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Biomedical subjects

R A Moore

Publications and source records attributed to R A Moore.

300 records · Page 17Linked to original sources

Comparison of whole blood and plasma morphine.

Thirty paired samples of plasma and whole hemolyzed blood were obtained from patients undergoing surgery. Morphine concentrations were measured with the DPC serum morphine kit without prior treatment. In a regression analysis, the equation to the regression line was blood = 1.02 plasma + 1.0 ng/mL, and the correlation coefficient was 0.994. Radioimmunoassay screening of postmortem blood samples can be performed without prior sample treatment.

Humans↗

Radioimmunoassay of buprenorphine in urine: studies in patients and in a drug clinic.

A radioimmunoassay kit (DPC buprenorphine double antibody) was evaluated with clinical samples and samples from a drug clinic. Urine samples were collected over a 2-day period from 5 hospital in-patients receiving sublingual buprenorphine, 400 to 2000 micrograms/day, for the relief of chronic pain. Samples were measured before and after enzymatic hydrolysis. Urine buprenorphine concentrations were measurable at all doses studied (minimum value 5.6 ng/mL) and were greater with larger doses. The increase in concentration after hydrolysis averaged 49% and was similar for all doses studied. The authors conclude that the method has extensive cross-reactivity with glucuronides of buprenorphine and its metabolites and that samples may be analyzed without prior hydrolysis. The prevalence of buprenorphine use in 97 patients attending a drug clinic was also studied. Sixty (62%) had measurable urinary buprenorphine concentrations of 1 ng/mL or more by direct assay. The buprenorphine users were significantly younger and reported significantly greater use of opiates than nonusers.

Adult↗

Cimetidine and parenteral nutrition.

A number of patients receiving continuous intravenous infusions of hyperalimentation solutions require cimetidine (CT) for treatment of gastric hypersecretory conditions. Four patients were selected to receive a CT-hyperalimentation mixture and serial blood sampling for CT concentrations. Rates of infusion of CT ranged from 38 to 56.3 mg/hr. Average serum concentrations (C88) of CT at steady state ranged from 0.6 to 1.0 microgram/ml. This concentration range is near levels reported in patients receiving long-term oral CT and is lower than levels reported to be associated with central nervous system toxicity. No evidence of renal toxicity was noted. Pharmacokinetic parameters were comparable to previous reports in the literature. This initial investigation reveals that continuous intravenous infusion of CT in hyperalimentation solutions appears to be a safe mode of drug administration. More definitive studies are needed to assess efficacy.

Adult↗

Systematic review of systematic reviews of acupuncture published 1996-2005.

Systematic reviews of acupuncture have tended to support its use, but few applied rigorous inclusion criteria. We tested the credibility of conclusions of systematic reviews of acupuncture published since 1996 by applying rigorous inclusion criteria. Reinterpretation used randomised and double blind trials with valid outcomes or design, and with information available from at least four trials or from 200 patients. Qualified support for acupuncture was originally reported in 12 out of 35 systematic reviews, and strong support was found in another six. Applying stricter inclusion criteria, however, showed that none of the 35 reviews supported acupuncture, predominantly because there were too few patients in the randomised, double blind studies. Six reviews with more than 200 patients in randomised, double blind studies had good evidence of no benefit. Systematic reviews of acupuncture have overstated effectiveness by including studies likely to be biased. They provide no robust evidence that acupuncture works for any indication.

Acupuncture Therapy↗

Hospital-based HMO: an outpatient study.

With the increasing pressure from managed care companies and in cooperation with its medical staff's independent practice association, the Vista Hill Foundation formed its own specialty health maintenance organization. This is a report on an outpatient study of treatment satisfaction among 124 mental healthcare providers (50% of whom were psychiatrists) and their 218 patient experiences. Treatment outcome was rated as "very satisfactory" or "satisfactory" in 82% of the studied cases. Managed care was found to cause "mild" to "moderate" treatment interference in 26% of the cases and "significant" to "major" interference in 6%. There was no interference reported in 60% of the cases studied. Our study demonstrates that a hospital provider and its managed care system can provide satisfactory care, but it also reveals the need to constantly review treatment programs to reduce interference. The study and report are part of Vista Hill Foundation's ongoing quality review efforts.

Attitude of Health Personnel↗

Nafcillin necrosis.

Explore the source record for details and available documents.

Female↗

Developing a strategy for the prevention of hip fractures in the elderly due to osteoporosis: the application of economics to the findings from a clinical trial.

The occurrence of a fracture is the most obvious manifestation of osteoporosis. Preventive measures can reduce the risk of such events. The cost of preventing fractures depends on the cost and effectiveness of the intervention and the cost associated with treating the fractures. This paper aims to develop a framework for commissioners to evaluate new technologies by integrating the evidence on effectiveness with the costs likely to be incurred in providing interventions and the probable benefits generated. The explicit aim is to show how the effectiveness of an intervention designed to prevent hip fractures in the elderly, combined with an analysis of its potential economic impact, can provide an indication of how quality improvements in health-care provision and cost savings may be generated.

Aged↗