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Biomedical subjects

J Coleridge

Publications and source records attributed to J Coleridge.

4 recordsLinked to original sources
PubMed1993

Intravenous aminophylline confers no benefit in acute asthma treated with intravenous steroids and inhaled bronchodilators.

BACKGROUND: The role of intravenous aminophylline in acute asthma is unclear despite meta-analysis of many studies comparing aminophylline with other bronchodilator therapies. AIMS: The aim of this study is to determine whether continuous aminophylline infusion confers any benefit in acute severe asthmatics treated with intravenous steroids and inhaled bronchodilators. METHODS: The study was randomised, double-blind and placebo-controlled. All patients received nebulised salbutamol (1 mL of 0.5%) and ipratropium bromide (1 mL of 0.025%) with glycol diluent (1 mL) at 0, two, four, six, eight and 12 hours, and six-hourly thereafter. In addition all patients were given intravenous hydrocortisone 250 mg six-hourly and oxygen to maintain normoxia. Aminophylline infusions were adjusted to maintain therapeutic levels. Peak expiratory flow rate (PEFR) was measured before and after nebulised bronchodilator on a two-hourly basis in the Emergency Department (ED) and six-hourly on the inpatient wards. RESULTS: Thirty-one patients were clinically sufficiently improved within 12 hours to be discharged home from the ED. The remaining 28 patients were admitted to the inpatient ward for a total trial duration of 48 hours. No significant difference was found between the placebo and treatment groups for measurements of PEFR, or for the duration of stay of the patients in hospital. The power of the study was 80% for a 25% to 33% difference at a 5% level of significance. Presentation values of PEFR and arterial blood gases did not predict which patients would require inpatient admission and which could be safely discharged home from the ED.

Acute Disease↗
PubMed1992

Survey of drug-related deaths in Victoria.

OBJECTIVE: To audit drug-related deaths to determine the types of agents causing death in Victoria and to identify possible strategies for prevention of deaths in future. DESIGN: Retrospective audit of Coroner's case records. SUBJECTS: All deaths reported to the Coroner during 14 months from 1 July 1989 to 31 August 1990 in Victoria in which toxicological investigation was undertaken and drugs or poisons were detected and were believed to be a major cause of death. RESULTS: Of the 231 people who had drug-related deaths, 156 were males, 75 were females and the average age was 35.5 +/- 14 years. Heroin and morphine were judged to be the primary cause of death in 35% of subjects and methadone in a further 4.8%. Tricyclic antidepressants were responsible for 14% of deaths, with no deaths due solely to mianserin. Benzodiazepines were the prime cause of death in 6.5% of subjects, but were identified in 40%. Poisons and chemicals were involved in only 3% of deaths. Prescription drugs were primarily responsible for 47% of deaths. Forty-eight per cent of deaths occurred in known injecting drug users and 42% of all subjects had a clear history of antecedent depression. Only one drug-related death was clearly accidental, that of a two-year-old child taking his parents' medications, but the mode of most deaths was not clear, and may not have been suicide. Most deaths occurred outside hospital, only 25 subjects reaching hospital alive. CONCLUSIONS: Barbiturates and chloral hydrate are no longer major causes of drug-related deaths, probably because of decreased availability. Some drug-related deaths, especially those related to tricyclic antidepressants, may be prevented if deaths and hospitalisations due to toxic substances are monitored and the availability and scheduling of toxic substances are regularly reviewed.

Adolescent↗