PubMed Health⌕ Search

Biomedical subjects

K D Mutchie

Publications and source records attributed to K D Mutchie.

6 recordsLinked to original sources
PubMed1982

The use of an antihistamine-decongestant in conjunction with an anti-infective drug in the treatment of acute otitis media.

We evaluated the efficacy of an antihistamine-decongestant combination as adjunctive therapy in the treatment of acute otitis media with effusion. In a randomized study, 53 children were treated for acute otitis media with antibiotics and either Naldecon or placebo. Subjects were evaluated by tympanometry and pneumotoscopy. Follow-up evaluation was performed at days seven and 14 of therapy. The antihistamine-decongestant prescription was found to influence both the duration of nasal congestion and the course of middle ear effusion: Naldecon-treated subjects were symptomatic with nasal congestion for an average of six days compared to nine days reported by those given placebo, and the risk of persisting middle ear effusion was approximately two times greater in the placebo-treated group when evaluated by tympanometry.

Acoustic Impedance Tests↗
PubMed1979

Pharmacist monitoring of parenteral nutrition: clinical and cost effectiveness.

The effect of pharmacist involvement in total parenteral nutrient (TPN) therapy on patient outcome and cost of therapy was studied. Data from 26 patients who received standard TPN solutions without pharmacist monitoring (Group 1) were compared with those from 26 patients whose TPN therapy was individualized (by use of a minicomputer) and monitored by a pharmacist (Group 2). Six patients from each group who were 35 days of age or younger and who received TPN as the only caloric source for 8 to 20 days were compared for clinical response. Mean duration of TPN therapy increased form 12.3 +/- 9 days for Group 1 to 14.8 +/- 12 days for Group 2, and the TPN use rate for Group 2 was 31% above that for group 1. The mean daily charge for TPN was greater for Group 1 ($72.00) than for Group 2 ($50.18). The pharmacy's mean cost per course of TPN for Group 2 was $44.10 less than that for Group 1. The mean weight gain in Group 1 was significantly less (4 g/day) than that in Group 2 (17 g/day) (p less than 0.05) (for the six patients per group compared). Pharmacist monitoring of TPN reduced the pharmacy's costs and patient charges for TPN and improved the patients' clinical responses to TPN.

Child, Preschool↗
PubMed1979

Drug therapy for Reye's syndrome.

The pathogenesis, biochemical defects, pathophysiology, clinical and laboratory symptoms, and treatment of Reye's syndrome are reviewed. The etiology of the syndrome is unknown, but it appears to be a viral interference with basic biochemical processes. Increased intracranial pressure is one of the most lethal aspects of the disease; cerebral edema often ensues. Physiologic and pharmacologic methods of treating cerebral edema, including the use of osmotically active agents (mannitol, urea and glycerol), corti-costeroids and potent diuretics are reviewed. Correction of the biochemical abnormalities with enzyme and nutritional factor replacement is discussed. Intensive supportive care, including maintenance of fluid and electrolytes, reduction of intracranial pressure and elective endotracheal intubation, is the mainstay of treatment.

Adolescent↗
PubMedDate not supplied

Total and free salicylate concentrations in juvenile rheumatoid arthritis.

Salicylates are known to be highly protein bound, primarily to albumin. Patients with juvenile rheumatoid arthritis (JRA) are known to have decreased albumin concentrations. Total and free salicylate concentrations were determined for 19 patients with JRA. Although many of these patients were below the normal therapeutic range, the percent of salicylate bound was essentially constant and did not differ significantly regardless of albumin concentrations or total salicylate concentrations. Elevated liver enzymes did not correlate with total or free salicylate concentrations. We conclude that total salicylate concentrations should be used for monitoring aspirin therapy in JRA. Free salicylate concentrations do not appear to be more reliable or feasible.

Adolescent↗
PubMedDate not supplied

Interlaboratory salicylate variability.

Nineteen patients with juvenile rheumatoid arthritis had salicylate concentration determination by 2 different methods in 2 laboratories. Differences in the results from these laboratories prompted testing at 4 laboratories with known samples of salicylates. Significant variation was shown between spectrofluorometric and Trinder methods. We feel that it is imperative that physicians and clinical pharmacists determine the reliability of salicylate determinations performed in their laboratories prior to making recommendations for changes in patients' drug regimens.

Adolescent↗