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Biomedical subjects

D J Carroll

Publications and source records attributed to D J Carroll.

16 recordsLinked to original sources
PubMed1992

Effect of education on the appropriateness of serum drug concentration determination.

The purpose of this study was to document the effect of education on the appropriateness of serum drug concentration (SDC) collection. This study included a period of education for hospital personnel involved in the acquisition of drug levels. These included nursing staff, lab personnel, house-staff (residents/interns), ward clerks, and pharmacists. This study included patients receiving aminoglycoside and/or vancomycin while on the general medicine service during the specified study periods. Patients receiving less than 72 h of antimicrobial therapy and patients transferred to or from the surgery service were excluded from the study. A retrospective pre- and posteducation comparison using Chi-square analysis was made to determine whether the percentage of appropriate and useful SDCs was improved through education. There was a significant difference (p less than 0.005) between the percentage of appropriate SDCs in the pre- and posteducation period. As a result of the study, a change in procedure for ordering SDCs was initiated, using an educational program, in order to continue the trend of appropriate SDCs at the Veterans Administration.

Aminoglycosides↗
PubMed1992

Progesterone production by cultured luteal cells in the presence of bovine low- and high-density lipoproteins purified by heparin affinity chromatography.

The objectives of this study were to separate plasma lipoprotein particles based on the presence (low-density lipoproteins; LDL) or absence of apolipoprotein B (high-density lipoproteins; HDL) and to compare the abilities of bovine LDL and HDL to stimulate progesterone production by bovine luteal cells in culture. Plasma lipoproteins were isolated by ultracentrifugation and separated into LDL and HDL by heparin affinity chromatography. Luteal cultures were treated with LDL or HDL cholesterol for 48 h on d 3 of the culture (d 0 = day of dissociation). Progesterone production by luteal cells increased in a dose-dependent manner with increasing concentrations of either LDL or HDL cholesterol. There were no differences in the ability of LDL or HDL cholesterol to stimulate luteal cells to produce progesterone. Because LDL and HDL were equally potent, and experiment was designed to investigate the ability of modified LDL or reconstituted particles without apolipoproteins to stimulate progesterone production. Stimulation of luteal cell progesterone production by lysine-modified LDL was 70% of unmodified LDL. Progesterone production in the presence of phosphatidylcholine liposomes or BSA containing cholesterol was 50 and 108% of that obtained with HDL or LDL. Evidence indicated that apolipoprotein-free particles that contained free cholesterol but not cholesterol esters stimulated luteal cells to produce progesterone.

Animals↗
PubMed1992

Stimulation of luteal cell progesterone production by lipoproteins from cows fed control or fat-supplemented diets.

Plasma lipoproteins from lactating dairy cows fed 0 or 7% supplemental fat were examined for their composition and ability to stimulate luteal cell progesterone production in vitro. Ultracentrifugation was utilized to isolate blood lipoproteins, and heparin affinity chromatography allowed separation of lipoprotein fractions based on the presence (low density lipoproteins) or absence of apolipoprotein B (high density lipoproteins). A portion of high density lipoproteins was fractionated by size, utilizing gel filtration chromatography. Slaughterhouse corpora lutea were dissociated, and plasma lipoproteins were added to the luteal cells on d 3 of culture and incubated for 48 h. In Experiment 1, blood was collected from heifers fed a diet that was not supplemented with fat. The addition of cholesterol from large, high density lipoproteins with a high cholesterol to protein ratio to luteal cultures increased progesterone production by an average of 17% compared with the addition of cholesterol from small, high density lipoproteins with a low cholesterol to protein ratio. In Experiment 2, electrophoretic mobility, apolipoprotein composition, and size of lipoproteins from control and fat-supplemented cows were similar. Lipoproteins from cows assigned to either a control or fat-supplemented diet showed no difference in their ability to stimulate progesterone production. Increased plasma progesterone concentration in lactating dairy cows fed supplemental fat does not appear to be mediated by alterations in lipoprotein composition.

Animals↗
PubMed1991

Rapid development of ciprofloxacin resistance in methicillin-susceptible and -resistant Staphylococcus aureus.

The fluoroquinolones, particularly ciprofloxacin, have been suggested to treat methicillin-resistant Staphylococcus aureus (MRSA) infections and colonization and methicillin-susceptible S. aureus (MSSA) infections. The development of ciprofloxacin resistance in MRSA and MSSA was prospectively evaluated. After 3 months of ciprofloxacin use, high-level resistance (MIC90, 64 micrograms/ml) developed in MRSA and increased at an alarming rate, from none to 79% over a 1-year period. High-level ciprofloxacin resistance also developed in MSSA, increasing to 13.6% over the same period. Antibiograms, phage typing, and plasmid profile analysis suggest that more than one clone of MRSA developed resistance and that ciprofloxacin resistance is not associated with the acquisition of a new plasmid. Most patients had nosocomial acquisition and about one-half had a history of previous ciprofloxacin use. Ciprofloxacin resistance can develop rapidly in S. aureus; thus, ciprofloxacin appears to have limited usefulness in treating staphylococcal infections and colonization, especially those due to MRSA.

Ciprofloxacin↗
PubMed1991

Effects of dietary fat on metabolic disorders and reproductive performance of dairy cattle.

Improved reproductive performance and reduced incidence of metabolic disorders have been postulated to be benefits of feeding supplemental fat to dairy cows. Increased plasma nonesterified fatty acid concentrations during fat supplementation may result from incomplete tissue uptake of fatty acids after lipoprotein lipase hydrolysis of very-low-density lipoprotein triglyceride; however, evidence suggests that net adipose tissue triglyceride hydrolysis may be increased during fat supplementation. Plasma 3-OH-butyrate concentrations remain relatively constant during fat supplementation but may have a tendency to be reduced if fat is supplemented to cows having relatively high basal plasma 3-OH-butyrate concentrations. Because plasma ketone levels usually increase when nonesterified fatty acid concentrations are elevated, it is hypothesized that potential antiketogenic effects of added fat are due to a glucose sparing effect. Supplemental fat does not seem to reduce hepatic lipid infiltration near the time of calving. Potential mechanisms by which supplemental fat may improve reproductive performance include stimulation of prostaglandin F2 a synthesis and secretion and enhanced utilization of blood cholesterol for progesterone synthesis. Days postpartum until first ovulation and luteal function of dairy cattle have been related to energy balance during the first 3 wk postpartum. Energy balance data for early lactation cows fed supplemental fat are not plentiful; however, slight but statistically nonsignificant increases have been observed when feeding fat. Cows fed supplemental fat that experience improved energy balance may begin to cycle sooner because of enhanced follicular growth and development. Applied studies examining the effects of supplemental fat on reproductive performance have provided inconsistent results.

Animals↗
PubMed1990

Effects of fat supplementation and immature alfalfa to concentrate ratio on lactation performance of cattle.

Forty-six multiparous Holstein cows were assigned 5 d postpartum to a completely randomized design employing a 2 x 3 factorial treatment arrangement. Factors were 0 or 5% added prilled fat (DM basis) substituted for shelled corn and alfalfa silage fed in forage-to-concentrate ratios of 45:55, 64:36, and 84:16 (DM basis). Interactions between fat and forage level were not observed for any of the parameters measured. Energy density, calculated using data from a digestibility trial, was similar between 45:55 and 64:36 diets (1.66 Mcal NE1/kg) and was lower with 84:16 diets (1.48 Mcal NE1/kg) for the 100 d trial. Fat supplementation increased energy density of the diets (1.67 vs. 1.53 Mcal NE1/kg). Dry matter digestibility, energy intake, and 4% FCM yields were similar for cows fed 45:55 and 64:36 diets and lower for those fed the 84:16 diets. Fat supplementation did not affect DM digestibility. Dry matter intake declined with increasing forage level and fat supplementation. Milk yield decreased as forage level increased. Fat supplementation did not affect yield of milk or FCM. Milk fat percentage was lower for cows fed 45:55 than 64:36 or 84:16 diets. Fat supplementation increased milk fat percentage. Milk protein yield decreased as forage level increased but was unaffected by fat supplementation. Results suggest higher levels of concentrate support higher milk yields, and prilled fat supplementation improves fat test when fed with immature forages. Prilled fat supplementation did not enhance lactation performance because of depressed DM intake in early lactation.

Animal Feed↗
PubMed1990

Effects of fat supplementation and immature alfalfa to concentrate ratio on plasma progesterone, energy balance and reproductive traits of dairy cattle.

Forty-six multiparous Holstein cows were assigned at 5 d postpartum to a completely randomized design employing a 2 x 3 factorial arrangement of treatments. Factors were 0 and 5% added prilled long-chain fatty acids (DM basis) and three forage to concentrate ratios (45:55, 64:36, 84:16). Diets consisted of immature alfalfa silage and a concentrate of shelled corn and soybean meal with or without fat replacing a portion of the corn. Mean plasma concentration of cholesterol was higher for cows fed 5% vs. 0% fat and increased over the first 100 d in milk for all animals regardless of treatment. There were no differences in reproductive performance due to either of the main effects. Mean plasma progesterone was higher due to fat treatment in the mid to late luteal phase of the second postpartum cycle as well as the metestrous to early luteal phase and mid to late luteal phase of the third cycle. Even though progesterone concentrations were higher in cows fed 5% fat during the luteal phase after breeding, the conception rates at this service were not different from those fed 0% fat. The biological significance of increased plasma progesterone concentration was not identified with any postpartum reproductive trait measured in this trial.

Animal Feed↗
PubMed1989

Binding of bovine follicular fluid glycosaminoglycans to fibronectin, laminin and low-density lipoproteins.

Interactions of bovine follicular fluid glycosaminoglycans (GAGs) with extracellular matrix (ECM) components fibronectin and laminin and with low-density lipoproteins (LDL) were examined using affinity chromatography. Glycosaminoglycans from small (diameter less than 5 mm) and large (diameter 11-20 mm) follicles were isolated from follicular fluid. The dermatan sulphate or heparan sulphate from small or large follicles was applied to Fn-, Lm- or LDL-Sepharose columns. Portions of each fraction of the bound or unbound GAG were then subjected to gel filtration h.p.l.c. for quantification. The binding interaction between dermatan sulphate and fibronectin was significantly greater than between heparan sulphate and fibronectin (P less than 0.05); the binding interaction between GAGs from small follicles and fibronectin was significantly greater than between GAGs from large follicles (P less than 0.05). The binding interaction between GAGs from small follicles and laminin was significantly greater than for GAGs from large follicles (P less than 0.05). Dermatan sulphate from small follicles bound to fibronectin (42%), laminin (36%) and LDL (14%) and that from large follicles bound to fibronectin (14%), laminin (23%) and LDL (14%). Heparan sulphate from small follicles bound to fibronectin (17%), laminin (15%) and that from large follicles bound to fibronectin (13%), laminin (10%) and LDL (6%). These results suggest that dermatan sulphate, but not heparan sulphate, from follicles at different stages of development exhibit a varied ability to interact with components of the ECM. Both substances bound to LDL comparably in small amounts.

Animals↗
PubMed1988

A review of lipoprotein cholesterol metabolism: importance to ovarian function.

Cholesterol utilized for steroid synthesis by ovarian tissue may be derived from de novo synthesis or cellular uptake of lipoprotein cholesterol. The majority of blood cholesterol is transported by either low (LDL) or high (HDL) density lipoproteins, depending on the animal species. Prior to vascularization, only HDL are in follicular fluid and contribute sterol to granulosa cells because other lipoproteins are unable to transverse the basement membrane due to their molecular masses. Following vascularization, both LDL and HDL bathe luteal cells. Most species preferentially use LDL cholesterol as a precursor for ovarian steroid synthesis. The LDL uptake by ovarian tissue occurs by receptor-mediated endocytosis. The receptor recognizes apolipoprotein B of LDL and apolipoprotein E found on some, but not all, HDL. Within a species, a positive relationship may exist between HDL apolipoprotein E content and importance of HDL cholesterol as a precursor for steroidogenesis. A "HDL pathway" exists for uptake of sterol from HDL void of apolipoprotein E. The HDL receptor exhibits broad binding specificity. Unlike LDL, the HDL particle is not internalized, and cholesterol preferentially is taken up relative to other HDL constituents. In most species, lipoproteins, rather than de novo synthesis from acetate, contribute the majority of cholesterol used for steroid production. Trophic hormones increase lipoprotein binding, internalization, degradation and conversion of lipoprotein-derived sterol to steroids, effects that are mediate through cyclic adenosine monophosphate. Knowledge recently acquired regarding lipoprotein sterol utilization by the ovary may be useful in developing nutritional, pharmacological or endocrine manipulations that may positively affect cholesterol clearance by the ovary, steroidogenesis and reproductive performance.

Animals↗
PubMed1988

Influence of protein intake and feeding strategy on reproductive performance of dairy cows.

A study was conducted to determine the impact of dietary CP concentration (13 vs. 20%) and feeding strategy (total mixed ration vs. separate feeding of the forage and concentrate) on reproductive performance of 57 early lactation dairy cows. Cows were assigned to one of four treatments in a 2 x 2 factorial arrangement. Rations composed of 40% forage (50% grass-legume silage:50% corn silage) and 60% concentrate (DM basis) were fed from d 5 to 100 postpartum. Cows fed a total mixed ration had lower ruminal ammonia and plasma urea N concentrations compared with cows fed separately. Feeding strategy groups showed no differences in reproductive performance. Cows fed a 20% CP ration had higher CP intake, higher ruminal ammonia, and higher urea N concentration in plasma and vaginal mucus. There were no differences between low and high CP groups in days to first observed estrus (24 vs. 27), days to first service (55 vs. 59), days open (72 vs 82) or services per conception (1.5 vs. 1.8). Days to first estimated ovulation were longer (22 vs. 17) in the high vs. low CP groups, and there was an interaction between protein intake and lactation number. Cows managed with an intensive program for detection of estrus and for reproductive health did not show differences in reproductive efficiency when fed 13 or 20% CP rations.

Animals↗
PubMed1986

Effect of methylprednisolone on CSF IgG parameters, myelin basic protein and anti-myelin basic protein in multiple sclerosis exacerbations.

Clinical exacerbations of multiple sclerosis (MS) are characterized by elevated levels of cerebrospinal fluid (CSF) myelin basic protein (MBP). The purposes of this study were to determine whether anti-MBP antibodies are present in increased titer in CSF of MS patients with exacerbations, and whether they can be suppressed by the administration of immunosuppressive dosages of methylprednisolone (MP). A solid phase radio-immunoassay (RIA) was used to detect free and total anti-MBP antibodies before and after acid hydrolysis of CSF. In MS exacerbations, the majority of elevated anti-MBP is in the free form. With the exception of subacute sclerosing panencephalitis (SSPE) and some cases of post infectious encephalomyelitis, anti-MBP antibodies are not present in either MS patients in remission or in non-MS controls. Anti-MBP levels remained elevated over a 10 day period when patients are managed by bed rest only or when treated with intravenous (IV) ACTH. IV administration of MP in "high" (160 mg/day) or "mega" (2 g/day) dosages produces a highly significant reduction of both MBP (p less than 0.01) and anti-MBP (p less than 0.001) levels. Total intrathecal IgG synthesis is also significantly suppressed by IV-MP but not by ACTH.

Adrenocorticotropic Hormone↗
PubMed1985

Vesical dysfunction in multiple sclerosis.

Sixty-four patients with multiple sclerosis and associated symptoms of neurogenic bladder dysfunction underwent urodynamic evaluation. The most common symptoms were urgency, incontinence, and frequency which did not correlate with urodynamic findings. Cystometrography demonstrated hyperreflexic bladders in 78 per cent and areflexic bladders in 20 per cent of patients. In those patients with hyperreflexia, voiding cystourethrography revealed poorly sustained uninhibited contractions associated with ineffective bladder emptying in 50 per cent, well-sustained contractions in 38 per cent, and detrusor-sphincter dyssynergia in 12 per cent. Therapy consisted of intermittent catheterization, pharmacologic manipulation, or transurethral resection of the external sphincter, according to urodynamic evaluation.

Adolescent↗
PubMed1985

A double-blind controlled pilot study of plasma exchange versus sham apheresis in chronic progressive multiple sclerosis.

Twenty patients with chronically progressive multiple sclerosis (MS) were randomised in a double-blind controlled study to assess the efficacy of plasma exchange therapy. All patients were immunosuppressed with prednisone and azathioprine and underwent either plasma exchange or sham apheresis. The 10 patients in each group were similar in age, sex, duration of disease and degree of disability. Clinical and laboratory responses were assessed immediately following the course of exchange or sham therapy, and 3 to 6 months later, by individuals blinded to the type of therapy administered. Although modest improvement was suggested on clinical examination in 7 of 10 patients exchanged and 3 of the 10 sham treated group, this was transient and was not accompanied by any change in disability status scores. No differences in abnormal laboratory investigations were demonstrable between the two patient groups following therapy. We conclude that plasma exchange therapy using this protocol is unlikely to be of clinical benefit as an adjunct in the management of chronically progressive M.S.

Adult↗