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Biomedical subjects

B McLaughlin

Publications and source records attributed to B McLaughlin.

83 records · Page 5Linked to original sources

General practitioner and public health nurse views of nutritional risk factors in the elderly.

A number of risk factors for malnutrition in the elderly have been identified, but their relative importance has yet to be established. General practitioners and public health nurses were interviewed to elicit the relative weights placed on 6 major risk factors when assessing nutritional risk in the elderly (living alone, recent bereavement, denture problems, mobility problems, psychiatric morbidity and multiple medication use). Participants rated risk for 35 hypothetical cases, described by their status on the 6 risk factors. Multiple regression models of these judgments revealed a consistently high weight for psychiatric morbidity compared to the other factors. Little group variation in diagnostic policies was observed between general practitioners and public health nurses or by case gender. These policies may reflect the perception that psychiatric problems pervade many areas of life functioning related to nutritional intake and are therefore more likely to cause malnutrition than other, more specific risk factors.

Aged↗

Epidemic Serratia marcescens in a neonatal intensive care unit: importance of the gastrointestinal tract as a reservoir.

Between a March and December of 1979, and outbreak of infections due to multiply antibiotic resistant Serratia marcescens took place in a 50-bed neonatal intensive care unit. Fifteen neonates suffered major infections (sepsis, meningitis and pneumonia) with one death, and 20 suffered minor infections (conjunctivitis, cystitis, wound infections). Epidemiologic investigation failed to reveal a common source; S. marcescens, however, ws isolated from an employee's hand, emollient skin cleanser, suction tubing, and three in-use manual infant resuscitation bags. The skin cleanser and equipment-cleaning agents were ineffective against S. marcescens. Asymptomatic, colonized infants were the major reservoir of S marcescens. These infants were identified by daily cultures of the nose, umbilicus and rectum. The rectal swab most commonly (76%) yielded first-positive cultures in previously uncolonized infants, and was ultimately positive in 92% of colonized infants. A control program was begun by: 1) removing all inanimate sources of S. marcescens; and 2) cohorting patients and staff into a S. marcescens-exposed group and a new patient group. The new patient group of infants was surveyed by daily triple-site cultures for colonization and subsequent transfer to the S. marcescens-exposed group. After four months, the epidemic was controlled and the organism eradicated from the neonatal intensive care unit.

Cross Infection↗

Raised endothelial cell stimulating angiogenesis factor in ankylosing spondylitis.

Endothelial cell stimulating angiogenesis factor (ESAF) is important in the neovascularisation that precedes new bone formation, and raised levels are found in association with healing fractures and osteoarthritis. We investigated its relevance to the new bone growth that is found at inflammatory sites in ankylosing spondylitis (AS). Forty-one patients with AS were studied clinically and radiographically and had their serum ESAF levels measured. In comparison to age-matched controls the AS patients had significantly raised ESAF levels (p < 0.0001). Within the AS group, patients with relatively higher ESAF levels had no characteristic clinical or radiological features.

Adult↗

Prevalence of human immunodeficiency virus and associated risk behaviour in injection drug users in Toronto.

During 1989-90, interviews were conducted with 582 current injection drug users in the City of Toronto, 535 of whom also provided blood and/or saliva for anonymous unlinked HIV antibody testing. The rate of seropositivity identified was 4.3% (95% CI 3-6). The subjects were predominantly male, with a mean age of 28.3. The commonest drug of choice was cocaine (70%). Forty-six percent of the subjects reported using someone else's needle in the preceding six months, 60% of these indicating that they always cleaned it first. Eighty-one percent of those interviewed had been in jail at some time since they began injecting; 25% of these had injected while in custody, and of these 61% had shared injection equipment. Eighty-two percent of the men and 85.4% of the women reported opposite sex partners in the previous six months. Only about 20% of men reported consistent condom use, while 22% of females reported condom use at least 75% of the time.

Adolescent↗