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Biomedical subjects

E S Martin

Publications and source records attributed to E S Martin.

32 records · Page 2Linked to original sources
PubMed1991

Postinduction carbamazepine clearance in an adult psychiatric population.

The objective of this study was to describe the postinduction clearance of carbamazepine (CBZ) in adult psychiatric patients by population pharmacokinetic analysis using the NONMEM program. Specifically, an estimate of CBZ clearance and insight into the effect of common patient characteristics on clearance were sought. Steady-state trough CBZ serum concentrations, CBZ dosing history, concomitant drug administration, and other data from 45 patients were collected retrospectively. A one-compartment model with first-order absorption and first-order elimination was used, with absorption rate, bioavailability, and volume of distribution fixed to literature values. No evidence was found that race, sex, age, ethanol use, smoking, and concomitant lithium significantly affected CBZ clearance. In the final model, clearance was based on lean body weight. The coefficient of variation for clearance estimates was 16.5%. Residual variability was modest. Estimates for volume of distribution, rates of absorption and elimination, and bioavailability could not be pursued rigorously. Although these results may assist in understanding CBZ disposition in this population, their general clinical application should be approached with caution.

Adult↗
PubMed1991

Current and investigational therapies for AIDS-associated Mycobacterium avium complex disease.

The epidemiology, pathogenesis, clinical manifestations, and treatment of Mycobacterium avium complex (MAC) infection are reviewed. MAC infection is one of the most common infections in AIDS patients. Its pathogenesis is poorly understood, but it is believed to develop by gastrointestinal colonization followed by systemic invasion. The relatively poor response to treatment may be partly accounted for by the tremendous mycobacterial load present by the time patients develop systemic symptoms. Clinically, MAC infection is difficult to differentiate from the signs and symptoms of AIDS or from other opportunistic infections. Signs and symptoms include fever, malaise, anorexia, night sweats, and weight loss; diarrhea and abdominal pain may also be present. There is no established therapy for MAC infection, although combinations of three to five antimicrobial agents are typically used. There has been consistently poor correlation between in vitro results and in vivo outcomes in the treatment of MAC infection. Currently, the role of treatment is mainly to suppress the progression of infection and to relieve symptoms. Recent in vitro studies and animal studies have revealed possible alternative agents and combinations of agents (e.g., macrolide antibiotics, quinolones, amikacin, cytokines) that may influence therapy of MAC infection. No known therapy for MAC has been shown to prolong survival in AIDS patients, possibly because of the high organism load that exists once patients become symptomatic. Research is needed to find improved methods for earlier detection of MAC infection, determine optimal dosage regimens of current antimycobacterial agents, develop better antimycobacterial drug-delivery systems (e.g., liposomes), and discover new antimicrobials with better activity against MAC and methods of immune modulation that will overcome immune system defects.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Population pharmacokinetics of lithium.

The population pharmacokinetics of lithium was determined. Psychiatric inpatients who were at least 18 years old, had normal renal function, and were receiving lithium two or three times daily were the subjects of the study; 79 patients met the criteria. Serum lithium concentrations were measured by flame photometry 12 hours after the evening dose. Other data collected included age, gender, race, height, weight, serum creatinine and sodium concentrations, diet, and concurrent drug use. The nonlinear mixed-effects model (NONMEM) program was used to estimate lithium clearance, lithium volume of distribution, and error variability and to determine the influence of patient characteristics on lithium clearance. With the initial model, the mean lithium volume of distribution was 32.8 L and mean lithium clearance was 1.36 L/hr. With an intermediate model, lithium clearance estimates improved on the basis of patient size (weight and body surface area), daily lithium dosage, age, gender, and race. When only the most significant variables--lean body weight and creatinine clearance--were retained, a final model was obtained that yielded a coefficient of variation for lithium clearance of about 24% and gave fairly accurate predictions of steady-state lithium concentrations (coefficient of variation, about 16%). Analysis of lithium pharmacokinetics with the NONMEM program suggested that lean body weight and creatinine clearance are important predictors of lithium clearance.

Adolescent↗
PubMed1989

Comparison of immediate and delayed culture methods for isolation of group A streptococci.

Recovery rates of Group A beta-hemolytic streptococci in throat cultures from 300 children were studied using three different methods. The swabs were streaked onto plates immediately, streaked from the same dry swabs held at room temperature for 3 to 6 hours and streaked from swabs held in transport media at room temperature for 3 to 6 hours. The cultures were processed in a pediatric office and interpreted by a microbiologist. The recovery rates were similar for the three methods, but the cultures were easier to interpret when the swabs had been allowed to dry before streaking as a result of a decrease in the normal flora on these plates. In a separate study the recovery of Group A beta-hemolytic streptococci from 187 swabs was identical whether the swabs were streaked at 3 to 6 hours or at 18 to 24 hours.

Child↗
PubMed1986

Comparison of a latex agglutination test and four culture methods for identification of group A streptococci in a pediatric office laboratory.

A latex agglutination test and four culture methods for the detection of group A hemolytic streptococci were compared in a pediatric office laboratory. The anaerobic (GasPak) and Detekta-Kit methods produced the highest recovery rates, but aerobic incubation of 5% blood agar plates gave very acceptable results (sensitivity 92%, or 98% if the 1+ positive cultures were eliminated; specificity 100%), and had fewer disadvantages. Delaying inoculation of plates for 2 to 6 hours resulted in significantly greater numbers of strongly positive (3+ and 4+) cultures. The group A selective sheep blood agar media as used in this study offered no advantage. The Culturette test had a sensitivity of 72% and specificity of 98%, compared with the GasPak method, and 77% and 97%, respectively, compared with standard aerobic cultures. Thus it appears too insensitive to be used alone, but might complement culture methods in selected patients.

Acute Disease↗
PubMed1982

On the activation of symbiotic gratification fantasies as an aid in the treatment of alcoholics.

Seventy-two alcoholics being treated at Veritas Villa were divided into an experimental and a control group. In addition to the regular treatment program both groups received four subliminal exposures of a verbal message in each of six sessions over a 2-week period. The messages were MOMMY AND I ARE ONE (experimental) and PEOPLE ARE WALKING (control), administered under double-blind conditions. In keeping with the main hypothesis, the experimental Ss were rated as significantly more involved in treatment. In addition, among the alcoholics who were more symptomatic to begin with, the MOMMY message, when contrasted with the control, lowered anxiety and depression, enhanced self-concept, and reduced alcohol consumption after a 3-month follow-up.

Adolescent↗
PubMed1981

Critical weight loss and malnutrition in breast-fed infants.

In four infants of primiparous mothers, critical dehydration, hypothermia, and azotemia developed while they were being breast-fed exclusively. Three had significant hypernatremia, one had a perforated duodenal ulcer, and one had transient renal failure. Although the causes of the inadequate nutrition are unclear, these cases emphasize the necessity of close follow-up for breast-fed babies, especially those of primiparous mothers and those in whom there has been excessive weight loss while in the hospital.

Acute Kidney Injury↗
PubMedDate not supplied

[Increase of mast cells in the peritoneal cavity of rats treated with atopic patient's serum].

In accordance with the experiments described by the author, the injection of atopic serum and the serum of patients infected with ascaris into the peritoneal cavity of the rats produces after 24 hours an increase in mast cells of the mesentery together with vascular congestion. The experiment was made in the following way: injecting 0.5 ml. of the serum in the peritoneal cavity and the observations were made after 24 hours in the ileum-cecal mesentery. The increase of mast cells is shown to have statistical significance in atopic serum (hay fever and atopic dermatitis) as well as in serum of patients infected with ascaris lumbricoides. The increase of the mast cells is seen particularly in the vascular areas. On the other hand, the injection of non-atopic serum and inactivated atopic serum by heat (56 degrees C, 2 hours) does not produce this increase in mast cells. This phenomenon of the increase of the mast cell population which the atopic serum produces is only observed after 24 hours and not in a shorter time (20 minutes). Also we would emphasize that the increase is due only to the application of the atopic serum without any need to apply the appropriate antigen. The results obtained are as follows:A) 6 control rats--38.6 mast cells/mm2 B) 7 rats + serum of patient with hay fever--88.5 mast cells/mm2 C) 4 rats + inactivated serum (56 degrees C 2 hours) from the same patient with hay fever. 47.0 mast cells/mm2 D) 4 rats + 4 serum from non-atopic persons--38.1 mast cells/mm2 B') 6 rats + 6 serum from patients with hay fever--89.0 mast cells/mm2 C') 4 rats + 4 serums from patients with atopic dermatitis. 108.0 mast cells/mm2 D') 4 rats + 4 serums from patients with ascaris lumbricoides--116.0 mast cells/mm2. Although it is known that the serum from atopic patients and those infected with ascaris lumbricoides has a high level of IgE we cannot be sure that this increase in mast cells in the rat is produced by the human IgE. The true cause of this phenomenon is unknown.

Animals↗