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Biomedical subjects

J P Hunt

Publications and source records attributed to J P Hunt.

16 recordsLinked to original sources
PubMed1995

A statewide, population-based time-series analysis of the increasing frequency of nonoperative management of abdominal solid organ injury.

UNLABELLED: Emergency operative intervention has been one of the cornerstones of the care of the injured patient. Over the past several years, nonoperative management has increasing been recommended for the care of selected blunt abdominal solid organ injuries. The purpose of this study was to utilize a large statewide, population-based data set to perform a time-series analysis of the practice of physicians caring for blunt solid organ injury of the abdomen. The study was designed to assess the changing frequency and the outcomes of operative and nonoperative treatments for blunt hepatic and splenic injuries. METHODS: Data were obtained from the state hospital discharge data base, which tracks information on all hospitalized patients from each of the 157 hospitals in the state of North Carolina. All trauma patients who had sustained injury to a solid abdominal organ (kidney, liver, or spleen) were selected for initial analysis. RESULTS: During the 5 years of the study, 210,256 trauma patients were admitted to the state's hospitals (42,051 +/- 7802 per year). The frequency of nonoperative interventions for hepatic and splenic injuries increased over the period studied. The frequency of nonoperative management of hepatic injuries increased from 55% in 1988 to 79% in 1992 in patients with hepatic injuries and from 34% to 46% in patients with splenic injuries. The rate of nonoperative management of hepatic injuries increased from 54% to 64% in nontrauma centers compared with an increase from 56% to 74% in trauma centers (p = 0.01). In patients with splenic injuries, the rate of nonoperative management increased from 35% to 44% in nontrauma centers compared with an increase from 33% to 49% in trauma centers (p < 0.05). The rate of nonoperative management was associated with the organ injury severity, ranging from 90% for minor injuries to 19%-40% for severe injuries. Finally, in an attempt to compare blood use in operatively and nonoperatively treated patients, the total charges for blood were compared in the two groups. When compared, based on organ injury severity, the total blood used, as measured by charges, was lower for nonoperatively treated patients. CONCLUSIONS: This large, statewide, population-based time-series analysis shows that the management of blunt injury of solid abdominal organs has changed over time. The incidence of nonoperative management for both hepatic and splenic injuries has increased. The study indicates that the rates of nonoperative management vary in relation to the severity of the organ injury. The rates increase in nonoperative management were greater in trauma centers than in nontrauma centers. These findings are consistent with the hypothesis that this newer approach to the care of blunt injury of solid abdominal organs is being led by the state's trauma centers.

Humans↗
PubMed1992

Duplex ultrasonography versus arteriography in the diagnosis of arterial injury: an experimental study.

Duplex ultrasonography (DUS) and arteriography (ART) were evaluated using an experimental model of arterial trauma in order to determine the accuracy of DUS compared with ART and to define the characteristic ultrasonographic features of arterial injuries. Occlusions (n = 19), blunt injuries (n = 24), lacerations (n = 25), arteriovenous fistulae (n = 13), or no injuries (sham, n = 19) were surgically created in the femoral and carotid arteries of 25 dogs. Following closure of the incisions, DUS was performed and interpreted by a staff vascular surgeon without knowledge of the presence or type of injury. Biplane selective ART was evaluated by an independent staff radiologist. Although DUS and ART were equally accurate in evaluating arterial injuries, DUS was more sensitive (90.1% +/- 3.3% versus 80.2% +/- 4.4%, p = 0.002) and better at identifying lacerated arteries (p = 0.01). However, ART had greater specificity (94.7% +/- 5.1% versus 68.4% +/- 10.7%, p = 0.04) and was more accurate for identifying normal arteries (p = 0.04). The validity of DUS increased in the latter half of the study, thus demonstrating a learning curve. Duplex ultrasonography was a more sensitive screening modality than ART for evaluating arterial injuries in our experimental model, thereby supporting its use in clinical trials to evaluate its accuracy, reliability, and cost effectiveness in the trauma setting. Furthermore, management decisions can be based on the specific type of injury, pathologic condition of the arterial wall, and hemodynamic factors identified by DUS. Clinically occult arterial injuries can be followed by repeat DUS to define the natural history of these injuries.

Angiography↗
PubMed1984

Motor control.

The acquisition of motor skills involves learning, memory, and transfer as well as attention. The aspects of motor control most relevant for everyday practice are the conditions of practice, the knowledge of results, and the assessment of athletes to identify talented performers. The optimal conditions for practice and methods for developing a test battery for use in a sports tryout are discussed.

Attention↗
PubMed1983

Thiazides III. Evidence of dose proportionality of hydrochlorothiazide 25, 50 and 100 mg tablets.

A pilot bioavailability study was carried out where two subjects each were administered a dose of 25, 50 or 100 mg of commercially available hydrochlorothiazide (HCT) tablets. Plasma and urine samples were collected and analyzed by HPLC. A maximum plasma concentration of 50-285 ng/ml was reached in 1-2 hours, and plasma levels declined very rapidly with a half life of about 2-4 hours during first 12 hours period. The AUC was calculated using the trapezodial rule. A linear correlation was seen between the dose administered and amount of drug excreted.

Adult↗
PubMed1982

Oral hydrocortisone pharmacokinetics: a comparison of fluorescence and ultraviolet high-pressure liquid chromatographic assays for hydrocortisone in plasma.

Three fasted, male subjects received single 10-, 30-, and 50-mg oral doses of hydrocortisone tablets on separate occasions. Endogenous hydrocortisone was suppressed by giving 2 mg of dexamethasone 9 hr prior to dosing. Plasma samples obtained serially for 8 hr after hydrocortisone dosing were assayed by reversed-phase high-pressure liquid chromatography (HPLC) with UV detection and by normal-phase HPLC with fluorescence detection of the dansylhydrazine derivative of hydrocortisone. The two assay methods yielded equivalent plasma hydrocortisone concentrations. Metabolite interference was absent in both assay methods. Drug concentrations in plasma from all three doses of hydrocortisone were described by one-compartment open-model kinetics, with first-order absorption and elimination, and an absorption lag time. Mean Cmax values of 199, 393, and 419 ng/ml were obtained at 1.0, 1.0, and 1.7 hr following the 10-, 30-, and 50-mg doses, respectively. Hydrocortisone was cleared from plasma with an elimination half-life of approximately 1.5 hr. Within the dosage range studied, plasma levels of hydrocortisone were related, but not directly proportional, to dose size. This apparent lack of proportionality may be due to reduced drug availability or altered distribution with increasing dose.

Administration, Oral↗
PubMed1981

Dissolution profiles and specifications for dihydroergotoxine sublingual tablets using a new in vitro method.

A dissolution method (paddle method) for determining the dissolution rate profile for 0.5- and 1.0-mg dihydroergotoxine methanesulfonate sublingual tablets was developed. A fluorometric method was used for measuring drug concentration in the dissolution medium, distilled water. It was essential to filter the dissolution sample to avoid interference from undissolved excipients. When different kinds of filters were used with the dissolution samples and standards, different degrees of apparent drug binding to the filter occurred. The dissolution rate profiles for several different products were compared to the innovator's product. The in vitro method and data obtained were used to propose dissolution specifications for these sublingual products.

Dihydroergotoxine↗
PubMed1981

Pharmacokinetics of theophylline in swine: a potential model for human drug bioavailability studies.

The pharmacokinetics of theophylline in swine were investigated following the oral and intravascular administration of single doses of theophylline free base. The mean half-life of theophylline following intravascular administration was 11.0 h, and the apparent specific volume of distribution was 0.61 liter/kg. Following oral administration, theophylline in solution was absorbed quite rapidly with a bioavailability of 79%. The similarity of the pharmacokinetics of theophylline in swine and humans suggests that swine may provide a useful model for the study of the bioequivalency of theophylline dosage forms intended for human use. The pharmacokinetic characteristics of theophylline also favor its consideration for usage as a therapeutic agent in swine.

Administration, Oral↗
PubMed1980

Suppression of endogenous hydrocortisone with dexamethasone.

A newly developed high-pressure liquid chromatographic method was used to study the optimum dosage regimen needed to suppress endogenous hydrocortisone. Nine volunteers were randomly placed in three groups. Each group received 1 mg of dexamethasone at 11 pm (Treatment A), 2 mg of dexamethasone at 11 pm (Treatment B), or 1 mg at 11 pm and an additional 1 mg at 6 am the following day (Treatment C). Analysis of multiple blood samples obtained the day before and the day after drug administration showed suppression in all three groups. Although the duration and extent of this suppression varied, adequate suppression to permit bioavailability studies was observed for Treatments B and C.

Adult↗
PubMed1979

A gas chromatographic screening procedure for the detection of non-steroidal anti-inflammatory drugs in horse urine.

A gas chromatographic screening procedure for the non-steroidal anti-inflammatory group of drugs is described. The method invovles on-column methylation of the carboxylic acid group using trimethylanilinium hydroxide as the methylating reagent. Fifteen such drugs were studied. Eight of these were detected in urine collected from horses that had received these compounds orally and for these drugs, rates of urinary excretion are recorded. Seven other members of this group of drugs were shown to be detectable by this procedure but in these cases the drug was added to urine and not administered to the horse.

Animals↗
PubMedDate not supplied

Thiazides XI: partitioning of chlorothiazide in red blood cells after oral administration.

Uptake of chlorothiazide by red blood cells after oral drug administration was investigated. Chlorothiazide was administered to normal healthy volunteers as a solution or a tablet. Frequent blood samples were collected and analysed by a specific HPLC method. The results indicate that there is a significant uptake of chlorothiazide by red blood cells, resulting in a higher blood AUC compared to plasma AUC.

Administration, Oral↗
PubMedDate not supplied

Influence of dioctyl sodium sulfosuccinate on the absorption of tetracycline.

A pilot bioavailability study was carried out to evaluate the drug interaction and influence of dioctyl sodium sulfosuccinate (DS) on the absorption/bioavailability of tetracycline. Three tetracycline products--a fast dissolving capsule, a slow dissolving capsule and a suspension, were used in the study. DS was administered 30 minutes before tetracycline administration; and on -3, -2 and -1 day in the evening before tetracycline administration. Frequent urine samples were collected up to 48 hours and analyzed by a microbiological method. Although not statistically significant in this small study, the results suggest that there is a reduction in tetracycline bioavailability due to DS. The indiscriminate use of surface active agents to increase the dissolution rate of solid oral dosage forms in the belief that the resulting increased dissolution improves product bioavailability must be questioned.

Biological Availability↗
PubMedDate not supplied

Analysis of subjective knee complaints using visual analog scales.

A questionnaire using a system of visual analog scales was developed for analyzing subjective knee complaints. This system was tested on 117 consecutive patients who had undergone knee surgery and 65 patients at their initial office evaluation of a knee disorder. The validity of and patient affinity for this type of questionnaire was compared with that of three other established subjective evaluation methods. The visual analog scale system was shown to be valid and comparable to other methods while offering several advantages. It brought greater sensitivity and greater statistical power to data collection and analysis by allowing a broader range of responses than did traditional categorical responses. It removed bias that was introduced by examiner questioning, and it allowed graphic temporal comparisons. Most importantly, patient affinity was higher for this type of subjective evaluation than for other methods.

Data Interpretation, Statistical↗