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Biomedical subjects

C B Watson

Publications and source records attributed to C B Watson.

At least 19 recordsLinked to original sources
PubMed1999

A Mexican restaurant-associated outbreak of Salmonella Enteritidis type 34 infections traced to a contaminated egg farm.

In May 1996, the Georgia Division of Public Health was notified about a cluster of persons with Salmonella Enteritidis (SE) infections in Waycross, Georgia. A matched pair case-control study to determine risk factors for illness found a statistically significant association of SE infection with a history of having eaten at Restaurant A during the 5 days before onset of illness (relative risk = 13 [95% confidence interval (CI) = 3-62, P < 0.01]). In a second case-control study, to determine specific food exposures, consumption of a deep-fried Mexican dish (chile relleno) (4 of 21 cases vs. 0 of 26 controls, odds ratio undefined, 95% CI > 1.46, P = 0.034) was found to be significantly associated with SE infection. An environmental investigation found evidence of suboptimal food storage and cooking temperatures at Restaurant A; cross contamination of foods may have contributed to the low attributable risk identified for chile rellenos. Five of 37 Restaurant A food and environment specimens yielded SE strains. All five positive specimens were from chiles rellenos. Of the seven outbreak-associated strains (six patient isolates and one food isolate from Restaurant A) for which phage typing was conducted, all were phage type 34. A FDA traceback investigation through Restaurant A's single-egg supplier identified the potential source as three interrelated farms in South Carolina. Environmental culture from one of these farms yielded SE phage type 34. As a result of this outbreak, FDA helped institute a statewide egg quality-assurance programme in South Carolina to minimize SE contamination of eggs.

Animal Husbandry↗
PubMed1995

Anesthesiology critical care medicine fellowship training.

Anesthesiology critical care medicine (ACCM) fellowship training was accredited in 1989, and a small number of graduating anesthesiology residents pursue this additional training. Considering the flexible program guidelines of the American Board of Anesthesiology (ABA), we hypothesized that ACCM fellowship training programs varied significantly among the 42 institutions accredited to offer this program. This study of ACCM fellowship programs used a six-part, 57-item questionnaire completed by 36 program directors to describe six aspects of the program: institution size, program director, attending staff, fellowship applicants, curriculum, and the role of the American Society of Critical Care Anesthesiologists (ASCCA). Ninety-four percent of ACCM fellowships are in facilities with more than 400 beds; 81% of these institutions have more than 20 intensive care unit (ICU) beds as the basis for fellowship teaching. Eighty-three percent of ACCM program directors have practiced critical care for more than 5 yr. All programs had more than one attending physician, with the majority having a multidisciplinary attending staff. During two academic years (1990-1992), 12 (33%) of 36 programs did not have a fellow, resulting in an average of less than one fellow for each program. ACCM fellow involvement in patient care was characterized as "primary" in medical and pediatric ICUs and "cooperative" in surgical ICUs. Fellowship curricula had varied requirements for research, intraoperative anesthesia, and ICU procedures performed by the fellow. In general, program directors believe that salary and on-call responsibility are not important issues for applicants. Nineteen percent of program directors train ACCM fellows longer than the 12 mo required by the ABA and believe that ACCM training should be lengthened.

Accreditation↗
PubMed1991

Is routine preoperative hemodynamic evaluation of nonagenarians necessary?

An Incidence of co-morbid cardiac disease in the elderly surgical patient as high as 66% has been previously reported. Even in the absence of clinically significant cardiac disease, advanced age alone is often considered sufficient indication for Swan-Ganz placement, hemodynamic evaluation, adjustment of fluid states, and inotropic support. Yet data clearly documenting the need for this evaluation and therapy are difficult to obtain. All major general surgical and orthopedic operations in non-agenarians were reviewed in our institution from July 1, 1987 through December 31, 1988. Fifty-one procedures were performed on 46 patients. None of these patients had preoperative Swan-Ganz catheterization or hemodynamic evaluation. Eighteen general surgical, 30 orthopedic, 2 neurosurgical, and 1 gynecological procedures were performed. Forty-three were performed under general anesthesia, 7 under spinal anesthesia, and 1 with local anesthesia. Seven out of 51 patients (14%) experienced major complications, and 16 out of 51 (31%) experienced minor complications. Thirty-day mortality was 0%, and 6-month survival was 92%. Only one complication occurred within 48 hours of surgery that might possibly have been prevented with hemodynamic evaluation, adjustment of fluid status, inotropic support, and intensive care unit monitoring.

Aged↗
PubMed1987

Changes in plasma atrial natriuretic peptide--immunoreactivity in patients undergoing coronary artery bypass graft placements.

Plasma atrial natriuretic peptide immunoreactivity (IrANP) was measured before, during, and after cardiopulmonary bypass for coronary artery bypass graft placement. Eight subjects scheduled for elective operation had in the premedicated preoperative state slightly elevated IrANP compared to controls. Neither induction of anesthesia with a high dose narcotic/non-depolarising relaxant/diazepam technique nor cardiopulmonary bypass changed IrANP significantly. Mixed venous and arterial IrANP increased immediately after discontinuing bypass, and remained elevated 1 h later. Because ANPs affect peripheral resistance as well as urinary sodium loss, the post-bypass elevations in these peptides may contribute to cardiovascular and diuretic effects after cardiopulmonary bypass.

Anesthesia↗
PubMed1987

Anesthesia for tonsillectomy and adenoidectomy.

Despite advances in the anesthetic pharmacopeia and improved noninvasive monitoring techniques, subjective bias and individual clinical experience remain major determinants of individual practice. Medicolegal pressures have increased in recent years, as has the concept of shared responsibility for surgical and anesthetic complications. New standards of anesthesia monitoring and practice are evolving in response to the need for perioperative risk management and cost-effective surgical care. Continued vigilance and close communication between the otolaryngologist and anesthesiologist remain key elements for safe anesthetic practice.

Adenoidectomy↗
PubMed1986

Anesthesia for trauma.

This article presents basic anesthetic management problems and procedures together with newer anesthetic drugs and monitoring techniques that are likely to be encountered by intensive care physicians. The author's goal is to familiarize all critical care unit based members of the resuscitation team with current aspects of anesthetic management of the trauma patient.

Anesthesia↗
PubMed1985

Continuous mixed venous oxygen saturation measurement: a significant advance in hemodynamic monitoring?

Development of the flow-directed pulmonary artery catheter in combination with reflective fiberoptic oximetry techniques allows the clinician to continuously measure mixed venous oxygen saturation (SvO2). A brief review of the determinants of oxygen balance, the Fick principle, and the technology of continuous SvO2 monitoring is preliminary to a debate between two clinicians on the usefulness of SvO2 monitoring. One clinician highly recommends use of the flow-directed pulmonary artery catheter in patients who require pulmonary artery catheterization. Monitoring of SvO2 is described as a safe, convenient, and reliable option that is cost-effective. Continuous availability of this dynamic physiologic monitor is of great value in improving understanding of serious disturbances in oxygen balance, providing information for rapid diagnosis, and guiding therapeutic interventions. Another clinician suggests a less enthusiastic approach to SvO2 monitoring and argues that SvO2 is a nonspecific index of the matching of oxygen delivery with supply. Although it is a useful adjunct in specific clinical situations, it provides uncertain information in the presence of a number of diseases. Major mistakes in patient management could follow from overreliance upon either absolute SvO2 measurements or analysis of trends over time. Use of the SvO2 monitor has not been proven cost-effective and may actually increase monitoring costs. Both clinicians agree that continuous SvO2 monitoring is valuable in many clinical circumstances, provided the limitations of the measurement are understood.

Cardiac Output↗
PubMed1984

Secreted glycoproteins of human kidney tumour cells contain sulphated complex-type oligosaccharides.

Human kidney tumour cells in culture incorporated [3H]glucosamine and 35SO4 into glycoprotein products, which were secreted into the culture medium. The effects of sodium butyrate, a known differentiation-inducing agent, on the production of these sulphated glycoproteins were studied. Cells were cultured in the absence or presence of butyrate (2 mM) in serum-containing medium, for various times, and the labelled glycoproteins were partially purified by DEAE-cellulose chromatography. Treatment of these cells with butyrate resulted in an increase in the synthesis of secreted [3H]glucosamine- and 35SO4-labelled glycoproteins over several days of culture. This same increase in levels of 35SO4 incorporation was not observed with B16 melanoma cells. Sodium dodecyl sulphate (SDS)/polyacrylamide gel electrophoresis revealed that five major glycoproteins labelled with [3H]glucosamine also were labelled with 35SO4. The major secreted glycoproteins from cells cultured in the absence or presence of butyrate over a 3-day period were similar by SDS/polyacrylamide gel electrophoresis. Analyses of Pronase-derived glycopeptides indicated that these secreted 3H/35S-labelled glycoproteins contained sulphated oligosaccharides with terminal sialic acid----Gal----GlcNAc residues similar to glycoproteins secreted by vascular endothelial cells.

Butyrates↗