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Biomedical subjects

W E Goetter

Publications and source records attributed to W E Goetter.

8 recordsLinked to original sources
PubMed1989

Prediction of outcome from critical illness. A comparison of clinical judgment with a prediction rule.

Quantitative methods to enhance clinical judgment would be of tremendous benefit to physicians caring for the critically ill. The ability of physicians to predict outcome is a logical standard on which to base the prospective evaluation of a prediction rule intended for this clinical use. The APACHE (acute physiology and chronic health evaluation)-II score was compared with critical care physicians' prediction of outcome for a group of patients in a medical intensive care unit. Physicians were significantly better in predicting outcome in the critically ill. However, the APACHE-II score was still a good predictor of outcome in the intensive care unit and, according to analysis using Bayes' theorem, might still be a useful test to support physicians' judgment, especially in patients with a predicted mortality risk of less than 30%.

Bayes Theorem↗
PubMed1984

The pathophysiology of asthma. Extrinsic influences other than immunologic.

Atopy is not the most common factor causing asthma in adults. Recent elucidations of pathophysiologic mechanisms involving the autonomic nervous system, cyclic nucleotide metabolism, and arachnoidonic biochemistry give us a better understanding of the similarities and unique differences among asthma events related to exercise, aspirin, emotions, occupational environments, atmospheric conditions, and respiratory tract infections. The ultimate value of this information is no greater than its potential to aid the physician in decreasing the interference of asthma in the daily lives of patients.

Aerosols↗
PubMed1982

Ceftriaxone: in vitro studies and clinical evaluation.

The in vitro activity of ceftriaxone against 437 clinical isolates of gram-negative bacilli was determined. Ceftriaxone was found to have high in vitro activity against Enterobacteriaceae, with the exception of Enterobacter cloacae. Ceftriaxone was only minimally active against Pseudomonas aeruginosa and Acinetobacter calcoaceticus. We evaluated the clinical efficacy and toxicity of ceftriaxone in 55 adult patients. Bacterial infection was confirmed by the isolation of etiological bacteria in 30 patients. Infectious disorders treated included 10 pneumonias, 13 urinary tract infections, and 7 soft tissue or bone infections. Pathogens identified were 25 isolates of gram-negative bacilli, 5 isolates of Staphylococcus aureus, 5 isolates of pneumococci, and 4 isolates of other streptococci. The overall efficacy of ceftriaxone was excellent. The clinical cure rate was 93%, and the bacteriological cure rate was 93%. A total of 30 adverse reactions were noted in 22 of 55 patients receiving ceftriaxone, but only one necessitated discontinuation of treatment. Adverse effects frequently noted were elevated hepatic enzymes (16%), thrombocytosis (16%), and eosinophilia (8%). Ceftriaxone is an effective and well-tolerated antimicrobial agent that appears promising for the treatment of serious gram-negative bacillary infections.

Adolescent↗
PubMed1981

Evaluation of the ordering of serum theophylline concentrations.

The ordering of serum theophylline concentrations in a 900-bed university hospital was evaluated. Data were collected during the first week of three consecutive months from the records of adult inpatients who had serum theophylline assays performed. The appropriateness of ordering the serum theophylline determinations was evaluated on the basis of criteria including sampling at steady-state concentrations and sampling in proper relationship to the dosage schedule to represent a peak or trough concentration. A total of 113 determinations in 79 patients were reviewed. Pulmonary service patients accounted for 54 (48%) of the determinations. For the 56 concentrations ordered for patients receiving aminophylline continuous infusions, 25 (45%) of the determinations did not meet the criteria for appropriateness. For the 57 other determinations (oral theophylline products and intermittent bolus injections of aminophylline), 42 (74%) were not ordered according to the established criteria. Overall, 67 (59%) of 113 serum theophylline determinations were found to be ordered inappropriately. Corrective educational programs based on standard guidelines for ordering serum theophylline concentrations were established.

Evaluation Studies as Topic↗