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Biomedical subjects

S R Hayes

Publications and source records attributed to S R Hayes.

10 recordsLinked to original sources
PubMed1992

Butorphanol tartrate (Stadol) relieves postanesthesia shaking more effectively than meperidine (Demerol) or morphine.

The cause of postanesthesia shaking (PS) is unknown. PS develops spontaneously and unpredictably in up to 67% of patients emerging from general anesthesia, and it continues for minutes to hours when not treated with medications or radiant heat lamps. The purposes of this study were to (1) examine whether butorphanol tartrate (Stadol; Anaquest, Madison, WI/Bristol-Meyers Squibb, Evansville, IN), meperidine (Demerol; Winthrop, NY, NY), and morphine are differentially effective in suppressing PS, (2) compare PS suppression by sex, and (3) determine time to PS development. PS, measured on a 0 to 3 visual scale, developed in 120 of 533 patients (23%). Medication treatment was initiated for 66 of 120 patients by PACU nurses following standard policies and procedures for intravenous doses of 1 mg butorphanol (n = 12), 15 to 30 mg meperidine (n = 18; n = 23), or 2 to 4 mg morphine (n = 13). Treatment effect was measured in units on a 0 to 2 visual scale. By t test, butorphanol is more effective within 2 minutes than meperidine for suppressing shaking alone (P less than .02) or shaking among patients also complaining of pain (P less than .02). Morphine does not relieve shaking. The chi 2 test indicates women suppress PS more rapidly than men (P less than .01), and PS develops within 5 minutes of PACU arrival (P less than .001). Findings suggest that butorphanol is an alternative PS treatment to meperidine, since it relieves shaking within 2 to 5 minutes without producing nausea, vomiting, or recurrence of shaking.

Adolescent↗
PubMed1991

Use of an indoor air quality model (IAQM) to estimate indoor ozone levels.

Currently, outdoor ozone levels in many U.S. cities exceed the primary health-based national ambient air quality standard. While outdoor ozone levels are an important measure of the severity of those exceedances, people typically spend more than 80 percent of their time indoors, where ozone levels are lower. Indoor ozone levels range from 10 to 80 percent of outdoor levels, with many people receiving a substantial portion of their ozone exposure while indoors. This paper uses an indoor air quality model (IAQM) to estimate indoor ozone levels by microenvironment type (home, office, and vehicle) and configuration (windows open, windows closed, older construction, weatherized, and air conditioned). The formulation of IAQM is discussed, along with specification of model parameters for ozone. The multicompartment version of IAQM is described, with a single-compartment version used for the analyses. IAQM-calculated ozone indoor-outdoor ratios compare well with research-reported values. Results indicate that ozone peak-concentration indoor-outdoor ratios range as follows: home--0.65 (windows open), 0.36 (air conditioned), 0.23 (typical construction, windows closed), and 0.05 (energy-efficient construction, windows closed); office--0.82 (heating, ventilation and air conditioning systems supplying 100 percent outdoor air), 0.60 (typical HVAC), and 0.32 (energy-efficient HVAC); and vehicle--0.41 (85 mph), 0.33 (55 mph), and 0.21 (10 mph). Analysis results are presented to characterize IAQM's sensitivity to assumed model parameters.

Air Pollutants↗
PubMed1991

Opiate receptors and analgesia: an update.

Opiates remain the choice of analgesia for severe pain despite numerous side effects. They possess the unique ability to alter the interpretation of noxious sensations normally sensed as pain, while leaving the sensations of touch, temperature, and proprioception essentially unchanged. Opiates act by mimicking naturally occurring endogenous peptides at a variety of receptors in the central nervous system (CNS). Disruption of pain sensation occurs because of the action of different opiate receptor types located along pain pathways in the CNS. Analgesic activity and adverse side effects of all narcotic analogs are directly related to the activity of the drugs at a combination of opiate receptors. The currently known opiate receptors (mu 1, mu 2, kappa, sigma, and delta) are described with respect to function and location along pain pathways. A brief description of nociceptive (pain) pathway anatomy is also presented. Application of knowledge has allowed the development of mixed agonist-antagonist drugs such as butorphanol (Stadol; Anaquest, Madison, WI/Bristol Meyers Squibb, Evansville, IN) that capitalize on specific opiate receptor activation or antagonism to decrease adverse side effects and abuse-dependence potential. Future research areas are discussed.

Classification↗
PubMed1991

Butorphanol tartrate (stadol): a review.

Butorphanol tartrate (Stadol; Anaquest, Madison, WI/Bristol-Meyers Squibb, Evansville, IN) is an analgesic possessing mixed agonist-antagonist activity at opiate receptors. Receptor specificity has been used to limit respiratory depression, gastrointestinal side effects, and reduce the risk of dependency. Theoretically it offers an advantage over traditional opiates such as morphine and meperidine in the treatment of moderate pain. Butorphanol has been used as a preoperative sedative and analgesic, as a supplement to balanced anesthesia, and for suppression of postanesthesia shaking. Other recognized uses include obstetric analgesia during labor and relief of moderate postpartum pain. In addition, butorphanol has been used effectively for conscious sedation. Its lack of euphoric effects may be useful in emergency medicine for clinical populations prone to drug-seeking behavior. Butorphanol has been used more recently for epidural analgesia or for intravenous patient-controlled analgesia when allergies to opiates exist. Since butorphanol is not a controlled substance, its use can reduce administrative liability for abuse and can lower the number of distribution records associated with Schedule II narcotics.

Butorphanol↗
PubMed1989

Estimating the effect of being indoors on total personal exposure to outdoor air pollution.

A personal air quality model (PAQM) has been developed to estimate the effect of being indoors on total personal exposure to outdoor-generated air pollution. Designed to improve air toxics risk assessment, PAQM accounts for individual hourly activity patterns, indoor-outdoor differences, physical exercise level, and geographic location for up to 56 different population groups. Unique hourly activity profiles are specified for each population group; group members are assigned each hour to one of up to 10 different indoor and outdoor microenvironments. To illustrate PAQM use, we apply it to two example cases: a long-term example representative of situations where pollutant health impact is related to integrated exposure (as in the case of potentially carcinogenic air toxics) and a short-term example representative of situations where health impact is related to acute exposure to peak concentrations (as with ozone). Case study results illustrate that personal exposure, and thus health risk, attributable to outdoor-generated air pollution is sensitive to indoor-outdoor differences and population mobility. Where health impact is related to long-term integrated exposure (e.g., air toxics), exposure and subsequent risk are likely to be lower than that estimated by previous modeling techniques which do not account for such effects.

Air Pollution↗
PubMedDate not supplied

Long-tube gastrostomy with internal intestinal splinting: ten-year experience.

Long-tube bowel splinting at operation, with use of a gastrostomy for introduction of the tube, has many advantages in varying conditions. Results are evaluated in 79 patients undergoing operations, over a 10-year period, for first or recurrent intestinal adhesive obstruction, complicated Crohn's disease, peritonitis, ventral hernia repair, ileostomy, radiation enteritis, etc. Technique and complications are reviewed. Advantages of a recently-developed bi-lumen tube over a single-lumen tube are discussed.

Adolescent↗