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Biomedical subjects

D Albright

Publications and source records attributed to D Albright.

11 recordsLinked to original sources
PubMed1991

Air medical tracheal intubation: establishing a threshold for this QA indicator.

Endotracheal intubation is a critical skill necessary in a number of situations encountered by air medical personnel. The purpose of this study was to establish a threshold for the quality assurance indicator of successful tracheal intubation in a physician-staffed air medical system. The records of all patients transported by a physician-staffed air medical system over a 36-month period were reviewed. One hundred and forty-three patients had endotracheal intubation attempted. Blind nasotracheal intubation attempts were successful in 71% of those in whom it was attempted, while the overall intubation success rate was 92%. Based on this study and the existing literature, a threshold of 90% is recommended for the quality assurance indicator of successful tracheal intubation in physician-staffed air medical systems.

Aircraft↗
PubMed1991

Continuation and maintenance treatment of major depression with the monoamine oxidase inhibitor phenelzine: a double-blind placebo-controlled discontinuation study.

Long-term treatment with antidepressant drugs has received little attention until recently. A study is reported comparing the effectiveness of maintenance treatment with phenelzine in responding major depression patients. If they responded initially to nonblind phenelzine treatment and sustained remission for 16 weeks, patients were randomized to 2-year double-blind treatment with phenelzine 60 mg/day, phenelzine 45 mg/day, or placebo. Both doses of phenelzine were significantly better than placebo in preventing relapse of depression. Phenelzine 45 mg/day may be an optimal maintenance dose for many patients.

Adult↗
PubMed1987

Field survey of circadian rhythm in PEF of electronics workers suffering from colophony-induced asthma.

Twenty-two British electronics workers suffering from occupationally-induced asthma due to their exposure to colophony fumes self-recorded their peak expiratory flow (PEF) every 1-2 hr throughout the waking span for at least two weeks, both during work and vacation periods. Data were analyzed by a two-step procedure using the statistical techniques of Single and Population Mean Cosinor analyses. The objective endpoints of mesor (24-hr mean), amplitude (measure of 24-hr rhythmic variation) and acrophase (peak time along the scale of 24 hr) for the time-spans of the work-week (Monday-Friday), weekend after work (Saturday-Sunday) and vacation weekdays and vacation weekends were compared. The PEF data of four workers who participated in the study for nearly one year also were evaluated for seasonal variation. A statistically significant difference (P less than 0.04) was detected in the PEF amplitude between work and vacation weeks; the difference in the PEF mesor and acrophase between work-weekdays and work-weekends achieved near or statistical significance (P = 0.07 and 0.05, respectively). The at-work amplitude was higher and the acrophase earlier timed. There was no statistically significant difference between work-week and weekend-after-work PEF mesors. Winter PEF mesors were significantly lower than summer ones in the four subjects self-measuring their bronchial patency over the year. Overall, the findings indicate that data obtained through employee surveys, using lightweight portable and inexpensive PEF Wright meters and analyzed by statistical analyses used in the field of biological rhythm research, yield objective evidence of occupationally associated decrements in pulmonary function resulting from colophony fume exposure.

Adult↗
PubMed1985

Amitriptyline and hydroxylated metabolite plasma levels in depressed outpatients.

As part of a double-blind clinical trial comparing phenelzine and amitriptyline in outpatients with predominantly major depressive disorder, plasma tricyclic antidepressant drug concentrations were measured in 83 amitriptyline-treated patients. In 29 of these patients, hydroxymetabolites were also assayed. Patients were treated for 6 weeks at a fixed dose of 150 mg/day of amitriptyline after the first 5 days. Therapeutic outcome was assessed with a structured depression interview schedule, the Symptom Checklist-90, a side effects checklist, and a global improvement scale. Steady state plasma levels of 10-hydroxynortriptyline were in the same range as amitriptyline or nortriptyline concentrations. Clinical response did not relate significantly to plasma levels of either the parent drug, its metabolites, or the sum of all four pharmacologically active substances. Minimum threshold tricyclic antidepressant levels for therapeutic effect were not found. Assay of its active hydroxymetabolites does not appear to improve the clinical utility of routine amitriptyline level monitoring in patients with major depression in an outpatient setting.

Adult↗
PubMed1983

Plasma levels of catecholamines and dihydroxyphenylglycol during antidepressant drug treatment.

Plasma norepinephrine, epinephrine, and 3,4-dihydroxyphenylglycol levels were measured in depressed outpatients treated in a double-blind controlled clinical trial with 150 mg/day of amitriptyline or 60 mg/day of phenelzine for 6 weeks. Both antidepressant drug treatments were associated with a significant decline in plasma dihydroxyphenylglycol concentrations, which was more pronounced with phenelzine. Plasma norepinephrine levels also declined during phenelzine but not amitriptyline treatment, and the posttreatment values correlated with clinical improvement with the monoamine oxidase inhibiting drug. Reductions in norepinephrine and dihydroxyphenylglycol correlated highly with the degree of platelet monoamine oxidase inhibition. Mechanisms of these antidepressant drug effects on amine metabolism and their implications are discussed.

Adult↗