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Biomedical subjects

D Ast

Publications and source records attributed to D Ast.

12 recordsLinked to original sources
PubMed1992

A comparison of the safety, timing and cost-effectiveness of administering antibiotics by intravenous bolus (push) versus intravenous piggyback (slow infusion) in surgical prophylaxis.

This study was carried out to evaluate the safety, timing and cost-effectiveness of administering perioperative antimicrobial prophylaxis with cefmetazole via intravenous (IV) bolus, or 'push', compared with the more common method of IV 'piggyback' administration. A total of 60 patients were studied, 30 in each group. No major adverse reactions were noted in either group. Phlebitis did not occur with either method of administration. Loss of patency was noted in 2 patients in the IV bolus group at the time of catheter removal. While no overall difference in timing of antibiotic administration in relation to the surgical procedure was noted, 2 patients in the IV piggyback group did not receive their preoperative dose until after surgery had started. Both pharmacy preparation time and nursing administration time were shorter with the IV push method, resulting in a cost avoidance of $US0.60 per dose. Material cost avoidance, primarily due to elimination of the minibag and IV tubing with bolus administration, was $US3.25 per dose. Extrapolated cost avoidance for our institution, for both prophylaxis and treatment, is $US184 000 per year. Administration of selected antibiotics by IV push is safe, allows optimal timing of administration, minimises preparation and administration time, and is cost-effective. Hospitals and outpatient care facilities should consider this alternative method of antibiotic administration.

Adult↗
PubMed1990

Chronic encephalitis caused by leukoencephalopathy.

As mentioned previously, both MS and PML are demyelinating conditions of the CNS and pose diagnostic difficulties in their differentiation because of similarities in their clinical findings. However, certain features unique to each of these diseases are helpful in clinical diagnosis. MS, unlike PML, is a disease of unknown cause. Polygenetic influences in combination with exposure to an environmental agent and immune-mediated factors may be operative in the pathogenesis of MS. Age of onset peaks in the third to fourth decades with a predominance in women, as contrasted with PML, which peaks in the fifth to sixth decades in most non-AIDS-associated cases with a slight predominance in men. MS is more prevalent in areas farther from the equator: North America, Europe, Australia, and New Zealand. Common initial symptoms seen in MS include bilateral limb weakness (with the legs being affected twice as often as the arms), hyperreflexia, spasticity, optic neuritis, diplopia, incoordination, and paresthesias. (Paresthesias are typically found in the lower limbs in a symmetric pattern, but may follow no obvious anatomic distribution and often do not correspond to the distribution of sensory symptoms. Vibration and position sense are more frequently disturbed than pain and temperature.) Intellectual impairment and mental deterioration are uncommon early in MS, whereas they are a more frequent initial presentation in PML. In addition, the presence of speech impairment and monoparesis or hemiparesis with homonymous hemianopsia is more suggestive of PML. Brain stem involvement is infrequent.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Comparison of heparin and 0.9% sodium chloride injection in the maintenance of indwelling intermittent i.v. devices.

Heparin sodium 10 units/mL was compared with 0.9% sodium chloride injection as a flush solution for indwelling intermittent i.v. devices, or i.v. locks (IVLs), in a prospective, randomized, double-blind study. The heparin and 0.9% sodium chloride injections were prepared in the pharmacy using aseptic technique. Most of the IVLs were inserted by an i.v. therapy team member. Each patient's IVL site was evaluated for phlebitis and patency by one of three study nurses, and when a catheter was removed, its contents were flushed so that clots or fibrin strands could be detected. Nurses also collected information regarding disease states, surgical procedures, medications administered, and how long each site lasted. A total of 173 sites were studied in 76 patients in the heparin group, and 131 sites were studied in 71 patients in the sodium chloride group. The groups were well matched, except that the sodium chloride group received more vancomycin and dextrose-containing i.v. solutions, while the heparin group received more penicillins. There was no significant difference in the incidence of phlebitis or lost patency between the groups. When locks through which vancomycin, penicillins, and dextrose-containing i.v. solutions were administered were excluded, there was still no significant difference between the groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Postinfusion phlebitis after intravenous push versus intravenous piggyback administration of antimicrobial agents.

The incidence and severity of phlebitis associated with the i.v. push method versus the i.v. piggyback method of administration of antimicrobial agents were evaluated. All patients admitted to two nursing units of an 886-bed, tertiary-care hospital from March through June 1987 who received intravenous cephalosporins or extended-spectrum penicillins were considered for inclusion in the study. The method of administration, either i.v. push or i.v. piggyback, was randomly assigned. Each patient's catheter site was evaluated every 24 hours according to standardized definitions of phlebitis and patency. Information on each patient and venipuncture site also was collected. A total of 319 catheter sites were studied in 155 patients. There was no significant difference in the incidence or severity of postinfusion phlebitis between the i.v. push and the i.v. piggyback groups (41% versus 47%). When studying only those catheter sites discontinued because of phlebitis, the time until development of phlebitis averaged 45 +/- 20.5 hours in the i.v. push group, compared with only 36.2 +/- 17.6 hours in the i.v. piggyback group; this difference was significant. The fact that the catheter sites lasted significantly longer in the i.v. push group, combined with elimination of the cost of syringe infusion pumps or i.v. tubing and minibags, suggests that use of the i.v. push method may result in substantial cost savings. Other advantages associated with the i.v. push method include time savings for nursing personnel and patients and greater ease in scheduling doses of multiple antimicrobial agents.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1981

Effects of chronic exposure to diluted automotive exhaust gas on the CNS of normotensive and hypertensive rats.

Regarding the potential impact of traffic-born air pollutants on public health, attention during the last years has been increasingly focused on the possible effects in high-risk groups of the population. In order to evaluated this point further, the combined influence of both, chronic arterial hypertension and long-time exhaust gas exposure on the CNS has been studied. Both, normotensive Wistar) and spontaneously hypertensive rats (SHR) of either sex were exposed 5 X 8 hours per week for up to 18 months to atmospheres polluted by the emissions of an idling Otto engine with CO concentrations held constant at about 0,90 and 250 ppm, respectively. Biochemical data, body weight, and blood pressure were checked regularly. Characteristic histomorphological findings in the non-exposed SHR brains were hyalinosis and hyperplasia of intracerebral arterioles and -- in some cases -- small focal hemorrhages and infarcts. In the exposed SHR brains, large infarcts of the hemisphere and in the basal ganglia were found, which possibly corresponds to the increase of the mortality rate in SHR. We assume that the increase hematocrit plays an important role in the disturbance of microcirculation of the CNS.

Air Pollutants↗
PubMed1975

Deposition of blood cells on collagen and cuprophane membranes.

Dogs were dialyzed with collagen and cuprophane membranes, human renal failure patients were dialyzed with cuprophane membranes, and samples of the membranes were observed by scanning electron microscopy at different time periods. Fixation was done in glutaraldehyde and cacodylate buffer, and samples were dried at the critical point. All cellular elements were well preserved and appeared viable. Cuprophane adsorbed platelets almost selectively in dog dialyses, whereas collagen adsorbed a smaller number and more heterogeneous group of cells. In contrast to these findings, when cuprophane was used in clinical dialyses, the cell population was predominantly polymorphonuclear leukocytes.

Adsorption↗