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Biomedical subjects

G Dworkin

Publications and source records attributed to G Dworkin.

At least 19 recordsLinked to original sources
PubMed2001

Responding to aquatic facilities.

The primary and fundamental responsibility of a local EMS system is to provide prehospital care to the citizens of the community. Therefore, each community must have a system in place to ensure continual, efficient prehospital care. There are a variety of levels of EMS education, which include first responder, EMT-Basic, EMT-Intermediate and EMT-Paramedic, along with other components, including the emergency medical dispatcher, other healthcare providers and specialty care centers. In order for a community to provide and ensure continual, efficient prehospital care, the components must work together in a well-planned and coordinated effort. If lifeguard personnel are expected to respond to respiratory, cardiac and spinal-injury incidents within their aquatic facilities, they must be included within this comprehensive community EMS system. Therefore, fire, rescue and other prehospital EMS agencies must coordinate their efforts and training responsibilities with the local lifeguard services in their area.

Community-Institutional Relations↗
PubMed1998

Improving efficiencies and reducing costs in adult cardiac surgery: a team approach.

The article reviews a team effort to reduce operating room costs by 25 percent. The team achieved this goal by participating in the Institute for Healthcare Improvement Breakthrough Series on adult cardiac surgery. The process improvements included standardizing practices, reevaluating equipment, and reducing operating room cycle time.

Adult↗
PubMed1997

Should there be property rights in genes?

This paper deals with the following questions. Are there property rights in the human body or its parts? What legal control is, or should be, available in respect of genetic material? Can, or should, patents be granted for genes or for products incorporating human genetic material? How extensive are patent rights over genetic material? Should ethical matters be a critical part of the patent granting process?

Genes↗
PubMed1996

Comparison of volume output from two different continuous nebulizer systems.

BACKGROUND: Continuous nebulization is a safe and practical method of administration of beta 2-adrenergic agonists during acute asthma. There are essentially two types of continuous nebulizer systems; one utilizes a large volume nebulizer and the other a small volume nebulizer attached to a constant volume infusion pump. OBJECTIVES: We compared the volume output characteristics of these two systems. METHODS: Study performed at Danbury Hospital. Both types of continuous nebulizers were reconstructed as reported in the literature and output monitored hourly for four hours. A total of nine nebulizers from each type of continuous nebulizer was evaluated, three from each of three different lots. RESULTS: The volume output of the large volume nebulizer ranged from 37.7 to 55.4 mL/h with a mean of 45.96 mL/h (P = .0001). Contrasts within the repeated measure ANOVA revealed that all pairwise contrasts in time were significant (P < .05) except for the 60 and 120 minute means. The volume output of the small volume nebulizer ranged from 15.0 to 16.6 mL/h with a mean of 15.88 mL/h. There was a significant difference in the mean volume output across time for the 60-minute value only. No other significant differences were found. CONCLUSION: These data suggest that the small volume nebulizer utilized in this manner for continuous nebulization is a more consistent delivery device than the large volume nebulizer. Further data are required on both actual drug output and mass median aerodynamic diameter of the particles generated by these nebulizers before one can recommend a particular system.

Adrenergic beta-Agonists↗
PubMed1995

Continuous versus frequent intermittent nebulization of albuterol in acute asthma: a randomized, prospective study.

BACKGROUND: In acute severe asthma the optimal dose, frequency, duration and method of administration of beta-2 agonists is unknown. No study to date has evaluated the efficacy of high dose beta-2 agonists beyond the initial two hours. OBJECTIVE: (1) To determine whether high-dose continuous nebulization of albuterol (7.5 mg/h) is as safe and as efficacious as high-dose intermittent nebulization of albuterol (2.5 mg every 20 minutes) for four hours. (2) To evaluate whether there is a continual improvement using high dose therapy beyond two hours. METHODS: We devised a simple means of continuous nebulization calibrated to deliver 7.5 mg albuterol per hour. Twenty-two nonsmoking, patients with acute, severe asthma who presented to the emergency department with less than 60% predicted normal PEFR were randomized to either the continuous or intermittent group. All patients received intravenously 125 mg methyl prednisolone on initiation of the study. No theophylline was administered. Spirometry and vital signs were measured at baseline and every 30 minutes thereafter. Electrocardiograms were obtained on all patients and all patients had continuous cardiac monitoring. RESULTS: Both groups doubled their baseline spirometric values over the four-hour period (P < .0001). The FEV1 did not differ significantly between regimens at any time interval. Improvement from 120 minutes to 240 minutes was statistically significant (P < .0001). There was no significant difference in vital signs at the end of the study compared with baseline in either group, nor between the two groups at any time interval. CONCLUSION: High-dose continuous nebulization of albuterol is as safe and as efficacious as intermittent nebulization of albuterol in the early treatment of asthma in an emergency department. To our knowledge, this is the first study showing continued significant improvement beyond the initial two hours of therapy using high dose nebulized beta-2 agonists.

Acute Disease↗
PubMed1991

Association of hematuria and mycobacterial infection.

Hematuria has been noted to be a presenting symptom of urinary tuberculosis. In the last few decades because of the decreasing incidence of tuberculosis in the United States, the association of tuberculosis and hematuria has been neglected. Now that the incidence of tuberculosis is again on the rise, it is timely to remind the medical community of this association. We present 3 children with hematuria associated with positive tuberculin tests. Mycobacterium tuberculosis was cultured from the urine of one patient. Mycobacterium avium-intracellulare was cultured from a second patient. All 3 patients showed clearing of their hematuria with antituberculosis therapy. A tuberculin test should once again be considered part of the standard work-up of hematuria.

Adolescent↗
PubMed1989

Mechanical ventilation for status asthmaticus in children.

We retrospectively reviewed the time course of recovery of pediatric patients in status asthmaticus who were undergoing mechanical ventilation for life-threatening respiratory failure to evaluate the results with current medications and technology. Ten patients between 2 and 18 years of age underwent intubation on 20 occasions. Mechanical ventilation was maintained for a mean of 2 days. Positive end-expiratory pressure was introduced in the recovery phase to prevent hypoxemia. Twelve episodes (Group 1) involved intubation less than 48 hours; in eight episodes (group 2) the patients required ventilatory support greater than 48 hours. The two groups did not differ in regard to age, pharmacologic therapy, preintubation arterial blood gas data, or initial ventilator settings, but the rise in pH and fall in Paco2 differed significantly over the first 12 hours of therapy. In the group 2 patients, peak pressures were not increased greater than 60 cm H2O despite elevated Paco2 values, and aggressive sodium bicarbonate therapy for pH correction was not pursued. Complications were few and all patients survived. We conclude that asthma patients have variable resolution of airway obstruction during mechanical ventilation and that controlled hypoventilation can be a safe therapy for the patients with more severe obstruction.

Adolescent↗
PubMed1983

Fraud and science.

In the past decade fraud, cheating, forged experiments, and plagiarism have been discovered in fields ranging from biomedical research to psychometrics. Scientists have reacted by attempting to deny and minimize the problem. I believe that we should recognize that the phenomenon is not rare nor to be explained as a result of individual pathology. I look at some incidents in the history of science, give a taxonomy of fraud, and draw some morals about ways in which we might try to decrease the incidence of scientific fraud.

Crime↗