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Biomedical subjects

D McGuire

Publications and source records attributed to D McGuire.

50 records · Page 3Linked to original sources

Rhmod, a second kindred (Craig).

Three Rhmod siblings were found to have identical Rh: w1, w2, -3, -4, w5 (see article) phenotypes. All had stomatocytic hemolytic anemia. On quantitative hemagglutination studies, as well as on hand tests, all Rh antigens were not equally depressed. Rh17 (Hr0, 'not D') and Rh29 (RH, 'total Rh') were both normal. Rh5 (hr", e) was only slightly depressed. Rh25 (LW) had 50% of the expression expected in normal Rh:-1 cells. Rh1 (Rh0, D), Rh13 (RhA), Rh14 (RhB), Rh15 (RhC), and Rh16 (RhD), were severely depressed. Rh2 (rh', C) was depressed, while Rh7 (rhi, Ce) was absent. Both Rh19 (hrS) and Rh31 (hrB) were depressed. Rh12 (rhG, G) was distinctly depressed, scoring considerably less than rGrG red cells. The unrelated parents, the child of the proposita, and some siblings of each parent showed lessened depression of Rh antigens without displaying the consistent pattern that might be expected from a presumed single suppressor gene. Absence of a consistent pattern may have resulted from differing Rh genotypes, but a frequently observed depression involved Rh14, Rh15, and Rh16 (RhB, RhC, and RhD) without an effect on either Rh1 (RH3 or D) or Rh13 (RhA).

Female↗

Ziconotide, a new N-type calcium channel blocker, administered intrathecally for acute postoperative pain.

BACKGROUND AND OBJECTIVES: Voltage-sensitive calcium channel conductance is essential for the nervous system to signal a painful event. However, intrathecal administration of L-type calcium channel blockers does not provide analgesia. The present investigation was designed to assess the safety and analgesic efficacy of ziconotide, a new N-type calcium channel blocker, when administered intrathecally to patients with acute postoperative pain. METHODS: This randomized, double-blind, pilot study included patients undergoing elective total abdominal hysterectomy, radical prostatectomy, or total hip replacement. After intrathecal injection of local anesthetic and before surgical incision, a continuous intrathecal infusion of either placebo or 1 of 2 doses of ziconotide (0.7 microg/h or 7.0 microg/h) was started and continued for 48 to 72 hours postoperatively. Primary and secondary efficacy variables were the mean daily patient controlled analgesia (PCA) morphine equivalent consumption and visual analog pain intensity (VASPI) scores, respectively. RESULTS: Thirty patients received study drug; 26 were evaluable for efficacy. Mean daily PCA morphine equivalent consumption was less in patients receiving ziconotide than in placebo-treated patients, and the difference was statistically significant between 24 and 48 hours (P = .040). VASPI scores during the first 8 hours postoperatively were markedly lower in ziconotide-treated than in placebo-treated patients. In 4 of 6 patients receiving the high-dose of ziconotide (7 microg/h), adverse events, such as dizziness, blurred vision, nystagmus, and sedation contributed to study drug being discontinued after 24 hours. After ziconotide discontinuation, these symptoms resolved. CONCLUSIONS: Ziconotide showed analgesic activity, as shown by decreased PCA morphine equivalent consumption and lower VASPI scores. Because of a favorable trend of decreased morphine consumption with an acceptable side-effect profile in the low-dose ziconotide group, 0.7 microg/h may be closer to the ideal dose than 7 microg/h. Large-scale studies are required to clarify this issue.

Acute Disease↗

A reverse transcriptase-polymerase chain reaction assay for detecting Highlands J virus.

Highlands J (HJ) virus is an arbovirus frequently recovered at high rates in mosquitoes collected in the eastern United States. HJ virus is primarily a veterinary pathogen causing disease in domestic birds including turkeys, chickens, and partridges. It has an enzootic cycle similar to eastern equine encephalitis (EEE) virus and is often used as an indicator species in EEE surveillance programs. Current immunologic techniques to identify HJ virus are often inefficient and can involve cross-reactivity of antibodies. Therefore, we developed a molecular-based assay by a reverse transcriptase (RT)-polymerase chain reaction (PCR) technique. Primers were constructed from conserved sequences of the E1 coding region from 19 strains of HJ virus. PCR amplifications from serial dilutions of HJ virus-infected Vero cell culture supernatants indicated that this assay could detect viral RNA at concentrations of 10 plaque-forming units per reaction. Extracted RNAs from western equine encephalitis, EEE, LaCrosse, and Jamestown Canyon viruses were not detected with this assay. RNA extracted directly from the brain tissue of a dead house sparrow and from a pool of Culiseta mosquitoes yielded a PCR product of the expected size. The RT-PCR technique developed was both sensitive and specific for detecting HJ virus from infected cell culture supernatants, bird brain tissues, and mosquitoes. This new assay will permit rapid and accurate diagnosis of HJ virus, both enhancing surveillance activities for EEE transmission risk and monitoring infections in domestic poultry and wild birds.

Alphavirus↗

A comparison of transparent adherent and dry sterile gauze dressings for long-term central catheters in patients undergoing bone marrow transplant.

Patients undergoing bone marrow transplant (BMT) are at great risk of infection and sepsis. Long-term central catheters (LTCCs), required for IV therapy, can be a portal of entry for infectious agents. This randomized, prospective study compared two types of catheter dressings in 98 patients undergoing BMT: a dry sterile gauze dressing (DSGD) changed daily and a transparent adherent dressing (TAD) changed every four days. Study outcomes included incidence and severity of local and systemic complications, patient assessment of comfort, and calculation of nursing time. One case of catheter-related infection occurred during the study. No significant differences existed between the two dressings in the incidence of positive skin cultures or local complications with the exception of skin irritation. The TAD caused less skin irritation, was preferred by patients, cost less, and required less nursing time. The findings indicate that TADs provide a safe, comfortable, and cost-effective alternative to DSGDs for patients undergoing BMT and receiving antibiotic support during aplasia.

Adolescent↗

A national survey of infection prevention practices on bone marrow transplant units.

PURPOSE/OBJECTIVES: To identify and describe bone marrow transplant (BMT)-specific infection prevention measures in the United States. DESIGN: Survey design using a mailed questionnaire. SETTING: BMT programs across the United States. SAMPLE: 91 BMT programs (80.5% response rate). METHODS: A questionnaire containing both closed- and open-ended items was mailed to identified nurse contacts following introductory phone calls. Descriptive statistics were computed on responses to closed-ended questions; content analysis was performed on responses to open-ended questions. FINDINGS: Although all programs used some type of protected environment, practices varied considerably. Wide variation existed in cover-garment and hand-washing practices, regardless of the type of protected environment in use. Other protective measures included skin decontamination (69%), gut decontamination with oral nonabsorbable antibiotics (30%), antifungal therapy (73%), acyclovir therapy (82%), immunotherapy (73%), granulocyte-macrophage colony stimulating factor therapy (58%), and modified microbial diets (66%). Numerous mouth care regimens, visitor and patient precautions, and environmental maintenance routines were described. CONCLUSION: Little standardization of infection-prevention practices exists nationwide. IMPLICATIONS FOR NURSING PRACTICE: Efforts should be made to test the cost effectiveness and benefits of the various measures in use prior to the development of national standards.

Anti-Bacterial Agents↗