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Biomedical subjects

A Galloway

Publications and source records attributed to A Galloway.

At least 55 records · Page 3Linked to original sources
PubMed1992

Cell-mediated and humoral immune responses induced by scarification vaccination of human volunteers with a new lot of the live vaccine strain of Francisella tularensis.

Tularemia is a disease caused by the facultative intracellular bacterium Francisella tularensis. We evaluated a new lot of live F. tularensis vaccine for its immunogenicity in human volunteers. Scarification vaccination induced humoral and cell-mediated immune responses. Indications of a positive immune response after vaccination included an increase in specific antibody levels, which were measured by enzyme-linked immunosorbent and immunoblot assays, and the ability of peripheral blood lymphocytes to respond to whole F. tularensis bacteria as recall antigens. Vaccination caused a significant rise (P less than 0.05) in immunoglobulin A (IgA), IgG, and IgM titers. Lymphocyte stimulation indices were significantly increased (P less than 0.01) in vaccinees 14 days after vaccination. These data verify that this new lot of live F. tularensis vaccine is immunogenic.

Antibody Formation↗
PubMed1992

Home sweet HEN--a guide to home enteral nutrition.

Initial experience of home enteral nutrition (HEN) was gained from malnourished patients with Crohn's disease. The rationale for HEN was to improve the patients' lifestyle by reducing the need for repeated admissions for nutritional support: this method is extremely useful in correcting nutritional problems. Over the past ten years the use of HEN has expanded to cover other clinical areas including correction of growth retardation secondary to gastrointestinal disease, cystic fibrosis, inborn errors of metabolism, congenital heart disease, and chronic renal failure, in addition to many types of neoplasia and chronic neurological diseases. At the present time, approximately 150 patients receive HEN within the catchment area of the Greater Glasgow Health Board (population 940,000). Despite the increasing availability of HEN many clinicians and dietitians are still reluctant to consider HEN as a 'routine adjunct' to clinical management, claiming that it is too dangerous or complicated. The aims of this article are to explain our method of running a HEN service, offer advice on practical problems and discuss further developments and potential difficulties.

Enteral Nutrition↗
PubMed1991

Penicillin-resistant pneumococci in a Merseyside hospital.

Strains of Streptococcus pneumoniae (N = 915) from clinical specimens were examined for penicillin resistance over a 2-year period. The prevalence of resistance [minimum inhibitory concentration (MIC) greater than 0.1 mg l-1] increased from 1.4 to 2.5% per year during this time. In addition, 83% of penicillin-resistant pneumococci (PRP) showed resistance to chloramphenicol. Most PRP were isolated from uninfected children colonized with the organism, but two out of the three adult cases were clinically infected, one by cross-infection between in-patients. In only two cases was there an association with foreign travel. Three children showed prolonged carriage providing a potential reservoir of infection for other members of the community. The percentage of strains showing high level resistance (MIC greater than 1 mg l-1) increased from 0.7% to 1.9% of all isolates during the 2-year study period. This high prevalence of high level resistance has not been reported previously in the UK and if the trend continues, it will have serious implications for the management of invasive pneumococcal infection, particularly meningitis.

Adult↗
PubMed1990

Stature loss among an older United States population and its relation to bone mineral status.

Age-related statural loss has been recorded but incompletely assessed in modern populations. In this study, data collected on stature during annual bone mineral assessments are analyzed for 1,024 Caucasian individuals from southern Arizona. Continued stabilization in reported maximum heights is seen in this population. With advancing age there is a gradual decrease in height apparently beginning in the mid-40s. Thereafter, there is a relatively rapid decrease in measured height. This contrasts to the much slower rates predicted from earlier populations (Trotter and Gleser: American Journal of Physical Anthropology 9:311-324, 1951). The rate of stature loss is associated with diminution of bone mineral density as well as with maximum height. Since there are suggestions of a secular trend toward greater reductions in bone mineral density, this study suggests there may be a secular trend toward an increase in statural loss with age.

Age Factors↗
PubMed1990

Magnesium deficiency in patients on home enteral nutrition.

Home enteral nutrition (HEN) is an established method of long term nutritional support. Many patients receiving HEN have Crohn's disease complicated by intestinal failure and malnutrition, including magnesium deficiency. It is unknown if HEN can correct magnesium deficiency or if patients on HEN can become magnesium deficient. We measured total magnesium intake in nine patients receiving HEN, and assessed their magnesium status. Two patients had magnesium intakes below the recommended dietary allowance of 15 mmol/day. Four patients (44%) had biochemical evidence of magnesium deficiency, although no patient had clinical signs of magnesium deficiency. Several magnesium deficient patients used a liquid feed which had a low magnesium content. Patients on HEN should have their magnesium status checked regularly and may require magnesium supplements.

Journal Article↗
PubMed1990

Antibody coated bacteria in urine of patients with recent spinal injury.

Twenty patients with an acute spinal injury were prospectively studied to assess the clinical importance of antibody coated bacteria (ACB) in the urine and the association among the different bacterial species with a positive antibody coated bacteria test. Clinical urinary tract infection was associated with a positive ACB test on 45% of occasions. Three hundred and ninety nine urine samples containing 541 bacterial isolates were assessed for the presence of ACB; 13% were found to be positive and 87% negative for ACB; 67% of urines contained a single bacterial isolate. Pseudomonas aeruginosa was most commonly associated with clinical urinary tract infection, found in 25% of episodes, followed by Proteus mirabilis (17.5%), Klebsiella sp (12.5%), and Proteus morganii (10%). Providencia stuartii, however, was most commonly associated with a positive ACB test (found in 17%). Other bacteria associated with a positive ACB test included Klebsiella sp (14%), Acinetobacter sp (12.5%), Pseudomonas aeruginosa (12%), Citrobacter sp (11.5%). A positive ACB test is not to be expected from a patient with spinal injury who has a catheter in place, and the test may provide a useful guide to identify those patients with an invasive infection. It is doubtful that a decision to treat or not treat bacteriuria could rest on the identification of the bacterial species alone.

Acute Disease↗
PubMed1989

The effect of ventilation on aortic blood gases during left ventricular ejection before separation from cardiopulmonary bypass.

The time to begin ventilating a cardiac surgical patient recovering from hyperkalemic arrest is controversial. Those who advocate ventilating as soon as the left ventricle begins to eject believe that blood ejected from the left ventricle is likely to be hypoxic since it perfuses collapsed, nonventilated alveoli and that this may be the major blood supply perfusing the coronary arteries. The present study attempts to answer this question by sampling blood gases from the aorta in proximity to the coronary ostia in patients both before and after ventilation. Ten patients undergoing coronary artery bypass grafting using the left internal mammary artery were studied. Each patient served as his own control. Distal anastomoses were placed under hyperkalemic, hypothermic cardiac arrest. The aorta was unclamped, and an intrinsic or paced heart rate of 70 beats per minute was achieved. The heart was allowed to eject to a pulse pressure of 20 to 40 mmHg. Rectal temperatures were between 32 degrees C and 34 degrees C. Blood gases were drawn simultaneously from the proximal aortic root, radial artery, pulmonary artery, and the venous circuit of the cardiopulmonary bypass (CPB) machine. The lungs were then twice inflated with a sustained positive pressure of 30 cm H2O, and the patient was ventilated (10 mL/kg tidal volume, FIO2 1.0, 10 breaths per minute) for two minutes. Another set of blood gases was then obtained. Filling pressures, aortic systolic and diastolic pressures, and CPB flows were kept constant for both sets of samples. There was no significant difference in aortic root PaO2 attributable to ventilation. PCO2 was significantly lower, and pH was significantly higher in the ventilated group.(ABSTRACT TRUNCATED AT 250 WORDS)

Aorta↗
PubMed1989

Decay rates of human remains in an arid environment.

The environment of southern Arizona with mild winters and hot, dry summers produces great variability in decay rates of human remains. Summer temperatures, which range well over 38 degrees C (100 degrees F), induce rapid bloating as a result of the accumulation of decompositional gases. However, in certain circumstances, the aridity can lead to extensive mummification, allowing preservation of remains for hundreds of years. A retrospective study of 189 cases, concentrating on remains found on the desert floor or in the surrounding mountains and on remains found within closed structures, outlines the time frame and sequences of the decay process. Remains can retain a fresh appearance for a considerable time in the winter, but the onset of marked decomposition is rapid in the summer months. Bloating of the body usually is present two to seven days following death. Following this, within structures, there is frequently rapid decomposition and skeletonization. With outdoor exposure, remains are more likely to pass through a long period of dehydration of outer tissues, mummification, and reduction of desiccated tissue. Exposure of large portions of the skeleton usually does not occur until four to six months after death. Bleaching and exfoliation of bone--the beginning stages of destruction of the skeletal elements--begins at about nine months' exposure. Insect activity, including that of maggot and beetle varieties, may accelerate decomposition, but this process is greatly affected by location of the body, seasonal weather, and accessibility of the soft tissues. Carnivores and other scavengers also are contributing factors, as are clothing or covering of the body, substrate, elevation, and latitude.

Animals↗
PubMed1988

Estimating actual height in the older individual.

The widely used formulas for estimating adult stature require modification of the estimated height to account for the effects of age. The recording of measured and reported height in a living older population from southern Arizona, in conjunction with bone mineralization monitoring, provides an opportunity to test the currently used correction factor. Loss of height appears to commence around the age of 45, and the average rate of loss is relatively rapid at 0.16 cm per year. The correction factor suggested by this study is 0.16(age--45), subtracted from the maximum height. The loss is also affected by the maximum height of the individual. In cases of low bone mineralization, the increased incidence of vertebral crush fractures may cause further reductions in standing height. The low rate of recognition of height changes among the older community lowers the usefulness of the age adjusted height estimate. It is recommended that both the maximum and age adjusted heights be provided in forensic science reports to aid in matching with missing person reports.

Aged↗
PubMed1987

Spontaneous variability of ventricular arrhythmias in patients at increased risk for sudden death after acute myocardial infarction: consecutive ambulatory electrocardiographic recordings of 88 patients.

The Cardiac Arrhythmia Pilot Study, sponsored by the National Heart, Lung, and Blood Institute, is a multicenter, prospective, randomized, double-blind trial designed to identify patients having 10 or more ventricular premature complexes (VPCs) per hour within 6 to 60 days of acute myocardial infarction. The present investigation selected patients after acute myocardial infarction who had ambulatory electrocardiographic qualifying arrhythmia for CAPS. An additional baseline electrocardiogram was recorded before enrollment in the study to assess baseline spontaneous variability of VPCs. A total of 88 patients (15 women, 73 men, aged 57 +/- 10 years) were studied. The 43 patients (49%) receiving beta-blocking drugs were included because the dose was not altered between the 2 consecutive electrocardiographic recordings. This investigation shows that a 95% reduction in VPCs is required to document a significant drug effect rather than variability alone if 1 day of control and 1 day of treatment electrocardiographic recording are compared. Similarly, based on 1 day of electrocardiographic recording before and after antiarrhythmic therapy, 1,780% increase in VPC frequency is required to establish "arrhythmia aggravation" from an antiarrhythmic drug rather than from variability alone based on a 95% confidence interval. Variability of ventricular arrhythmias is independent of left ventricular function, whereas patients taking beta-blocking therapy tend to have greater VPC variability (p = 0.052), even though VPC frequencies were lower (59 +/- 19 vs 138 +/- 31 VPCs/hour, p less than 0.006) than those not taking beta-blocking drugs.

Adrenergic beta-Antagonists↗