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Biomedical subjects

B Martin

Publications and source records attributed to B Martin.

At least 181 records · Page 10Linked to original sources

Clinical comparison of the BACTEC 9000 Standard Anaerobic/F and Lytic/F blood culture media.

An 8-month prospective, volume controlled, comparison of Standard Anaerobic/F media with a new anaerobic high blood volume lytic medium (Lytic/F) was performed. A total of 2,092 compliant sets, consisting of an aerobic resin bottle or standard aerobic bottle, Standard Anaerobic/F, and Lytic/F bottle were evaluated. A total of 220 (10.6%) positive specimens were detected from the paired anaerobic bottles. These consisted of 194 true positive and 26 false positive bottles. Of 207 total organisms isolated, 122 were considered clinically significant. A comparison of significant organism recovery revealed 79 isolates in both anaerobic bottles, 7 isolates in the standard Anaerobic/F bottle only, and 36 isolates in the Lytic/F bottle only (p < 0.001). The lytic/F bottle detected significantly more Enterobacteriaceae (p < 0.005) and Streptococci (p < 0.05). There were 24 false positive Standard Anaerobic/F bottles and 2 false positive Lytic/F bottles (p < 0.001). When both bottles were positive the Standard Anaerobic/F bottle was positive 12 hours earlier in 1 instance whereas the Lytic/F bottle was positive 12 hours earlier in 8 instances. The mean time for detection in the Standard Anaerobic/F bottle was 18.2 hours versus 13.2 hours for the Lytic/F bottle. The new Lytic/F anaerobic blood culture media was found to be superior to Standard Anaerobic/F media for both total organism recovery and time to organism detection.

Anaerobiosis↗

Enhancement of nuclear receptor transcriptional signalling.

Glucocorticoids and thyroid hormones induce complex responses in about every mammalian tissue. These effects are mediated by the transcription factor function of the corresponding nuclear receptors, which in most cases achieve the observed regulatory strength in synergy with other factors. Here we describe the functional interaction of the glucocorticoid receptor (GR) with liver-specific transcription factors, the functional synergy of GR with the thyroid hormone receptor (TR), the synergizing sub-domains of the TR, and finally the direct interaction of the GR with other proteins.

Animals↗

The social construction of drug debates.

Drug debates normally proceed without scrutiny of why the particular issues being debated are considered the crucial issues. One plausible influence on the terms of debates is the interest groups involved. Four drug debates are addressed in this paper: neuroleptics, drugs in sport, analgesics and marijuana. The key interest groups and their likely influence on the terms of debates are examined. The implication of this analysis is that more attention should be directed to the terms of drug debates rather than just arguing within those terms.

Analgesics↗

The mmsA locus of Streptococcus pneumoniae encodes a RecG-like protein involved in DNA repair and in three-strand recombination.

We describe the characterization of a mutant strain of Streptococcus pneumoniae previously isolated on the basis of its sensitivity to Methyl Methane Sulphonate (MMS). The mutant strain also exhibited increased sensitivity to UV light and to X-rays, together with a reduced capacity for recombination and Hex-mediated generalized mismatch repair. We show that the original mutant contains two unlinked mutations in the mmsA and in the pms genes. The mmsA wild-type region was cloned and the nucleotide sequence of the mmsA gene was determined. mmsA encodes a polypeptide of 671 amino acids related to a large family of DNA-RNA helicases, with the highest similarity to Escherichia coli RecG, a protein involved in the branch migration of Holliday junctions. A plasmid carrying the intact mmsA coding region was shown to restore UV resistance to E. coli recG mutant strains. An mmsA-null mutant constructed by insertion of a chloramphenicol-resistance gene exhibited a 25-fold reduction in recombination during transformation. We suggest that MmsA recognizes and branch migrates three-strand transformation intermediates to extend donor-recipient heteroduplex regions. The mmsA-null mutant exhibited the other phenotypes of the original mutant, apart from mismatch-repair deficiency and, in addition, an alteration in colony-forming ability was noticed. In the pms mutant background, all phenotypes caused by the mmsA mutation were attenuated. Therefore, the pms mutation, although it affected mismatch repair and, to some extent, DNA repair and recombination, acted as a suppressor of the mmsA mutation.

Amino Acid Sequence↗

The acute care nurse practitioner in collaborative practice.

Successful collaborative practice between an acute care nurse practitioner and a physician impacts positively on patient care. Collaboration among disciplines can provide the patient with superior care that is organized, efficient, and prompt. Collaboration also gives each partner in the relationship a great deal of professional satisfaction. The acute care setting in Head and Neck Surgical Oncology provides an excellent environment for collaboration. The patient with head and neck cancer has many complicated medical and nursing problems that challenge the efficiency of this integrative practice model. In this article, the authors demonstrate the effectiveness of this practice model in the management of this patient population.

Group Practice↗

Effects of topical dorzolamide on retinal and retrobulbar hemodynamics.

PURPOSE: Topical carbonic anhydrase inhibitors such as dorzolamide have been developed as ocular hypotensive agents devoid of the side effects plaguing their systemic predecessors. We evaluated the influence of dorzolamide on retinal and retrobulbar blood flow markers to determine if the drug has orbital vascular as well as ocular hypotensive effects. METHODS: Eleven persons with healthy eyes received either placebo or two drops 2% dorzolamide, 2 h prior to studies conducted in double-masked, counterbalanced fashion. Four retrobulbar vessels (nasal and temporal posterior ciliary, central retinal, and ophthalmic arteries) were analyzed by color Doppler imaging; scanning laser ophthalmoscopy was used to examined retinal and superficial optic nerve head blood linear velocity. RESULTS: Dorzolamide lowered IOP from 15.7 +/- 0.7 to 13.7 +/- 0.7 mmHg (p < 0.05). The drug also hastened retinal arteriovenous passage of fluorescein dye, and accelerated capillary dye transit in the macula and optic nerve head. The drug, however, left unaltered blood velocity or resistance index in any retrobulbar vessel. CONCLUSIONS: Dorzolamide is an effective ocular hypotensive agent that accelerates blood velocity in the retinal and superficial optic nerve head without an apparent effect upon retrobulbar hemodynamics.

Administration, Topical↗

Acute IOP elevation with scleral suction: effects on retrobulbar haemodynamics.

AIMS/BACKGROUND: Mechanical and vascular factors may both contribute to glaucoma. This study investigated the relation of mechanical to vascular factors by examining how acute IOP elevation altered flow velocities in the central retinal and ophthalmic arteries. METHODS: IOP was elevated from a baseline near 14 to approximately 45 mm Hg using suction ophthalmodynamometry. During recovery from scleral suction, IOP fell to near 8 mm Hg. At each IOP, peak systolic and end diastolic velocities (PSV and EDV) were measured in the central retinal and ophthalmic arteries using colour Doppler imaging (Siemens Quantum 2000). Eleven healthy people served as subjects. RESULTS: Acute elevation in IOP had no effect upon PSV, EDV, or the derived resistance index in the ophthalmic artery: flow velocities in this vessel were identical at IOP of 8 mm Hg or 45 mm Hg. In contrast, in the central retinal artery, PSV and EDV fell, and the resistance index rose, in steady progression as IOP was acutely elevated (each p < 0.01). At IOP of 45 mm Hg, EDV was virtually absent and the resistance index was very nearly 1.0. CONCLUSION: Ophthalmic arterial haemodynamics are unrelated to acute fluctuations of the IOP over a wide range, suggesting that ocular hypertension itself cannot induce vascular dysfunction in this artery. In contrast, flow velocities in the central retinal artery were highly IOP dependent, implying that haemodynamic and mechanical factors are closely linked in this vascular bed.

Acute Disease↗

Ocular hemodynamic effects of acute ethanol ingestion.

PURPOSE: Because the protean biological effects of ethanol include acute alterations in both cortical function and circulatory control, we investigated the effect of acute alcohol consumption on retrobulbar hemodynamics and contrast sensitivity in healthy human volunteers. SUBJECTS AND METHODS: Twelve young adults received orange juice with and without ethanol in a double-masked fashion. The ethanol dose was sufficient to raise blood alcohol to 0.07 +/- 0.003 g/dl. Retrobulbar hemodynamics were assessed at baseline and twice at elevated blood alcohol by color Doppler imaging. RESULTS: Acute elevation of blood alcohol lowered intraocular pressure from 13.0 +/- 0.7 to 10.7 +/- 0.7 mm Hg (p < 0.05). In contrast, elevated blood alcohol left peak systolic velocity, end-diastolic velocity and the resistance index constant in three retrobulbar arteries (ophthalmic, central retinal and posterior ciliary). For example, in the central retinal artery, peak systolic velocity, end-diastolic velocity and the resistance index averaged 11.0 +/- 1.3 cm/s, 2.8 +/- 0.4 cm/s and 0.75 +/- 0.03 before ethanol, as compared with 10.5 +/- 1.0 cm/s, 2.9 +/- 0.3 cm/s and 0.72 +/- 0.03 after ethanol (all p = NS). Alcohol ingestion also failed to alter either visual acuity or contrast sensitivity, as assessed under both photopic and mesopic conditions. CONCLUSIONS: Although ethanol has widespread cognitive and cardiovascular effects, at blood levels near legal definitions of intoxication we found it ineffective in altering either retrobulbar hemodynamics or contrast sensitivity.

Adult↗

Musculoskeletal Disorders: Work-related Risk Factors and Prevention.

Work-related musculoskeletal disorders cause chronic pain and functional impairment, impose heavy costs on society, and reduce productivity. In this position paper from the Scientific Committee for Musculoskeletal Disorders of the ICOH, the most important risk factors at work are described. Work-related musculoskeletal disorders have high incidences and prevalences among workers who are exposed to manual handling, repetitive and static work, vibrations, and poor psychological and social conditions. The application of ergonomic principles in the workplace is the best method for prevention. International organizations should develop standards, common classifications, and terminologies. Surveillance systems should be further developed nationally and in workplaces, and more effort should be directed to information dissemination, education, and training.

Journal Article↗

Development of a model of advanced practice.

BACKGROUND: The acute care nurse practitioner role is relatively new and not yet clearly defined. Our institution is in the first phase of a role delineation study that includes model development, validity testing, model revision, and dissemination. OBJECTIVES: To identify domains of practice, activities within each domain of practice, and common conceptual strands that cut across each domain, and to synthesize this information into a usable format to guide practice and role development. METHODS: A nonexperimental study design was used, including review of literature, expert consultation, brainstorming, and review of practice. RESULTS: The patient is central to the model. The identified domains of practice include direct comprehensive care, support of systems, education, research, and publication, and professional leadership. The conceptual strands include empowerment, collaboration, and scholarship. A continuum of experience from novice to expert was also identified within each domain. CONCLUSIONS: The development of the model is the first and most important phase in the role-delineation process. We believe that the model is accurate but still in need of testing. Nevertheless, our model can be used to guide institutions and individual practitioners.

Critical Care↗

[Intraperitoneal vascular emergencies].

Intraperitoneal vascular lesions constitute severe causes of acute abdomen. These disorders include ischemia and infarction of colon and small bowel and abdominal hemorrhage. In case of intestinal ischemia, the radiologic procedures are performed in order to establish the diagnostic, identify the site of ischemia, and detect the etiology of ischemia. Plain radiography of the abdomen, ultrasonography, CT scan and angiography may be performed. In case of intestinal hemorrhage, angiography may be performed when endoscopy fails to establish the diagnosis. Embolization can be performed in selected cases.

Adult↗

Acetazolamide and CO2: acute effects on cerebral and retrobulbar hemodynamics.

PURPOSE: Acetazolamide and CO2 are cerebral vasodilators whose specific effects in various brain regions have not been carefully defined. We investigated the effects of these agents in both larger cerebral and smaller, retrobulbar arteries, to compare their general cerebral vasodilatory influence with their specific ocular vascular effects. METHODS: Twelve young adults with healthy eyes were studied under normocapnic and hypercapnic (6% CO2, 94% O2 tanked gas) conditions after receiving either placebo or 1,000 mg acetazolamide (3 h before study). Color Doppler imaging was used to measure peak systolic and end-diastolic velocities (PSV and EDV) in the internal carotid, middle cerebral, ophthalmic, and central retinal arteries under each condition. RESULTS: Acetazolamide and CO2 each lowered intraocular pressure; combining the agents provided no additive ocular hypotensive effect. Hypercapnia or acetazolamide per se failed to alter PSV, EDV, or the derived resistance index [RI; (PSV-EDV)/PSV] in the internal carotid or in either orbital artery. However, when hypercapnia was superimposed upon acetazolamide, the resistance index fell in the internal carotid and central retinal arteries (each p < 0.05). In contrast, the middle cerebral artery was responsive to either vasodilator and to their combination: PSV and EDV rose, and RI fell with each experimental treatment. CONCLUSIONS: In the brain, the middle cerebral artery exhibits substantial dependence of flow velocity on the vasodilators CO2 and acetazolamide. In contrast, the ophthalmic and central retinal arteries appear less responsive. Nonetheless, the combination of carbonic anhydrase inhibition (acetazolamide) with CO2 augmentation did lower vascular resistance distal to the central retinal artery, suggesting that this mechanism vasodilates critical ocular tissues.

Acetazolamide↗

Synthesis, structure-affinity relationships, and biological activities of ligands binding to retinoic acid receptor subtypes.

The retinoic acid receptors (RARs) transduce retinoid dependant gene regulation, and many biological effects of retinoids are mediated through binding and activation of three closely related receptor subtypes (RAR alpha, RAR beta, and RAR gamma). In order to investigate the role of receptor subtypes, we have carried out a chemical synthesis program to seek selective retinoids for these receptors. We measured receptor binding affinity using recombinant RAR alpha, -beta, and -gamma proteins and assessed cellular differentiating activity in F9 murine teratocarcinoma cells (F9 cells). This research has identified the 4-substituted-3-(1-adamantyl)phenyl moiety as a new pharmacophore which can replace the beta-cyclogeranylidene ring of the naturally occurring all-trans-retinoic acid. Two chemical series derived from the general structures 6-(3-tertioalkylphenyl)-2-naphthoic acid (series I) and 4-[(E)-2-(3-tertioalkylphenyl)propenyl]benzoic acid (series II) were developed. In particular, we have obtained the RAR gamma selective derivatives 6-[3-(1-adamantyl)-4-hydroxyphenyl]-2-naphthoic acid (7) [Ki(RAR alpha) = 6500 nM, Ki(RAR beta) = 2480 nM, Ki(RAR gamma) = 77 nM] and 4-[(E)-2-[3-(1-adamantyl)-4-hydroxyphenyl]propenyl]benzoic acid (19) [Ki(RAR alpha) = 1,144 nM, Ki(RAR beta) = 1245 nM, Ki(RAR gamma) = 53 nM]. In series I, the presence of a phenol group, irrespective of the nature of tertioalkyl group, imparted at least partial RAR gamma selectivity, whereas in series II, the presence of both adamantyl and phenol groups is needed to confer RAR gamma selectivity. The RAR gamma selective ligands induce differentiation in F9 cells (7, AC50 = 33 nM; 19, AC50 = 66 nM). From series I, a mixed RAR beta-gamma agonist with potent cellular differentiating activity was selected for development as a topical antiacne agent, 6-[3-(1-adamantyl)-4-methoxyphenyl]-2-naphthoic acid (5, CD 271) [Ki(RAR alpha) = 1100 nM, Ki-(RAR beta) = 34 nM, Ki(RAR gamma) = 130 nM, AC50(F9) = 37 nM]. Finally, from series II, we have obtained a weak antagonist in the F9 cellular differentiation assay, 4-[(E)-2-(3-tert-butyl-4-hydroxyphenyl)propenyl]benzoic acid (15, IC50 = 700 nM).

Animals↗