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Biomedical subjects

C Franklin

Publications and source records attributed to C Franklin.

At least 91 records · Page 5Linked to original sources
PubMed1987

Management of major or massive hemoptysis in active pulmonary tuberculosis by bronchial arterial embolization.

Management of massive hemoptysis in patients with active pulmonary tuberculosis is complicated. Transcatheter hemostatic embolization of bleeding vessels with absorbable material has been reported to be useful in controlling this problem. Twelve patients with active pulmonary tuberculosis who had major or massive hemoptysis were managed at Cook County Hospital, Chicago, from 1982 to 1986. Various methods of treatment have been evaluated. The technique of angiographic embolization and the criteria for selection of patients for its use constitute the basis of this report.

Adult↗
PubMed1987

Iodine absorption after topical administration.

Absorption from povidone-iodine preparations after topical administration has been reported to be negligible, but an elderly woman had increased serum iodine levels with possible metabolic complications after povidone-iodine solution was applied to decubitus ulcers.

Administration, Topical↗
PubMed1986

The properties of arginine transport in vacuolar membrane vesicles of Neurospora crassa.

We have measured the uptake of arginine into vacuolar membrane vesicles from Neurospora crassa. Arginine transport was found to be dependent on ATP hydrolysis, Mg2+, time, and vesicle protein with transported arginine remaining unmodified after entry into the vesicles. The Mg2+ concentration required for optimal arginine transport varied with the ATP concentration so that maximal transport occurred when the MgATP2- concentration was at a maximum and the concentrations of free ATP and Mg2+ were at a minimum. Arginine transport exhibited Michaelis-Menten kinetics when the arginine concentration was varied (Km = 0.4 mM). In contrast, arginine transport did not follow Michaelis-Menten kinetics when the MgATP2-concentration was varied (S0.5 = 0.12 mM). There was no inhibition of arginine transport when glutamine, ornithine, or lysine were included in the assay mixture. In contrast, arginine transport was inhibited 43% when D-arginine was present at a concentration 16-fold higher than that of L-arginine. Measurements of the internal vesicle volume established that arginine is concentrated 14-fold relative to the external concentration. Arginine transport was inhibited by dicyclohexylcarbodiimide, carbonyl cyanide m-chlorophenyl-hydrazone, and potassium nitrate (an inhibitor of vacuolar ATPase activity). Inhibitors of the plasma membrane or mitochondrial ATPase such as sodium vanadate or sodium azide did not affect arginine transport activity. In addition, arginine transport had a nucleoside triphosphate specificity similar to that of the vacuolar ATPase. These results suggest that arginine transport is dependent on vacuolar ATPase activity and an intact proton channel and proton gradient.

Adenosine Triphosphate↗
PubMed1986

Survival rates and prehospital delay during myocardial infarction among black persons.

Over a 12-month period, a consecutive series of 111 black patients admitted to a municipal hospital in Chicago was studied. The 2-week mortality rate for the entire group was 19% (95% confidence intervals, 11.7 to 26.3), and the rate was twice as high for women as for men. A history of systemic hypertension was encountered in 75% of the patients, and diabetes mellitus was present in 33%, although they were not significant predictors of mortality within this group. The delay time from onset of symptoms to arrival at the hospital was markedly prolonged compared with studies of predominantly white populations--twice as long at the median and 3 times as long at the mean. Preventive campaigns aimed at this population should include educating patients on the symptoms of coronary artery disease and encouraging them to seek prompt medical care. Attention must also be given to eliminating obstacles to access to care in this group.

Adult↗
PubMed1986

Costs in the ICU.

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Costs and Cost Analysis↗
PubMed1986

A randomized comparison of nifedipine and sodium nitroprusside in severe hypertension.

We randomized patients with severe hypertension in the Medical Intensive Care Unit to a treatment regimen of oral nifedipine or intravenous nitroprusside. Patients treated with nifedipine achieved a sustained reduction in diastolic blood pressure to less than or equal to 120 mm Hg in an average of less than five hours. Patients treated with nitroprusside achieved a similar reduction in 14 hours (p less than 0.05). Treatment with nifedipine was less expensive and required less time in the ICU than treatment with nitroprusside and was accompanied by no associated increase in morbidity or mortality. Oral nifedipine can be used as an alternative to intravenous nitroprusside in severe uncomplicated hypertension.

Administration, Oral↗
PubMed1985

Clinical computing in a teaching hospital.

This report describes a hospital-wide clinical computing system that permits physicians, nurses, medical students, and other health workers to retrieve data from the clinical laboratories; to look up reports from the departments of radiology and pathology; to look up demographic data and outpatient visits; to look up prescriptions filled in the outpatient pharmacy; to perform bibliographic retrieval of the MEDLINE data base; to read, write, retract, edit, and forward electronic mail; and to request delivery of a patient's chart. During a one-week study period, from 300 video display terminals located throughout the hospital, 818 patient care providers used a common registry of 539,000 patients to look up clinical and laboratory data 16,768 times; 477 other hospital workers used the patient registry 46,579 times. In a separate study of 586 health care providers, 470 (80 per cent) indicated that they used computer terminals "most of the time" to look up laboratory results; in contrast, 48 (8 per cent) preferred printed reports. Of 545 hospital workers, 440 (81 per cent) indicated that the computer terminals definitely or probably made their work more accurate, and 452 (83 per cent) indicated that terminals enabled them to work faster. The large amount of use by clinicians and their judgment that the computer has been so helpful to them suggests that a reliable, comprehensive, and easy-to-use computer system can contribute substantially to the quality of patient care.

Boston↗
PubMed1985

Profile of medical ICU vs. ward patients in an acute care hospital.

Demographic characteristics, severity of illness, resource utilization, and outcome were compared for 351 medical ICU (MICU) and 329 ward patients of a large, urban, tertiary care hospital. Patients were similar in age, race, sex, and insurance coverage. Both MICU and ward patients had similar health status distributions 3 to 6 months before hospitalization. Severity of illness, as measured by the Acute Physiology Score was significantly higher in the MICU patients, although there was considerable overlap in the distributions. Resource utilization, as measured by the Therapeutic Intervention Scoring System (TISS), was also significantly higher in the MICU; again, the distributions of the two groups overlapped, although mostly for low values of TISS. Of the MICU sample, 28% to 30% never required active therapeutic interventions; 11% of the ward sample received active treatment. The significant overlap between MICU and ward distributions of severity of illness and resource utilization has implications for admission and discharge policies.

Delivery of Health Care↗
PubMed1984

Causes of death in an urban public hospital.

For the study reported here, we examined the charts and autopsy reports of every death in the Department of Medicine at Cook County Hospital for the year 1983. In that period, there were 11,677 admissions to the Department and 476 deaths, yielding a mortality of 4.1 percent. There were 50 percent more deaths in the intensive care unit than on the general wards. Malignancies accounted for greater than one-third of all deaths. Lung cancer, which occurred in one of every six deaths in the department, was the single most-common diagnosis. The other leading causes of death were cirrhosis, gastrointestinal malignancies and cerebrovascular accidents. Cardiovascular mortality was somewhat less than expected. These figures reflect some of the serious diseases of the urban indigent population, which are, in turn, associated with cigarette smoking, alcoholism and hypertension. Decreases in morbidity and mortality are likely to be influenced by preventive medical measures and early detection campaigns. Department of medicine curricula and outpatient clinic programs should devote attention and resources to these areas.

Chicago↗
PubMed1983

Discharge decision-making in a medical ICU: characteristics of unexpected readmissions.

To identify those patients most likely to be readmitted to a Medical ICU (MICU), we studied 512 MICU admissions during a 1-yr period. There were 36 readmissions within the same hospitalization in that interval. When ICU deaths and short-term drug overdoses were excluded, these 36 readmissions comprised 12% of all patients discharged from MICU. The mortality rate of this group was 58%, greater than twice the overall mortality rate for the year. Fifty-three % of the patients were readmitted because of recurrence of their initial disease on admission, with septicemia being the most common disease. Another 30% were readmitted because of a new complication, one-half of which were medication toxicities. We have attempted to delineate diseases, medications, and complications which may predict the high-risk discharge from MICU. Further studies to identify high-risk and low-risk admissions and discharges will effect better use of intensive care.

Decision Making↗