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James Reed

Publications and source records attributed to James Reed.

7 recordsLinked to original sources
PubMed2003

Effect of physostigmine and gastric lavage in a Datura stramonium-induced anticholinergic poisoning epidemic.

This study examines the impact of the administration of physostigmine and of nasogastric evacuation of Jimsonweed seeds on intensive-care unit (ICU) use and the length of stay in the hospital after Jimsonweed poisoning. Clinical data for this retrospective study were gathered from records of consecutive patients treated for Jimsonweed poisoning from September to November 1997. Descriptive statistics, Fisher's exact test, and Student t-test were used to analyze important clinical and sociodemographic variables. There were 17 victims of the Jimsonweed ingestion epidemic, all of whom presented with an anticholinergic toxidrome 3 to 9 hours after ingestion. Reported quantities of seed ingestion ranged from a low of 7 seeds to as high as 200 seeds. Altered mentation, manifested by combative behavior, necessitated admission of 13 patients to the ICU. The administration of physostigmine did not reduce admissions to the ICU (P = 0.54) or reduce length of stay in the hospital (P = 0.45) compared with the use of benzodiazepines alone. Nasogastric lavage was performed in 14 (82%) and seeds were recovered in 8 (57%) of those lavaged. The successful removal of Jimsonweed seeds did not decrease ICU use rates (P = 0.68) or shorten length of stay in the hospital compared with not recovering seeds (P = 0.85). The use of physostigmine and the successful nasogastric lavage of Jimsonweed seeds did not result in decreased intensive-care use or shorter length of stay in the hospital for Jimsonweed-induced anticholinergic toxicity.

Adolescent↗
PubMed2003

Levalbuterol is as effective as racemic albuterol in lowering serum potassium.

Albuterol is an effective treatment for hyperkalemia through beta-adrenergic induction of potassium (K+) uptake. Levalbuterol, the R-enantiomer of racemic albuterol, is used for the treatment of asthma and 0.63 mg of levalbuterol has the same therapeutic efficacy as 2.5 mg of albuterol but with a decreased adverse effects profile. We hypothesized that levalbuterol can reduce serum K+ levels similarly to albuterol when used in equipotent doses. In a randomized, double blind, placebo-controlled prospective study, we compared the K+-lowering effects of nebulized saline and equipotent bronchodilatory doses of albuterol (10 mg) and levalbuterol (2.5 mg) in healthy adult volunteers. Nine subjects entered each of the three study groups. Serum K+ was measured at baseline, at 30 min (immediately after treatment), at 60 min, and at 90 min. All adverse effects were recorded. The three groups had similar baseline K+ values. Immediately after nebulization, only levalbuterol showed a significant decrease in potassium level (p = 0.024). At 30 and 60 min after treatment, both albuterol and levalbuterol groups had significantly lower K+ values compared to placebo. No significant difference occurred between the albuterol and levalbuterol groups. Levalbuterol caused fewer reported adverse effects compared to albuterol.

Adrenergic beta-Agonists↗
PubMed2003

In vitro stability of tris-acryl gelatin microspheres in a multipharmaceutical chemoembolization solution.

PURPOSE: To evaluate the in vitro stability of tris-acryl gelatin microspheres (TAGMs) in a multipharmaceutical solution as a preliminary step before planned hepatic chemoembolization with TAGMs. MATERIALS AND METHODS: Half-cm(3) aliquots of 100-300- micro m and 300-500- micro m TAGMs were suspended in 1 mL of normal saline solution (NSS), 1 mL of ethiodized oil, or 1 mL of a standard chemoembolization solution (cisplatin 100 mg, doxorubicin 50 mg, mitomycin 10 mg, ethiodized oil 3 mL, and iodixanol 5 mL). Mixtures were incubated at 37 degrees C for 24 hours and were then examined visually and with use of light microscopy. Solutions containing ethiodized oil required centrifugation for separation. Determination of average sphere diameter after 24-hour chemoembolization incubation was performed after washing in ethanol, washing in acetone, and rinsing in 0.9% aqueous sodium chloride solution. RESULTS: TAGMs in NSS had no gross degradation, were intact on light microscopy, and had no visually perceptible change in average diameter. TAGMs in ethiodized oil alone appeared to dissolve into a cloudy solution; however, centrifugation separated spheres from ethiodized oil as a layer, which was intact on light microscopy. Spheres incubated in the chemoembolization solution were not grossly visible as a result of the deep red color of doxorubicin (which stained the spheres), but were easily seen after centrifugation. There were similar numbers of spheres per field on microscopy with a minimal (but significant) increase in analyzed diameter. CONCLUSION: TAGMs are stable in a standard chemoembolization solution and may be suitable as a substitute for PVA particles in hepatic chemoembolization.

Centrifugation, Density Gradient↗
PubMed2003

Functional outcomes in octogenarian trauma.

BACKGROUND: Outcome data on geriatric trauma patients (GTPs) (age >or= 65) focus on mortality and resource use. We examined mortality and outcome in GTPs and octogenarian trauma patients (OTPs) (age >or= 80). We hypothesized that OTPs would have worse functional outcomes than GTPs as defined by functional independence measurement (FIM) scales. METHODS: Our study was a 13-year retrospective analysis of a statewide trauma database. Isolated hip fractures and intubation with Glasgow Coma Scale scores of 3 at admission were excluded. Demographic data, preexisting conditions, complications, discharge destination, mortality, and FIM were analyzed. RESULTS: OTPs constituted 17742 (40.9%) of 43297 GTPs admitted to trauma centers. Falls (64.4%) and motor vehicle collisions (24.5%) were predominant. Average Injury Severity Score (ISS) was higher in GTPs (11.5 +/- 9.2 vs. 10.8 +/- 8.3, p = 0.001). Cardiac disease was the most common preexisting condition. Diabetes, obesity, and pulmonary disease were more common in GTPs than in OTPs (p = 0.001). Dementia, congestive heart failure, and hematologic disease were more common in OTPs than in GTPs (p = 0.001). Pulmonary and infectious complications were most common and occurred with equal frequency in OTPs and GTPs. Mortality rates were higher (10.0% vs. 6.6%, p = 0.001) for OTPs overall and when stratified into low (<10), moderate (11-20), and high (>20) ISS subgroups (p = 0.001). Discharge destination was most often home (53.3% vs. 28.8%, p = 0.001) or a rehabilitation facility (20.0% vs. 17.4%, p = 0.001) for GTPs versus OTPs. OTPs were discharged to skilled nursing facilities (37.2% vs. 14.9%, p = 0.001) far more often than GTPs. FIM at discharge was lower in all categories for OTPs. Modified dependence in locomotion and transfer was seen for OTPs but not GTPs overall and when stratified by ISS subgroups (p = 0.001). Some dependence in feeding was seen for OTPs but not GTPs with high injury severity (p = 0.001). Otherwise, feeding, expression, and social independence were preserved for both OTPs and GTPs. CONCLUSION: Functional outcomes after blunt trauma are worse for OTPs; however, functional independence in feeding and social interaction are preserved in OTPs even with moderate injury severity.

Activities of Daily Living↗
PubMed2000

1999 Clinical Advisory Treatment of Hypertension and Diabetes.

The last Joint National Committee Report on the Detection, Evaluation, and Treatment of High Blood Pressure (JNC-VI) was published in 1997. Periodically, the National Heart, Lung, and Blood Institute has issued updates or advisories dealing with specific topics whereas featured recommendations may have changed as a result of new studies or new analyses. Recent and forthcoming updates include Hypertension in Pregnancy as well as Hypertension in Renal Disease. Presented below is an update (advisory) on the Treatment of Hypertension and Diabetes. (c)2000 by Le Jacq Communications, Inc.

Journal Article↗