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Biomedical subjects

R L Wears

Publications and source records attributed to R L Wears.

62 records · Page 4Linked to original sources
PubMed1986

Which laboratory tests should be performed on children with apparent febrile convulsions? An analysis and review of the literature.

There exist wide variations among clinicians as to management of the child who presents with the first febrile convulsion. In 1980, the American Academy of Pediatrics issued a consensus statement on febrile convulsions which included recommendations for initial management. Multiple studies have also addressed this topic. From these studies, guidelines for management have been drawn. Review of these studies reveals little scientific support for current management strategies. The decision to perform lumbar puncture is analyzed as an example of the practical limits of clinical investigations. Reliance upon consensus clinical opinion is therefore recommended.

Child↗
PubMed1979

Circumventing the Henderson-Hasselbalch equation.

Prompt blood-gas analysis consisting of pH, PCO2, and PO2 is now almost universally accessible. PCO2 directly conveys the role of the respiratory mechanism in any acid-base disturbance. The metabolic condition, however, is hidden in a relationship between pH and PCO2 that is most faithfully expressed by the cumbersome Henderson-Hasselbalch equation (HHE). Two methods of quickly determining metabolic status from pH and PCO2, without resorting to the HHE, are discussed. The first method is well known and adjusts pH to represent only metabolic state by quantitatively cancelling the influence of hyper- or hypoventilation. The second method, not previously reported, uses measured pH to estimate the ratio [HCO3-]/PCO2, which, when multiplied by PCO2, equals bicarbonate ion concentration.

Acid-Base Imbalance↗
PubMedDate not supplied

Objective determination of the optimal red blood cell count in diagnostic peritoneal lavage done for abdominal stab wounds.

The purpose of this study was to determine objectively the optimal value or positivity criterion for red blood cell counts in diagnostic peritoneal lavage in stab wounds to the anterior abdomen. Our study group consisted of 91 consecutive adults with abdominal stab wounds who underwent peritoneal lavage. We excluded those patients who met criteria for immediate laparotomy and those with negative stab wound exploration. We divided the patients into two groups based on outcome. Group 1 consisted of those who had undergone laparotomy and had findings that required surgical intervention. Group 2 patients had either undergone laparotomy but had no injury requiring surgical intervention or had no surgery and a benign hospital course and follow-up. Receiver operator characteristic analysis was done on the diagnostic peritoneal lavage RBC counts for both groups. The overlap between the groups was minimal, with 75% of patients in Group 1 having > 120,000 RBC/mm3 and 75% of patients in Group 2 having < 486 RBC/mm3 in the lavage effluent. Using the observed probability of 23.1% of patients with abdominal stab wounds requiring surgery, a RBC count of 50,000/mm3 discriminated best those patients who required surgery from those who did not.

Abdominal Injuries↗