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Biomedical subjects

A J Berry

Publications and source records attributed to A J Berry.

At least 55 records · Page 3Linked to original sources
PubMed1986

Paradigms and practices: the organization of the delivery of nursing care.

The patient allocation paradigm of nursing care is slowly superseding the task allocation paradigm. A research study reported here upon the introduction of patient allocation in a maternity hospital found that patients experienced few significant changes in their satisfaction; similar to previous studies this research found that the nurses reported significant gains in satisfaction. Following analysis of the 'medical model' assumptions inherent in the two paradigms and the methods used in the studies, it is suggested that a third paradigm of nursing care is emerging, 'patient centred'--a paradigm within which the patient is a participating individual.

Consumer Behavior↗
PubMed1986

Imipenem therapy of experimental Staphylococcus epidermidis endocarditis.

Imipenem was evaluated for its activity against Staphylococcus epidermidis in vitro and in a rabbit model of endocarditis. The MBC for imipenem of 55 methicillin-resistant S. epidermidis isolates from patients with prosthetic valve endocarditis increased by eightfold or greater with increasing inoculum size; there was no inoculum-associated increase in the imipenem MBC for 20 methicillin-susceptible S. epidermidis isolates. Endocarditis was produced in rabbits with either a methicillin-susceptible or a methicillin-resistant S. epidermidis isolate to investigate the correlation in vivo of the in vitro inoculum effect for imipenem. Six days of imipenem treatment eradicated methicillin-susceptible S. epidermidis from vegetations of infected rabbits significantly better than no therapy but was less effective against methicillin-resistant S. epidermidis in this regard. Among methicillin-resistant S. epidermidis-infected rabbits, 6 days of imipenem therapy (i) was not significantly better than that of the control and was significantly worse than that of vancomycin in eradicating bacteria from infected vegetations and (ii) increased the frequency of imipenem-resistant subpopulations in infected vegetations. Resistant subpopulations were not seen in vegetations from untreated or imipenem-treated, methicillin-susceptible S. epidermidis-infected rabbits. Imipenem may not be effective therapy for serious human methicillin-resistant S. epidermidis infections.

Animals↗
PubMed1985

A multicenter study of the epidemiology of hepatitis B in anesthesia residents.

Practicing anesthesiologists are at high risk of hepatitis B infection, but the risk for anesthesia residents has not been assessed. Anesthesia residents at seven universities were surveyed to study the epidemiology of hepatitis B in these trainees. Hepatitis B virus markers in serum were measured and data from questionnaires were used to determine characteristics of anesthetic practice, effectiveness of strategies for hepatitis B virus infection control, and nonvocational hepatitis B risk factors. Of 267 participants, 12.7% (range of the seven centers, 8.7%-22.7%) had serum markers for hepatitis B virus. The seropositivity (17.8%) in anesthesia residents who had completed more than 12 months of nonanesthesia postgraduate clinical training, or who had practiced medicine in another specialty prior to anesthesia, was greater than in the other trainees (9.4%). Based on their risk and the ineffectiveness of current control measures, anesthesia residents who lack hepatitis B virus immunity should be vaccinated prior to or as early as possible in their training.

Anesthesiology↗
PubMed1984

The prevalence of hepatitis B viral markers in anesthesia personnel.

The prevalence of hepatitis B viral markers is increased in some groups of medical workers who are exposed to blood from patients carrying the virus, but this has not been studied critically in physicians and others who administer anesthesia. Physician anesthesiologists (M.D.) and nurse anesthetists and anesthesia assistants (non-M.D.) at four university-affiliated hospitals were evaluated for hepatitis B markers as determined by seropositivity for hepatitis B surface antigen, antibody to the hepatitis B surface antigen, or antibody to the hepatitis B core antigen. In the 86 subjects (38 M.D., 48 non-M.D.) who represented 80.4% of possible participants, the overall prevalence of serologic markers of hepatitis B was 23.3%. The frequency did not differ between M.D. (23.7%) and non-M.D. (22.9%) groups or between men (20.3%) and women (26.9%). Of 81 subjects who had no clinical history of hepatitis, 16 (19.8%) had positive serologic markers. The frequency of seropositivity increased with time since graduation from medical school (M.D.) or nursing school or college (non-M.D.). The prevalence of serologic markers of hepatitis B virus in this study of anesthesia personnel is five to eight times that of the general population but is similar to that of other medical workers who frequently are exposed to blood.

Adult↗
PubMed1984

The effect of long-term controlled mechanical ventilation with positive end-expiratory pressure on renal function in dogs.

The effects of 46 h of mechanical ventilation and PEEP on urinary output, sodium excretion, and renal and cardiovascular function were examined. Dogs sedated with sodium pentobarbital were ventilated using one of three modes: spontaneous ventilation (SV), controlled mechanical ventilation (CMV), or CMV with 10 cmH2O positive end-expiratory pressure (CMV with PEEP). Intravenous fluids were given at a constant rate throughout the study and measurements of renal and cardiovascular function were made over four periods. Dogs whose lungs were ventilated with PEEP displayed more than two times the amount retention seen in the other groups as assessed by mean weight gain. This was due to an initial depression of urine flow, sodium excretion, and free water clearance. Urinary flow rate approximated the rate of fluid infusion by 20 h in SV dogs and by 27 h during CMV, while the maximum during CMV with PEEP occurred at 46 h. There were no significant differences in glomerular filtration rate, renal corticomedullary blood flow distribution, or renal blood flow between groups. During the 46 h, cardiac index increased (SV, +16%; CMV, +19%; CMV with PEEP, +64%), while systemic vascular resistance (SV, -28%; CMV, -30%; CMV with PEEP, -57%), renal vascular resistance (SV, -12%; CMV, -20%; CMV with PEEP, -23%), and mean arterial pressure (SV, -16%; CMV, -15%; CMV with PEEP, -15%) decreased in all groups. This study has demonstrated that when a constant sodium and water load was provided, the SV and CMV groups were rapidly able to adjust the urinary excretion to meet input, while the return of renal function toward normal in the CMV with PEEP group was delayed until almost 46 h from the start of ventilation.

Animals↗
PubMed1984

Penetration of aztreonam into cerebrospinal fluid of patients with and without inflamed meninges.

Aztreonam was administered as a single, 2-g intravenous dose to 25 patients with noninflamed meninges and to 9 patients with inflamed meninges. It was well tolerated and was detected in the cerebrospinal fluid at the initial sampling period at 1 h after the end of infusion. Aztreonam levels in the cerebrospinal fluid of patients with inflamed meninges were four times higher than those recorded for the same time period in patients with noninflamed meninges. Aztreonam concentrations in cerebrospinal fluid in the presence of normal and inflamed meninges exceeded the inhibitory and bactericidal concentrations for most gram-negative bacteria. Thus, a multiple-dose treatment regimen with 2-g intravenous doses every 6 h appears to be appropriate for clinical trials of aztreonam for the treatment of gram-negative bacillary meningitis which is caused by susceptible organisms.

Adult↗
PubMed1984

A multicenter study of the prevalence of hepatitis B viral serologic markers in anesthesia personnel.

Health care workers with frequent blood contact are at high risk of infection with hepatitis B virus. We surveyed 154 physician anesthesiologists (MD) and certified registered nurse anesthetists (CRNA) at four university-affiliated medical centers to determine the prevalence of serologic markers of hepatitis B virus (HBV). Questionnaires were used to ascertain historical and demographic information, nonoccupational risk factors, and characteristics of the participants' anesthesia practice. The overall prevalence of seropositivity was 18.8% (range 10.2-30.3%), and there were no statistically significant differences among the four centers, MD and CRNA groups, or males and females. In contrast to other studies, the prevalence of seropositive markers did not increase with an increase in the participants' age or length of time in the specialty. For the groups sampled in this study, geographic location or type of practice did not influence the increased prevalence of HBV seropositivity in anesthesia personnel. The current methods of HBV infection control were not associated with a decreased prevalence of serum markers. The majority of the susceptible anesthesia personnel at these four institutions did not plan to receive the hepatitis B vaccine when surveyed at the time of this study.

Anesthesiology↗
PubMed1983

Chronic relapsing colitis due to Strongyloides stercoralis.

The small intestine is the usual site of chronic infection with Strongyloides stercoralis. Colonic involvement has generally been seen in the hyperinfection syndrome in immunosuppressed individuals. We describe an immunologically competent female who underwent multiple abdominal operations over a 5-year period for hematochezia and diffuse abdominal pain of obscure etiology. Eosinophilia had been present but never investigated until 1981, at which time stool examination revealed S. stercoralis larvae. Pathological specimens from operations in 1977 and 1981 demonstrated extensive colonic wall invasion with filariform larvae consistent with S. stercoralis. Involvement of other organs was never documented. We believe this case is consistent with chronic colitis due to strongyloidiasis. This entity has not been previously described, and expands the spectrum of this disease.

Adolescent↗
PubMed1982

Influence of ventilation on response to fluid load in dogs: body water and albumin distribution.

Beagle dogs were sedated with intravenous pentobarbital ventilated for 46 h with either spontaneous ventilation (SV), controlled ventilation (CV), or controlled ventilation with 10 cmH2O end-expiratory pressure (CV + PEEP). Throughout the study period saline (0.45 per cent with added KCl) was infused at 120 ml/h. The influence of ventilatory mode on the accumulation and organ distribution of body water during continuous fluid loading was determined. Five animals were studied with each ventilatory mode. In all groups body weight increased, but with SV weight increase began only after 28 h and increased by 7.2 per cent of body weight by 46 h. With CV the weight increase was continuous and was 9.2 per cent of initial body weight at 46 h. With CV + PEEP the increase was earlier and greater reaching 22 per cent by 46 h. Radioisotopic analysis of total body water, extracellular water, and plasma and erythrocyte water demonstrated that the body weight increase was due to water retention principally in the extracellular compartment. Postmortem analysis of the major body organs for water and albumin distribution demonstrated increased water in the muscle and subcutaneous tissue of the CV + PEEP group that accounted for the total difference in water retention compared to the SV or CV animals. Organ extravascular albumin content varied relatively little between ventilatory modes. Ventilation with increased mean pressure was accompanied by marked and prolonged fluid retention. In these otherwise healthy dogs the water accumulation confined to sites that appeared unlikely to interfere with organ function.

Albumins↗