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Biomedical subjects

M A Rie

Publications and source records attributed to M A Rie.

18 recordsLinked to original sources
PubMed2001

Acute care crisis simulation for jury education.

A major impediment to appropriate adjudication in medical malpractice cases is the large difference in knowledge and background of the expert witness compared to judges, other litigants and juries. Such disparities make it plausible for an expert witness to support an issue, even in defiance of common sense. The most basic understanding of the atmosphere and practices surrounding critical events and the routine procedures, techniques and equipment which are employed in critical situations is absent. (McAbee GN: Improper expert medical testimony: existing and proposed mechanisms of oversight. Journal of Legal Medicine 19: 257-272, 1998).

Education↗
PubMed1992

Practicing medicine, fiduciary trust privacy, and public moral interloping after Cruzan.

The Supreme Court decision in Cruzan reaffirmed the power of the states to set procedural standards for due process regarding the individual's exercise of his liberty interest. As a result, to effect an autonomous decision to refuse treatment when one becomes incompetent requires an affirmative articulation by means of an advance directive. This article argues against simplified advance directives in that they fail to enhance individual liberty and responsibility and fail to provide physicians with needed information. A model protective advance directive is advocated with direction to terminate personal and health insurance payments for health care that is not desired by the patient.

Advance Directives↗
PubMedDate not supplied

Eicosanoids and hypoxic pulmonary vasoconstriction in normal man.

Pulmonary haemodynamics and blood gas tensions were investigated in eight healthy volunteers, breathing room air and at the 15th min of an acute inspiratory hypoxia (fraction of inspired oxygen, (FIO2), 0.125) before and after administration of ibuprofen, a cyclooxygenase inhibitor, and of dazoxiben, a thromboxane A2 (TxA2) synthetase inhibitor; both drugs either with or without an infusion of prostaglandin E1. Hypoxia decreased arterial oxygen tension (PaO2) to below 50 mmHg in every subject and increased pulmonary vascular resistance by an average of 100-150% from baseline values. Acute and chronic dazoxiben or ibuprofen administration markedly reduced serum thromboxane B2 (TxB2), the stable metabolite of TxA2, but had no effect on pulmonary haemodynamics and blood gas tensions in both normoxic and hypoxic conditions. Prostaglandin E1 given in addition to ibuprofen or to dazoxiben did not inhibit hypoxia-induced increases in pulmonary vascular resistance. The stability of this hypoxic pressor response on repetition of an acute hypoxic exposure was established in six additional healthy subjects. Although obtained on a small number of subjects, these results do not suggest that products of the cyclooxygenase pathway of arachidonic acid metabolism play an important role in modulating normoxic or hypoxic pulmonary vascular tone in man.

Adult↗