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Biomedical subjects

D S Adler

Publications and source records attributed to D S Adler.

11 recordsLinked to original sources
PubMed1989

Controlled release infusion kinetics of tobramycin.

Ten healthy male volunteers received two doses of tobramycin (2 mg/kg) in a crossover fashion, first by intravenous piggyback (IVPB), then by the CRIS infusion system after a washout period. Serum samples were drawn both during and after the infusions. Twenty-four-hour urine collections were assayed for tobramycin. Residual fluid from the lines of both delivery systems was measured and assayed for tobramycin concentration. All samples were run in duplicate, using an enzyme-multiplied immunoassay technique assay. The results indicate that there was a statistically higher amount of drug delivered via the CRIS system (98.3 +/- 0.3% versus 90.4 +/- 2.3%). No significant difference was found in urinary recovery between the two groups. Peak serum levels were significantly higher with the CRIS system, with 8/10 subjects having at least one serum level greater than 10 micrograms/ml, as compared to 0/10 when given by IVPB. Peak serum levels occurred at 30 min in all subjects given tobramycin through the CRIS system, compared to 50-60 min when delivered by IVPB. This difference in peak serum levels is primarily related to the rate of drug delivery and to the difference in the dose delivered to each subject. The significance of the serum concentration profiles is discussed.

Adult↗
PubMed1987

Effect of postgraduate training on the careers of University of California Pharm.D. graduates.

Graduates of the University of California at San Francisco (UCSF) doctor of pharmacy degree program were surveyed to determine the effect of postgraduate pharmacy residency or fellowship training on the professional outcomes of these graduates. In 1982, a 39-item questionnaire was sent to 1061 UCSF School of Pharmacy alumni who had graduated in the years 1970 through 1981. The survey addressed several issues, including the graduates' general attitudes toward the profession of pharmacy, their practice patterns, and their professional activities. The response rate of the survey was 72%. Of the survey respondents, 30% had completed or were currently involved in a residency or fellowship program. Both postgraduates (PGs) and non-postgraduates (NPGs) indicated an overall satisfaction with life and the pharmacy profession as a whole. A greater fraction of PGs than NPGs worked in the hospital setting and held positions with varied job components (i.e., clinical, managerial, teaching, and operational activities). First-position salaries for both groups were the same regardless of postgraduate training status. Gender, rather than postgraduate status, was the major determinant of annual changes in salary, especially among men PGs. For managers, both men PGs and men NPGs had a greater change in mean salary per year of experience than their women counterparts. Of those graduates who did not hold management positions, men had a greater change in mean salary per year of experience than women. PGs had greater involvement in professional, educational, and publication activities than NPGs, and a smaller percentage of PGs than NPGs left the profession.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗
PubMed1986

Long-term survival of more than 2,000 patients after coronary artery bypass grafting.

Among 2,004 patients who underwent their first coronary artery bypass graft operation between January 1970 and December 1980 without concomitant valve replacement or aneurysmectomy, life-table survival was 89% at 5 years and 80% at 8 years after surgery. In a multivariate Cox model analysis, the independent correlates of long-term survival were emergent operation with cardiogenic shock (multivariate mortality rate ratio [RR] = 14.0), use of a postoperative intraaortic balloon pump (RR = 3.9), ejection fraction less than 50% (RR = 2.4), preoperative history of congestive heart failure (RR = 2.2), cardiopulmonary bypass time (RR = 1.4 for each 30-minute increment), uncorrected mitral regurgitation (RR = 1.5 for each increment of angiographic gradation), left main coronary artery narrowing (RR = 1.7) and diabetes (RR = 1.6). After controlling for these factors, age, sex and the percentage of narrowings that were bypassed were not independent correlates of long-term survival.

Adult↗
PubMed1985

Practice patterns, attitudes, and activities of University of California Pharm.D. graduates.

Graduates of the University of California at San Francisco (UCSF) Doctor of Pharmacy program from 1970 to 1981 were surveyed to determine their practice patterns, professional activities, and attitudes toward the profession of pharmacy. Of 1061 surveys mailed in September 1982, 752 (72%) were returned. A majority of respondents indicated that they would choose pharmacy as a profession again if starting over and that they would advise a friend to enter the profession. The private hospital setting was the practice site cited most frequently by respondents. Over one third of practicing pharmacists were actively enrolled in or had completed advanced pharmacy training. California was the practice location for 84% of respondents; only one third indicated that salary was very important or somewhat important in their decision to practice at their current location. A large percentage of respondents were involved in teaching, community service activities, and professional associations. Most entry-level UCSF Pharm.D. graduates are satisfied with their professional status and find opportunities for advancement.

Attitude of Health Personnel↗
PubMed1977

Removal of phenytoin by hemodialysis in uremic patients.

The removal of phenytoin by hemodialysis was determined in seven uremic patients. Four patients were receiving phenytoin sodium for therapeutic purposes; three received one dose each intravenously to quantitate its disposition in uremia. The drug was measured in whole blood, plasma, saliva, and dialysate. Only 2% to 4% of the intravenous dose was recovered in the dialysate. Phenytoin clearance by dialysis was 7 to 14 ml/min; plasma clearance was 53 to 133 ml/min. Since hemodialysis contributes little toward shortening to 11-to-18-hour half-life of phenytoin in the uremic patients, no supplemental dose is necessary for uremic patients undergoing hemodialysis.

Adolescent↗
PubMed1976

Warfarin.

Explore the source record for details and available documents.

Biological Availability↗
PubMed1975

Hemodialysis of phenytoin in a uremic patient.

Removal of phenytoin by hemodialysis was determined in a uremic patient. The rate of appearance of the drug in dialysate, the plasma concentration with time, and the plasma clearance by dialysis were measured. Plasma protein binding of phenytoin was also determined. In spite of greatly reduced plasma protein binding in the uremic patient, removal rate was observed to be less than 10% of the rate of presentation of the dialyzer. During the 6-hr period of dialysis, the plasma concentration showed little change. The amount collected in the dialyase, 43.6 mg, was only a small fraction of drug in the body. These results indicate that replacement of phenytoin based on the amount of drug removed by dialysis is unnecessary in chronically dialyzed uremic patients. In addition, the utility of hemodialysis in phenytoin overdose is questioned.

Adult↗
PubMed1975

Three variants of concealed bigeminy.

Long electrocardiographic strips were analyzed from five patients who exhibited periods of typical "concealed bigeminy," i. e., recurrent unifocal extrasystoles which were separated from one another by odd numbers of normally conducted sinus beats. However, in each of these patients, there were periods in which one of three different variants of concealed bigeminy was observed. Three patients displayed an "even number" variant; i. e., there were large numbers of consecutive extrasystoles which were separated exclusively or preponderantly by even rather than by odd numbers of sinus beats. One other patient exhibited an "interpolated extrasystole" variant: those interectopic intervals which were initiated by an interpolated extrasystole contained an even number of sinus beats, whereas all other interectopic intervals contained an odd number. In the fifth patient, the distribution of the numbers of sinus beats separating extrasystoles was such as to suggest a periodic fluctuation between the classical forms of concealed bigeminy and concealed trigeminy; i. e., a "combined bigeminy and trigeminy" variant.

Aged↗