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Biomedical subjects

L A Long

Publications and source records attributed to L A Long.

At least 19 recordsLinked to original sources
PubMed1986

Esophageal gastric tube airway vs endotracheal tube in prehospital cardiopulmonary arrest.

We evaluated the efficacy of the esophageal airway (EA) by prospectively randomizing 175 prehospital cardiopulmonary arrest patients to receive either an esophageal gastric tube airway (EGTA) or an endotracheal tube (ET). If attempts with the initial airway failed, the alternate airway was attempted. The cost of training paramedics in EA use was considerably less than the ET ($80 vs $1,000). Survival to the emergency room, to hospitalization and to discharge in ET and EGTA groups were 64.4 percent, 25.6 percent, 11.1 percent, and 54.1 percent, 27.1 percent, 12.9 percent, respectively--differences not statistically significant. The incidence of neurologic residual (ET 50 percent, EGTA 36.4 percent) and congestive heart failure (ET 40 percent, EGTA 45.5 percent) in surviving ET and EGTA patients did not differ (NS). An additional 125 consecutive patients with only the opportunity to receive an EA were also evaluated and did not differ in mortality, neurologic residual, or congestive heart failure from ET patients. We conclude that the EA is a satisfactory alternative to the ET for short-term prehospital use in cardiopulmonary arrest patients.

Aged↗
PubMed1984

Feasibility of simulating physicians' judgments of patient severity.

This article reports on adopting Gustafson's multiattribute utility method to develop a specific momentary severity index (vis-à-vis severity over time) for nontraumatic chest pain patients. A panel of physicians identified an appropriate set of indicators for the index. Three mathematic models were generated on the basis of these indicators with each model predicting no less than 81% of the variance in overall scores of 96 simulated patients with chest pain. High interrater reliability (0.94) was demonstrated. Congruent validity coefficients between the three model scores and the overall scores vary between 0.71 and 0.92 depending on how the panel physicians are grouped. Results indicate the feasibility of simulating physician judgments regarding patient severity in chest-pain-related cases.

Acute Disease↗
PubMed1965

Agranulocytosis: a report of 30 cases.

Thirty cases of acute agranulocytosis, as defined by Schultz, were observed between 1946 and 1964 at the Hôtel-Dieu Hospital, Montreal. In 14 cases agents incriminated were: aminopyrine, phenylbutazone, sulfonamides and chlorpromazine. Aminopyrine alone was responsible for eight cases. In the remaining 16 cases no definite etiology was established. Clinical manifestations included fever, prostration, angina and multiple pharyngeal ulcerations; these were associated with severe leukopenia and agranulocytosis. The bone marrow showed hypoplasia, lymphocytosis and maturation arrest. Localized and pulmonary infections, pseudomembranous enterocolitis and septicemia were frequent complications in 21 cases and were usually responsible for death, which occurred in 12 cases. Almost all patients who developed septicemia or pseudomembranous enterocolitis died. The pathogenesis is still not clear, but chlorpromazine and its analogues may act as a metabolic inhibitor, while the aminopyrine group probably operates through an immune mechanism.

Adult↗