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Biomedical subjects

M D Reed

Publications and source records attributed to M D Reed.

At least 109 records · Page 6Linked to original sources
PubMed1984

Moxalactam therapy of serious pediatric infections.

Forty children with documented or suspected bacterial infections arising outside the central nervous system (CNS) were studied. Fifteen different pathogens for a total of 30 isolates were obtained from multiple sources. Staphylococcus aureus (minimum inhibitory concentrations 4-8 micrograms/ml) was the most common pathogen isolated, involving seven patients. Each patient received moxalactam 50 mg/kg iv over 15 minutes q8h and responded favorably to therapy, exhibiting bacteriologic and/or clinical cures. Toxicity associated with moxalactam occurred in only two patients and necessitated discontinuation of drug therapy. Moxalactam 50 mg/kg iv q8h is effective therapy for non-CNS infections occurring in infants and children.

Bacteria↗
PubMed1983

Cyclic parenteral nutrition during bone marrow transplantation in children.

Nine children underwent ten bone marrow transplants for malignancies and were supported by parenteral alimentation administered in cyclic fashion 18 hours daily. Children received cyclic parenteral nutrition for an average of 29 days, which provided a caloric intake (mean +/- SD) of 55.9 +/- 18.1 Kcal/kg/day, and a nitrogen intake of 0.28 +/- 0.08 g/kg/day. Nutritional status was assessed using nitrogen balance, creatinine-height index, and visceral protein concentrations including serum albumin, transferrin, and prealbumin. Minimal transient elevation in tests of liver function were observed without marked derangement in blood glucose, electrolytes, or osmolality. Unlike prealbumin, determinations of nitrogen balance, creatinine-height index, serum albumin and transferrin concentrations did not parallel changes in clinical status. Cyclic parenteral alimentation is a practical approach to the maintenance of nutrition during intensive antitumor therapy and provides an infusion-free period for the administration of drugs and blood transfusions without interfering with nutritional support. Prealbumin accurately reflects changes in the patient's clinical status at any point and is easily and reliably determined.

Adolescent↗
PubMed1983

Clinical pharmacology of antitubercular drugs.

Isoniazid, rifampin, and ethambutol are the three major drugs used in the modern treatment of patients with tuberculosis. Data on these drugs in children have been derived primarily from their clinical use in pediatrics and extrapolation from experiences in adults. A number of questions remain concerning the clinical pharmacology and appropriate use of these drugs in children. Additional pediatric pharmacokinetic studies are necessary to confirm the current dosage recommendation and use of these agents in the pediatric patient.

Antitubercular Agents↗
PubMed1983

Ceftazidime in cystic fibrosis: pharmacokinetics and therapeutic response.

The pharmacokinetics of ceftazidime were assessed following a single-dose in 20 patients (8 to 30 years) with cystic fibrosis. All patients received 50 mg/kg (0.9 to 3.5 g) bolus over 30 to 60 sec. Multiple timed samples were obtained over 8 h and analysed by a sensitive HPLC technique. Two-compartment pharmacokinetic analysis revealed means (+/- S.D.) T 1/2 alpha, 0.45 (0.20) h; T 1/2 beta, 1.74 (0.63) h; Vd, 270.0 (50.0) ml/kg; Vc, 190.0 (50.0) ml/kg and Cl beta, 133.7 (22.8) ml/min/1.73 m2. Probenecid pretreatment in six patients was without effect on T 1/2 beta and Cl beta. Urinary excretion was (% of dose) 0 to 2 h, 65.4 (11.1); 2 to 4 h, 14.9 (3.4) and 4 to 8 h, 9.8 (5.8). Ceftazidime was used to treat pulmonary exacerbations in 12 adult cystic fibrosis patients with multiply-resistant Pseudomonas species. Each patient received 2 g iv 8-hourly for 14 to 35 days. Ten of 12 patients showed dramatic improvement as determined by increased appetite and weight gain and arterial pCO2. No hepatic, renal or bone-marrow toxicity was noted. Ceftazidime is an effective antipseudomonal agent possessing favourable pharmacokinetic characteristics with potential use in the treatment of pulmonary exacerbations in cystic fibrosis.

Adolescent↗
PubMed1983

Developmental pharmacokinetics of moxalactam.

A pharmacokinetic evaluation of moxalactam was performed with 30 infants and children with documented or suspected bacterial infections arising outside the central nervous system. Each child received 50 mg of moxalactam per kg infused intravenously over a period of 15 min every 8 h. A total of 26 children were studied after receiving the first dose; 20 of these, along with 4 additional patients, were evaluated after receiving continuous therapy for at least 3 days. After the first dose, the elimination half-life, apparent volume of distribution, and plasma clearance averaged 1.59 h, 0.331 liter/kg, and 100.9 ml/min per 1.73 m2, respectively. The biodisposition of the moxalactam epimers was also evaluated, with similar overall results. No differences in pharmacokinetic parameters were observed when the first-dose values were compared with those obtained at the steady state. Age-dependent changes in moxalactam elimination were observed for children of less than or equal to 1 year of age, suggesting that a dosage reduction may be necessary for children of less than or equal to 2 months of age.

Adolescent↗
PubMed1983

Efficacy and safety of ceftriaxone in serious pediatric infections.

Thirty-four patients aged 1 month to 19 years were treated with ceftriaxone for suspected bacterial infections. Bacterial pathogens were isolated from 25 children. The overall bacterial cure rate was 88%, with an overall clinical response rate of 96%. No side effects requiring cessation of therapy were observed. Ceftriaxone proved to be safe and effective in the treatment of serious infections in children.

Adolescent↗
PubMed1982

Topical corticosteroid therapy for corneal toxicity from systemically administered cytarabine.

Eleven patients with leukemia refractory to conventional therapy were treated with high doses of cytarabine (3 g/m2 intravenously every 12 hours for six days) followed by daunorubicin (30 mg/m2/day intravenously for three days). Each patient received, in a double-masked, randomized manner, either 1% prednisolone phosphate or placebo eyedrops in each eye 12 hours before and along with the cytarabine so that we could determine whether a topical corticosteroid prevents corneal toxicity from systemic cytarabine. Ten of the 11 patients had a significant reduction in the intensity and duration of the symptoms and signs of corneal toxicity in the corticosteroid-treated eye (P less than .0005). In the placebo-treated eye, pain, photophobia, and tearing occurred at a median time of 6.5 days after initiation of therapy but resolved in approximately one week. Patients receiving high doses of intravenously administered cytarabine should receive topical corticosteroid prophylaxis to reduce the corneal toxicity associated with this treatment.

Administration, Topical↗
PubMed1982

Anomalies of the left renal vein: analysis of 433 CT scans.

The incidence of circumaortic left renal vein (4.4%) and single retroaortic left renal vein (1.8%) was evaluated in 433 abdominal computed tomography (CT) studies. Computed tomography was felt to be adequate for demonstrating anomalies in a majority of cases. Important preoperative evaluation can be provided by routine CT, obviating more invasive procedures in some instances. Differentiation of these anomalies from retroperitoneal pathology can be made by the radiologist.

Contrast Media↗
PubMed1981

Use of intravenous iron dextran injection in children receiving total parenteral nutrition.

We conducted studies using intravenous (IV) iron dextran injection in 14 hospitalized infants and children with iron deficiency who required total parenteral nutrition. A single, total dose of IV iron dextran was administered during a two-hour period (preceded by a test dose of 25 mg). Doses administered ranged from 50 to 782 mg, with an average dose of 15.2 mg/kg body weight. No adverse reactions were noted during the test dose or infusion. The IV administration of iron dextran appears to be a safe method of treatment for iron repletion in children who are unable to tolerate feedings as a result of malabsorption, inflammatory bowel disease, or chronic debilitating diseases.

Adolescent↗
PubMed1981

Are measurements of urine enzymes useful during aminoglycoside therapy?

We prospectively evaluated concentrations of beta-D-galactosidase, alpha-L-fucosidase, beta-D-N-acetylglucosaminidase, and lysozyme in urine from normal subjects, ambulatory patients with cystic fibrosis (CF), and CF patients with previously normal renal function who were receiving intravenous aminoglycoside (AG) therapy. Enzyme activities were generally low or negligible in subjects not receiving AG. Enzymuria was documented during 12 of 13 AG treatment courses and most frequently involved beta-D-N-acetylglucosaminidase excretion. In nine courses, enzymuria occurred in the absence of proteinuria or elevations of blood urea nitrogen and serum creatinine. In three courses attended by enzymuria and evidence of nephrotoxicity, neither the time of appearance nor the magnitude of enzymuria was different from that of nonnephrotoxic patients. In two of these three treatment courses, enzymuria preceded clinical evidence of nephrotoxicity of 16 and 5 days, and in the third course enzymuria and elevation of blood urea nitrogen and serum creatinine occurred simultaneously. We conclude that enzymuria is not a reliable predictor of nephrotoxicity due to AG in CF patients and is not an indication of discontinue AG therapy.

Acetylglucosaminidase↗
PubMed1981

Stability of an extemporaneous formulation of injectable cholecalciferol.

THe stability of an extemporaneous formulation of injectable cholecalciferol 40,000 IU/ml was assessed. A preparation of cholecalciferol 40,000 IU/ml in a solution of propylene glycol with ethanol 10% was prepared. The solution was stored at 4 degrees C in 2-ml sterile glass vials protected from light. Cholecalciferol content was measured initially and periodically for 199 days using a high-pressure liquid chromatography technique. A 7.3% loss of cholecalciferol potency from baseline was observed over the 199-day period. In contrast to currently available preparations, this extemporaneous formulation of injectable cholecalciferol potentially offers a versatile dosage form for therapeutic or prophylactic therapy of vitamin D deficiency. It was easily prepared and retained more than 90% potency of cholecalciferol for at least six months. The addition of this formulation to large-volume parenteral or parenteral nutrition solutions is not recommended, however, because compatibility data are not available. In addition, the biological activity of the preparation has not been assessed.

Cholecalciferol↗
PubMed1981

Salicylate hepatitis: a complication of the treatment of Kawasaki's disease.

A case of salicylate hepatitis in a seven-week-old boy with Kawasaki's disease, mucocutaneous lymph node syndrome, is reported. The infant was admitted to the hospital with fever and a diffuse maculopapular petechial rash. He was treated with antibiotics for 72 hours for presumed septicemia. His condition deteriorated and he developed mucous membrane lesions and edema in his hands and feet. When the cultures of spinal fluid, blood, and urine were found to be negative, the antimicrobial therapy was discontinued; however, the cyanosis of his extremities progressed and gangrenous regions developed in his toe and finger pads. Oral aspirin therapy was started at a dosage of 100 mg/kg/day, every six hours. After five days, the rash, membrane lesions, and swelling in his hands and feet resolved. The cyanosis regressed. Liver enzyme tests revealed mild elevations of SGOT and LDH, and on the 12th hospital day these values peaked to a level consistent with salicylate hepatitis. The aspirin therapy was discontinued and within four days the liver function test results were normal. Aspirin therapy was reinstituted at a single daily dose of 30 mg/kg with no recurrence of hepatitis. The careful monitoring of liver function tests is recommended for children with Kawasaki's disease receiving aspirin therapy to avoid salicylate-induced hepatitis.

Adult↗
PubMed1979

Antibiotic compatibility and stability in a parenteral nutrition solution.

Eight antibiotics, alone and in selected combinations, were evaluated for stability and compatibility in a protein hydrolysate parenteral nutrition solution. Samples were stored under varying conditions and evaluated at 12-hour intervals over a period of 24--48 h. Compatibility and stability were assessed by quantitative bacteriologic assay, pH determinations and visual inspection. In most cases, antibiotics were compatible and stable over the entire study period. Carbenicillin, methicillin in combination with gentamicin, and tobramycin in combination with cephalothin or methicillin, exhibited a gradual loss of antibacterial activity after 24 h. These results indicate that the antibiotics studied may be administered in protein hydrolysate parenteral nutrition solutions. This mode of therapy offers a means of combating infection, while maintaining a nutritional source for host defences, tissue repair, and growth.

Anti-Bacterial Agents↗