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Biomedical subjects

B Miller

Publications and source records attributed to B Miller.

At least 235 records · Page 13Linked to original sources
PubMed1993

Preventive therapy for tuberculosis.

TB is the most prevalent infection in the world. The emergence of the HIV epidemic has dramatically increased the risk of developing clinical TB in infected persons, substantially increasing TB rates globally. Preventive therapy with INH for 6 to 12 months substantially reduces the risk of developing clinical TB in persons with tuberculous infection. Yet, preventive therapy is not fully used because of lack of knowledge about TB among health care professionals, patient nonadherence with preventive therapy regimens, and drug toxicity. Persons at high risk for developing TB should be screened for infection with a tuberculin skin test and given preventive therapy when appropriate. Promising new regimens of shorter duration and new drug delivery systems are currently being evaluated. Preventive therapy must be widely adopted if the goals of TB control and eventual elimination are to be achieved.

AIDS-Related Opportunistic Infections↗
PubMed1993

Superoxide dismutase and allopurinol improve survival in an animal model of hemorrhagic shock.

We studied the efficacy of resuscitation with antioxidants in an animal model of hemorrhagic shock. Male Sprague-Dawley rats were anesthetized, and 27 mL/kg of blood was withdrawn from the carotid artery over 2 minutes. The animals remained in hemorrhagic shock for 45 minutes, followed by 1 hour of resuscitation. Experimental groups were as follows: 1) 15,000 u/kg superoxide dismutase (SOD) in 54 mL/kg lactated Ringer (LR); 2) 175,000 u/kg catalase (CAT) in LR; 3) 15,000 u/kg SOD+175,000 u/kg CAT in LR; 4) allopurinol in LR; 5) deferoxamine bound to pentafraction (DFO), 27 mL/kg; 6) pentafraction alone; and 7) LR alone. Compared with resuscitation with LR alone, SOD and allopurinol improved survival over 72 hours, P < 0.05. Survival with SOD+CAT was not different from LR alone. Deferoxamine bound to pentafraction did not increase survival over that with pentafraction alone. CAT had increased mortality compared to LR, P < 0.01. The efficacy of both SOD and allopurinol in decreasing mortality suggests the importance of superoxide radicals after hemorrhagic shock and resuscitation. These and other antioxidants are potential therapeutic agents in the clinical setting of trauma and hemorrhagic shock.

Allopurinol↗
PubMed1993

Excessive water drinking and cataract formation: a case report.

We report a case of a 46-year-old man who developed mature cataract in one eye and nearly mature cataract in his other eye over a 14-month period. No genetic, traumatic, or toxic etiology or intraocular pathology or history of irradiation were present. The patient had intentionally been drinking 15 liters of water a day for 11 months, up until 3 months prior to his admission, and 5 liters a day thereafter, until his admission. During his hospitalization he was found to suffer from insulin-dependent diabetes mellitus. The rest of his medical work-up was found to be normal. We suggest that the huge water overload put on his lens played a role in the premature and rapid cataract formation.

Cataract↗
PubMed1993

The predictive value of hysterosalpingography for tubal and peritoneal infertility factors.

OBJECTIVE: To investigate a practical classification system of hysterosalpingogram (HSG) results that accurately identifies patients with severe pelvic disease or a normal pelvis to allow appropriate patient counseling of therapeutic options. DESIGN: Retrospective chart review from university teaching hospital. Hysterosalpingography results were classified as normal, abnormal (bilateral distal tubal obstruction), or suspicious (all others). At surgery, chromopertubation was performed, and pelvic disease was documented. RESULTS: From a total of 756 patients, HSGs were confirmed surgically in 96.6% of normals, 63.1% of suspicious, and 95.7% of abnormal. Associated moderate-severe pelvic disease was found in 16.2% of normals, 53.9% of suspicious, and 81.7% of abnormal. CONCLUSION: Abnormal HSGs are highly predictive of severe pelvic disease, and counseling of treatment options does not require diagnostic laparoscopy. Patients with suspicious HSGs frequently have normal tubes but also have a significant likelihood of tubal or associated pelvic disease, and they are responsible for the poor predictive value of the HSG. This group of patients requires confirmatory laparoscopy preferably by a physician qualified in pelviscopic surgery. Normal HSGs have a high negative predictive value. Nevertheless, the incidence of associated pelvic disease in the normal HSG group is high enough to warrant diagnostic laparoscopy if nonsurgical treatment is unsuccessful.

Fallopian Tube Diseases↗
PubMed1993

Selected issues in long-term care: profile of cognitive disability of nursing home residents and the use of informal and formal care by elderly in the community.

In summary, this section suggests that hospital care and physician office care are frequently used community health care services. There were relatively few differences by sex, age, or race in patterns of community health service use. There were differences by sex, age, race, and level of ADL disability in the number of informal helpers a frail elder used. Marital patterns appear to be an important underlying influence on the number of informal helpers. When a spouse is present, he or she becomes the primary and only helper in many instances. The number of informal helpers that a frail elder had was associated with an increased risk of mortality and institutionalization. Overall, there is somewhat more stability than change in the number of informal helpers over the 2-year period. This section, however, could not identify if the composition of the informal helper network remained the same over time.

Activities of Daily Living↗
PubMed1993

Job descriptions for differentiated nursing practice and differentiated pay.

Compensation of nurses in differentiated practice is based on distinctive job descriptions. The employer can then pay according to education, position, and actual performance level and seek to hire the staff mix that is most cost-effective for the institution. Both staff nursing and manager job descriptions are presented in this article. The authors discuss generic job descriptions that differentiate the practice of the staff nurse and the nurse unit manager according to the incumbent's educational level.

Educational Status↗
PubMed1993

Sibling education: implementing a program for the NICU.

Many nurses have recognized the need for sibling visitation and education in maternity units, but few sibling programs have been initiated for premature or ill infants. This article describes a model neonatal intensive care unit sibling education and visitation program that was designed and implemented by nurses practicing in a 60 bed NICU. The program strives to strengthen family functioning and bonding by involving siblings in the family experience of the hospitalization and care of a premature or ill infant. Over 100 children, ages three to eight years old, have attended the program since its inception and both the children and their parents have reported high levels of satisfaction with the program. Since the idea and implementation of NICU sibling education is so new, nursing research needs to be initiated in this area to determine the effectiveness of such programs.

Child↗
PubMed1992

Hereditary microphthalmia with colobomatous cyst.

We examined five members of a highly inbred kinship who had isolated microphthalmia associated with colobomatous cysts and various other ocular lesions. They were all offspring of consanguineous (first cousins) and unaffected parents. Microphthalmia in this kindred was transmitted as an autosomal recessive trait. Ultrasonography was effective for prenatal diagnosis in two pregnancies at risk.

Child↗
PubMed1992

Factors affecting the stability of methanol dehydrogenase from Paracoccus denitrificans.

Methanol dehydrogenase from Paracoccus denitrificans was purified to homogeneity in two steps from the periplasmic fraction of methanol-grown cells. The enzyme was composed of subunits of M(r) 67,000 and 12,000, and non-covalently bound pyrroloquinoline quinone. It exhibited a pH optimum at pH values of 9.0 and above. It was not stable at pH greater than 9.0, but exhibited little loss of activity after prolonged incubation at pH values as low as 4.5. Methyl dehydrogenase was relatively stable to thermal denaturation. The thermal stability was enhanced by the presence of Ca2+ and diminished by the presence of EDTA. These data suggest a structural role for Ca2+ in this enzyme, similar to what has been observed with quinoprotein glucose and ethanol dehydrogenases.

Alcohol Oxidoreductases↗
PubMed1992

Potentiation of NMDA receptor currents by arachidonic acid.

Arachidonic acid is released by phospholipase A2 when activation of N-methyl-D-aspartate (NMDA) receptors by neurotransmitter glutamate raises the calcium concentration in neurons, for example during the initiation of long-term potentiation and during brain anoxia. Here we investigate the effect of arachidonic acid on glutamate-gated ion channels by whole-cell clamping isolated cerebellar granule cells. Arachidonic acid potentiates, and makes more transient, the current through NMDA receptor channels, and slightly reduces the current through non-NMDA receptor channels. Potentiation of the NMDA receptor current results from an increase in channel open probability, with no change in open channel current. We observe potentiation even with saturating levels of agonist at the glutamate- and glycine-binding sites on these channels; it does not result from conversion of arachidonic acid to lipoxygenase or cyclooxygenase derivatives, or from activation of protein kinase C. Arachidonic acid may act by binding to a site on the NMDA receptor, or by modifying the receptor's lipid environment. Our results suggest that arachidonic acid released by activation of NMDA (or other) receptors will potentiate NMDA receptor currents, and thus amplify increases in intracellular calcium concentration caused by glutamate. This may explain why inhibition of phospholipase A2 blocks the induction of long-term potentiation.

Animals↗
PubMed1992

Low antibody avidity in elderly chickenpox patients.

A small outbreak of chickenpox confirmed serologically in 3 elderly patients from a geriatric home is described. Disease was probably due to exogenous reinfection, yet nevertheless the avidity of specific antibodies measured by the urea denaturation test was even lower than in primary chickenpox controls, which themselves were, as expected, significantly lower than zoster controls. In elderly individuals susceptibility to reinfection with varicella-zoster virus (VZV) with clinical manifestation such as chickenpox may well be associated with the decay of specific humoral immunity detectable by antibodies of particularly low avidity, in contrast to reactivation of latent VZV presenting clinically as zoster, which is related to deficiencies in specific cellular immunity.

Aged↗
PubMed1992

Comparison of the fracture strengths of ceramometal crowns versus several all-ceramic crowns.

Fracture resistance to forces applied to the incisal edges of four types of anterior crowns was tested. Ceramometal crowns fractured at significantly higher values (720 psi) than the all-ceramic crowns (approximately 360 psi). No significant difference was found among the fracture values of the Dicor crowns, the aluminous porcelain jackets, and the crowns fabricated from Dicor veneered with aluminous body and incisal porcelain.

Aluminum Oxide↗