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Biomedical subjects

R Frye

Publications and source records attributed to R Frye.

25 records · Page 2Linked to original sources
PubMed1981

Urinary estrogens in postterm pregnancy.

A 40-month retrospective review of 677 postterm pregnancies was undertaken to determine the usefulness of 24-hour urinary estrogen per gram of creatinine (E/Cr) in monitoring such pregnancies. The cutoff value between normal and low E/Cr values was chosen at the tenth percentile (18 mg/gm). The corrected perinatal mortality rate (PMR) in post-term pregnancies with normal E/Cr was 0.23% (1/426) and was not different from that at term (0.23%; 4/1,775). However, in post-term pregnancies with low E/Cr, the corrected PMR was 9.2% (4/43), representing a 40-fold increase (P less than 0.001). The incidence of fetal distress was also significantly higher in patients with low E/Cr (57%) than in those with normal E/Cr (5.5%; P less than 0.001). It was worrisome to note that three of four stillborn infants had antepartum fetal heart testing within 4 days, which indicated fetal well-being. The E/Cr appears to be a reliable test for identifying those postterm pregnancies at risk that might benefit from obstetric intervention.

Adolescent↗
PubMed1977

A semi-automated fluorometric method for total estrogens in pregnancy urine.

We report a continuous-flow fluorometric method for total urinary estrogens that involves the Kober reaction, with extraction of the reaction product into dichloroethane containing trichloroacetic acid as described by Hahnel and Jones [Clin. Chim. Acta 16, 185 (1967)]. The dichloroethane extraction gives greater stability to the Kober color and sharper separation of aqueous and organic phases. The analytical system is adjusted to give maximum response to estriol 16alpha,beta-D-glucuronide, the principal estrogen conjugate in urine from late pregnancy, when calibrated with estriol standards. An initial 20-fold dilution of the sample with water increased analytical recovery of estriol conjugates from urine while maintaining adequate fluorescent response. Glucose interference was reduced by dilution and eliminated by treatment with sodium borohydride. Urinary protein up to 20 g/liter did not interfere. Total estriol, as determined by gas-liquid chromatography, comprises about 70% of total urinary estrogens in late pregnancy as measured by our continuous-flow fluorometric method. A reference range is presented based on 209 randomly collected urine specimens in which total urinary estrogens are expressed as a ratio to creatinine.

Chromatography, Gas↗
PubMed1973

Management and marketing in health care. Some lessons for the United States from the British system.

The British health care system has been examined by sociologists, political scientists, and medical care specialists before, but in this presentation a section of the British health care system is viewed through the eyes of modern business management, particularly as to cost and consumer effectiveness. Examination of positive features as well as problems may be helpful in relation to some future health care delivery system in the United States. Cross fertilization between the disciplines of management and medicine has much to offer to the rapidly changing delivery of health care in the United States.

Ambulatory Care↗
PubMedDate not supplied

Intermittent intravenous piperacillin pharmacokinetics in automated peritoneal dialysis patients.

BACKGROUND: Use of intermittent antibiotic dosing is increasing in the treatment of peritoneal dialysis (PD)-related peritonitis. We studied the pharmacokinetics of intravenous (i.v.) piperacillin in automated PD patients. PATIENTS AND METHODS: Eight patients (3 males, 5 females) were recruited and received a single i.v. dose of piperacillin (35 mg/kg actual body weight). Blood and dialysate samples were collected at the beginning, middle, and end of dwells 1-3 (on cycler), and end of dwells 4-5 (off cycler) for a 24-hour period. Baseline and 24-hour urine samples (nonanuric patients, n = 7) were collected. Pharmacokinetic parameters were calculated assuming a one-compartment model. Glomerular filtration rate (GFR) and piperacillin clearance (CL) values were normalized to 1.73 m2. RESULTS: The patients were 49.5 +/- 10.1 years of age (mean +/- SD) and had been receiving PD for a median of 3 months (range 2-66 months). Dwell times were 2.25 +/- 0.06 hours on cycler and 7.26 +/- 0.14 hours off cycler. Piperacillin half-life was not statistically different on or off the cycler (on cycler 1.99 +/- 0.39 hr, off cycler 4.39 +/- 5.4 hr; p = 0.12) and remained insignificant, even accounting for an outlier (on cycler 2.01 +/- 0.41 hr, off cycler 2.54 +/- 1.48 hr; p = 0.19). Piperacillin total CL (CL(T)) was 31.29 +/- 6.02 mL/minute. Renal CL (CL(R)) and PD CL (CL(PD)) accounted for 8.8% and 16.8% of CL(T); CL(R) correlated well with GFR (CL(R) = 0.86 GFR + 0.1; p < 0.00003). Mean piperacillin serum and dialysate end-of-dwell concentrations were above minimum inhibitory concentration of susceptible organisms (8 microg/mL) for the three cycler exchanges only. Serum and dialysate concentrations predicted using a one-compartment model suggest that i.v. piperacillin 4000 mg would provide adequate concentrations for susceptible organisms over a 12-hour period. CONCLUSION: The current i.v. piperacillin dosing recommendations of 4000 mg every 12 hours for PD-related peritonitis are appropriate for patients on automated PD. Intermittent intraperitoneal piperacillin is not recommended.

Adult↗