PubMed Health⌕ Search

Biomedical subjects

J J Kresel

Publications and source records attributed to J J Kresel.

12 recordsLinked to original sources
PubMed1987

Application of decision analysis to drug selection for formulary addition.

Decision analysis (DA) is a quantitative method for making decisions, incorporating both probabilistic data and value judgments, and clinical and economic outcomes. The P & T Committee at the Mary Hitchcock Memorial Hospital used this technique to aid in selection of a third-generation cephalosporin for formulary addition. Cost-specific data from this hospital, together with clinical data derived from the medical literature, and a panel of infectious disease specialists were used to compare costs associated with antibiotic regimens of three infections. Results show that ceftizoxime is the least costly treatment for hospital-acquired pneumonia and sepsis of unknown origin, whereas metronidazole plus gentamicin is the least costly regimen for intra-abdominal infections. This demonstrates that drugs with higher acquisition costs can, in some cases, be less expensive than drugs with lower acquisition costs when the total cost of drug therapy is considered.

Cephalosporins↗
PubMed1986

Expired ipecac syrup efficacy.

A controlled prospective study to evaluate the efficacy of expired ipecac syrup was conducted at two regional poison control centers in New England. During a 6-month period, 200 study patients treated with expired ipecac syrup and 200 control patients treated with unexpired ipecac syrup were evaluated. There were no statistical differences between the control and study groups in patient characteristics (age and sex) and product characteristics (general class, emetic potential, pretreatment, previously opened bottles, and manufacturer). In both control and study groups, emesis occurred in 100% of cases with 90% of patients vomiting with the first dose. The mean time to emesis was 24.7 minutes and 24.8 minutes in the study and control groups, respectively. Expired preparations ranged from 1 month to greater than 4 years postexpiration, with the duration of expiration not altering the mean time to emesis. Mean time to emesis between the two groups was also not affected by manufacturer, pretreatment with milk, or whether the ipecac syrup bottle was previously opened. We conclude that expired ipecac syrup (up to 4 years postexpiration date) is an effective emetic.

Child, Preschool↗
PubMed1984

Effect of morphine sulfate concentration on flow rate in an implantable reservoir pump.

The effect of morphine sulfate concentration on flow rate in an implantable pump was studied. Solutions containing morphine sulfate 5 mg/3 ml, 10 mg/3 ml, 20 mg/3 ml, and 200 mg/3 ml were prepared from morphine sulfate powder; a solution containing morphine sulfate 20 mg/3 ml with bupivacaine hydrochloride 0.125% was also prepared. Sterile water was used for preparing the morphine solutions and as the control solution. A model 400 Infusaid pump was filled with 50 ml of the drug solution, placed in a water bath at 37 degrees C, and allowed to equilibrate for three hours. Samples of each concentration of morphine solution and control solution were then collected in an analytical graduate over 20-hour periods. Between each collection period, the pump was flushed twice with sterile water. Five samples of each morphine solution and control solution were collected. The osmolality of one sample of each solution was determined to assess drug concentration indirectly; morphine sulfate concentrations were not actually measured. Actual solution volumes collected during the 20-hour collection periods were corrected to 24 hours to allow comparison with the pump's preset daily flow rate. Collection volumes and calculated daily flow rates decreased with increasing morphine sulfate concentrations and solution osmolalities; a significant positive correlation between osmolality and assumed drug concentration was found. The flow rate of the solution containing morphine 200 mg/3 ml was approximately equal to the pump's stated flow rate; flow rates for all other solutions were higher than the stated flow rate.(ABSTRACT TRUNCATED AT 250 WORDS)

Infusions, Parenteral↗
PubMed1982

Comparison of large and small child-resistant containers.

Two studies, a 13-month prospective survey and a clinical trial, were conducted to evaluate how children less than 5 years of age opened children's aspirin (small container) and chewable multi-vitamin (large container) bottles. In study one, teeth were used to open a closed children's aspirin container in greater than 50% of reported exposures compared to 5% for reported multivitamin exposures. A clinical trial (study two) revealed an interaction between the child's age and the characteristics of the container (F = 2.83, df = 6,28; P less than 0.05). Larger containers were harder to open in the hands of a 23-28 month old child while smaller containers were harder to open in the 32-38 month age group. Neither container were more easily opened by children between 29 and 31 months of age. These results suggest that container characteristics and a child's age are both variables which may influence future poison prevention activities.

Aspirin↗
PubMed1978

Stability of carbenicillin and oxacillin frozen in syringes.

The stability of carbenicillin disodium and oxacillin sodium following storage in syringes for three months at -20 C was studied. Employing a spectrophotometric assay, it was found that carbenicillin (2500 mg/ml) and oxacillin (200 mg/ml) remained stable in both glass and plastic syringes for three months when frozen at -20 C. Stability was not altered by storage in either glass or plastic, nor by the size of the syringe used. Although the results were favorable, additional evidence is necessary before the practice of freezing reconstituted carbenicillin and oxacillin in syringes is advocated.

Carbenicillin↗
PubMedDate not supplied

Cost-effective choice of antimicrobial therapy for serious infections.

The authors evaluated the financial and health implications of treatment choices for three serious classes of infection: hospital-acquired pneumonia, intra-abdominal infection, and sepsis of unknown origin. Data were obtained from a systematic review of clinical literature and published data bases, by written questionnaire from a panel of infectious disease authorities, and from actual costs at a tertiary-care hospital. For pneumonia and sepsis, the third-generation cephalosporin evaluated (ceftizoxime) was found to be less expensive than other regimens, when costs of dose preparation and administration, monitoring, and toxicity were added to drug acquisition costs. The lowest-cost regimen for intra-abdominal infection was metronidazole plus gentamicin. Modest differences in efficacy would easily outweigh differences in toxicity, however, and could justify the use of more expensive regimens (e.g., mezlocillin plus gentamicin for hospital-acquired pneumonia, and cefoxitin plus gentamicin for intra-abdominal infection). If all regimens are assumed to be equally efficacious, then the third-generation cephalosporin was both lowest in cost and, owing to its low toxicity, greatest in net health benefit.

Abdomen↗