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Biomedical subjects

J R Miner

Publications and source records attributed to J R Miner.

13 recordsLinked to original sources
PubMed2001

Presentation, time to antibiotics, and mortality of patients with bacterial meningitis at an urban county medical center.

Our objective was to analyze the presentation, time to antibiotics, treatment, and mortality of patients with bacterial meningitis at a large urban county hospital over a 10-year period. A retrospective chart review of all patients with the diagnosis of bacterial meningitis was done. Information concerning presentation, etiologic organisms, treatment (including time to antibiotics), and outcomes were collected and analyzed. There were 165 charts reviewed with 171 total cases of bacterial meningitis. For adults with community-acquired meningitis, the mortality rate was 14%, for children it was 1.6%. Seventy-six percent of patients received antibiotics in the Emergency Department (ED) with a mean time to antibiotics of 1:08 h +/- 13 min. The rest received them as inpatients with a mean time to antibiotics of 6 +/- 9 h. The mortality rate for patients with community-acquired disease who received an Emergency Department antibiotic was 7.9%; for patients who received their antibiotics as inpatients the mortality rate was 29%. Our results indicate that the mortality rates from bacterial meningitis at our institution are lower than previously published results. Furthermore, our study supports the concept that the early administration of antibiotics in the ED may reduce mortality and may be an explanation of the lower mortality rates seen here.

Adolescent↗
PubMed2001

Droperidol vs. prochlorperazine for benign headaches in the emergency department.

OBJECTIVE: To compare the efficacy of droperidol with that of prochlorperazine for the treatment of benign headaches in emergency department (ED) patients. METHODS: Prospective, randomized clinical trial in an urban ED. Patients were given either droperidol, 5 mg intramuscular (IM) or 2.5 mg intravenous (IV), or prochlorperazine, 10 mg IM or 10 mg IV. Measurements included side effects and the patient's pain perception as measured on a 100-mm visual analog scale (VAS) at baseline, 30, and 60 minutes after the medication was given. Data were analyzed using chi-square, two-tailed t-tests, and two-way analysis of variance (ANOVA) when appropriate. RESULTS: During an eight-month period, 168 patients were enrolled. Eighty-two (48.8%) of the patients received droperidol; 86 (51.2%) received prochlorperazine. In the droperidol group, 49 (59.6%) received IM administration and 33 (40.4%) IV. In the prochlorperazine group, 57 (66.3%) received IM administration and 29 (33.7%) IV. Sixty minutes after the medication, the mean decrease in the VAS scores was 81.4% for droperidol and 66.9% for prochlorperazine (p = 0.001). At 30 minutes, 60.9% of the patients receiving droperidol and 44.2% of the patients receiving prochlorperazine had obtained at least a 50% reduction in their VAS scores (p = 0.09). At 60 minutes, 90.2% of the patients receiving droperidol and 68.6% of the patients receiving prochlorperazine had at least a 50% reduction in their VAS scores (p = 0.017). No difference between IM dosing and IV dosing was detected. Side effects, including dystonia, akathisia, and decreased level of consciousness, were seen in 15.2% of the patients receiving droperidol and 9.61% of the patients receiving prochlorperazine. No significant or persisting morbidity was detected. CONCLUSIONS: Droperidol was more effective than prochlorperazine in relieving pain associated with benign headaches.

Adult↗
PubMed1999

Alternatives to minimize the environmental impact of large swine production units.

Large swine production facilities have become controversial additions to the agricultural landscape as their numbers and sizes have increased. In addition to being larger enterprises, these units have involved greater specialization, the influx of outside capital, and the employment of labor without extensive investment in the enterprise. Major complaints have included water pollution and odors. Water pollution complaints have been related to surface and groundwater resources. Accidental spills, structural failure, and purposeful discharges have been noted. Odor problems are most often related to manure management techniques. Large anaerobic lagoons and irrigation of lagoon effluent have the potential to emit odors that travel long distances. Fortunately, technology and management alternatives exist to achieve higher levels of environmental acceptability. More effective water pollution and odor control alternatives generally increase construction and operating costs. Producers, regulatory officials, and the local public have an opportunity to interact to achieve progress in establishing acceptable compromises. This article identifies the range of existing and evolving alternative strategies and provides some assistance to producers and neighbors in achieving the necessary equilibrium.

Animal Husbandry↗
PubMed1997

Nuisance concerns and odor control.

Nuisance and odor control continue to be major challenges to livestock and poultry producers across the country. Dust and flies are the two most frequently mentioned nuisances after odors. Research and testing have devised systems that are capable of achieving reduced frequency and intensity of odors, flies, and dust; however, these systems are typically more expensive to build and operate than is the standard lagoon holding basin. Producers who operate close to sensitive odor perception sites are at a clear disadvantage to those located in more remote locations. In addition to the cost factor is the uncertainty associated with nuisance and odor control. Some dairies are able to co-exist with their neighbors despite frequent odor detection, but others find that their neighbors demonstrate much less tolerance. Odor control additives, either fed or applied to the manure, have generally been less than fully successful. Careful site selection, appropriate facility design, flawless management, and a generous amount of positive local relations have proved to be the most effective means of avoiding cost from odor confrontations.

Animals↗
PubMed1967

Salmonella infantis in cattle feedlot runoff.

Ten isolates of Salmonella infantis (serologically typed) were found in litter and runoff collected from two experimental feedlots near the Kansas State University campus. Pathogenic implications are discussed relative to recreation water sites. Agricultural runoff maybe a source of viable salmonellae.

Agriculture↗