Biomedical subjects

R M Ruddy

Publications and source records attributed to R M Ruddy.

21 records · Page 2Linked to original sources

PubMed1985

Pediatric trauma: an approach to the injured child.

The approach to the injured child requires great care and clinical acumen to establish the diagnosis and institute appropriate treatment. Loss of life from occult internal hemorrhage or neurologic sequelae from a missed unstable cervical spine injury may be devastating. Yet, physicians in the ED must also know which children need only a careful physical examination, and when laboratory testing or admission is unnecessary. We have described a schema for providing appropriate care to children with trauma in such a way that specific issues about management can be reasonably approached by the emergency physician.

Abdominal Injuries↗

PubMed1985

Cardiac involvement in cystic fibrosis: early noninvasive detection and vasodilator therapy.

Cardiac involvement in cystic fibrosis (CF) occurs commonly but may remain undetected by usual evaluation in its early stages when right ventricular dysfunction (RVD) may be treatable. To assess the role of vasodilator therapy for early RVD in CF, we performed a prospective study in 23 ambulatory CF patients with mild CF (clinical score m = 79 +/- 8, range 61 to 90). Echocardiography (echo) and radionuclide angiography (RA) were performed at rest and with exercise stress testing (EST) in all 23 to select patients with early RVD. Thirteen of twenty-three had RVD on echo or RA evidenced by increased RV dimensions (P less than 0.001) on echo and decreased RV ejection fraction (EF) on RA (P less than 0.01) but 30% of these patients were abnormal only with EST. All 13 with RVD underwent inpatient double-blinded randomization to receive placebo or hydralazine orally without changing other standard therapy. Nine of thirteen received hydralazine (2 mg/kg/day) for 3 days. With hydralazine no change from placebo was seen on any echo or RA measurement at rest or with EST other than left ventricular STI which fell (P less than 0.05). These data indicate: 1) EST with echo and RA detects RVD in CF earlier than resting studies, 2) patients with mild CF (clinical score less than 85) frequently have RVD on EST, and 3) hydralazine does not improve RVD in CF even very early in its development.

Adolescent↗

PubMedDate not supplied

Aerosolized metaproterenol compared to subcutaneous epinephrine in the emergency treatment of acute childhood asthma.

In a double-blind, randomized trial, we compared the effects of aerosolized metaproterenol to subcutaneous epinephrine in 35 episodes of acute asthma in children between 6 and 19 years of age. Patients were randomized to two parallel groups and then received both a placebo medication and an active medication to a maximum of three treatments. Repeated treatments were given to 15 patients on metaproterenol and 12 patients on epinephrine. Initial improvement in PEFR and FEV1 were statistically significant and comparable in both groups. Patients receiving a second metaproterenol treatment had more improvement in respiratory rate and clinical score compared with those in the epinephrine group. There were fewer treatment failures in the metaproterenol group. Followup at 24 to 48 hours showed significant treatment failure differences between the two groups (metaproterenol = 0, epinephrine = 5; p less than 0.05). Side effects were similar in both groups; in all instances they were mild, and their frequency did not increase in patients receiving repeated doses of medications. In conclusion, aerosolized metaproterenol was well tolerated in acute childhood asthma in repeated doses, and it appeared to be associated with prolonged bronchodilation and improved outcome.

Acute Disease↗