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Biomedical subjects

C L Beck

Publications and source records attributed to C L Beck.

29 records · Page 2Linked to original sources
PubMed1985

Treatment of presumed asystole during pre-hospital cardiac arrest: superiority of electrical countershock.

Standard drug therapy for asystole during cardiac arrest includes epinephrine, atropine, and calcium chloride (CaCl). Recent studies have shown that ventricular fibrillation (VF) can appear to be asystole when recorded from the chest surface. To determine the efficacy of these drugs and electrical countershock for asystole, a group of 83 adult nontraumatic cardiac arrest victims (55 men, 28 women, mean age of 64 +/- 14 years) were studied. Asystole appeared at some time during arrest in 44 patients (53%) and was the initial rhythm in 24 (29%). The rate of survival to hospital discharge was significantly higher in patients whose initial rhythm was VF (46%) than in patients whose initial rhythm was asystole (0%). Epinephrine, CaCl and atropine infrequently changed the rhythm from asystole. Electrical countershock infrequently altered the rhythm from asystole when it appeared as the initial rhythm. However, countershock was significantly more effective than epinephrine (P less than 0.003), atropine (P less than 0.04), or CaCl (P less than 0.03) in altering the rhythm from asystole, which appeared later in resuscitation. Ventricular fibrillation was the most common rhythm appearing after countershock for asystole. Countershock appears to be superior to epinephrine, CaCl, and atropine for treating asystole during the course of resuscitation, suggesting that the rhythm diagnosed as asystole may actually be VF in many cases.

Aged↗
PubMedDate not supplied

Pharmacogeriatrics.

The elderly comprise one of the fastest growing populations in the United States. By the year 2020, an estimated 45 million will be classified as elderly. Aging is a highly variable process as declines occur in physiologic functions. Alterations in cardiovascular, renal and hepatic function have the greatest effect on drug therapy. All pharmacokinetic and pharmacodynamic variables may be altered by age. Adverse drug reactions, drug interactions and poor compliance are frequent and may further complicate drug therapy. A review of those processes that commonly influence pharmacologic response and patient compliance to drug therapy is appropriate.

Aged↗
PubMedDate not supplied

Physeal bridge resection in infantile Blount disease.

Physeal bridge resection and osteotomy were used in the treatment of three cases of Stage VI Blount disease. At follow-up, all patients showed continued growth of the proximal tibial physis, as well as maintenance of alignment. Bridge resection with realignment osteotomy offers an attractive alternative in the treatment of skeletally immature patients with Blount disease and a medial physeal bridge.

Child, Preschool↗
PubMedDate not supplied

The GORE-TEX anterior cruciate ligament prosthesis. A long-term followup.

The GORE-TEX anterior cruciate ligament prosthesis has been implanted in 268 patients at our institution since April of 1984. Follow-up for this study was available on 70% of these patients (188). Eighty-one percent (152) of these had the ligament for chronic injuries, 14% (26) for acute, and 5% (10) for subacute injuries. The patient population had an average age of 27.6 years (SD = 8.4) and a Tegner activity score of 6.05 (SD = 1.53). Prior procedures had been performed on 56% (105) of the patients. Concomitant procedures were performed in 73% (137) and included iliotibial band tenodesis, partial meniscectomy, posterior oblique ligament advancement, or meniscal repair. Followup averaged 48 months (range, 24 to 68). Evaluation included a questionnaire, physical examination, radiographs, KT-1000 arthrometer testing, and an activity score. Results were graded as excellent, good, fair, and poor. Acceptable results (good and excellent) were obtained in 83 patients (44%). Fifty-eight patients (32%) were rated excellent and 25 (13%) were rated good. Unacceptable results (fair and poor) were obtained in 105 patients (56%). Twenty-five patients (13%) were rated fair and 80 (42%) were rated poor. Subjective improvement was indicated by 166 patients (88%). Activity levels postoperatively as rated by the Tegner Scale improved in 2 (1%), remained the same in 167 (89%), and decreased in 19 patients (10%). Effusions occurred in 63 patients (34%) and caused an unacceptable result in 22 (12%). Rupture occurred in 23 patients (12%). Loosening greater than 3 mm occurred in 64 patients (34%) and led to unacceptable results in 37 (20%). Infection occurred in 5 patients (2.7%).(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMedDate not supplied

Evaluation of therapeutic drug monitoring in a long-term care facility: a pilot project.

The need for a therapeutic drug monitoring service was evaluated in a 150-bed long-term care facility. Thirty blood samples from 28 residents (mean age 87.9 years) were assayed to determine trough drug concentrations. All subjects were examined to determine pharmacodynamic effect. Pharmacokinetic consultations were written for serum drug concentrations outside accepted ranges. Fifty percent (15 of 30) of serum drug levels measured were subtherapeutic; the remaining levels were in the normal therapeutic range. Based on this sample data, it could be concluded that a minimum of 32 percent and as many as 68 percent of serum drug levels would be subtherapeutic following drug analysis in similar nursing home populations. Of 12 consultations, recommendations for seven (58 percent) were accepted by the subject's primary care physicians. Four of the consultations (33 percent) resulted in dosage modifications. These results support the need for further study.

Aged↗
PubMedDate not supplied

[Collective responsibility of nurses in their involvement in their professional organizations].

This study has as its objective the discussion of the nursing professionals' responsibility regarding their participation in professional associations, such as the Brazilian Association of Nursing (ABEn), the Regional Board of Nursing and the Nursing Union. The investigation was carried out with nurses from a private and a public educational institution and also from a private institution of assistance. As a result, it was verified that the participation of nurses in the organizations mentioned above is still scarce, but there is already some awareness of the need for integrating them.

Brazil↗
PubMedDate not supplied

Education of young children concerning poison prevention.

Every year about 5,000 fatal accidental poisonings occur in the United States. About 50 percent of those who die are children under the age of 5 years. Medications, house plants, and household cleaning agents are the three leading causes of accidental poisonings in this age range. Since there is an always changing population of children under the age of 5 years, there is a continuing need for education. A committee of the Student American Kentucky Pharmaceutical Association decided to become actively involved in filling the need for education by writing and performing a poison prevention puppet play. The 10-minute play is suitable for small volunteer organizations. It requires only a small financial outlay, and two persons with minimal training can present the play. The play has been shown to more than 6,000 youngsters in the past 2 years. Responses to followup surveys of both the teachers and the students have shown a positive effect on the children's attitudes toward poison prevention.

Child↗