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Biomedical subjects

B A Friedman

Publications and source records attributed to B A Friedman.

At least 73 records · Page 4Linked to original sources
PubMed1968

Identification of Zoogloea species and the relationship to zoogloeal matrix and floc formation.

Three floc-forming, gram-negative, polarly flagellated rods were isolated and characterized. Our isolates were compared to four similar floc-forming organisms previously isolated in another laboratory and classified as two species of Zoogloea, one of Pseudomonas, and as one unidentified gram-negative rod. Possession of zoogloeal matrix or flocculent growth habit was examined in relation to growth and biochemical patterns of the bacteria. A possible relationship of Zoogloea to other gelatinous matrix-producing bacteria is also discussed.

Bacteria↗
PubMed1968

Fine structure and composition of the zoogloeal matrix surrounding Zoogloea ramigera.

The fingerlike projections, which have been considered to be characteristic of the genus Zoogloea, appear to consist of generally globular packets of cells, each surrounded by capsular matrix. The individual packets which surround Z. ramigera 115 cells appear to adhere one to another by intermeshed fibrils that measure 2 to 5 nm in diameter. The fibril polymer appears to be polyglucose that is susceptible to cellulase. The polymer resembles cellulose in several respects, with the exception that it is soluble in 1 n NaOH. Although Z. ramigera I-16-M does not possess an observable zoogloeal matrix when viewed under a light microscope, chemical data indicate that it does produce cellulase-susceptible polymer. Fibrils can be observed under the electron microscope, which are resistant to 1 n NaOH and may be cellulose. Less polymer fibrils are observed around isolate I-16-M cells than around isolate 115 cells; the inability to observe the I-16-M material as a zoogloeal matrix under light microscopy may be due to lack of sufficient amount of polymer.

Bacteria↗
PubMedDate not supplied

Short-term and long-term effects of plasmapheresis on serum proteins and immunoglobulins.

In order to evaluate the short-term and long-term effects of plasmaapheresis on serum proteins and immunoglobulins, the levels of alpha1, alpha2, beta, and gamma globulins, and IgG, IgA, and IgM were measured and statistically evaluated in 41 active plasmapheresis donors donating 500 to 1,000 ml of plasma weekly for up to three years. During the initial four months of plasmapheresis, the percentage of alpha1 and alpha2 globulins manifested a statistically significant rise and the IgG, IgA, and IgM concentrations declined. By the end of ten months, only the IgM continued to be depressed. Although the concentration of IgM continued to show a statistically significant decline for three years, it remained well within the normal range of values for our laboratory. Although no statistically significant difference existed between the baseline value of albumin and the level reached at the end of the third year, a gradual rise was followed by a decline in this interval. Most of the statistically significant alterations of serum protein and immunoglobulins occurring in plasmapheresis donors are seen in the initial six months of plasmapheresis. A falling serum protein in this time period is most likely an indication of declining immunoglobulins. It is feasible and appropriate to measure the donor's total serum protein at the time of each plasmapheresis. Any untoward reduction in this value necessitates quantification of the serum immunoglobulins. Routine measurement of the immunoglobulins in the face of normal total serum protein can be performed on a less frequent basis as is presently recommended by accrediting agencies, although this study should be performed more often during the first six months of a serial plasmapheresis program.

Alpha-Globulins↗
PubMedDate not supplied

Plasmapheresis-induced hemodilution and its effects on serum constituents.

Samples were obtained from 23 plasmapheresis donors before, during, and after double plasmapheresis. Seventeen chemical analyses were performed on these specimens and the results were subjected to statistical analysis. Representative samples can be obtained from plasmapheresis donors before the procedure has begun, immediately after the first unit of whole blood has been removed, or 15 minutes after the completion of the entire procedure. The sample obtained after the first unit of whole blood has been removed will show dilutional lowering of the uric acid concentration and the 15-minute equilibration sample will show dilutional lowering of the inorganic phosphorus concentration. Short-term donors and long-term donors manifest a somewhat different hemodilutional response to plasmapheresis.

Adult↗
PubMedDate not supplied

The maximum surgical blood order schedule and surgical blood use in the United States.

The outdating of units of blood can be reduced by decreasing the amount of time they spend in an assigned or crossmatched status. This reduction can be achieved in a hospital by establishing a maximum surgical blood order schedule (MSBOS) which reduces the excessive number of units of blood crossmatched preoperatively for patients undergoing elective surgery. The various steps which occurred in the development of a MSBOS in a large general hospital are detailed and the projected reduction in the number of crossmatched units which can be achieved with the MSBOS is illustrated. illustrated. The projected number of units of blood transfused to patients during their hospitalization for 50 common primary surgical procedures in the United States during 1974 is presented as a basis for defining maximum blood orders for each procedure.

Blood Banks↗
PubMedDate not supplied

The risk of abbreviating the major crossmatch in urgent or massive transfusion.

The risk of abbreviating the major crossmatch in urgent situations by issuing blood after an "immediate spin" phase was evaluated by a retrospective study of 82,647 crossmatches performed on serum from approximately 13,950 patients. Although the initial screening test for unexpected antibodies for all patients failed to show agglutination or hemolysis of the reagent red blood cells, agglutination was subsequently noted during at least one crossmatch performed for 148 of them. Further evaluation of these patients' serums indicated that most positive reactions were due to weakly reactive low thermal amplitude antibodies. Eight of the incompatible crossmatches were related to antibodies in the Kell, Kidd or Rh systems, and a ninth antibody, anti-E, was identified through subsequent evaluation of a cold antibody-induced crossmatch incompatibility. Issuance of blood in urgent situations after an "immediate spin" phase of the crossmatch, for patients whose red blood cells have been typed, and whose serums have been screened for unexpected antibodies, has a low level of risk.

Antibody Specificity↗
PubMedDate not supplied

Patterns of blood utilization by physicians: transfusion of nonoperated anemic patients.

Prior studies have suggested that a high percentage of blood transfusions to hospital patients are unnecessary. If such transfusions can be reduced, more blood would be made available for those patients with legitimate blood requirements. In this study, blood transfusion of 401 nonoperated hospital patients with anemia as the final diagnosis explaining admission and with admission hemoglobin values equal to or greater than 10 gm/dl was analyzed. These patients were drawn from a 300 hospital sample distributed across the United States. Descriptive data showing the extent to which this selected population of patients is transfused with blood must be considered as one measure of unnecessary blood transfusion in this country. Hospital-based programs designed to identify and eliminate unnecessary blood transfusions should be established. The first step in the creation of such programs at the hospital level must be the development of guidelines for blood transfusion derived through the cooperative efforts of hospital physicians who fully understand and accept the rationale for them. Once guidelines for blood transfusion are established in a hospital, transfusion practice need only be measured against them.

Adult↗
PubMedDate not supplied

Anti-lea as an autoantibody in the serum of le(a - b+) individual.

The first example of anti-Lea, as an autoantibody, in the serum of a phenotypically Le(a-b+) individual is described. The patient is a 55 year old male with squamous cell carcinoma of the esophagus. His saliva contains Lea, Leb and H substances, and inhibits the hemagglutinating activity of his serum anti-Lea. The Leb antigen content of his red blood cells is approximately half that of control Le(a-b+) red blood cells. The patient's disease process may be responsible for the development of this unexpected autoantibody.

ABO Blood-Group System↗
PubMedDate not supplied

An analysis of surgical blood use in United States hospitals with application to the maximum surgical blood order schedule.

Excessive preoperative crossmatching can be limited with a maximum surgical blood order schedule (MSBOS) which is a list of the commonly performed elective surgical procedures performed in a hospital with the maximum number of units of blood which will be crossmatched preoperatively for each. The purpose of this study was to analyze the blood requirements of 535,031 surgical patients treated in 300 United States hospitals during 1974, and to suggest maximum preoperative blood orders including type and screen recommendations based on data derived from this large national patient sample. Such recommendations are offered for 63 common elective surgical procedures. Specific reference is made to blood utilization during hysterectomy, transurethral resection of the prostate, and cesarean section. A preoperative type and screen order is adequate for the vast majority of patients undergoing these latter procedures.

Blood Transfusion↗
PubMedDate not supplied

A study of blood utilization by diagnosis, month of transfusion, and geographic region of the United States.

The purpose of this study was to analyze blood utilization by 92,815 transfused patients treated in 300 United States hospitals during 1974. In order to achieve this end, transfused patients were first divided into 349 diagnosis groups. Blood transfusion data for the highest ranking 50 groups in terms of total units administered to patients in the group are presented and discussed, as well as the blood needs of patients in 19 major disease categories such as malignant neoplasm. Blood transfusion is then correlated with the month of the year by presenting the mean number and the total number of units transfused per month for the country as a whole and for each of four geographic regions. Individual diagnosis groups with significant variation in the mean number of units transfused among the months are also listed and discussed. To aid in the interpretation of mean monthly transfusion rates for the various diagnosis groups, a list of operative procedures with significant variation in the quarterly frequency is offered. Diagnosis groups with significant variation in the mean transfusion rate among the four geographic regions are presented with interpretation of the data.

Blood Transfusion↗
PubMedDate not supplied

An analysis of blood transfusion of surgical patients by sex: a question for the transfusion trigger.

The factor or constellation of factors which precipitates blood transfusion in hospitals can be termed the "transfusion trigger." The blood transfusion experience of 535,031 male and female surgical patients was compared in order to evaluate the importance of the hematocrit as a component of this transfusion trigger. Transfusion data presented support the hypothesis that surgeons use the same support and ceiling hematocrit levels to regulate blood transfusion in men and women, despite the fact that women have lower hematocrits. The use of a lower hematocrit support level to govern the blood transfusion of female surgical patients should be considered. Data cited showing that women have a degree of physiologic adaptation to their lower hematocrits suggest that this change could be introduced without causing increased morbidity. A net saving of blood would most certainly result from it.

Abdomen↗
PubMedDate not supplied

A study of blood utilization in association with hysterectomy.

We performed a retrospective study of 167 women undergoing hysterectomy in a large tertiary-care teaching hospital in order to assess intraoperative blood requirements and to study the decision-making process that occurs when blood is transfused intraoperatively. Recommended preoperative blood orders for hysterectomy patients based on data from the study are provided. Although "type and screen" is commonly considered to be an adequate preoperative order for patients undergoing vaginal hysterectomy, our data indicate that 2 units may be a more appropriate order when the procedure is combined with pelvic floor repair. The preoperative hematocrit, the estimated intraoperative blood loss, and the duration of the hysterectomy were integral to the decision-making process. If women undergoing hysterectomy were transfused intraoperatively only when their hematocrit actually fell to 30 percent, and not in anticipation of such an event, unnecessary transfusions would be reduced.

Adult↗
PubMedDate not supplied

Organizational innovation and the laboratory information system.

There is an urgent need for more innovation in health care and in clinical laboratories. Innovation can be divided into five separate categories: core products, components of the core products, production processes, uses of products, and the organization of production. Organizational innovation is an important as technological advances in increasing the quality and efficiency of clinical laboratories. The use of a laboratory information system (LIS) can stimulate organizational innovation such as the assignment of computer-oriented tasks to personnel within individual clinical laboratories. The authors refer to such LIS support personnel as "hidden personnel" and suggest that such a shift of responsibility empowers laboratory professionals and makes them stakeholders in automated information processing.

Clinical Laboratory Information Systems↗
PubMedDate not supplied

The deployment of information technology in clinical laboratories and its impact on professional roles.

New information technology is deployed in hospital clinical laboratories to increase both the quality and efficiency of laboratory operations. Although total laboratory expenses may rise as a result of technology deployment, the average cost per test may decline. S-curves can be used to illustrate the effects of new information technology--such as a laboratory information system (LIS)--on the useful output and use of resources in laboratories. Major changes are now occurring as a result of the deployment of information technology, most notably in the area of automated information management. The role of laboratory professionals must be modified in response to this new information environment. The generation of information within clinical laboratories should be considered as the beginning--not the end--of the responsibility of laboratory professionals.

Clinical Laboratory Information Systems↗