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Biomedical subjects

B S Linn

Publications and source records attributed to B S Linn.

At least 73 records · Page 4Linked to original sources

The very old patient in ambulatory care.

The aims were twofold: to determine differences between the very old and younger patients in ambulatory care and to examine their self-assessments of health and whether these related to: subjective data such as symptoms and attitudes, objective data such as utilization of health services, and physician assessments of the patient's health. Although they had about one more diagnosis, the very old were similar in most respects to younger patients. Variables that discriminated the groups were physician ratings. About two-thirds of the older and younger patients regarded their health as good. Good health perceptions were associated with fewer symptoms, outpatient visits, and hospitalizations in both groups. Physician assessments were only lowly correlated with patient assessments of health. Patient perceptions of health were highly stable over a two month follow up. The subjective belief that one is healthy or ill may be more important than actual medical condition in maintaining good emotional and behavioral functioning.

Aged↗

Split-thickness skin grafts: an experimental study of factors related to ease or difficulty of procuring satisfactory grafts of skin from man and some common laboratory animals.

Split-thickness grafts of skin of satisfactory quality were found to be more difficult to obtain from rabbits than from animals of other genera. An explanation for this was sought in the histology of the skins of the various experimental animals. Density of hair was judged to be the factor most critical for ease or difficulty in procuring satisfactory split-thickness grafts of skin, and a cluster of histologic characteristics of skin seemed to have meaning for taxonomic classification. Silver's dermatome was found to be the test instrument for taking grafts from all subjects.

Animals↗

Does skin have antimicrobial properties? An in-vitro experiment and literature review.

Skin grafts placed over burn wounds were first reported to reduce bacterial growth levels about 20 years ago. Recently, three separate groups of investigators have studied effects of skin in vitro in order to better understand the mechanism of this in vivo phenomenon. Although significant bacterial inhibition was not found, the interaction of host tissue factors with the skin which is possible in vivo was not included in these experiments. Hence, the question of in vitro activity of skin was still not resolved. In this experiment human and pig skin, fresh and preserved, intact and homogenated, were all tested separately with and without active serum against four representative bacteria and one fungus, individually and in mixed cultures. No growth inhibition was observed under any circumstances on daily review for up to three-week periods. In light of conflicting reports related to antibacterial effects of skin grafts used clinically, it now seems important to definitively clarify whether skin really possesses antibacterial properties in vivo.

Animals↗

Evaluation of burn care in florida.

To determine if additional burn-care facilities or educational programs for burn care were needed within Florida, 73 of the state's 220 hospitals were studied. Data were collected on hospital statistics for a one-year period, as well as on 1656 patients admitted for burns to these hospitals during that year. When results were adjusted for severity of the injury, there was no evidence that outcomes of patients were better in any one or group of the State's eight regions, or in hospitals that had special burn units. Considerable evidence, however, indicated the need for additional educational programs in burn care. Many records were poor, admissions were inappropriate, patients with minor burns stayed too long, and burn shock was too frequent.

Adult↗

Patient outcome as a measure of quality of nursing home care.

One thousand males transferred from a general medical hospital into 40 community nursing homes were classified by their physicians as to expectations of outcome within six months and measured on physical functioning at the time of their transfer. They were followed up six months later and retested on functional status. Subjects were classified on follow-up as improved, the same deteriorated, or dead. They were also classified as discharged from the nursing home, still in the home, or readmitted to the hospital. Nursing homes were measured every six months on structural variables. Outcomes of the patients were related to the nursing home characteristics by multivariate analysis of variance, controlling for expected outcome, age, and diagnoses of cancer and chronic brain disease. Homes with more RN hours per patient were associated with patients being alive, improved, and discharged from the home. Better ratings on meal services were related to being alive and improved. A higher professional staff-to-patient ratio, better medical records, and more services were related to being discharged from the nursing home.

Aged↗

Performance rating scale for peer and self assessment.

A performance rating scale was developed and tested on a class of junior medical students who rated themselves and four to ten of their peers. When 928 ratings were factor analysed, two strong factors, knowledge and relationship, emerged. Test-retest reliabilities were good. Validity was measured by correlation of ratings with grades, and though both sources of ratings correlated significantly with grades given by faculty, peer ratings were more highly related to grades than were self ratings. Students tended to rate themselves lower than they were rated by their peers. Grades are probably not the best estimate of performance, but are currently one of the most reliable. Use of the scale to judge performance of physicians in practice has not been tested. The question of how such evaluation of peer and self would relate to other measures of quality of care is raised.

Attitude of Health Personnel↗

The varying sensitivity to antibacterial agents of micro-organisms in pure vs. mixed cultures.

In this study the disc sensitivities of five organisms growing in pure cultures (Staphylococcus aureus, beta-hemolytic Streptococcus, Proteus mirabilis, Pseudomonas aeruginosa, and Candida albicans) were first determined against each of seven antibacterial agents (penicillin, streptomycin, gentamicin, kanamycin, silver nitrate, Sulfamylon, and Betadine). Then the sensitivity of each organism growing in combination with one of the others (10 combinations) was tested against each of the same antibacterials. Significantly increased and decreased sensitivities were found in 30 percent of the cultures with decreases largely predominating. Total obliteration of all sensitivity occurred 10 percent of the time. The changes in sensitivity were not distributed randomly but rather were associated more with particular agents and organisms. Sulfamylon, was associated with decreases 70 percent of the time with sensitivity obliteration in 50 percent of the tests. Streptococcus led all the organisms, being associated with decreases in half of the tests. It is possible that mixed-culture sensitivities could provide the most valid information when mixed infections exist, since they more closely simulate the real clinical situation. Therefore it is suggested that both mixed and pure culture sensitivity testing be done for all mixed infections.

Anti-Bacterial Agents↗