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Biomedical subjects

C Baker

Publications and source records attributed to C Baker.

At least 127 records · Page 7Linked to original sources

Alteration of monocyte function following major injury.

The macrophage exerts its stimulatory and regulatory functions within the specific immune response via the interleukin 1 (IL-1) and prostaglandin E2 (PGE2), respectively. In a screening study of macrophage-related variables following injury, a total of 58 patients (mean age, 32 years; mean injury Severity Score, 38), macrophagic phenotyping with the monoclonal antibody Leu M3 and serial measuring of the antagonistic monokines IL-1 and PGE2 and of the macrophage-activating lymphokine interferon gamma were carried out on posttrauma days 0, 1, 3, 5, 7, 10, 14, and 21. The posttraumatic course was characterized by significant monocytosis, showing a peak value of 32% of Leu M3-positive cells compared with 15% of these cells in normal control subjects. During the posttrauma course, the macrophagic PGE2 output was significantly elevated up to eightfold on days 5 and 7 compared with that of control subjects (0.441 +/- 0.14 ng/mL vs 0.052 +/- 0.01 ng/mL). Conversely, macrophagic IL-1 synthesis was significantly suppressed until day 10. Levels of interferon gamma were suppressed to a significant degree during the two-day observation period, with a trend to slow recovery at the end of week 3. These data suggest that a negative regulatory macrophagic function may be the event initiating posttraumatic immunosuppression. To restore impaired macrophagic T-helper cell interaction, cyclo-oxygenase inhibition and substitution of interferon gamma may be useful to potentiate facilitatory macrophagic function and to block inhibitory macrophagic activity.

Adolescent↗

Asymptomatic Chlamydia trachomatis infections in teenage males.

This study examined the prevalence of Chlamydia trachomatis infections of the urethra in asymptomatic teenage males in a juvenile detention setting. Gonorrhea cultures, chlamydia smears using the direct immunofluorescent antibody (DFA) technique, and 15-20 ml of a first-catch urine (FCU) sample were obtained. Of the 227 adolescent males screened, 205 had experienced sexual intercourse. Twenty-seven (13.2%) of the sexually active adolescents had positive DFA smears for C. trachomatis. Three (1.5%) had positive Neisseria gonorrhoeae cultures. A urine leukocyte count of greater than 10 per high-power field gave a 91% specificity but only a 26% sensitivity for a positive DFA. The high prevalence of chlamydia in this population and the relative low cost of the DFA screen for chlamydia make this a useful procedure for discovering unsuspected disease, particularly in a high-risk population. The FCU screen for leukocytes was of limited value in identifying asymptomatic infection.

Adolescent↗

Nursing interventions for children with a parent in the intensive care unit.

Hospitalization of a family member in an intensive care unit is a stressful event for the entire family. Nurses should be concerned not only with the hospitalized patient but with the family, as a unit. Attention is often focused on the patient and to a lesser extent on the spouse. The needs of the children may be neglected. To reduce the long-term negative effects of the crisis event on the life of the child, appropriate interventions should be made at the time of the crisis. It is important for nurses to recall emotional and cognitive phases of growth and development when counseling parents. This information is used to help the nonhospitalized parent identify the needs of the child. The nurse can act as a resource person for this parent in planning strategies that will prevent or alleviate problems for the child.

Adolescent↗

Demystifying hypoglycemia. When is it real and how can you tell?

Contrary to popular belief, hypoglycemia is an infrequently encountered condition and its presence is questionable until confirmed by appropriate tests. In ambulatory patients, blood glucose levels obtained during intake of a normal diet are more reliable than those obtained during a glucose tolerance test. If the blood glucose is actually abnormally low and the other two criteria of hypoglycemia are also satisfied, a search for the cause is in order. In hospitalized patients, excessive doses of insulin or oral hypoglycemic agents, the effect of drugs, or chronic renal failure are the most common causes of hypoglycemia. If these factors are absent, another chronic illness known to cause hypoglycemia may be the source. If the cause is still obscure, a thorough evaluation of the endocrine status is warranted.

Anxiety↗

Protective effect of BCG in Ahmednagar, India.

As part of a series of investigations to determine the effect of sensitisation by environmental mycobacteria on the efficacy of BCG vaccination in India, this study was carried out in Ahmednagar in Maharashtra. A preliminary skin test survey showed that the rate of sensitisation with age was much lower than in Agra, the site of a previous study, and BCG vaccination scars were associated with considerable enhancement in sensitisation to Tuberculin and other reagents. It was possible to set up prospective BCG vaccination studies in pre-school and primary and secondary school children. Follow up with skin tests were carried out 1 and 2 years later. By the second year, results were obtained almost identical with those 10 years after BCG administration in the UK. On this basis it is proposed that the vaccine is likely to provide a considerable level of protection in Ahmednagar. The results of this study also resemble those obtained in the very youngest age group studied in Agra. The marked differences between Indian towns strongly suggest the influence of exposure to mycobacteria in the environment.

Adolescent↗

Sensory-affective relationships among different types of clinical and experimental pain.

Different types of pain patients used visual analogue scales (VAS) to rate their level of pain sensation intensity (VAS sensory) and degree of unpleasantness (VAS affective) associated with pain experienced at its maximum, usual, and minimum intensity. Women used the same VAS to rate their labor pain during early, active, and transition phases of stage I and in pushing (stage II). Consistent with the hypothesis that the affective dimension of clinical pain can be selectively augmented by perceived degree of threat to health or life, cancer pain patients and chronic pain patients gave higher VAS affective ratings as compared to VAS sensory ratings of their clinical pain, whereas labor patients and patients exposed to experimental pain gave lower VAS affective ratings compared to their VAS sensory ratings of pain. Affective VAS but not sensory VAS ratings of pain were considerably reduced when women in labor focused on the birth of the child as compared to when they focused on their pain. The results underscore the importance of utilizing separate measures of the sensory intensity versus the affective dimension of clinical pain and provide evidence that the affective dimension of different types of clinical pain is powerfully and differentially influenced by psychological contextual factors.

Adult↗

LY164846 in vitro antimicrobial activity testing, including disk diffusion susceptibility tests using 30-microgram disks.

A new oral cephalosporin, LY164846 (Eli Lilly & Co., Indianapolis, Ind.), was found to have a unique antimicrobial spectrum confined to methicillin-susceptible Staphylococcus spp., streptococci (except Enterococcus spp.), Haemophilus influenzae, Branhamella catarrhalis, and some anaerobes. Cephalothin in vitro tests (30-microgram disks or dilution) can represent LY164846 for laboratory testing if comparable interpretive breakpoints are applied to strains within the spectrum of LY164846. Organisms not inhibited by LY164846 (MICs greater than or equal to 32 micrograms/ml) were members of the family Enterobacteriaceae, Pseudomonas spp., Acinetobacter spp., enterococci, and some strains of Staphylococcus haemolyticus and of the Bacteroides fragilis group.

Anti-Bacterial Agents↗

Correlation between the number of placental opioid receptors, mode of delivery, and maternal narcotic use.

Human placental opioid receptors were assayed using the radioactive opioid agonist, etorphine, to determine the number of binding sites in villous tissue membrane preparations. Significant differences in receptor concentration per milligram of protein of tissue were found between placentas obtained following vaginal or abdominal delivery (P less than 0.002). Labor itself did not alter apparent receptor numbers. In patients with maternal narcotic abuse during pregnancy, no opioid binding could be detected regardless of the mode of delivery, suggesting possible receptor down-regulation.

Cesarean Section↗

Diabetes management: an update.

The diabetic diet is no longer as rigid as it once was. Oral hypoglycemic agents continue to have a place in management, and the declining cost of human insulin makes it an increasingly attractive option. Home glucose testing is the preferred monitoring method, and its use is becoming more common. Regardless of the management method used, close control offers the potential benefit of fewer diabetic complications but also presents increased hazards from hypoglycemia.

Automobile Driving↗

Strategy for the use of biliary scintigraphy in non-iatrogenic biliary trauma.

Biliary scintigraphy was used to examine 21 patients who had suspected non-iatrogenic biliary trauma. Seven patients (33%) had scintigraphic evidence of biliary leakage. Ultimately, surgical biliary repair was required for only three of these patients. Visualization of the gallbladder did not occur in eight trauma patients, but only one patient was shown to have cholecystitis. In this series, 16 patients had Tc-99m sulfur colloid scans that offered no significant advantage over cholescintigraphy in the detection of hepatic parenchymal defects. Biliary scintigraphy provides clinically useful information in cases both of blunt and penetrating trauma.

Adult↗