Biomedical subjects
Publications and source records attributed to R M Greendyke.
Cost analysis of the bedside blood glucose testing program at a Veterans Affairs medical center indicated a per-test cost of $11.50, as opposed to the conventional laboratory testing cost for serum glucose of $3.19. Extrapolated to the 172 Veterans Affairs hospitals, the extra cost of the procedure is estimated to be in excess of $3 million each year.
A study was conducted on a group of chronically hospitalized, brain-damaged male patients to assess the effectiveness of treatment with pindolol on behavioral problems. The study was conducted in two parts. The first was a double-blind, placebo-controlled analysis of the effect of pindolol on assaultive behavior, both verbal and physical. The second part was open and sought to determine whether pindolol would diminish such behaviors as resistance to care, sexual preoccupation, or provocation of others, which were sufficient to preclude placement at a lower level of care. These target behaviors and nursing interventions were monitored and clinical global assessments of improvement in behavior and of suitability for lower levels of care were developed. Eight of 13 patients were considered improved. Those with significant premorbid personality disorders showed little benefit. Pindolol appears to ameliorate some management problems and, by inference, improve the quality of life in many patients with behavioral pathology due to organic brain disease.
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Twenty-six male patients with intermittent explosive disorder secondary to organic brain disease were studied. Each had been treated with long-term administration of thioridazine, haloperidol, phenytoin, and/or phenobarbital, either singly or in combination. The effect of adding increasing doses of pindolol--a beta-adrenergic blocking agent previously demonstrated to be effective in the treatment of intermittent explosive disorder--on serum levels of each long-term medication was determined. Moderate, dose-related increases in serum levels of thioridazine and two of its metabolites were found when pindolol was added. Conversely, higher-than-expected serum pindolol levels occurred in patients receiving thioridazine. No serum level increases were found for haloperidol, phenytoin, or phenobarbital when pindolol was added to each of these drugs individually, but serum phenytoin levels did rise in two patients receiving all three drugs simultaneously when pindolol was added. Three treatment failures with pindolol occurred in association with low serum pindolol levels.
The relationship between chronic oral dosage with a long-acting formulation of propranolol and plasma propranolol levels 22 to 23 hours later is described in 12 adult male patients with organic brain disease. Separately, the effects on plasma levels of thioridazine plus metabolites with concomitant rising dose long-acting propranolol administration were studied in five patients. Significant dose-related increases in levels of thioridazine and metabolites were found when long-acting propranolol was given. No changes in haloperidol levels were found in three patients studied in a similar protocol.
A double-blind, placebo-controlled crossover study was conducted to examine the effects of long-acting propranolol in the treatment of violent behavior associated with organic brain disease in 10 patients whose symptoms had proved refractory to various conventional medications. Long-acting propranolol treatment was associated with reductions of assaultive behavior without apparent sedative effects. Cautions are noted regarding potential undesirable side effects which may necessitate careful patient monitoring during treatment.
A double-blind, placebo-controlled crossover study was conducted to examine the effects of pindolol for the treatment of 11 patients with impulsive, explosive behaviors and other emotional-behavioral abnormalities as a consequence of brain disease or injury. Pindolol treatment was associated with significant therapeutic benefits without sedation and without the use-limiting side effects that occur with propranolol.
The results of 100-cell and 500-cell manual differential white blood cell counts were compared with those obtained using a Coulter S-Plus IV electronic particle counter. Significant (P less than 0.001) correlations were observed between the manual and instrument-derived data for percentages of granulocytes and lymphocytes.
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Propranolol in doses up to 520 mg/day was administered to eight patients with organic brain disease characterized by violent and assaultive behavior refractory to conventional treatment. Improvement was demonstrated in the seven patients able to tolerate adequate drug dosages. Hypotension, bradycardia, and interactions with other medications constituted complications.
A series of experiments was conducted to assess the performance of technologists in the blood bank, with particular reference to precision and accuracy in the technical and mechanical aspects of routine work, including preparation of erythrocyte suspensions, pipetting, interpretation of hemagglutination, detection of mixed-field agglutination, detection of weak alloantibodies, and antibody titration and scoring. The authors conclude that use of semiquantitative technics contributes significantly to imprecision in blood bank work. A plea is made for expediture of increased effort in quality assurance programs directed toward the technical staff.
The authors evaluated the suitability of using a pneumatic tube system for transport of patient blood samples to a hospital blood bank. Hemolysis and occasional reduction in serum antibody reactivity were found in some clotted blood samples after tube transport. Modifications would be necessary to make the system acceptable for routine blood bank use.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.