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Biomedical subjects

R E Kravath

Publications and source records attributed to R E Kravath.

10 recordsLinked to original sources
PubMed1992

The role of assisted ventilation in survival after respiratory failure in children with AIDS.

OBJECTIVES: To determine the role of assisted ventilation in children with the acquired immunodeficiency syndrome and acute respiratory failure, and to identify any measurement or variable that predicted survival. DESIGN: Retrospective study. SETTING: Kings County (New York) Hospital Center, a tertiary-level inner-city municipal hospital. PARTICIPANTS: Twenty-three children with acquired immunodeficiency syndrome who were endotracheally intubated and mechanically ventilated because of acute respiratory failure. MEASUREMENTS/MAIN RESULTS: There were 24 episodes of acute respiratory failure, as one patient survived a first episode and died during the second episode 2 years later. We failed to identify any measurement or variable that predicted survival. During 12 episodes (50%), the patients survived and were weaned from the ventilator. CONCLUSIONS: Our findings indicate that a decision to avoid intubation and assisted ventilation in a child with acquired immunodeficiency syndrome and acute respiratory failure should not be made based merely on the presumption of a lethal outcome.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Childhood asthma mortality: the Brooklyn experience and a brief review.

Pediatric asthma mortality is a perplexing and increasingly serious problem. Although many possible etiologic factors have been suggested, clear relationships are yet to be delineated. In addition to reviewing the literature, we studied the clinical and pathologic features of 14 local pediatric asthma deaths that occurred over a 7-year period. Thirteen of 14 children were African-American. Nine of 14 children (64.3) were older than 10 years of age, and 11 of 14 (78.6) were males. Based on a history of clinical features, 10 of the 14 children were characterized as severe asthmatics. Despite the fact that the majority of the children were regarded as severe asthmatics, only 1 of 14 had been evaluated with pulmonary function testing, and only 2 of 14 were receiving corticosteroids. Furthermore, only 2 of 14 were regarded as having good medical follow-up for their asthma. Ten of 14 children died suddenly secondary to asthma. One child was possibly abusing sympathomimetic inhalers, and none had evidence of toxic serum levels of theophylline. Six of 14 children (all adolescents) who died suddenly were negative on urine toxicology screening for cocaine, heroin, etc. Pathologic findings available for 10 children revealed mainly mucus plugging of the airways and collapse of various segments of the lungs, as well as pneumonia and pneumothorax in one child. In this group of children with sudden deaths (except for one child with pneumothorax), no other cause of death could be found.

Adolescent↗
PubMed1987

Heat-shock protein synthesis by human polymorphonuclear cells.

Mature human neutrophils from peripheral blood are known to be capable of limited protein biosynthetic activity. We now show that these cells are inducible for heat-shock protein synthesis when placed in short-term culture. Synthesis of hsp70 and hsp85 as well as the response to various temperatures and the time course of induction were typical for mammalian cell systems. This heat-shock response was blocked by actinomycin D added before heat exposure. This demonstration that hsp genes can be activated by heat exposure of terminally differentiated neutrophils supports the hypothesis that gene activation can serve a physiological role in these cells and opens up the possibility that synthesis of other gene products is similarly inducible.

Dactinomycin↗
PubMed1977

Hypoventilation during sleep in children who have lymphoid airway obstruction treated by nasopharyngeal tube and T and A.

Three children with sleep apnea, alveolar hypoventilation, apparent mental retardation, and poor growth associated with chronically enlarged tonsils and adenoids were treated with the use of a nasopharyngeal tube followed by tonsillectomy and adenoidectomy. The effectiveness of this therapy was documented by polygraphic recording of sleep stages and respirations, and by correlation with serial arterial blood gases and pH. The nasopharyngeal tube was well tolerated, easy to use, and effective in diagnosis and treatment. We suggest that its use be further evaluated in patients with obstructive apnea.

Adenoidectomy↗
PubMed1976

A lethal pacifier.

Explore the source record for details and available documents.

Accidents, Home↗
PubMedDate not supplied

Educational objectives for house staff in the pediatric intensive care unit.

The educational objectives in use in our Pediatric ICU are described. These have importance for educational programs in critical care medicine, in particular, where patient care needs can easily overwhelm educational needs. It is important not to overlook our role as teachers in the development of proper attitudes and of the more complex areas of thought; skills and rote memory should not be overstressed.

Goals↗