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Biomedical subjects

C Butler

Publications and source records attributed to C Butler.

At least 55 records · Page 3Linked to original sources
PubMed1994

Development of o.a.s.i.s., a new automated blood culture system in which detection is based on measurement of bottle headspace pressure changes.

o.a.s.i.s. (Unipath Ltd., Basingstoke, United Kingdom) is a new automated blood culture system. The metabolism of microorganisms is detected by measuring changes in the pressure of the headspace of blood culture bottles. These changes are measured by monitoring the position of a flexible sealing septum, every 5 min, with a scanning laser sensor. This noninvasive system can detect both gas absorption and production and does not rely solely on measuring increasing carbon dioxide levels. A research prototype instrument was used to carry out an evaluation of the media, the detection system, and its associated detection algorithm. In simulated blood cultures, o.a.s.i.s. supported growth and detected a range of clinical isolates. Times to positivity were significantly shorter in o.a.s.i.s. than in the BACTEC 460 system. Results of a clinical feasibility study, with a manual blood culture system as a control, confirmed that o.a.s.i.s. was able to support the growth and detection of a variety of clinically significant organisms. On the basis of these findings, full-scale comparative clinical trials of o.a.s.i.s. with other automated blood culture systems are warranted.

Adolescent↗
PubMed1994

Cavitary coccidioidomycosis with fungus ball formation. Diagnosis by fiberoptic bronchoscopy with coexistence of hyphae and spherules.

Pulmonary cavitary coccidioidomycosis with fungus ball formation was observed in two individuals with hemoptysis. The first patient had no overt compromise; the second was an insulin-dependent diabetic. In both, fiberoptic bronchoscopy was performed and cultures yielded Coccidioides immitis. The coexistence of spherules and hyphae of C immitis was seen histologically on bronchoscopic biopsy specimen of one cavitary lesion. Specific antifungal therapy and surgical excision were withheld and each patient has done well. This report provides for the first time nonsurgical confirmation that C immitis can produce an intracavitary fungus ball.

Adult↗
PubMed1993

Excising customs.

Explore the source record for details and available documents.

Consumer Behavior↗
PubMed1993

Impact of diagnosis on utilities assigned to states of illness.

This paper addresses some of the fundamental issues surrounding the measurement of quality of life in relation to health care and highlights the need for continuous and careful review. Healthy volunteers were used to study the effect of diagnosis on the utilities placed on three dimensions of health-related quality of life encompassing 17 states of disability, distress, and discomfort including pain. The standard gamble (SG) was used to elicit values for appropriate levels of each dimension for selected diagnostic conditions. It was shown that clinical diagnosis affects the utilities that people assign to different states of ill-health. Mental conditions were consistently assigned lower utilities with subjects attributing their decisions to the social unacceptability and intractability associated with these conditions. These findings suggest that the comprehensiveness of the descriptive system for health indicators and profiles is important and should be kept under review. Furthermore, these data have implications for the role of the Quality Adjusted Life Years (QALY) estimates which assume that utility is uniform across various conditions. Finally, the study may have implications for mental health services if other population samples were to accord such high priority to the relief of mental conditions.

Diagnosis↗
PubMed1989

Contamination of K-Sol corneal storage medium with Propionibacterium acnes.

K-Sol is a widely used corneal preservation medium. It has an excellent record for corneal storage and no previous report of contamination. During September 1988, on five of our K-Sol-stored donor rims Propionibacterium acnes grew. Cultures of unopened K-Sol also yielded P acnes. This report reviews previous contaminations of corneal storage media and the special characteristics of P acnes that enabled it to survive precautions taken against infection. The detection of P acnes was not obvious, and we emphasize the need for appropriate culturing of all donors, both aerobically and anaerobically, and close scrutiny of delayed inflammation in postoperative patients.

Chondroitin↗
PubMed1989

Double blind trial of loperamide for treating acute watery diarrhoea in expatriates in Bangladesh.

To determine if loperamide is effective and safe in treating watery diarrhoea, we randomly assigned 50 adult expatriates in Bangladesh with more than three unformed stools in the previous 24 hours and illness of less than 72 hours to receive loperamide or a placebo. On entry into the five day study patients took two capsules (one loperamide capsule = 2 mg) and one after each unformed stool up to a maximum of eight per day. The groups did not significantly differ in pretreatment features or pathogens identified. Mean number of stools on study day 1 was 2.6 in the loperamide group and 4.0 in the placebo group (p = 0.035); on day 2 it was 1.3 versus 3.4 (p less than 0.001). Differences in stool frequencies during the final three study days, or proportion of patients with cramps, nausea, or vomiting on any study day, were not significant. No serious side effects occurred in either group. We conclude that loperamide, by decreasing stool frequency during the early part of illness, may have a role in the symptomatic treatment of this self-limiting disease.

Acute Disease↗
PubMed1989

MELVYL MEDLINE: reference service implications of an end-user search system.

The implementation of MELVYL MEDLINE, a successful online end-user system in the University of California (UC) health sciences libraries greatly enhanced the capabilities of reference desk service by providing immediate access to current medical literature from the MEDLINE database. With these enhancements, the extent of the impact on the delivery of reference service was not anticipated. Concurrent with providing traditional reference service requests, there was a constant need for individualized end-user instruction by MELVYL MEDLINE users, and continual maintenance of workstation equipment and supplies. This paper describes the experiences at the UC Irvine (UCI) Biomedical Library and compares these experiences with other UC health sciences libraries. The purpose of this paper is to discuss some of the issues which must be considered when planning for the implementation of an end-user system within the reference service function.

California↗
PubMed1988

Histologic chorioamnionitis in pregnancies of various gestational ages. II: Implications in preterm labor.

A retrospective review of placental materials (membranes, chorionic plate, umbilical cord) derived from preterm birth is reported. All those studied had intact membranes on admission and did not have spontaneous rupture. Those with preterm labor unresponsive to tocolysis, including those with brief and more prolonged labors, were compared with those delivered preterm because of maternal or fetal indications without labor. Those with labor had inflammatory changes in all three sites of greater frequency than those without labor. Those with longer labors had significantly higher rates of inflammation than those without labor. In this population, removing the influence of spontaneous rupture and labor over 6 hours long greatly diminished the likelihood of inferring that inflammation of the choriamniotic environment is a cause of preterm labor unresponsive to tocolysis.

Chorioamnionitis↗
PubMed1988

Cardiac effects produced by long-term stimulation of thoracic autonomic ganglia or nerves: implications for interneuronal interactions within the thoracic autonomic nervous system.

Electrical stimulation of an acutely decentralized stellate or middle cervical ganglion or cardiopulmonary nerve augments cardiac chronotropism or inotropism; as the stimulation continues there is a gradual reduction of this augmentation following the peak response, i.e., an inhibition of augmentation. The amount of this inhibition was found to be dependent upon the region of the heart investigated and the neural structure stimulated. The cardiac parameters which were augmented the most displayed the greatest inhibition. Maximum augmentation or inhibition occurred, in most instances, when 5-20 Hz stimuli were used. Inhibition of augmentation was overcome when the stimulation frequency was subsequently increased or following the administration of nicotine or tyramine, indicating that the inhibition was not primarily due to the lack of availability of noradrenaline in the nerve terminals of the efferent postganglionic sympathetic neurons. Furthermore, as infusions of isoproterenol or noradrenaline during the period of inhibition could still augment cardiac responses, whereas during the early peak responses they did not, the inhibition of augmentation does not appear to be due primarily to down regulation of cardiac myocyte beta-adrenergic receptors. The inhibition was modified by hexamethonium but not by phentolamine or atropine. Inhibition occurred when all ipsilateral cardiopulmonary nerves connected with acutely decentralized middle cervical and stellate ganglia were stimulated, whereas significant inhibition did not occur when these nerves were stimulated after they had been disconnected from the ipsilateral decentralized ganglia. Taken together these data indicate that the inhibition of cardiac augmentation which occurs during relatively long-term stimulation of intrathoracic sympathetic neural elements is due in large part to nicotinic cholinergic synaptic mechanisms that lie primarily in the major thoracic autonomic ganglia. They also indicate that long-term stimulation in intrathoracic sympathetic neural elements with frequencies as low as 2 Hz may augment the heart as much as higher stimulation frequencies, depending upon the structure stimulated and the cardiovascular parameter monitored.

Adrenergic beta-Antagonists↗
PubMed1988

Effective multimodality treatment of epithelial ovarian tumors.

Forty patients with epithelial ovarian tumors underwent cyto-reductive surgery followed by a five drug (Adriamycin, D.D.P., 5FU, M.T.X. and C.T.X.) combination chemo and progestin therapy. They all had an initial complete clinical response and 58% were complete histologic responders. One patient developed reactivated disease six months after a negative second look laparotomy. Two of four fatal outcomes were due to development of mixed mesodermal tumors in patients who originally had serous cystadenocarcinomas. We conclude that this regimen is highly effective, independent of residual tumor size, histologic grade of tumor and prior therapy. Its attendant toxicity is acceptably low.

Adult↗