Detroit Receiving Hospital

About: Detroit Receiving Hospital is a healthcare organization based out in Detroit, Michigan, United States. It is known for research contribution in the topics: Vancomycin & Population. The organization has 877 authors who have published 850 publications receiving 37202 citations. The organization is also known as: Detroit General.

Efficacy and cost of ampicillin-sulbactam and ticarcillin-clavulanate in the treatment of hospitalized patients with bacterial infections.

Abstract: Study Objective. To evaluate the efficacy and cost of treatment with two β-lactam/β-lactamase-inhibitor combinations. Design. Retrospective, open-label multicenter study. Setting. Fifty-four hospitals across the United States. Patients. Eight hundred ninety patients with skin and soft tissue, intraabdominal, gynecologic, respiratory, urinary tract, or other infections that required parenteral antibiotic therapy. Intervention. Patients were administered either ampicillin-sulbactam 1.5 or 3.0 g every 6 hours or ticarcillin-clavulanate 3.1 g every 6 hours. Measurements and Main Results. The agents did not differ significantly in efficacy for most infections; although, ampicillin-sulbactam was bacteriologically superior to ticarcillin-clavulanate in the treatment of intraabdominal infections (p=;0.0011). Costs of ampicillin-sulbactam, particularly the 1.5-g dose, were lower than those of ticarcillin-clavulanate for skin and soft tissue (p<0.001), intraabdominal (p=;0.005), and respiratory tract (p<0.001) infections. Conclusion. Ampicillin-sulbactam provides effective coverage for patients with the above infections and is as effective as the broader-spectrum agent.

The John Doe syndrome: diagnosis and outcome of patients unidentified at the time of emergency department admission.

Abstract: Patients unidentified at the time of admission to urban emergency departments are a group about whom little is known. To determine the medical diagnoses and outcomes of these "John" and "Mary Does", we reviewed emergency department charts for these patients admitted from January 1 to December 31, 1988. During this period there were 344 initially unidentifiable patients, for 0.44% of all visits. Age was 36.9 ± 15.6 years (mean ± SD); 71% were male. All patients had one or more of the following diagnoses, with mortality highest for cardiopulmonary arrest (n = 42, mortality=100%), followed by major trauma (163, 68%), drug overdose (27, 41%), miscellaneous medical conditions (11, 18%), neuropsychiatric disorders (59, 12%), acute alcohol intoxication (62, 0%), and seizures (13, 0%). Overall mortality was 47%. Identification was made prior to hospital discharge in 92% of cases. In this group, the most cummon sources of information were the patient (38%), family (19%), or documents eventually found on the person or in belongings (4%). Survivors were much more likely to be identified than those who died (99% versus 84%, P

Therapeutic management of primary dysmenorrhea.

Abstract: Primary dysmenorrhea is a common gynecologic disorder. Dysmenorrheic pain normally has an onset of from 2-12 hours before the start of menses and tapers over the next one to two days. Although the exact etiology is unknown, this condition is associated with an increase in prostaglandin F2 alpha. In the past, nonspecific treatments such as heat and exercise were tried, with poor results. Little relief was offered by antispasmodics or low-dose aspirin. Currently, effective therapy for primary dysmenorrhea includes oral contraceptives and prostaglandin synthetase inhibitors. Oral contraceptives should be prescribed only for women who desire contraception and who are candidates for this type of therapy. Prostaglandin synthetase inhibitors can be given to women who do not desire oral contraceptives or those who do not respond to hormonal therapy. Secondary dysmenorrhea should be suspected in women who do not respond to either treatment modality.

Amiodarone-induced changes in lipid metabolism.

Abstract: Hypothyroidism is a major cause of secondary hypercholesterolemia Amiodarone treatment alters both the levels of serum lipids and thyroid hormones We investigated whether the amiodarone-induced changes in lipid metabolism are related to the changes in thyroid hormone levels Eighteen patients received amiodarone (31 +/- 3 g cumulative dose) for six weeks Serum triglyceride, total-cholesterol, high density lipoprotein-cholesterol and its subfractions, apolipoproteins B and AI, and plasma post-heparin lipoprotein lipase and hepatic triglyceride lipase activities were determined Amiodarone treatment caused significant increases in serum total-cholesterol (baseline 44 +/- 021 (SE), 6 weeks 512 +/- 026 mmol/l, P less than 001), in low density lipoprotein cholesterol (baseline 261 +/- 026, 6 weeks 336 +/- 021 mmol/l, P less than 005) and in apolipoprotein B (baseline 195 +/- 015, 6 weeks 226 +/- 013 mmol/l, P less than 001) concentrations Serum high density lipoprotein and its subfractions, or apolipoprotein AI levels did not change Plasma post-heparin lipoprotein lipase activity increased (baseline 137 +/- 21, 6 weeks 168 +/- 21 U/ml, P less than 001) while hepatic triglyceride lipase did not change Amiodarone also caused an increase in serum thyroxine (baseline 110 +/- 8, 6 weeks 136 +/- 6 mmol/l, P less than 005), although values remained in euthyroid range In summary, amiodarone therapy increased the concentrations of atherogenic lipoproteins in the serum similar to that seen in hypothyroidism On the other hand the effect of amiodarone on lipoprotein lipase was opposite to that seen in hypothyroidism Therefore, amiodarone-induced changes in lipid metabolism cannot be explained solely on the basis of the changes in circulating thyroid hormone levels