PubMed Health⌕ Search

Biomedical subjects

J W Calkins

Publications and source records attributed to J W Calkins.

8 recordsLinked to original sources
PubMed1995

Hemodynamic comparison of direct vision versus blind oral endotracheal intubation.

STUDY OBJECTIVE: To determine the hemodynamic response to airway manipulation and endotracheal intubation by comparing the direct oral method of the Macintosh laryngoscope to the blind oral method of the Augustine guide. DESIGN: Prospective, comparative, randomized study. SETTING: University medical center. PATIENTS: 24 ASA physical status I and II, nonpregnant female patients aged 18 years or older, undergoing outpatient gynecologic surgery with general anesthesia. INTERVENTIONS: Patients were preoxygenated and received alfentanil 10 mcg/kg five minutes prior to anesthesia induction with thiopental sodium 5 mg/kg and succinylcholine 1 mg/kg. Under random assignment, patients (n = 12 in each group) were intubated with the Macintosh laryngoscope or the Augustine guide. After intubation, 50% nitrous oxide and 50% oxygen and 1.5% inspired concentration of isoflurane were administered. MEASUREMENTS AND MAIN RESULTS: Oxygen saturation, heart rate (HR), and mean arterial pressure (MAP) were measured at baseline and at minutes 1 to 6 postinduction (time zero). Intubation time was defined as the interval between removal of the face mask from the patient's face and reconnection of the circle system airway connector after successful endotracheal intubation. The number of attempts and time to successful endotracheal intubation were noted. There was no difference between groups in age, weight, height, Mallampati airway class, oxygen saturation (at least 98%), or MAP. There was a significant difference (p < 0.01) between groups (percent change from baseline) in HR from minutes 1 to 4 postinduction. Time to successful endotracheal intubation was significantly longer (p < 0.05, mean +/- SEM) with the Augustine guide (91.0 +/- 15.9 seconds) than with the Macintosh laryngoscope (24.0 +/- 1.73 seconds). CONCLUSIONS: The Augustine guide, a new technique for orally intubating patients blindly and when head and neck manipulations are contraindicated, had less of an effect on HR compared with the Macintosh laryngoscope. Minimal lifting of the tongue and mandible required with the Augustine guide could account for the decreased HR response. The Augustine guide appears to be a promising new addition to the airway armamentarium and deserves further testing.

Adolescent↗
PubMed1986

Androblastomas and thyroid disease in postmenopausal sisters.

Androblastomas are virilizing ovarian tumors found predominantly in premenopausal women. Reported are two postmenopausal sisters with androblastomas, the first such occurrence in the literature. An association has been proposed between the familial occurrence of these tumors and thyroid adenomas or nontoxic goiter. Of the two patients studied, one had a history of Graves disease and the other had thyroid cancer. The authors conclude that the associated thyroid pathology in the families described and in the studied patients is inconsistent and does not represent a unique multiple endocrine neoplasia syndrome.

Adenocarcinoma↗
PubMed1982

Management of condylomata acuminata with the carbon dioxide laser.

Ninety-four patients with condylomata acuminata of the lower genital tract and perianal region were treated with the carbon dioxide laser. Most were managed in the outpatient clinic, but 1 to 4 treatments were required depending upon extent of involvement. Of 90 patients, 75 (83.3%) were free of lesions on all follow-up examinations after initial treatment. Of 15 patients with recurrent lesions, 13 underwent a second laser treatment; 7 of these 13 have been subsequently free of condylomata. The overall success rate was 91%. The carbon dioxide laser provides an appealing method of management of condylomata acuminata because of its precision, rapid healing without scarring, and safety when used during pregnancy.

Adolescent↗
PubMed1981

The carbon dioxide laser in cervical intraepithelial neoplasia: a five-year experience in treating 230 patients.

Two hundred and thirty patients with cervical intraepithelial neoplasia were treated over a 5-year period with the carbon dioxide laser at the University of Kansas. Analysis of cytologic findings, biopsy results, location of the lesion, treatment factors, and recurrence rates are reported. Ninety percent of the patients were cytologically free of intraepithelial neoplasia at the end of the study.

Carbon Dioxide↗
PubMedDate not supplied

Effect of esmolol on hemodynamics and intraocular pressure response to succinylcholine and intubation following low-dose alfentanil premedication.

STUDY OBJECTIVE: To determine the effectiveness of esmolol hydrochloride (Brevibloc) as an additional adjunct to low-dose alfentanil premedication in controlling the hemodynamic response [heart rate (HR), mean arterial pressure (MAP), and intraocular pressure (IOP)] to succinylcholine and endotracheal intubation. DESIGN: Randomized, double-blind, placebo-controlled, prospective study. SETTING: Ambulatory gynecologic surgery at a university medical center. PATIENTS: Twenty ASA physical status I and II female patients scheduled for outpatient laparoscopy under general anesthesia. INTERVENTIONS: All patients received alfentanil 10 micrograms/kg as a preoperative medication 4 minutes prior to induction of anesthesia. Study patients (n = 10 in each group) received either esmolol 1.5 mg/kg or a placebo (normal saline) 30 seconds prior to induction (210 seconds after alfentanil and 90 seconds prior to endotracheal intubation). Anesthesia was induced with thiopental sodium 5 mg/kg and succinylcholine 1 mg/kg. Postintubation, 70% nitrous oxide, 30% oxygen, and 1% isoflurane were administered. MEASUREMENTS AND MAIN RESULTS: Time of study drug administration was defined as time zero. Measurements of HR, MAP, and IOP were made at baseline (patient awake) and at each minute from minutes 1 through 6 after administration of the study drug (time zero). Analysis of variance was used to analyze the data, with a value of p less than 0.05 considered significant. Esmolol 1.5 mg/kg was found to blunt the maximum increase in HR but not MAP or IOP following low-dose alfentanil premedication. CONCLUSIONS: In an eye patient with coronary artery disease, or in any patient in whom tachycardia may be detrimental, esmolol may be a useful adjunct in combination with low-dose alfentanil to attenuate the increase in HR due to laryngoscopy and endotracheal intubation.

Adrenergic beta-Antagonists↗