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Biomedical subjects

J A Colliver

Publications and source records attributed to J A Colliver.

89 records · Page 5Linked to original sources
PubMed1985

Bicitra (sodium citrate) and metoclopramide in outpatient anesthesia for prophylaxis against aspiration pneumonitis.

To evaluate the effect of Bicitra (Willen Drug Company, Baltimore, Maryland), a commercial preparation of sodium citrate and metoclopramide, on gastric contents 150 elective outpatients allocated into six groups with 25 patients in each group were studied. Patients in Group 1 served as controls. Patients in Groups 2, 3, 5, and 6 received Bicitra, po, either 15 ml (Groups 2 and 5) or 30 ml (Groups 3 and 6). In addition, patients in Groups 5 and 6 also received metoclopramide 10 mg, iv; Group 4 patients received metoclopramide 10 mg, iv. Eighty-eight per cent of patients in the control group had a gastric pH less than or equal to 2.5, while 36% had a gastric content volume greater than or equal to 25 ml with pH less than or equal to 2.5. Bicitra, 15 ml and 30 ml, po, increased mean gastric pH and decreased the proportion of patients with a gastric pH less than or equal to 2.5 to 32 and 16%, respectively, in Groups 2 and 3. However, Bicitra 15 ml and 30 ml, increased the mean gastric volume in Group 3 and also increased the proportion of patients with a gastric volume greater than or equal to 25 ml to 56% in Group 2 and 84% in Group 3. The addition of metoclopramide 10 mg, iv, to Bicitra reduced the proportion of patients with a gastric volume greater than or equal to 25 ml in Groups 5 and 6 to 28 and 36%, respectively. Metoclopramide (Group 6) independently reduced mean gastric volume (15.6 ml vs. 32.7 ml) and the proportion of patients with a gastric volume greater than or equal to 25 ml (20% vs. 36%). Bicitra and metoclopramide combination significantly reduced the proportion of patients with gastric contents greater than or equal to 25 ml with pH less than or equal to 2.5.

Adult↗
PubMed1985

Evaluation of ranitidine as an oral antacid in outpatient anesthesia.

We studied the effects of preanesthetic ranitidine on gastric contents in 60 outpatients scheduled for elective surgery, with random allocation into three groups of 20 patients each. Patients in group 1 did not receive ranitidine and served as controls. Patients in groups 2 and 3 received ranitidine orally, 150 and 300 mg, respectively, one to five hours before induction of anesthesia. In the control group, mean pH and volume of gastric contents were 1.90 and 27.7 ml respectively. Ninety percent of the control subjects had gastric pH less than or equal to 2.5, and 65% of the patients had pH less than or equal to 1.8; 65% of the patients had gastric volumes of 20 ml or greater. Ranitidine in 150 and 300 mg doses markedly raised mean gastric pH to 6.40 and 5.87 respectively and reduced the proportion of patients with gastric pH less than or equal to 2.5 to 10% in group 2 and 0% in group 3. Mean gastric volume and proportion of patients with volume greater than or equal to 20 ml were significantly reduced in both treatment groups. Proportions of patients with combination of pH less than or equal to 2.5 and volume greater than or equal to 20 ml were significantly low in both treatment groups, as there was only one patient in group 2 and none in group 3 with both low pH and high volume. With respect to reduction of gastric acidity and volume, 300 mg of ranitidine had no advantage over 150 mg.

Adult↗
PubMed1985

Assessment of age-related acid aspiration risk factors in pediatric, adult, and geriatric patients.

One hundred inpatients scheduled for elective surgery were studied to determine the age-related risk of pulmonary aspiration as indicated by gastric acidity and volume. Twenty-five patients from 6 months to 12 years old were included in the pediatric age group, 50 patients from 18 to 64 years old were included in the adult age group, and 25 patients older than 65 years old were included in the geriatric group. Mean gastric pH was 1.99, 2.40, and 3.32 in the pediatric, adult, and geriatric age groups, respectively; the differences between the three groups were statistically significant. The proportions of patients with pH less than or equal to 2.50 were also significantly different among three groups: 92%, 76%, and 60% in the pediatric, adult, and geriatric age groups, respectively. Mean gastric volumes were 0.49, 0.37, and 0.24 ml/kg and proportions of patients with volumes greater than or equal to 0.40 ml/kg were 60, 32, and 12% in pediatric, adult, and geriatric patients, respectively. Gastric contents with both pH less than or equal to 2.5 and volume greater than or equal to 0.4 ml/kg were seen in 60, 28, and 12% in the three respective groups. Risk of acid aspiration pneumonitis theoretically is present in all age groups, with children being at greatest risk and geriatric patients with least risk. We have also noted a correlation between age and gastric contents because gastric acidity and volume both decreased as age increased. Increasing length of fasting period increased gastric acidity without significant effect on volume.

Adult↗
PubMed1985

Diagnosis of secondary depression in schizophrenia.

Four diagnostic groups were studied to determine the relationship of depression secondary to schizophrenia to DSM-III major depression criteria and Hamilton Depression Rating Scale scores. The symptoms found in schizophrenic patients with major-type depressions differed qualitatively from those in primary depressives. Some of the criteria used to diagnose depression in schizophrenic patients (retardation and insomnia) probably arise from the schizophrenic syndrome. Since secondary depression in schizophrenia is associated with poor outcome, it is important that specific diagnostic criteria for distinguishing depressed from nondepressed schizophrenics be developed. Such criteria should not include symptoms that are part of the schizophrenic syndrome.

Adult↗
PubMed1984

Ranitidine and metoclopramide for prophylaxis of aspiration pneumonitis in elective surgery.

The effects of preanesthetic oral ranitidine and metoclopramide on gastric contents were studied in 150 inpatients scheduled for elective surgery with random allocation into ten groups with fifteen patients in each group. Patients in group I served as controls. Group II patients received metoclopramide, 10 mg, in the morning. Patients in group III received ranitidine, 150 mg; while group IV patients received ranitidine, 150 mg, and metoclopramide, 10 mg, also in the morning. Group V patients received ranitidine, 150 mg, at bedtime and in the morning; while patients in group VI received ranitidine as in group V and, in addition, received metoclopramide, 10 mg, in the morning. Group VII patients received ranitidine, 300 mg, in the morning; while patients in group VIII received ranitidine, 300 mg, and metoclopramide, 10 mg, in the morning. Patients in group IX received ranitidine, 300 mg, at bedtime and in the morning; while group X patients received ranitidine as in group IX, and in addition, received metoclopramide, 10 mg, in the morning. Patients with gastric pH less than or equal to 2.5 or gastric content volume greater than or equal to 20 ml were defined to be at risk of pulmonary damage in the event of aspiration. Patients in group I had a mean gastric pH of 2.33 with 73% of the patients with pH less than or equal to 2.5, while 47% of the patients presented with a combination of pH less than or equal to 2.5 and volume greater than or equal to 20 ml. Ranitidine and metoclopramide independently and in combination significantly reduced risk factors.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

Human trophoblast-lymphocyte cross-reactive (TLX) antigens define a new alloantigen system.

Antisera to human syncytiotrophoblast microvillous cell surface membranes from different placentas are cytotoxic for lymphocytes from some people but not others, demonstrating the presence of allotypic trophoblast-lymphocyte cross-reactive (TLX) antigens. Exploratory principal components factor analysis, performed on limited data consisting of 300 cytotoxic reactions produced by ten separate trophoblast antisera on a panel of lymphocytes from 30 random donors, suggested the presence of three distinct TLX antigen groupings. It is proposed that such TLX alloantigens are central in establishing maternal recognition and protection of the blastocyst, and that lack of recognition results in implantation failure and spontaneous abortion. These findings are compatible with contemporary results of immunotherapy to prevent recurrent spontaneous abortions, and their implications extend to other conditions of allogeneic coexistence, such as organ transplantation and the tumor-host relationship.

Antigens, Surface↗
PubMed1983

Similarity of obesity indices in clinical studies of obese adults: a factor analytic study.

The similarity of measurements obtained with six commonly used obesity indices was assessed with correlational and factor analyses performed on data for 951 obese adults participating in a weight reduction study. Intercorrelations among the indices were found to be very high, with a mean of 0.96. A factor analysis of the six indices resulted in a single factor which accounts for 97% of the aggregate variance in the six indices. A factor analysis of the six indices plus height and weight resulted in two factors. The six indices loaded nearly perfectly on one factor and not at all on the second. Height loaded perfectly on the second factor. The results of these analyses constitute strong empirical evidence that the obesity indices are measuring the same thing and that factor is independent of height. Although anthropological or other special studies may necessitate the use of a particular index, these results suggest that it should make little difference which of the six indices is used in a clinical study of obesity with obese adults.

Analysis of Variance↗
PubMedDate not supplied

Management of febrile seizures: survey of current practice and phenobarbital usage.

A questionnaire survey was mailed to all members of the Child Neurology Society in North America to determine current methods used by pediatric neurologists in the management of febrile seizures and the influence of public awareness of phenobarbital side-effects on practice. Responses were received from 574 of 869 deliverable questionnaires (66%). The mean number of febrile seizures treated by respondents was 42 +/- 58 (mean +/- S.D.), of which 22 +/- 36 were simple and 19 +/- 31 were complex. In the control of the acute, continuing febrile seizure, intravenous phenobarbital, lorazepam, and diazepam were equally preferred and phenytoin was used infrequently. For intermittent administration by parents, diazepam was prescribed by 20% for seizure prevention and by 31% for control of seizure recurrence. Long-term phenobarbital was prescribed by 89% for prevention of complex febrile seizures and by 43% for simple febrile seizures. Parental anxiety was a factor in the prescription of intermittent or long-term therapy by 67% of respondents.

Acute Disease↗
PubMedDate not supplied

Interactive effects of physostigmine and exercise on cholinesterase activity in red blood cells and tissues of rat.

Physostigmine is considered to be a potential pretreatment agent against organophosphate intoxication. This investigation elicits the effects of three intensities of acute exercise (50, 80 and 100% VO2max), administration of physostigmine (70 micrograms/kg, i.m.) and the combined effect of physostigmine and three intensities of acute exercise on cholinesterase activity in red blood cells and various tissues and endurance time in rats. The cholinesterase activity in red blood cells in exercised rats not exposed to physostigmine was significantly greater than that of unexercised controls (116, 112 and 108% of control, p less than 0.05, at 50, 80 and 100% VO2max, respectively) while in other tissues the cholinesterase activity in general decreased slightly. In unexercised rats given physostigmine, the cholinesterase activity ranges were 73-79, 66-68, 68-74, 67-81 and 57-61% of controls from 10-30 min in red blood cells, brain, heart, diaphragm and thigh muscle, respectively. In exercised rats exposed to physostigmine, the cholinesterase activity ranges were 54-51, 58-50, 77-73, 71-83 and 54-58% of controls from 10-30 min in red blood cells, brain, heart, diaphragm and thigh muscle, respectively. The results indicate that in control rats not given physostigmine, different intensities of acute exercise affect the cholinesterase enzyme to a moderate degree in red blood cells (p less than 0.05) and heart (p less than 0.05) without affecting brain, diaphragm and thigh muscle. Acute exercise modifies the effect of physostigmine significantly (p less than 0.01) by increasing the cholinesterase inhibition in red blood cells and brain without affecting other tissues. Exposure of rats to physostigmine (70 micrograms/kg, i.m.) increases the endurance time in rats (160-200 g weight), possibly due to peripheral vasodilatation and lowering of core temperature.

Animals↗
PubMedDate not supplied

Using standardized patients for assessing clinical performance: an overview.

Standardized patients are being used increasingly worldwide to assess the clinical skills and competencies of medical students, residents, and physicians; plans are now underway for the use of standardized patients in licensure and certification examinations. The Morchand Center for Clinical Competence was established at Mount Sinai School of Medicine for the purpose of assessing clinical performance with the use of standardized patients, and currently all students in the eight medical schools in the New York City Consortium are tested at The Morchand Center. This paper presents an overview of standardized-patient assessment, a description of the assessment program at The Morchand Center, and a summary of research on this assessment approach including research at The Morchand Center.

Bias↗