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Biomedical subjects

C Granger

Publications and source records attributed to C Granger.

45 records · Page 3Linked to original sources
PubMed1991

Working group recommendations: research on content and efficacy of geriatric evaluation and management interventions.

Methods of conducting comprehensive geriatric evaluation and management (GEM) are proliferating in a variety of clinical settings. However, rigorous evaluations of efficacy for this new approach to care of older patients have demonstrated a favorable impact on patient outcome in only a few studies. All of these have been controlled single site studies, and replication is needed. If replication studies show similar results, further studies should be undertaken to define the minimum necessary intervention to achieve the desired outcome. Controlled trials are needed to determine if consultative geriatric evaluation and/or primary patient management is effective. Further innovative work is needed in model development for geriatric assessment and management in outpatient settings. Finally, studies of geriatric evaluation and management in other environments, such as home care or the nursing home, are recommended.

Forecasting↗
PubMed1990

Metabolism of epirubicin to glucuronides: relationship to the pharmacodynamics of the drug.

In pharmacokinetic studies of epirubicin, we observed that its main metabolite, epirubicin glucuronide, presented a marked interpatient variation. It was even possible to separate the patients into two groups: those with a high epirubicin glucuronide:epirubicin plasma ratio and those with a low ratio, with few patients in between. We retrospectively analyzed the clinical files of 48 patients who had been subjected to a pharmacokinetic study of epirubicin. We observed that those with a low epirubicin glucuronide:epirubicin ratio had significantly lower plasma levels of fibrinogen and alpha 2-globulins, suggesting that a reduced glucuronidation of epirubicin could be associated with hepatocellular insufficiency. These patients also had significantly lower percentages of change in granulocytes after therapy and responded better to the course of treatment studied. We cannot presently propose a hypothesis to explain these observations.

Epirubicin↗
PubMed1986

[Palliative chemotherapy of endometrial cancer. Value of combinations with doxorubicin and cisplatin].

The study of a series of 21 consecutive cases of adenocarcinomas of the endometrium requiring chemotherapy, has permitted to demonstrate the superior efficacy of an association of doxorubicin and cisplastin as compared to other plans containing only anthracyclin (45% of partial and complete remissions versus 20%); this difference, however, is not statistically significant. Intolerance reactions were similar in both groups. Confirming recent data from the literature, the results conclude in favor of: the determinant contribution of cisplastin to chemotherapy, the need of a strict selection of the patients intended for chemotherapy, the usefulness of induction chemotherapy trials, prior to pelvic radiotherapy in locally advanced forms, to improve their distant prognosis.

Adult↗
PubMed1986

[Clinical evaluation of ceftriaxone in severe infections in adults].

Thirty patients (17 male, 13 female; age 17 to 84 years; normal renal function in 23 cases) with severe bacterial infections were treated with ceftriaxone. The infections was septicemia in 20 cases, a septicemia-like condition in 2 and a focal infection in 8 (2 abscesses of the lung, 2 pyelonephritis, 1 abscess of the liver, 1 subphrenic abscess, 1 meningitis developed from an abscess of the brain and 1 acute intestinal infection). 25 infections were bacteriologically documented, with recovery of the following pathogens: 20 Gram negative rods (including 10 E. coli) that were all susceptible to ceftriaxone (MIC = 0.02 to 0.5 mg/l) except 2 (1 Pseudomonas and 1 E. cloacae), 5 susceptible Gram positive cocci (3 Pneumococcus, 1 Streptococcus and 1 Staphylococcus epidermidis) and 3 susceptible anaerobes (2 B. fragilis and 1 B. melaninogenicus). Ceftriaxone was given alone in 15 cases and in association with another antibiotic in 15 cases (aminoglycoside in 10 cases, nitroimidazole in 4 and fosfomycin in 1). The dose of ceftriaxone was 1 to 2 g per day in 28 cases, 3 g per day in 1 case (meningitis with abscess of the brain) and 1 g every other day in 1 case (chronic renal failure under hemodialysis). Duration of treatment ranged from 10 to 62 days (average 17 days). The usual routes of administration were IV and IM; the SC route was used on 4 occasions. Pharmacokinetic studies of serum levels were carried out in several patients including two who had ceftriaxone subcutaneously; results were consistent with those previously reported in the literature.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1977

Vocational and functional assessment of clients reopened for service.

Former clients (107) of the Massachusetts Rehabilitation Commission were evaluated to determine the reasons for their return to the Commission a second time. Clients returned to obtain physical restoration services, employment or training such as in a vocational school or college. Clients were given a vocational interview (the Goldberg Scale) and the Tufts Programmed Functional Assessment, embracing the Barthel and PULSES Profile. Work status at follow up was significantly predicted by the Goldberg Scale and the PULSES Profile. A significant number returned to work after receiving services a second time.

Adult↗
PubMedDate not supplied

Functional status and therapeutic intensity during inpatient rehabilitation.

The objective of this study was to describe the relationships between functional status at discharge and intensity of therapies received during inpatient medical rehabilitation. The sample was comprised of 140 patients with traumatic brain injury and 106 patients with spinal cord injury at eight hospitals that subscribe to the Uniform Data System for Medical Rehabilitation. Data included linear measures of motor and cognitive ability derived from the Functional Independence Measure at admission to and discharge from rehabilitation. Multiple regression was used to predict intensity of therapies, discharge motor and cognitive function, the extent to which potential functional gains were achieved, and the efficiency of gains. Intensities of occupational, physical, and speech therapies were not significant predictors of outcomes for either group, controlling linearly for admission function, psychology intensity, length of stay, onset to admission interval, age, and interrupted stays. Only intensity of psychology services seemed to have any relation to functional gain (in cognition for patients with traumatic brain injury). The apparent lack of benefit related to intensity of therapies may be due to factors such as spontaneous recovery, goals not measured by the Functional Independence Measure, limited modulation of therapy intensity according to likely patient responsiveness, or therapies focused on impairment or other goals rather than disability. We suggest that efficiently staged rehabilitation should vary the intensity and nature of services according to patients' functional status, impairments, comorbid conditions, and other clinical factors.

Adult↗