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Biomedical subjects

B Gribetz

Publications and source records attributed to B Gribetz.

7 recordsLinked to original sources
PubMed1988

The admission cardiorespiratory performance in relation to outcome in pediatric ICU patients.

We tested the hypothesis that the admission cardiorespiratory performance determines the outcome in pediatric intensive care unit (PICU) patients. We studied 331 patients who were assigned to one of the three commonly encountered PICU clinical entities: respiratory disease, cardiovascular disease and head trauma. All patients were evaluated by a simple cardiorespiratory scoring system which we named "Rule of 60" (RO60), and their highest score within the first 24 h of arrival in the PICU was used for the study. This scoring system includes 6 cardiorespiratory parameters where a value of 60 represents a cut-off point above or below which 0 points (low risk) or 10 points (high risk) are assigned. The relationship between score and mortality rate revealed that the higher the score the higher is the mortality rate. We determined two categories of severity of illness in our patients. Patients at severity level A had scores ranging from 0 through 30 and the mortality rate in this category ranged from 2% to 5%. Patients at severity level B had scores ranging from 40 through 60 and had a higher mortality rate: 30% to 80%. The overall mortality rates for patients at severity level A and B were 2% and 54% respectively. Patients with respiratory disease at severity level B had the lowest mortality rate (20%), whereas patients with cardiovascular disease and head trauma had mortality rates of 52% and 80% respectively. We found that our cardiorespiratory scoring system was as good as the Glasgow Coma Scale for indicating prognosis and outcome in head trauma patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Amoxicillin and diaper dermatitis.

Multiple skin sites and the gastrointestinal tract of 57 infants with otitis media were cultured quantitatively for Candida albicans before and after antibiotic therapy. Ten days of systemic therapy with amoxicillin was associated with a twofold increase in the recovery of C. albicans from the rectum and skin. Infants who developed diaper dermatitis had a significant increase in the number of C. albicans organisms recovered from these sites. We conclude that the use of amoxicillin increases the risk for developing diaper dermatitis.

Administration, Oral↗
PubMed1988

Interpretation of color change in blood with varying degree of methemoglobinemia.

The ability to detect the characteristic "chocolate" brown color of methemoglobin containing blood was tested in a double blind study. We prepared three concentrations of methemoglobin by adding sodium nitrite to 1-2 ml of venous, heparinized blood that was "arterialized" by mixing with room air in vacutainer tubes. House officers (HO) were asked, in a standardized protocol, to make observations ("chocolate", "abnormal" or "normal") about the methemoglobin blood alone (first in Vacutainer, and then on filter paper), and then in comparison with control blood, again in Vacutainer, then filter paper. Each HO assessed only one methemoglobin concentration. Three methemoglobin blood samples were studied with 12-14%, 26-35% and 68% methemoglobin concentrations respectively. We found that the ability to detect visually an abnormal appearance of methemoglobin was significantly improved when the test sample was compared to control blood. The descriptive term "darker than normal" was much more commonly used than "chocolate" to describe the methemoglobin blood.

Blood Specimen Collection↗
PubMed1987

Underdosing of acetaminophen by parents.

The parents of 96 young children seen in an inner-city walk-in clinic for perceived or measured "fever" were asked about their management of the symptom. Eighty-eight (92%) administered acetaminophen, and of these, 67% gave less than the usual recommended dose of 10 to 15 mg/kg per dose. Underdosing was most commonly noted in the younger, lighter patient population. Of the parents who gave an acetaminophen elixer preparation (160 mg/5 mL), 26% measured the dose with the 0.8-mL dropper intended for use with the infant drops preparation (80 mg/0.8 mL), resulting in significant underdosing of acetaminophen (2.3 +/- 1.3 mg/kg per dose). Health care professionals should specifically inquire about the details of acetaminophen administration when discussing antipyresis with parents.

Acetaminophen↗
PubMed1981

Death and injury in aerial spraying: pre-crash, crash, and post-crash prevention strategies.

To prevent crash-related death and injury among spray pilots, a program including pre-crash, crash and post-crash stages of intervention for aircraft, physical environment, and pilots and ground crews was proposed in accordance with a matrix of options derived from road crash epidemiology. In addition to the dangers of fixed obstacles, low-altitude runs, and heavy work schedules, work hazards included combined exposures to noise, vibration, G forces, heat stress, pesticides, and dehydration. Together, these exposures were believed to have produced slight, but crucial decreases in pilot performance, alertness and skill. For aircraft, the major pre-crash measure was cockpit air cooling, with filter technologies to prevent in-flight pesticide exposure. Crash and post-crash design changes to reduce energy transfers to the pilot's body (thermal, kinetic) were the most important recommendations, because absolute prevention of the crash event was unlikely. For the environment, pre-crash recommendations included marking fixed obstacles, such as power and telephone lines, but preferably their elimination. Other measures included drainage pits with sodium hydroxide points to neutralize parathion and prevent dispersion of parathion-containing mists. Pilot pre-crash measures (more fluid intake, biological monitoring--EMG, urinary alkyl phosphate, cholinesterase testing) required special organizational arrangements. Systematic application of options from the foregoing matrix suggest that the high risk of death and injury from aerial spraying is unnecessary.

Accidents, Aviation↗
PubMed1980

Heat stress exposure of aerial spray pilots.

Heat stress (WBGT index) in the cockpits of agricultural spray pilots, and its physiological and subjective effects, were measured for 9 pilots flying in hot weather for a large Israeli aerial spray company. There was concern that heat exposure may be one of the factors involved in a recent increase in the fatal and non-fatal crash rate among Israeli spray pilots. WBGT index calculations were based on sequential cockpit wet bulb, dry bulb, and globe temperatures read when aircraft landed. The WBGT was always above 25 degrees C and exceeded 26.7 degrees C in 70% of observations. In pilots, a daily weight loss of 0.6-1.2% of total body weight was usual, as were rectal temperature increases of 0.5 degrees C. Daily water intakes ranged from less than 100 ml to 2000 ml per workshift. Questionnaires indicated that 42 of 45 pilots said they would drink more fluids if they were provided between flights by ground crews. An unresolved problem was whether conventional threshold standards for heat exposure were set at levels that may produce insidious impairments in pilot psychomotor performance. Cockpit air cooling is suggested as a measure for preventing heat stress in hot climates. However, appropriate filter technologies would be needed to prevent pesticide exposures during flight. Engineering and other measures to prevent heat stress and dehydration should rank high as part of a comprehensive program to protect the health and performance levels of agricultural spray pilots.

Accidents, Aviation↗