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Biomedical subjects

M Wandell

Publications and source records attributed to M Wandell.

6 recordsLinked to original sources
PubMed1987

Screening and diagnostic performance of enzyme immunoassay for antibody to lymphadenopathy-associated virus.

In a multicenter cooperative study, an enzyme immunoassay (EIA) using purified antigen of lymphadenopathy-associated virus was compared with radioimmune precipitation (RIP) for detection of antibody to human immunodeficiency virus (HIV) in 634 patients with acquired immunodeficiency syndrome or related conditions, 687 apparently healthy persons at risk for HIV infection, 93 controls with cancer or autoimmune diseases, and 10,038 blood or plasma donors. Excluding the donors, the EIA was reactive in 875 (61.9%) of 1,414 subjects; compared with RIP, the sensitivity and specificity of EIA both were 99.8%. There was one false-positive EIA among 148 intravenous drug abusers and two false-negative EIAs among 472 apparently healthy homosexual men; no other discordant results between EIA and RIP occurred in these subjects. The EIA was repeatably reactive in 20 donors (0.2%), among whom 13 (65%) were positive by RIP; none of 529 randomly selected EIA-negative donors was RIP positive. In addition to its utility as a screening test in low-risk populations, the EIA for antibody to lymphadenopathy-associated virus is useful as a diagnostic test in persons with clinical evidence of or at risk for HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Computer-assisted drug assay interpretation based on Bayesian estimation of individual pharmacokinetics: application to lidocaine.

A microcomputer program for individualized drug level prediction based on Bayesian forecasting is presented. It is written so that the clinician can integrate patient demographics and drug levels to design a new dosage regimen tailored to an individual patient. The program's great flexibility and robustness make it appropriate for realistic clinical settings. A validation with a data set of lidocaine concentrations measured in 18 patients revealed that the program can predict serum lidocaine levels accurately enough to enhance individual patient dosage adjustment within a few hours after a dosage regimen is started.

Bayes Theorem↗
PubMed1981

Cimetidine decreases theophylline clearance.

This study tested the hypothesis that cimetidine decreases theophylline clearance. Aminophylline (6 mg/kg) was administered intravenously both before and after cimetidine treatment in 5 healthy adults. Cimetidine (300 mg) was administered orally every 6 h for 2 days before and 18 h after the aminophylline dose. Plasma samples were collected before and for 24 h after each aminophylline dose, and theophylline concentrations were determined by an enzyme-mediated immunoassay technique. Cimetidine significantly decreased theophylline clearance, mean decrease, 39% (3.85 +/- 0.27 L/h control versus 2.34 +/- 0.23 L/h with cimetidine treatment, p less than 0.002). The apparent volume of distribution was unchanged (p greater than 0.5), whereas the elimination rate constant was significantly decreased by a mean of 42% (control, 0.091 +/- 0.013 h-1 versus 0.053 +/- 0.007 h-1 with cimetidine treatment, p less than 0.005). This corresponded to an average increase in elimination half-life of 73% (range, 50 to 97%). Cimetidine probably slowed theophylline elimination by relatively nonspecific inhibition of the hepatic microsomal mono-oxygenase system. This effect may produce clinically significant changes in serum theophylline concentrations.

Administration, Oral↗
PubMed1980

Effect of quinine on digoxin kinetics.

Six subjects were evaluated for the effect of quinine, the l-isomer of quinidine, on digoxin pharmokinetics. A 1.0-mg intravenous digoxin dose was given before and during quinine administration, followed by the measurement of digoxin serum and urine concentrations for 96 hr after each dose. Quinine reduced digoxin total body clearance by 26% from 2.98 to 2.22 ml/min/kg (p < 0.03). Digoxin elimination half-life (t 1/2) was lengthened from 34.2 to 51.8 hr, reflecting a 32% decrease in digoxin elimination rate constant (p < 0.003). Quinine did not reduce digoxin renal clearance or any volumes of distribution. The amount of digoxin excreted into the urine increased from x = 628. 29 micrograms to x = 772.52 micrograms (p < 0.02). Digoxin nonrenal clearance decreased an average of 55% from 1.2 to 0.55 ml/min/kg (p < 0.05). These results suggest that quinine alters digoxin metabolism or biliary secretion, reducing digoxin total body clearance by a mechanism that is qualitatively similar, but quamtitatively different, from quinidine.

Adult↗
PubMed1977

Dextromethorphan toxicity: reversal by naloxone.

Naloxone has been shown to be effective in antagonizing the effects of a number of narcotic and related drugs. Its successful use in managing a patient with an overdose of dextromethorphan extends its application as a specific antidote.

Dextromethorphan↗