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Biomedical subjects

B Bivins

Publications and source records attributed to B Bivins.

8 recordsLinked to original sources
PubMed1988

Nitrogen balance in adult hospitalized patients with the use of a pediatric amino acid model.

Normalization of plasma amino acid patterns and that relationship to improved nitrogen balance was studied using a pediatric-specific amino acid solution in 21 adults requiring total parenteral nutrition therapy. There was a significantly positive correlation between improved nitrogen balance and the amino acids cystine, tyrosine, total cysteine/cystine, and ornithine. When additional cysteine was added to the solution of 11 subjects, taurine also correlated with nitrogen balance. Despite higher amounts of histidine in solution, plasma amino acid levels were not normalized. These amino acids, heretofore considered nonessential, may be required in specific molar ratios in stress. The use of a 30% branched-chain pediatric-balanced amino acid solution resulted in near normalization of plasma amino acid levels and group mean positive nitrogen balance.

Adult↗
PubMed1988

Sequential treatment of a simple pneumothorax.

In a prospective investigation of isolated simple pneumothorax, the treatment of 35 patients with a total of 37 pneumothoraces was studied. A standardized sequential treatment approach was followed for evacuation of the pneumothorax and maintenance of lung reexpansion. The protocol involved catheter placement using a Seldinger technique, aspirations, and documentation of reexpansion by chest radiography and observation. Reaccumulation of air was treated with Heimlich valve attachment to the catheter at intrapleural pressure and further observation. Continued air leak following Heimlich valve attachment was treated with chest catheter suction using a Pleurovac at -20 cm H2O pressure. Chest tube thoracostomy was performed for continued failure of reexpansion. In 22 of the 37 pneumothoraces (59%) simple catheter aspiration maintained lung reexpansion without complications. In the remaining 15 pneumothoraces (41%), seven (47%) responded to Heimlich valve attachment, and three (20%) maintained expansion with chest catheter suction. Chest tube thoracotomy was required to maintain expansion in 33% (five) of those who failed catheter suction (14% of all pneumothoraces studied). Patients treated successfully with simple catheter aspiration were sent home. Patients requiring a Heimlich valve, chest catheter suction, or chest tube thoracostomy were hospitalized. Use of these catheter techniques resulted in lower cost and was associated with shorter hospitalizations than in chest tube thoracostomy. Our study suggests that sequential treatment of simple pneumothorax should be considered as a cost-effective and therapeutically successful alternative to immediate chest thoracostomy in selected cases.

Adolescent↗
PubMed1976

Residues in antibiotic preparations, i: scanning electron microscopic studies of surface topography.

The surface characteristics of residues obtained from several commercial antibiotic products were studied using scanning electron microscopy. The photomicrographs showed the presence of particulates possessing crystalline or amorphous properties with particle sizes ranging from 1 mum to several mum. Small, well-defined, granular crystalline particulates seemed to predominate in residues of products which were processed under optimum pH conditions. Coalescing or aggregating of small crystalline particles (1-10mum) to form larger masses was interpreted as a sign of instability of the antibiotic. Most of the penicillin and semisynthetic penicillins produced residues that were characterized as amorphous, flaky, bulky and of no distinct shape. Such structures were attributed to the drying of gelatinous particulates. The possible sources and causes of the occurrence of these particulates are discussed. It appears that in many of the products the particulates are product-related rather than process-related, and subtle degradation may be involved. Advice is given to practitioners regarding the preparation, storage and administration of these products.

Amphotericin B↗
PubMed1975

Filtration and infusion phlebitis: a double-blind prospective clinical study.

The effect of final filtration on the incidence of infusion phlebitis was studied in a prospective, double-blind investigation involving 146 postoperative patients. The incidence of infusion phlebitis was found to be significantly reduced when an inline, 0.45-mum membrane filter was used. The greatest reduction of infusion phlebitis was in the filter groups receiving unbuffered solutions and no set change over the 72 hours of therapy. Buffering the infusion fluid or 24-hour change of the administration set did not have any effect on reducing the incidence of phlebitis. Antibiotic therapy appeared to have a slightly beneficial effect only when inline filters were employed. A significant rise in white blood cell count and an increase in sedimentation rate were observed in the patients receiving unfiltered fluids. It is recommended that inline final filters should be a part of routine intravenous therapy.

Adolescent↗
PubMed1975

Evaluation of a prototype air-venting inline intravenous filter set.

A prototype inline intravenous final filter with a large filtration area and an air-elimination feature was evaluated. Adequate and uniform flow rates were maintained with infusion solutions containing cephalothin and ampicillin, while with oxytetracycline, flow rates decreased significantly. Challenging the unit with air demonstrated the suitability of the air-elimination system. In a brief clinical trial on 53 patients, the unit appeared easy to use and gained the acceptance of nurses, pharmacists and physicians.

Ampicillin↗