Thomas Hyers - Academia.edu (original) (raw)

Papers by Thomas Hyers

The American review of respiratory disease, 1981

We report here the occurrence of focal pulmonary edema within 4 h after massive acute pulmonary e... more We report here the occurrence of focal pulmonary edema within 4 h after massive acute pulmonary embolism. The edema appeared to develop only in areas with intact pulmonary arterial blood flow and occurred in the apparent absence of left ventricular dysfunction. This pattern of pulmonary edema after precapillary obstruction is similar to that seen in animal models of permeability pulmonary edema induced by acute nonuniform pulmonary arterial obstruction.

Postgraduate Medicine, 1982

Clinics in Chest Medicine, 1984

During the last 25 years, there has been much progress in the diagnosis, treatment, and preventio... more During the last 25 years, there has been much progress in the diagnosis, treatment, and prevention of venous thromboembolic disease. The guest editor believes that a great deal remains to be done and attempts, in this article, to outline some of the challenges remaining by developing themes put forth by the various authors of this issue.

Respiratory Research, 2020

Background Oral CXC chemokine receptor 2 (CXCR2) antagonists have been shown to inhibit neutrophi... more Background Oral CXC chemokine receptor 2 (CXCR2) antagonists have been shown to inhibit neutrophil migration and activation in the lung in preclinical and human models of neutrophilic airway inflammation. A previous study with danirixin, a reversible CXCR2 antagonist, demonstrated a trend for improved respiratory symptoms and health status in patients with COPD. Methods This 26-week, randomised, double-blind, placebo-controlled phase IIb study enrolled symptomatic patients with mild-to-moderate COPD at risk for exacerbations. Patients received danirixin 5, 10, 25, 35 or 50 mg twice daily or placebo in addition to standard of care. Primary end-points were the dose response of danirixin compared with placebo on the incidence and severity of respiratory symptoms (Evaluating Respiratory Symptoms in COPD [E-RS:COPD] scores) and safety. Secondary end-points included the incidence of moderate-severe exacerbations, health status (COPD Assessment test, CAT) and health-related quality of life...

Hämostaseologie, 1997

SummaryProblems with unfractionated heparin as an antithrombotic have led to the development of n... more SummaryProblems with unfractionated heparin as an antithrombotic have led to the development of new therapeutic agents. Of these, low molecular weight heparin shows great promise and has led to out-patient therapy of DVT/PE in selected patients. Oral anticoagulants remain the choice for long-term therapy. More cost-effective ways to give oral anticoagulants are needed.

Journal of Leukocyte Biology, 1992

Ketorolac tromethamine, a new nonsteroidal anti-inflammatory agent of the pyrrolo-pyrrole group, ... more Ketorolac tromethamine, a new nonsteroidal anti-inflammatory agent of the pyrrolo-pyrrole group, was assayed for inhibitory effects on polymorphonuclear leukocytes (PMN) in a variety of systems. Ketorolac inhibited PMN superoxide anion generation, lysozyme release, myeloperoxidase release, adherence to plastic surfaces, and chemotaxis in response to N-formyl-methionyl-leucyl-phenylalanine (fMLP) in a dose-dependent manner. Ketorolac also inhibited phorbol myristate acetate-stimulated adherence of PMN to bovine pulmonary artery endothelial cells. The drug inhibited lysozyme and myeloperoxidase release by PMN in response to C5a but failed to inhibit C5a stimulation of PMN in any of the other assays. Levels of ketorolac required to inhibit PMN function in most systems were in the range of 0.2 to 1.0 mg/ml, but chemotaxis to fMLP was inhibited by concentrations of ketorolac as low as 1 μg/ml. Ketorolac, currently the only nonsteroidal anti-inflammatory drug available in a parenteral for...

Venous thromboembolism (VTE) remains a significant threat to public health despite the availabili... more Venous thromboembolism (VTE) remains a significant threat to public health despite the availability of effec- tive and safe prophylactic measures and treatments. Guidelines based on randomized clinical trials are avail- able to improve the management of thromboembolic disease. However, gaps exist between recommendations and clinical practice, and many pa- tients are unnecessarily exposed to the risk of a deep vein thrombosis or potentially fatal pulmonary em-

American Review of Respiratory Disease, 1990

Apparatus and method to monitor patient breathing during weaning from Ventilator dependency to as... more Apparatus and method to monitor patient breathing during weaning from Ventilator dependency to assure adequate performance and Safety, and to provide Visual respiratory biofeedback breathing patterns to prompt respiratory center neurologic Signals to normal performance.

Federation proceedings, 1986

The increased microvascular permeability of the adult respiratory distress syndrome (ARDS) result... more The increased microvascular permeability of the adult respiratory distress syndrome (ARDS) results in multiple organ injury with the lungs and subsequently the kidneys as the principal targets. Direct pulmonary injury, for example aspiration of gastric contents, and indirect injury, for instance abdominal sepsis, can lead to the syndrome. The predominant infectious cause of the syndrome is gram-negative aerobic rods. Even in patients with noninfectious causes of the syndrome, the incidence of subsequent pneumonia and sepsis with gram-negative aerobic rods is high so that these organisms contribute greatly to the morbidity and mortality that result from the syndrome. Activation of polymorphonuclear leukocytes and platelets and proteolysis of complement and coagulation components contribute to the pathogenesis of the syndrome, particularly from the indirect or blood-borne causes. Therapy is largely supportive and has not progressed substantially since the introduction of positive end ...

The Journal of rheumatology, 1991

Elastin degradation by PMN and by PAM differs in the proteinases produced and in the method of ce... more Elastin degradation by PMN and by PAM differs in the proteinases produced and in the method of cellular attack on the substrate. To further characterize the elastinolytic mechanisms of these two cells, Â¹â´C-labelled bovine ligament elastin was dried onto 24-well culture plates and live cells were placed on the substrate in culture medium. Incubation times were 4 hours for PMN and 20 hours for PAM. Elastinolytic activity was determined by counting Â¹â´C-elastin peptides in the supernatant. By lidocaine release of PAM from the surface, Â¹â´C-elastin retained by the cell was measured. Studies on rabbit PAM showed that 40% of dpm remain associated with the cell at 20 hours. Transmission electron microscopy of human PAM confirmed that PAM can engulf and retain elastin particles at 4 and 24 hours of incubation when in close contact with the substrate. Of the number of dpm released by PMN in 4 hours, PAM in 20 hours released only 23% of that number into supernatant and retained 17% clo...

Seminars in Respiratory and Critical Care Medicine, 1981

Journal of Thrombosis and Thrombolysis, 2007

This multicenter, prospective, open label, observational study evaluated practice patterns of phy... more This multicenter, prospective, open label, observational study evaluated practice patterns of physicians using tinzaparin, a low-molecular-weight heparin (LMWH), and warfarin for the treatment of deep venous thrombosis (DVT) with or without pulmonary embolism (PE). Short-term recurrence of venous thromboembolism (VTE) and safety were also evaluated. Patients with an objective diagnosis of DVT, with or without PE, were invited by their physician to participate in this study. Treatment was given according to the approved U.S. package inserts for tinzaparin (175 IU/kg SQ QD) and warfarin and the clinical judgment of the prescribing physician. Baseline patient history including demographic information and the results of tests to confirm the diagnosis of DVT, with or without PE, were collected. Follow-up information included the treatment setting in which each dose of tinzaparin was administered, medical training of the person administering tinzaparin doses, timing of initiation of warfarin with respect to that of tinzaparin, length of overlap of tinzaparin and warfarin therapy, and adverse experiences. A total of 334 patients were enrolled at 65 sites. Patients across a wide age (range 18-93 years old) and body weight (range 40-261 kg) were included. Overall, 27.3% of patients had cancer, and 50% of the overall study population reported more than one VTE risk factor. Mean duration of tinzaparin treatment was 7.61 days. Therapy at home was more common in suburban and rural settings than in urban settings. High proportions of patient, even among the small group with concurrent PE, were treated at home with self-injection. Severity of disease was the primary reason for hospitalization. Home treatment of DVT, with or without PE, with self administration of tinzaparin at 175 IU SQ once-daily was safe and resulted in an acceptably low rate of recurrent venous thromboembolism and adverse events. Home therapy in the usual practice setting should achieve substantial overall cost savings in the treatment of DVT.

Journal of General Internal Medicine, 1992

Design: Survey. Setting: Medical intensive care unit of a tertiary care center. Participants: Phy... more Design: Survey. Setting: Medical intensive care unit of a tertiary care center. Participants: Physicians and families of 15 critically ill patients; in seven cases patients also participated. Measurements: Meetings between physicians and family members concerning a decision to withhold or stop treatment of a critically ill family member were tape-recorded. Transcriptions of the meetings were analyzed for 1) process: how the physician introduced the need for a decision, framed the likely outcomes of options, and closed on a decision; 2) what decision was made; and 3) the outcome; died, discharged home, or discharged to another institutiom Results: The concept of "~oatient's wishes" was a central orientation point for the negotiation of consensus regarding withholding or withdrawing therapy even when the patient was not a participant. Physicians tended to provide a direct and unambiguous introduction, give equal weights to options during decision framin~ but narrow the options during decision closure to correspond to their judgments. Not every decision was consistent with the physician's judgment. Conclusions: Decision making to withhold or withdraw life-support therapy from critically ill persons involves complex, difficult processes. Successful management of the tension among life extension, quality of life, patient autonomy, and social justice requires better understanding of these processes.