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Biomedical subjects

D McIntire

Publications and source records attributed to D McIntire.

26 records · Page 2Linked to original sources
PubMed1994

High-dose oxytocin: 20- versus 40-minute dosage interval.

OBJECTIVE: To determine whether an increase in the oxytocin dosing interval would decrease the incidence of uterine hyperstimulation. METHODS: This study included 1801 consecutive pregnancies receiving high-dose oxytocin. Oxytocin was used for labor augmentation in 1167 and induction in 634 women. Twenty- and 40-minute dosage intervals were compared. The study period was based on an 80% likelihood of detecting 5 and 10% differences in the cesarean and hyperstimulation rates, respectively. Statistics were analyzed with chi 2, Fisher, and Wilcoxon rank-sum tests where appropriate. Multivariate logistic regression and analysis of covariance were used to control for confounding demographic variables. RESULTS: Comparison of the 20- and 40-minute regimens for labor induction yielded no differences in the rates of cesarean delivery for dystocia (16 versus 19%) or fetal distress (5 versus 6%). The 20-minute regimen for augmentation was associated with a significant reduction in cesarean for dystocia (8 versus 12%; P = .05). The incidence of uterine hyperstimulation was greater with the 20-minute than the 40-minute regimen for induction (40 versus 31%; P = .02), but not for augmentation (31 versus 28%). Neonatal outcomes were unaffected by the dosage interval for both augmentation and induction. CONCLUSION: A 40-minute dosing interval for high-dose oxytocin offers no clear advantage over a 20-minute interval. Both regimens were safe and efficient, with no differences in perinatal outcome. The 20-minute interval was associated with fewer cesareans for dystocia when used for labor augmentation, whereas the 40-minute interval resulted in less hyperstimulation when used for labor induction.

Adult↗
PubMed1993

Antibodies against autologous tumor cell proteins in patients with small-cell lung cancer: association with improved survival.

BACKGROUND: The frequency and clinical relevance of human antitumor immune responses is not well known, and few target antigens have been identified. PURPOSE: This study was designed to determine the frequency of antibodies reactive against extracts of autologous tumor cell lines and to correlate these data with survival. METHODS: Serum samples were obtained from 40 lung cancer patients treated on National Cancer Institute protocols. These sera were used as probes in immunoblots against protein extracts from tumor cell lines derived from each of these patients. RESULTS: We detected serum antibodies against autologous tumor cell proteins in 21 (58%) of the 36 patients with small-cell lung cancer (SCLC) and three (75%) of the four with non-small-cell lung cancer (NSCLC). Two patients' sera detected the p53 tumor suppressor gene product and two detected the product of the HuD gene (associated with paraneoplastic neurological syndromes) in their autologous tumor cell lysates. SCLC patients with antibodies against autologous tumor cell proteins had improved survivals compared with those in the antibody-negative group (P = .059). All patients who lived longer than 36 weeks were antitumor antibody positive. Sera from six (86%) of seven patients with limited disease were positive for antibodies that reacted against autologous tumor cells, compared with 15 of 29 (52%) of sera from patients with extensive disease. CONCLUSIONS: Our results suggest that the sera from patients with SCLC frequently contain antibodies against tumor cell proteins and that these antibodies are associated with improved survival. IMPLICATIONS: These data suggest that an antitumor immune response may affect tumor growth, and that the anonymous proteins detected by antitumor antibodies in lung cancer patient sera may represent proteins involved in the development of lung cancer or in its clinical manifestations.

Antibodies, Neoplasm↗
PubMed1992

Effect of helium and oxygen on airflow in a narrowed airway.

A mixture of 80% helium and 20% oxygen has physical properties that increase airflow and decrease resistance in the airway when used as a portion of inspired gas. This study was designed to demonstrate and quantify the effects of a helium-oxygen mixture in a normal airway and when airway resistance is increased. Thirty healthy volunteers were studied breathing room air and the helium-oxygen mixture through a normal airway and an airway that included a resistor. Pulmonary function tests, directed by a registered respiratory therapist, were performed on all subjects using a computerized spirometer. The functional vital capacity, one-second forced expiratory volume, half-second forced expiratory volume, and peak inspiratory flow rate were analyzed. There was a statistically significant increase in 1-second forced expiratory volume using a helium-oxygen mixture in a normal airway. All pulmonary function test scores statistically improved when volunteers inspired helium and oxygen through the restricted airway, demonstrating that helium and oxygen can increase airflow in the presence of an increased airway resistance. This substantiates a role for helium and oxygen in treating conditions associated with decreased airway size and increased airway resistance.

Adult↗
PubMed1992

Spermatozoal characteristics from fresh and frozen donor semen and their correlation with fertility outcome after intrauterine insemination.

OBJECTIVE: To determine if conventional sperm parameters, specific characteristics of sperm motion determined by computer-aided semen analysis (CASA), sperm penetration assay (SPA), and/or spontaneous acrosome reaction assay could best predict fertility outcome after intrauterine insemination (IUI) from frozen donor sperm. DESIGN: A retrospective analysis of 2,245 cycles of therapeutic donor IUIs were initially studied; 1,147 cycles that met selection criteria were used in this report. SETTING: A university-based assisted reproductive technology center. PATIENTS, PARTICIPANTS: All IUIs were performed on women with documented patency of at least one fallopian tube, ovulatory cycles, and who did not receive human menopausal gonadotropins. Sperm donors had to be used for at least four different recipients (mean of 15) and at least 14 different cycles of insemination (mean of 41). INTERVENTIONS: None. MAIN OUTCOME MEASURE: Pregnancy. RESULTS: Statistical comparisons were made between donors of different relative fertility by using the Mann-Whitney test, Spearman's rank correlation, and multiple regression analysis. These analyses demonstrated that the most significant predictors of the fertility of frozen-thawed donor sperm were curvilinear velocity, straight line velocity, and the total number of motile sperm inseminated. The number of sperm with spontaneous acrosome reactions negatively correlated with fertility outcome, and SPA provided no predictive value. CONCLUSIONS: Our study supports the hypothesis that the study of sperm motion characteristics using CASA after thawing and washing of cryopreserved sperm is a better predictor of fertile outcome after IUI than analysis of fresh semen.

Acrosome↗
PubMed1991

Modeling shift workers' scheduling desires: an application involving nursing personnel.

We are developing a computerized scheduling program that considers the schedule preferences of individual nurses. We want schedules that satisfy the staffing requirements of the unit and the work preferences of the nurses, while being fair. To reach this goal, we must calculate the desirability of every possible schedule for every nurse. The calculated preference scores of the schedules will be used by the computer to assign individual schedules and to keep a running tally of how well nurses' desires have been met. We present here the first model of nurses' scheduling desires. We modeled the schedule preferences as the desire to work the assigned shifts, plus the pattern of day-off, plus the pattern of tour splitting. Using this model, we account for an average of 81% of the variance.

Attitude of Health Personnel↗
PubMedDate not supplied

Predictive value of serial middle cerebral and renal artery pulsatility indices in fetuses with oligohydramnios.

OBJECTIVE: To determine if unexplained changes in the amniotic fluid index or pulsatility indices of the fetal renal, middle cerebral, or umbilical artery are predictive of perinatal outcome in pregnancies complicated by oligohydramnios. METHODS: Changes in amniotic fluid measurements and fetal vessel velocimetry in patients with oligohydramnios were evaluated for correlation with fetal outcome. Fourteen fetuses with oligohydramnios underwent serial sonography evaluating the amniotic fluid index and fetal middle cerebral, renal, and umbilical velocimetry. Matched controls and neonatal outcomes were obtained. RESULTS: Change in amniotic fluid index and in renal artery pulsatility index were inversely correlated. Change in the middle cerebral artery pulsatility index was different in infants with normal outcome compared to infants with adverse outcome CONCLUSIONS: Serial velocimetry of the middle cerebral artery may identify fetuses with oligohydramnios at risk for adverse outcomes.

Amniotic Fluid↗
PubMedDate not supplied

Preferences for specific work schedules: foundation for an expert-system scheduling program.

An expert system was developed to schedule nurses according to their preferences for specific schedules. The first step in this project was to determine the reliability and stability of nurses' schedule preferences. If nurses' preferences changed frequently, the proposed expert system would not have been feasible. Our results show that for a 3- to 6-month period most nurses are consistent in their preferences of schedules. While each nurse is unique, cluster analysis indicates that it is possible to group nurses according to desire for tour.

Choice Behavior↗