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Biomedical subjects

K Grauer

Publications and source records attributed to K Grauer.

At least 19 recordsLinked to original sources
PubMed1999

Management of essential hypertension.

Hypertension, in spite of a very high prevalence, remains undertreated. This is not due to a lack of effective therapeutic modalities. Non-pharmacological treatments can be effective in many patients. If those treatments fail to reduce blood pressure sufficiently, the physician can choose between numerous classes of antihypertensive agents. However, interpatient variability in response to these agents is high, and use of multiple agents is frequently necessary. Thus, no single class has proven to be superior for the majority of patients. This article will review the different non-pharmacological and pharmacological methods available to treat hypertension, as well as the guidelines that are available to aid in proper selection of a treatment regimen.

Animals↗
PubMed1997

The serum digoxin concentration: ten questions to ask.

Although the role of digoxin therapy has been the subject of debate, the drug is generally accepted as effective in the treatment of heart failure due to systolic dysfunction and as therapy for atrial fibrillation and supraventricular tachyarrhythmias. Serum digoxin concentrations are commonly used to gauge patient response to digoxin. Digoxin pharmacokinetics are complex, and many factors can confound the interpretation of digoxin concentrations. The exact therapeutic range of serum digoxin varies in the literature but should be considered to be from 0.8 to 2.0 ng per mL, on the basis of population data regarding therapeutic response and toxicity. Renal function plays a major role in digoxin pharmacokinetics and is an important factor in determining digoxin doses. Many medications, including quinidine, amiodarone and verapamil, alter digoxin pharmacokinetics and can result in two- to three-fold increases in the serum digoxin concentration. Effective interpretation of the digoxin concentration requires consideration of the patient's renal function and clinical status, possible drug interactions, time of the assay and other variables.

Algorithms↗
PubMed1995

More pearls.

Explore the source record for details and available documents.

Humans↗
PubMed1994

Infectious vaginitis. Selecting therapy and preventing recurrence.

Vaginal candidiasis, trichomoniasis, and bacterial vaginosis can be difficult to manage because of predisposing factors and frequent recurrence. Thus, in addition to drug therapy, management should include attempts to minimize factors that contribute to recurrence. Both topical and oral agents are available for vaginal candidiasis and bacterial vaginosis, and both routes of administration appear equally safe and effective. Topical therapy may be used for these conditions in pregnant women. Only oral therapy is optimal for trichomoniasis. However, during pregnancy, the infection may be managed with topical clotrimazole. Currently, treatment of a woman's sexual partner is recommended in the management of trichomoniasis and is optional in cases of bacterial vaginosis. Sexual activity may also contribute to the recurrence of vaginal candidiasis; however, more studies are needed to evaluate the impact on recurrence rates of treating the male partner.

Bacterial Infections↗
PubMed1994

New trends in the pharmacologic management of cardiac arrest.

In recent years a number of trends in the pharmacologic management of cardiac arrest have developed. Interventions that should be considered, especially for patients with refractory ventricular fibrillation, are high-dose epinephrine and additional antifibrillatory therapies, such as amiodarone and magnesium sulfate. Other advances in the management of refractory ventricular fibrillation include an improved understanding of the mechanism of action of epinephrine and other pressor agents in the arrested heart, and refined indications and recommendations for the use of sodium bicarbonate, lidocaine, bretylium and beta-blocking agents.

Epinephrine↗
PubMed1994

The development and evaluation of new versions of the written examination for the American Heart Association Advanced Cardiac Life Support provider course.

STUDY OBJECTIVE: To create new versions of the written, multiple-choice examination used in the American Heart Association (AHA) Advanced Cardiac Life Support course, evaluate their reliability and difficulty, and then design revised versions with improved reliability and of standardized difficulty. DESIGN: Psychometric evaluation of new versions of the AHA Advanced Cardiac Life Support test and revisions. SETTING: AHA Advanced Cardiac Life Support courses. PARTICIPANTS: Candidates for completion of AHA Advanced Cardiac Life Support provider courses in five states. INTERVENTION: The course content was divided into 11 content areas that were weighted for importance and appropriateness for testing in a multiple-choice format. The weights were used to construct a blueprint for a 50-question, multiple-choice examination. Five versions of the examination were then constructed based on the content blueprint, drawing from new questions and expert revision of previously written questions. Reliability and difficulty were assessed using 915 administrations at five different sites nationwide. The initial test versions differed in their degree of difficulty, which was not explained by demographic factors. The results were used to revise three of the versions to improve reliability and equalize difficulty of the versions. MEASUREMENTS AND MAIN RESULTS: The final five versions have estimated reliability ranging from Cronbach's alpha of .62 to .86. Mean scores ranged from 87.4% to 89.1%. CONCLUSION: After field testing and revision, five examinations with acceptable reliability and roughly equal difficulty were constructed. The new examinations test the participants' knowledge of important aspects of resuscitation science and practice based on a blueprint of the course content.

American Heart Association↗
PubMed1993

Tuberculosis. The primary care physician's role in eradication.

The resurgence of tuberculosis in the United States presents a challenge for primary care physicians. The disease remains concentrated in the growing population of socioeconomically disadvantaged persons, immigrants from areas where drug resistance is common, certain racial groups, persons in extended-care facilities, alcohol and drug abusers, and persons infected with the human immunodeficiency virus. Because people in these groups are much less likely than others to seek regular medical care, it is difficult to identify and treat active tuberculosis in these populations. Contacts of patients with tuberculosis are equally difficult to identify. Active intervention by primary care physicians--including tuberculin screening, prophylactic therapy, treatment of active disease, and follow-up--is needed to help achieve the goal of eradicating tuberculosis.

Adolescent↗
PubMed1992

Expanding applications of the 12-lead ECG in suspected acute infarction.

In the setting of acute myocardial infarction, the importance of the 12-lead electrocardiogram has increased tremendously. In addition to facilitating diagnosis of acute ischemic syndromes, including acute myocardial infarction, the 12-lead electrocardiogram may provide invaluable assistance in determining which patients are most suitable for thrombolytic therapy, and it may provide information that is useful in prognostic stratification.

Acute Disease↗