pharmacy-conducted digoxin pharmacokinetic consultation service was implemented to determine the influence of the service on patient serum digoxin concentrations. Changes in digoxin dosages and serum levels during a three-week period were compared with a three-week control period in which the consultation was not offered. Of 47 patients evaluated, there was no statistically significant (P > 0.05) difference between the control and the study group in terms of population variables. The study group receiving pharmacokinetic consultations showed a significantly greater (P > 0.05) number of dosage changes resulting in therapeutic serum drug levels than did the control group whose physicians received a report of serum drug level by itself. The number of patients with steady-state serum digoxin levels in the therapeutic range of 1-2 ng/ml increased from 45.5% to 80% as a result of the clinical pharmacokinetic consultations. This study demonstrated that a pharmacy-based clinical pharmacokinetic consultation service can provide potential benefits to the patient by aiding clinicians in optimizing serum drug concentrations.

Computers↗
PubMedDate not supplied

On accreditation of healthcare organizations. Determining eligibility for Accreditation of Home Pharmaceutical Services.

Many misperceptions exist in the health care community about the Joint Commission's accreditation of home pharmaceutical services, primarily related to when pharmacy services are considered home care and which patients or services are eligible for survey. This article concentrates on eligibility for survey and accreditation of just one of the six eligible home care services-home pharmaceutical services. The concept of home care and pharmaceutical services is difficult for most people to understand. Unlike other home care services, pharmacy services cannot be provided directly in the patient's home. Pharmacy laws prohibit pharmacists from compounding and dispensing directly in the patient's home. The pharmacists must do these activities in a licensed pharmacy. Also, most patients who receive medications from pharmacies take their own medications in their homes. So the differences between home care pharmacy and ambulatory or retail pharmacy are much less clear-cut than the delivery of more traditional home care services such as nursing or home health aide services.

Eligibility Determination↗
PubMedDate not supplied

An evaluation of a microcomputer in reducing the preparation time of parenteral nutrition solutions.

A microcomputer was evaluated in reducing the activities of pharmacists and pharmacy technicians in processing orders for parenteral nutrition (PN) solutions. A program in BASIC was developed for a Radio Shack TRS-80 microcomputer. The program maintains a patient profile, prints a label, generates a worksheet for the preparation of solutions, and provides statistical data for the Pharmacy Nutritional Support Service. A direct time study by intensive samplings was performed on 24 patients utilizing 51 units of PN solution. The computerized method was compared to the current manual method for processing PN orders. The computerized method significantly reduced the processing time (p less than 0.001), saving an average of 2.61 minutes/order. This represented 41.3% of the manual processing time. The time savings was greater when two or more units per patient were ordered (3.37 minutes/order) when compared to patients who received only one unit of PN (0.76 minutes/order). At Rhode Island Hospital, this would result in a savings in time of 300 to 400 hours annually. The authors concluded that a microcomputer is a valuable addition to a nutritional support service. In addition, it should provide the pharmacist with substantially more time to engage in activities related to the care of patients receiving PN solutions.

Computers↗