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Biomedical subjects

R G Garmon

Publications and source records attributed to R G Garmon.

6 recordsLinked to original sources
PubMed1992

Acute severe asthma: Part 1. Pathophysiology and clinical assessment.

Asthma manifests itself in a two-phase reaction. An early phase, causing bronchial muscle contraction, occurs within minutes after an antigenic stimulus. Within 6 to 18 hours, a late asthmatic response begins. This response is associated with cellular infiltration of the bronchial submucosa by eosinophils, neutrophils, and lymphocytes. The late asthmatic response is most effectively reversed by the use of corticosteroids. Predicting patient outcome solely on the basis of either physical findings, or pulmonary function tests, or historical events is frequently inadequate. Historical events, clinical assessments, and laboratory and pulmonary function measurements are best used in a complementary and integrated fashion to determine appropriate disposition of the acutely asthmatic patient.

Acute Disease↗
PubMed1992

Acute severe asthma: Part 2. Current therapy.

Acute severe asthma is an extremely common and serious public health problem in the United States. Current optimum therapy of acute severe asthma includes supplemental oxygenation, nebulized beta-adrenergic receptor agonist therapy, and prompt use of glucocorticosteroids. In view of its low therapeutic index and the availability of more effective, less toxic agents, theophylline is no longer considered a first-line treatment. Ipratropium bromide combined with beta-agonist may augment bronchodilator responsiveness.

Acute Disease↗
PubMed1989

Effects of pressure-demand respirator wear on physiological and perceptual variables during progressive exercise to maximal levels.

Current regulations governing the certification of respiratory protective devices are based on data published in the early 1950s. The limited data base of this early work and documented increases in the average height of the population underscore the need for additional information concerning the parameters of certification. In the present study, a protocol using an inclined treadmill (0.5% grade every 12 sec) was used to test a heterogeneous population (n = 38). Through submaximal up to and including maximal exercise levels with and without respirator wear, maximal oxygen uptake (VO2max) was significantly greater (p less than 0.01) with the respirator (44.11 +/- 1.3 mL/kg.min) than without the respirator (42.18 +/- 1.4 mL/kg.min) while maximal ventilation volumes (VEmax) were not significantly different (with = 118.7 +/- 4 L/min; without 119.6 +/- 5 L/min). While peak inspired flows (PFI) with the respirator (268 +/- 7 L/min) were less than without the respirator (281 +/- 9 L/min), p greater than 0.05, the lower peak expired flow (PFE) with the respirator (289 +/- 12 L/min) than without the respirator (324 +/- 13 L/min), p less than 0.01, indicated a significant blunting effect of the respiratory flows by the expired resistance during exercise to maximal levels. Peak inspired pressures (PPi) with and without the respirator were not significantly different (p greater than 0.05). The negative values obtained within the facepiece of the respirator (-7.65 +/- 0.8 cmH2O), however, indicate that the positive pressure within the facepiece was lost, and respiratory protection may be compromised. Peak expired pressure with the respirator (13.05 +/- 0.7 cmH2O) was significantly greater than without the respirator (10.7 +/- 0.5 cmH2O) indicating that, despite a lower PFE, greater force was required to overcome the resistances of the respirator on expiration. The dyspnea index, an index of physiological effort; suggests that the subjects were working at a higher percentage of their respiratory reserve with the respirator (p less than 0.05) than without. Perceptually, subjects also felt that breathing with the respirator was more difficult (p less than 0.05). The maximum heart rate and the ratings of perceived exertion were not significantly different between the two tests at maximal exercise levels. Maximum oxygen uptake was considered reached when subjects attained a respiratory exchange ratio of at least 1.15, when a heart rate response at or greater than age-predicted maximum was achieved, when ratings of perceived exertion indicated exhaustion, and/or when the measure of VO2 had plateaued during the final minute of exercise.(ABSTRACT TRUNCATED AT 400 WORDS)

Equipment Design↗