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Biomedical subjects

R Grover

Publications and source records attributed to R Grover.

At least 73 records · Page 4Linked to original sources
PubMed1992

Determination of the herbicide diclofop in human urine.

A simple and sensitive method for the gas chromatographic determination of diclofop residues in human urine is described. Recoveries of diclofop, as its methyl ester, from fortified urine were greater than 85% at 100, 50, 10 and 1 micrograms kg-1, and were similar with and without the inclusion of a hydrolytic step in the analytical method. However, a hydrolytic step was necessary for analysis of 24-h urine samples collected from a male applicator following a single exposure to diclofop-methyl during application to wheat using a tractor-pulled sprayer. Diclofop residues determined with hydrolysis were approximately double those without hydrolysis, suggesting that a significant portion of diclofop was excreted in the conjugated form.

Chromatography, Gas↗
PubMed1992

What is the health care product?

Because of the current competitive environment, health care providers (hospitals, HMOs, physicians, and others) are constantly searching for better products and better means for delivering them. The health care product is often loosely defined as a service. The authors develop a more precise definition of the health care product, product line, and product mix. A bundle-of-elements concept is presented for the health care product. These conceptualizations help to address how health care providers can segment their market and position, promote, and price their products. Though the authors focus on hospitals, the concepts and procedures developed are applicable to other health care organizations.

Consumer Behavior↗
PubMed1991

Effect of pneumonectomy on the remaining lung in dogs.

To determine the magnitude of functional compensation after pneumonectomy and whether compensation is related to maturity of the animal at the time of resection, we performed left pneumonectomy in either adult or 10-wk-old beagles. Studies were performed in adults 7-9 mo after surgery and in puppies 18-23 mo after surgery when the dogs reached full maturity. Results were compared with those in age- and sex-matched unoperated controls. Measurements included pressure-volume relationships, pulmonary hemodynamics, rebreathing studies of lung volume, diffusing capacity and its components, lung tissue volume, and pulmonary blood flow. Computerized-tomographic scans were performed in the puppy groups to determine changes in thoracic shape and size. Morphometric analysis of the lungs was performed under light microscopy. There was partial compensation for loss of one lung by functional improvement in the remaining lung. Compensation was greater in those pneumonectomized as puppies than as adults. Volume of the remaining lung was larger than predicted for a given transpulmonary pressure in both groups. Diffusing capacity, pulmonary capillary blood volume, and lung tissue volume were larger than expected for the normal right lung. After pneumonectomy, compliance of the rib cage was greater in puppies than in adults. Weight of the costal diaphragm was reduced in pneumonectomized puppies. Pulmonary hypertension at rest did not develop, and pulmonary vascular reactivity to hypoxia was unchanged after pneumonectomy in both groups. Significant correlations were obtained between physiological and morphometric measurements.

Age Factors↗
PubMed1991

Febrile episodes in children with sickle cell disease treated on an ambulatory basis.

Children with sickle cell disease have a greatly increased potential for developing rapid and at times fatal sepsis from Streptococcus pneumoniae. Hospitalization and parenteral antibiotic treatment in all febrile children with sickle cell disease have thus become the standard of care at most sickle cell centers. As an alternative approach, we managed selected febrile children with sickle cell disease on an ambulatory basis with parenteral ceftriaxone to determine its safety and effectiveness in preventing sepsis and reducing the number of days of hospitalization. Twenty of 40 children who presented with significant fever met the study criteria and received ceftriaxone on an ambulatory basis. Three were subsequently hospitalized. Compared with a previous year, when all febrile children were admitted, ceftriaxone use reduced the days of hospitalization from 214 (6.3 +/- 1.6 days/patient) to 111 days (2.8 +/- 0.7 days/patient). The empiric use of ceftriaxone appears safe and effective, but it requires an expanded study over an extended period.

Adolescent↗
PubMed1990

Management of acute splenic sequestration crisis in sickle cell disease.

Acute splenic sequestration crisis (ASSC) is a significant cause of early morbidity in children with sickle cell disease. With timely diagnosis and prompt transfusion, the outcome is good. However, recurrences are frequent, and both splenectomy and long-term transfusion therapy have been advanced as appropriate preventive approaches. We describe the diagnosis, management, and course of 15 patients with ASSC followed at the St. Luke's-Roosevelt Hospital Center Comprehensive Sickle Cell Program. Based on our experience, we recommend surgery after the first episode of ASSC in the child 5 years of age and older and the choice of a year or more of long-term transfusion therapy for the child under 3. With intensive education of the parents, and with close observation and individualized management of the patient, the overall prognosis may be improved.

Acute Disease↗
PubMed1988

Spleen dysfunction in hemoglobinopathies determined by pitted red cells.

Splenic dysfunction measured by pitted red cells (pit) was studied in hemoglobinopathies (SS-, SC-, and S beta-type thalassemias and CC-type hemoglobinopathy) in relation to age, in steady state, and during certain significant events. Our experience revealed that the pit count rose with age during steady state in most children with SS disease. A marked increase in pit count was noted in patients with CC disease. The pit count in four patients with S beta+ thalassemia remained normal (i.e., less than 3.5%) at all ages. In children with homozygous SS disease tested at the time of pneumococcal sepsis, the pit count was universally elevated. The pit count was in the normal range in one child with SS disease and osteomyelitis but was elevated in all others. All children had normal pit counts (less than 3.5%) at the onset of acute splenic sequestration crisis, and the counts remained normal during transfusion therapy. No correlation was detected between the pit count and the size of the spleen in patients under 1 year of age.

Adolescent↗
PubMed1988

Functional effects of imipramine on the rabbit urinary bladder: an in-vitro study.

Imipramine is a tricyclic antidepressant that has been demonstrated to be useful in the treatment of certain voiding dysfunctions. Imipramine has a variety of pharmacological effects including direct antimuscarinic activity, inhibition of catecholamine reuptake, direct muscle relaxant, and calcium antagonism. Using the in-vitro whole bladder model we have studied the effect of imipramine on the rate and magnitude of both intravesical pressure generation and bladder emptying in response to field stimulation. The results can be summarized as follows: at concentrations as low as 1 mumol/l imipramine causes a significant inhibition of volume expulsion without significantly affecting pressure generation. Imipramine produced a dose-dependent inhibition of both pressure development and percent volume emptying; however, it was substantially more potent in inhibiting the ability of the bladder to empty than to generate pressure.

Animals↗
PubMed1987

Recruitment in the Cooperative Study of Sickle Cell Disease (CSSCD).

The Cooperative Study of Sickle Cell Disease (CSSCD) is a multiinstitutional investigation of the natural history of clinical course of sickle cell disease from birth through adulthood. The study is not a trial; rather, it involves data collection at 23 institutions in a uniform, standardized fashion on 3800 patients. Recruitment aspects that were addressed include issues related to recruitment of different age groups, ranging from newborns to pregnant women to patients over 50 years of age; the need to include mildly affected patients to ensure that the study would not reflect only a severe hospital-based population; recruitment from rural populations; and the need to screen and enter a newborn population at birth. The recruitment goal of entering 3200 patients, including 2100 patients with SS hemoglobinopathy, over a 24-month period was accomplished after 27 months.

Age Factors↗
PubMed1987

Reversibility of splenic function by transfusion in two young adults with sickle cell anemia.

A level of circulating "pitted" or vesiculated red blood cells higher than 3.5% was recently reported in studies in the Cooperative Study of Sickle Cell Disease to correlate with splenic dysfunction as shown by spleen scans. Reversal of splenic dysfunction by transfusion in children with sickle cell anemia (SS disease) is known to occur in the young child. We report two older patients with homozygous sickle cell disease, aged 17 and 21 years, whose spleen function, as measured by pit count, was restored to normal range after transfusion.

Adolescent↗
PubMed1986

Dermal exposure and urinary metabolite excretion in farmers repeatedly exposed to 2,4-D amine.

Following multiple exposures to 2,4-D amine salts under normal field conditions in which ground rigs were used, farmers who sprayed once or twice had an average dermal exposure of 655 micrograms 2,4-D acid equivalents (a.e.)/kg a.e. sprayed and an average cumulative urinary metabolite excretion of 10.9 micrograms 2,4-D a.e./kg a.e. sprayed. One very high outlier value was excluded from these averages (F). Following 4 to 7 exposures, the average cumulative dermal exposure was 1,077 micrograms 2,4-D a.e./kg a.e. sprayed and the average cumulative urinary metabolite excretion was 21.5 micrograms 2,4-D a.e./kg a.e. sprayed. The amount of 2,4-D metabolite in urine was significantly correlated with the amount of herbicide sprayed and the time required for the urinary metabolite excretion to return to background concentration was related to the amount sprayed and the number of exposures.

2,4-Dichlorophenoxyacetic Acid↗
PubMed1986

Newborn screening for hemoglobinopathies: the benefit beyond the target.

As a result of New York State's Newborn Screening Program 4,565 neonates with trait hemoglobinopathies were identified and 3,200 families were notified of the results of testing their infants in New York City in 1982. Of the 1,531 families (2,190 parents) tested and counseled, 22 parents were diagnosed with sickle cell disease and 39 couples were found to be at-risk for having a child with sickle cell disease. Amniocentesis was performed in 14 of the 28 at-risk pregnant women and three of the four affected pregnancies were terminated. MCH-331001-01 to 04

Anemia, Sickle Cell↗
PubMed1985

Procedure for the determination of 2,4-D and dicamba in inhalation, dermal, hand-wash, and urine samples from spray applicators.

Analytical procedures for the simultaneous determination of residues of 2,4-D and dicamba from polyurethane foam plug air samplers, ethylene glycol impregnated glass-fiber filter paper dermal samplers, 1% sodium bicarbonate hand wash solution, and urine are presented. Residues were derivatized with diazomethane and quantitated using electron capture gas chromatography. Recoveries were greater than 80% at the limit of detection in all substrates. The limits of detection for both herbicides were 0.1 microgram/foam plug and 0.5 micrograms/filter paper, and in the urine, 1.7 micrograms/100 mL and 5.0 micrograms/100 mL for dicamba and 2,4-D, respectively.

2,4-Dichlorophenoxyacetic Acid↗
PubMed1985

Combined use of autoradiography and enzyme histochemistry in studies on the mammalian testis.

Combined application of the methods of enzyme histochemistry and of autoradiography in one and the same section of tissue provides a method to achieve further informations on the individual cells. Prespermatogenesis and spermatogenesis in rodents with their well defined steps of development and very specific enzymatic patterns of each of the stages of the cycle of the seminiferous epithelium were used as a model to study the double labelling with the aid of the enzyme reaction and labelling with 3-H-thymidine. The techniques applied in this study are described and discussed in detail. Possibilities to elucidate the regeneration mode of the seminiferous epithelium by means of this method are discussed.

Alkaline Phosphatase↗
PubMed1983

Pitfalls in diagnosis of osteomyelitis in children with sickle cell disease.

The cases of three children with unusual features of osteomyelitis and sickle cell disease are presented. Two children had salmonella osteomyelitis, one with a recurrence 1.5 years after adequate intravenous therapy. In the second, the bone scan was negative despite verified disease. The causative organism in the third case was Staphylococcus aureus, and there was extensive bone involvement of the radius without symptoms, but with a positive bone scan. It is recommended that the possibility of osteomyelitis be entertained in a child with sickle cell disease whenever there are symptoms and/or objective findings referrable to bone. Radionuclide scans, when used in timely fashion, can assist in the diagnosis, but confirmation can best be achieved by the recovery of microorganisms through blood culture and/or bone aspirate. The choice, dosage, and duration of antibiotic therapy should be determined by causative organisms and by serologic titers.

Anemia, Sickle Cell↗