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Biomedical subjects

T L Kurt

Publications and source records attributed to T L Kurt.

At least 73 records · Page 4Linked to original sources
PubMed1979

Ambient carbon monoxide levels and acute cardiorespiratory complaints: an exploratory study.

Over a 92-day seasonally excessive period of ambient carbon monoxide (CO), chief cardiorespiratory complaints (CRC) of a nontraumatic origin were identified from each of 8,556 patient encounters at the Emergency Room of Colorado General Hospital. Excessive numbers of CRC were seen above a CO level of 5 ppm for the 24-hour mean and 11 ppm for the one hour mean maximum ambient CO (p less than 0.05 for both). Increasing relative risk was shown by comparing daily numbers of CRC with its mean in two-day trend analyses with both ambient CO measures above and below these thresholds. Other ambient pollutants were generally low during the winter period studies. These findings suggest an association between health effects and lower levels of CO than has been previously reported.

Air Pollutants↗
PubMed1978

Association of the frequency of acute cardiorespiratory complaints with ambient levels of carbon monoxide.

Intial cardiorespiratory complaints in an emergency room were studied to determine their relationship to ambient levels of carbon monoxide recorded at a nearby permanent station. All 8,556 encounters with patients (daily mean, 93) were studied during Denver's peak season for carbon monoxide pollution (three-month winter period). The one-hour mean maximum level of carbon monoxide was above 17.8 ppm, averaging 27.2 +/- 4.3 ppm (vs 12.1 +/- 1.8 ppm on "low carbon monoxide days," P less than 0.0001); and when significantly higher frequencies of cardiorespiratory complaints occurred (7.9 +/- 0.7 percent vs 6.4 +/- 0.3 percent [+/- 1 SE]; P less than 0.04), the mean 24-hour level of carbon monoxide averaged 9.3 +/- 1.4 ppm (vs 5.9 +/- 0.8 ppm on "low carbon monoxide rays;" P less than 0.001). The frequency of cardiorespiratory complaints also was correlated with each measurement of the ambient level of carbon monoxide (one-hour mean maximum level, 24-hour mean level, and two-day moving averages of each) in six of eight comparisons. These observations strongly suggest that the frequency of thoracic complaints in an emergency room can be affected by the ambient level of carbon monoxide.

Acute Disease↗
PubMedDate not supplied

Three fatal sodium azide poisonings.

We report 3 cases and review the published literature on sodium azide ingestion. A 38-year-old man intentionally ingested 2 tablespoonsful of sodium azide in water and developed seizures, coma, hypotension and fatal ventricular arrhythmias within 2 hours. A 33-year-old male ingested an unknown quantity of sodium azide. In the emergency department he was unconscious and underwent immediate intubation and gastric lavage. Nitrite therapy was instituted without improvement. He remained acidotic despite bicarbonate therapy and developed hypotension which was unresponsive to pressor agents. He died approximately 8 hours after admission despite resuscitative efforts. A 52-year-old male ingested 1.5 to 2g of sodium azide and survived for 40 hours. Nitrite therapy was ineffective. The role of sodium nitrite in treating sodium azide toxicity by producing methaemoglobin which complexes with azide is discussed.

Adult↗
PubMedDate not supplied

Drug utilization review of sedative/hypnotic agents in Texas Medicaid patients. Texas Medicaid Vendor Drug Program Drug Utilization Review Board.

OBJECTIVE: To assess use of sedative/hypnotic agents in Texas Medicaid patients and evaluate practitioner receptiveness to intervention letters concerning sedative/hypnotic prescribing generated by the Texas Medicaid Drug Utilization Review (DUR) Board. DESIGN: Retrospective DUR. SETTING: Texas Medicaid retrospective DUR program. PATIENTS OR OTHER PARTICIPANTS: 244 Texas Medicaid patients and 291 Texas physicians. INTERVENTION: Patient profiles for Texas Medicaid patients were reviewed retrospectively to quantify sedative/hypnotic prescribing practices. Intervention letters were prepared and sent to physicians directly involved in the care of patients receiving excessive sedative/hypnotic therapy. Physician responses were categorized based on information presented in the intervention letter and circumstances surrounding the identified patient. Prescribing practices were assessed approximately 1 year after the intervention to determine the impact of intervention letters on prescribing. MAIN OUTCOME MEASURE: Physician response to intervention letter. RESULTS: Responses were received from 208 of 291 physicians (71.5%). Approximately 40% of physicians agreed in principle with the suggestions offered by the Texas Medicaid DUR Board to minimize chronic sedative/hypnotic use. Almost one-half of these physicians had discontinued sedative/hypnotic therapy for the identified patients 1 year after the intervention. Approximately 9% justified continued sedative/hypnotic use based on patient diagnosis or refractory response to treatment, and 55 physicians (26.4%) were unwilling to alter therapy because of patient-specific factors. CONCLUSION: Through the use of retrospective DUR, Texas Medicaid patients receiving excessive amounts of sedative/hypnotic agents were identified and improvements in sedative/hypnotic therapy were initiated. DUR can be useful not only in identifying problem areas, but also in encouraging physicians to modify prescribing practices through educational means.

Adolescent↗