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Biomedical subjects

L Hogan

Publications and source records attributed to L Hogan.

14 recordsLinked to original sources

Broviac central venous catheters inserted via the saphenous or femoral vein in the NICU under local anesthesia.

We present our experience with 92 Broviac central venous catheters inserted into 84 infants over a 31-month period. Our technique specifies placement in the neonatal intensive care unit under local anesthesia, with insertion to the inferior vena caval-atrial junction via the saphenous or femoral vein, with a subcutaneous tunnel to an exist site on the anterior thigh. We conclude this technique to be safe, efficient, convenient, cost-effective, and minimally uncomfortable to the infant, with no increase in morbidity or mortality in comparison to previously described methods.

Anesthesia, Local

Family perspective on the necessity for advance medical directives.

Although our parents made no written advance medical directives before becoming terminally ill, with the support of the nursing staff we were able to assist them in their quest for a natural death with dignity. This article presents some of the dilemas faced by families in making end-of-life decisions. The author acknowledges the importance of permission for and support of the decision making by other health care providers, and reflects that advance directives would have facilitated the process.

Advance Directives

Effects of ethaverine hydrochloride on the walking tolerance of patients with intermittent claudication.

The effect of ethaverine hydrochloride on exercise tolerance of patients with intermittent claudication was evaluated in a double-blind, placebo-controlled study conducted at three sites. Forty-five patients with symptoms of occlusive arterial insufficiency of the lower extremities were randomly assigned to receive ethaverine 200 mg or placebo four times daily. The patients were evaluated biweekly for 12 weeks with treadmill claudication tests, patient and investigator assessments of symptom severity, and reports of adverse reactions. Doppler ankle/brachial pressure ratios were recorded for 26 patients. Walking tolerance improved for patients in both groups during the course of the study. Increases in distance-to-claudication were significantly greater for patients receiving ethaverine after 6, 8, 10, and 12 weeks of therapy. Ankle/brachial pressure index after exercise was unchanged in both groups. Incidence of adverse reactions was similar for the two groups. Although patients were generally unaware of any improvement in symptoms, the investigators judged significant relief of claudication among those receiving ethaverine compared to those receiving placebo. It was concluded that ethaverine safely increased distance-to-claudication in patients with intermittent claudication.

Ankle

A comparison of pharmaceutical manufacturers as a source of drug information to a telephone inquiry: generic vs brand.

A telephone survey was conducted to evaluate and compare drug information received from the pharmaceutical manufacturer in response to a drug interaction question concerning concurrent administration of tetracycline and cimetidine. This study assumes that the pharmaceutical company may often be consulted by the hospital pharmacist seeking information about a particular medication. Forty-five pharmaceutical companies, all marketing tetracycline products, were selected for the study. A conversation protocol was utilized. It was designed to assure consistency and evaluate information received for accuracy, response time, clinical judgement offered, and referrals. Forty pharmaceutical manufacturers responded: 18 brand manufacturers and 22 generic companies. Eleven companies provided information on the interaction identified. Five manufacturers stated that there were no contraindications to concurrent administration of the drugs, one company identified a similar interaction, and five manufacturers successfully provided information identifying the interaction with supportive documentation. Two of the five companies offered clinical judgement as to the clinical significance of the interaction. Both reached different conclusions. The mean time of all phone calls was 4.29 minutes (range 0.39 to 15.41 minutes). The investigator was referred to outside sources by twelve companies. In this study, brand manufacturers performed better than generic companies. Results indicate that few manufacturers are organized to answer drug information requests involving current information sources in a response to a telephone request.

Drug Industry

Readability testing of auxiliary labels.

Using a word familiarity index, we studied pharmacy auxiliary labels and selected brief information sheets to determine the reading difficulty of these forms of written communication, which cannot be evaluated by traditional readability testing methods. Results of the study show that 11.2 percent of the 110 words selected from these information sources are above the eighth-grade reading level. The word familiarity index also identified multiple meanings of words and appears to be a valuable tool for evaluating written information that is not suitable for traditional readability testing.

Drug Labeling

Verapamil.

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Cardiovascular Diseases