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Biomedical subjects

C Taylor

Publications and source records attributed to C Taylor.

At least 37 records · Page 2Linked to original sources

Nitrogen shuttling between neurons and glial cells during glutamate synthesis.

The relationship between neuronal glutamate turnover, the glutamate/glutamine cycle and de novo glutamate synthesis was examined using two different model systems, freshly dissected rat retinas ex vivo and in vivo perfused rat brains. In the ex vivo rat retina, dual kinetic control of de novo glutamate synthesis by pyruvate carboxylation and transamination of alpha-ketoglutarate to glutamate was demonstrated. Rate limitation at the transaminase step is likely imposed by the limited supply of amino acids which provide the alpha-amino group to glutamate. Measurements of synthesis of (14)C-glutamate and of (14)C-glutamine from H(14)CO(3) have shown that (14)C-amino acid synthesis increased 70% by raising medium pyruvate from 0.2 to 5 mM. The specific radioactivity of (14)C-glutamine indicated that approximately 30% of glutamine was derived from (14)CO(2) fixation. Using gabapentin, an inhibitor of the cytosolic branched-chain aminotransferase, synthesis of (14)C-glutamate and (14)C-glutamine from H(14)CO(3)(-) was inhibited by 31%. These results suggest that transamination of alpha-ketoglutarate to glutamate in Müller cells is slow, the supply of branched-chain amino acids may limit flux, and that branched-chain amino acids are an obligatory source of the nitrogen required for optimal rates of de novo glutamate synthesis. Kinetic analysis suggests that the glutamate/glutamine cycle accounts for 15% of total neuronal glutamate turnover in the ex vivo retina. To examine the contribution of the glutamate/glutamine cycle to glutamate turnover in the whole brain in vivo, rats were infused intravenously with H(14)CO(3)(-). (14)C-metabolites in brain extracts were measured to determine net incorporation of (14)CO(2) and specific radioactivity of glutamate and glutamine. The results indicate that 23% of glutamine in the brain in vivo is derived from (14)CO(2) fixation. Using published values for whole brain neuronal glutamate turnover, we calculated that the glutamate/glutamine cycle accounts for approximately 60% of total neuronal turnover. Finally, differences between glutamine/glutamate cycle rates in these two model systems suggest that the cycle is closely linked to neuronal activity.

Animals↗

Identification of factors contributing to increased length of stay in two diagnosis related groups.

This paper discusses a study conducted to identify factors that contributed to increased length of stay for two diagnosis related groups (DRGs) and their consequential impact on nursing salaries. The study shows that three separate clusters of cost drivers (DRG-related, nurse-related, and patient-related) contributed to increased length of stay for DRG 177 (chronic obstructive airways disease) and DRG 367 (cholecystectomy without exploration of the common bile duct). It was not possible to establish a link between length of stay and nursing salaries due to lack of relevant data. The results of the study can be used to raise professional awareness to the difficulties encountered by nurse managers in controlling length of stay when there are substantial numbers of different DRGs in acute care wards. The results can also be used as a basis for conducting larger studies into DRGs with higher than expected lengths of stay.

Cholecystectomy↗

Roman Catholic health care identity and mission: does Jesus language matter?

This article examines the current use of Jesus language in a convenience sample of twenty-five mission statements from Roman Catholic hospitals and health care systems in the United States. Only twelve statements specifically use the words "Jesus" or "Christ" in their mission statements. The author advocates the use of explicit Jesus language and modeling. While the witness of Jesus in the Gospel healing narratives is not only the corrective to current abuses in the health care delivery system, it is foundational to the integrity of Roman Catholic health care identity and mission. An analysis of Gospel healing narratives is used to illustrate the prophetic dimension of Jesus' wisdom, word, and witness.

Catholicism↗

Gene flow among populations of the malaria vector, Anopheles gambiae, in Mali, West Africa.

The population structure of the Anopheles gambiae complex is unusual, with several sibling species often occupying a single area and, in one of these species, An. gambiae sensu stricto, as many as three "chromosomal forms" occurring together. The chromosomal forms are thought to be intermediate between populations and species, distinguishable by patterns of chromosome gene arrangements. The extent of reproductive isolation among these forms has been debated. To better characterize this structure we measured effective population size, N(e), and migration rates, m, or their product by both direct and indirect means. Gene flow among villages within each chromosomal form was found to be large (N(e)m > 40), was intermediate between chromosomal forms (N(e)m approximately 3-30), and was low between species (N(e)m approximately 0.17-1.3). A recently developed means for distinguishing among certain of the forms using PCR indicated rates of gene flow consistent with those observed using the other genetic markers.

Animals↗

The Interdisciplinary Generalist Curriculum Project at the Medical College of Ohio.

The Interdisciplinary Generalist Curriculum (IGC) Project at the Medical College of Ohio sought to develop and introduce a new required preclinical community-based ambulatory experience and to incorporate existing clinically oriented courses in the first two years into one specific curriculum. The major portion of the IGC was the Introduction to Primary Care (IPC), which consisted of 180 hours of new and restructured curriculum time in the first and second years. It included a community-based ambulatory care experience involving students spending time with community-based preceptors, problem-based group discussions with two generalists of different backgrounds, patient-centered workshops in primary care during both first and second years, an in-depth experience in the first year for students who worked with preceptors for two full days, and the development of a two-day clinical assessment and feedback session just prior to entry into the third clinical year. The IGC Project progressed as planned with two major exceptions. The problem-based group discussions were difficult to coordinate with schedules of two physicians as well as the busy schedules of four students, and were adapted after the initial experience so that at least one preceptor attended each meeting. The second difficulty involved coordinating with other clinical departments to effect a true change in the culture of the institution. Nonetheless, as a result of having the IGC Project at the Medical College of Ohio, the curriculum has been revised to incorporate all of the basic IGC concepts and principles. Other results are the development of objective structured clinical examinations that are held at the end of the first and second years and institution of the primary care block in the third year, which have provided the impetus for the establishment of a clinical skills assessment center.

Curriculum↗

Pediatric eye injury due to Avena fatua (wild oats).

OBJECTIVE: We report on florid and unusual ophthalmic physical signs in three children where the trauma was caused by seeds from Avena fatua, a grass common in western North America. DESIGN: Case series and literature review. SETTING: Three local emergency departments (ED) during the fall of 1998. PATIENTS OR PARTICIPANTS: Three children reporting to an ED with an acutely painful eye from which the foreign body was identified botanically as Avena fatua. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Symptoms, interventions, duration of problem. RESULTS: Three male children (6, 10, 14 years) presented separately following incidents in which they had sustained direct eye injury. Each child immediately experienced severe pain and profuse watering of the eye. Severe localized edema of the conjunctiva and inflammation was evident with conjunctival vessel injection leading to bleeding, reminiscent of a chemical "burn." Initially, two children appeared to have an eyelash caught behind the lower lid. In both instances, the emergency physicians initially dismissed the possibility of there being a significant foreign body, but because of the severity of the pain, conjunctival vessel injection, and edema, they attempted to remove the "lash." Removal of the foreign body proved difficult in all three cases, requiring far greater traction than anticipated. Intact seedpods had become embedded in the subconjunctival space. Ophthalmic analgesia relieved the pain immediately, but in one child who was treated with topical antibiotic alone, significant pain was experienced for 18 hours, until steroid-antibiotic therapy was instituted. All injuries occurred in late summer when the grass propagates. CONCLUSIONS: The physical signs of scleral vasculitis and conjunctival edema can be mistaken for chemical injury or allergic chemosis, but where a foreign body resembling a hair or eyelash is visible, the presence of a seed-pod retained in the subconjunctival space must be considered, particularly if the patient reports exposure to wild grass. Application of local analgesia, foreign body removal, and steroid-antibiotic treatment is recommended.

Adolescent↗

Pregnancy smoking and childhood conduct problems: a causal association?

Recent investigations have highlighted associations between maternal smoking in pregnancy and antisocial behaviour in offspring, and suggested the possibility of a causal effect. We used data from the 1970 British birth cohort study (BCS70) to examine these links in a large. population-based sample studied prospectively from birth to age 16. We found a strong dose-response relationship between the extent of pregnancy smoking and childhood-onset conduct problems, but no links with adolescent-onset antisocial behaviours. Effects on childhood-onset conduct problems were as marked for girls as for boys, and were robust to controls for a variety of social background factors and maternal characteristics. Controls for mothers' subsequent smoking history modified this picture, however, suggesting that the prime risks for early-onset conduct problems may be associated with persistent maternal smoking--or correlates of persistent smoking--rather than with pregnancy smoking per se.

Adolescent↗

Decreased efficacy of polyethylene glycol lavage solution (golytely) in the preparation of diabetic patients for outpatient colonoscopy: a prospective and blinded study.

OBJECTIVES: The aim of the present study was to compare, in a prospective and blinded fashion, the efficacy of 6 L of polyethylene glycol-based lavage solution (Golytely) administered on an outpatient basis in diabetic versus nondiabetic patients. METHODS: A total of 54 consecutive nondiabetic and 45 consecutive diabetic patients requiring outpatient colonoscopy underwent colonic cleansing by drinking 6 L of Golytely the evening before the procedure. The entire procedure, from rectum to cecum, was videotaped and coded for later review by the Chief of Endoscopy who was blinded to the identity and medical history of the patients. The primary outcome measure was the quality of the preparation score, numerically rated on a 14-point scale (0-13) based on the surface area of the mucosa that could be examined and the consistency of the residual stool. RESULTS: There was a significant difference in the quality ratings for the bowel preparations, with an overall superior preparation in the nondiabetic group (2.4+/-1.6 vs 5.4+/-3.1, p < 0.001). A total of 97% of the nondiabetic patients had a preparation rated as good or better, compared with only 62% of the diabetic patients (p < 0.001). Preparations rated as poor or futile, necessitating repeat colonoscopy, occurred in no nondiabetic but in 9% of diabetic patients (p < 0.01). Within the diabetic group, there was no significant difference in bowel preparation scores between those patients aged >70 yr and those <70 yr, those requiring and those not requiring insulin, those with Hb A1c values >8% and those with values <8%, and those with and without peripheral neuropathy. CONCLUSION: We conclude that diabetic patients (irrespective of insulin use, diabetic control, or diabetic neuropathy) have a significantly poorer response to a 6-L Golytely preparation than do nondiabetic patients.

Adult↗

Treatment of EBV driven lymphoproliferation with erythrophagocytosis: 12 year follow up.

This is a report of a case of Epstein-Barr virus (EBV) associated haemophagocytic syndrome in a 17 year old woman with antibody deficiency. For two years before this presentation, serology showed abnormally high titres to EBV early antigen, suggestive of persistent infection with EBV. She became acutely unwell with clinical features consistent with virus associated haemophagocytic syndrome (VAHS). Histology showed lymphoproliferation with erythrophagocytosis and evidence of EBV encoded RNAs in liver, spleen, and lymph node. VAHS is often fatal, particularly when it occurs in patients with underlying immunodeficiencies. In this case, treatment with intravenous immunoglobulin, aciclovir, and alpha interferon was followed by a dramatic recovery. Twelve years later the patient remains relatively well on regular intravenous immunoglobulin.

Acyclovir↗

Nicotine, alcohol and drug dependence and psychiatric comorbidity. Results of a national household survey.

BACKGROUND: There is a well-recognised relationship between substance use disorders and other psychiatric disorders. This relationship has been well documented in a range of population-based studies. AIMS: This study aims to report on consumption patterns of and dependence on nicotine, alcohol and non-prescribed drugs and to report on the levels of psychiatric morbidity in these groups. METHOD: A national household study of psychiatric morbidity was conducted in England and Wales. Psychiatric assessment was based on the Clinical Interview Schedule-Revised (CIS-R). Measures of nicotine, alcohol and drug use and dependence were obtained. This paper compares the levels of psychiatric morbidity in the non-dependent and the nicotine-, alcohol- and drug-dependent cases. RESULTS: Twelve per cent of the non-dependent population were assessed as having any psychiatric disorder compared with 22% of the nicotine-dependent, 30% of the alcohol-dependent and 45% of the drug-dependent population. CONCLUSIONS: There is a clear relationship between dependence on nicotine, alcohol and drugs and other psychiatric morbidity.

Adolescent↗

Recognising examples of congenital heart disease.

With improved treatments now available, many children with congenital heart disease are living into adulthood. Increasingly, it is more important for the nursing team to be familiar with the more common conditions that may be encountered.

Heart Defects, Congenital↗

Comparison of spectrofluorometric and HPLC methods for the characterization of fecal porphyrins in river otters.

A spectrofluorometric method (B. Grandchamp et al., 1980, Biochem. Biophys. Acta 629, 577-586) developed for the determination of amounts of uroporphyrin I (Uro I), coproporphyrin III (Copro III), and protoporphyrin IX (Proto IX) in skin fibroblasts was compared with a high-performance liquid chromatography (HPLC) method for the analysis of porphyrins in fecal samples of river otters (Lutra canadensis). Heptacarboxylate porphyrin I and coproporphyrin I, two porphyrins determined to be critical in defining the porphyrin profile in fecal samples of river otters with the HPLC method, contributed substantially to the calculation of the concentrations of Uro I and Copro III, respectively, in standard solutions of porphyrins with the spectrofluorometric method. Fluorescent components of the fecal matrix complicated the determination of the concentrations of Uro I, Copro III, and Proto IX with the spectrofluorometric method and resulted in erroneous values for the concentrations of these porphyrins compared with values determined with the HPLC method. These results indicate that the complexity of the sample, particularly with regard to the potential presence of interfering fluorescent compounds, as well as porphyrins additional to Uro I, Copro III, and Proto IX, should be considered prior to the application of the spectrofluorometric method. An alternative HPLC method developed for the rapid characterization of porphyrin profiles in fecal samples of river otters is described.

Alaska↗

Modified spectral editing methods for (13)C CP/MAS experiments in solids.

The spectral editing approach of Zilm and coworkers utilizes polarization, polarization inversion, and spin depolarization methods for enhancing or suppressing NMR spectral lines in solids. The proposed pulse sequences allow nonprotonated C, CH, CH(2), and CH(3) types of carbon resonances to be separated from one another and identified accordingly. The former method tentatively separates the nonprotonated C and CH(3) peaks with a cutoff shift of 35 ppm. This shift is a reasonable demarcation shift for a preponderance of organic molecules, but exceptions do exist that could constitute a serious drawback in a few instances. The new approach separates the nonprotonated C and CH(3) carbon peaks unequivocally using modified pulse sequences similar to those of Zilm. Further, both the CH only and CH(2) only spectra, respectively, can be acquired directly from combining so called (+) and (-) sequences using different spectral delay periods and pulse parameters. The (+) and the (-) pulse sequences produce signals for the nonprotonated and methyl carbons that have essentially the same amplitude but opposite phases. These spectra, combined with the previously reported CH(3) and nonprontonated C only spectra, offer a complete spectral editing technique for solid samples. Examples of these spectral editing methods are provided for 3-methylglutaric acid, fumaric acid monoethyl ester, and two complex natural products: methyl o-methylpodocarpate and 10-deacetylbaccatin III.

Magnetic Resonance Spectroscopy↗