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Biomedical subjects

D Reeves

Publications and source records attributed to D Reeves.

At least 73 records · Page 4Linked to original sources
PubMed1985

Latamoxef: single agent prophylaxis in colorectal surgery.

To assess the suitability of latamoxef (moxalactam) as single agent chemoprophylaxis in elective colorectal surgery, 120 consecutive patients were randomized to receive latamoxef (L) 1 g or cephazolin 1 g and metronidazole 500 mg (CM) administered intravenously at induction of anaesthesia and 6 and 12 h postoperatively. The groups were well matched for age, sex, pathology and procedures. Serum and tissue levels of latamoxef were well above the MIC90 for most bowel organisms. Inpatient stay was similar for both groups. Pyrexia was seen in 44 patients (11 L, 23 CM) and eight developed a wound infection (3 L, 5 CM). Major intra-abdominal sepsis occurred in seven patients (2 L, 5 CM), secondary to anastomotic leakage in four (1 L, 3 CM). Twenty patients developed a chest infection (5 L, 15 CM) and eight urinary sepsis (2 L, 6 CM). No bleeding complication occurred, and there was no difference in clotting function between the two groups. Six patients died prior to follow-up at six weeks (1 L, 5 CM), two from anastomotic dehiscence. All but three wounds had healed (1 L, 2 CM) and one further patient had an incisional hernia (CM). These results suggest that latamoxef is an efficient chemoprophylactic agent in elective colorectal surgery, and is marginally better than cephazolin plus metronidazole.

Adult↗
PubMed1985

Ototoxicity of intraventricularly administered gentamicin in adult rabbits.

To determine whether daily intraventricular injection of gentamicin sulfate is ototoxic, adult male rabbits were given 0.2 ml of saline (group 1; n = 8) or 0.25 mg/kg of gentamicin sulfate in 0.2 ml of saline (group 2; n = 7) by intraventricular infusion once a day for 21 d. All rabbits were also given intramuscular gentamicin sulfate, 2 mg/kg, twice daily. Before and after antibiotic treatment, brainstem auditory evoked responses (BAERs) were recorded. During the experimental period, neurologic examinations were performed on all rabbits. After treatment, the animals were euthanized; brain tissue and cochleas were then removed for histopathologic examination. The ratios of neurologic abnormalities observed in group 1 and 2 animals, respectively, were 0/8 and 5/7; of abnormal BAERs, 0/8 and 5/7; of abnormal brain morphology, 2/5 and 6/6; and of abnormal cochlear morphology, 0/6 and 7/7. The electrophysiologic evidence of auditory deficit and the structural evidence of ototoxic insult are significantly associated (p less than or equal to 0.006) with intraventricularly administered gentamicin sulfate. These data suggest that intraventricular gentamicin should be used with caution.

Animals↗
PubMed1982

Characteristics of peripheral blood monocytes in hereditary xerocytosis and spherocytosis.

Peripheral blood monocytes isolated from patients with congenital hemolytic anemia, hereditary xerocytosis and spherocytosis, demonstrated in vivo engulfment of red cell and platelet fragments. In addition, morphometric studies performed on these monocytes showed an increase in cytoplasmic/nuclear ratio as well as lysosome and phagosome volumes. The production of carbon dioxide from glucose-1-14C in abnormal monocytes was increased (15-80%) but the intracellular values of beta-glucuronidase and esterase activity were similar to control monocytes. Monocyte locomotion assessed in the presence of chemotactic stimuli was found significantly increased (73 +/- 12 monocytes/oil immersion fields vs. 46 +/- 5 for control monocytes). We concluded that the monocytes in hemolytic anemias associated with increased in vitro red cell fragmentation have some features resembling the 'stimulated' monocytes and that this alteration may be due to red blood cell fragment ingestion.

Anemia, Hemolytic, Congenital↗
PubMed1981

Central nervous system toxicity of intraventricularly administered gentamicin in adult rabbits.

To determine whether daily intraventricular injection of gentamicin sulfate would cause neurologic or morphologic abnormalities of the central nervous system, adult male rabbits were given gentamicin sulfate, 2 mg/kg, intramuscularly twice a day plus saline, 0.2 ml (group 1), or gentamicin, 0.05 mg/kg (group 2), 0.25 mg/kg (group 3), or 0.5 mg/kg (group 4), given as the sulfate intraventricularly once a day. The majority of the animals in group 4 developed neurologic abnormalities which progressed to death in animals that were not euthanized; neuropathologic studies revealed chemical ventriculitis and meningitis that were associated with high levels of gentamicin in the cerebrospinal fluid and tissue of the central nervous system. Similar neurologic and morphologic changes were seen in most animals of group 3 but not in rabbits of groups 1 and 2. The ototoxicity and nephrotoxicity of gentamicin are well known; these data indicate that it may be toxic to the central nervous system as well.

Animals↗
PubMed1979

A comparative trial of pivmecillinam and ampicillin in bacteriuria of pregnancy.

A comparative trial of pivmecillinam and ampicillin was performed on 100 women with bacteriuria of pregnancy. They received either 400 mg pivmecillinam four times daily or 500 mg ampicillin four times daily for seven days. Cure rates at two weeks were 88% in the pivmecillinam group and 85% in the ampicillin group. At six weeks the respective rates were 76% and 64%. Failure of therapy was not associated with the appearance of bacterial resistance in either treatment group. Side-effects, particularly vomiting and premature cessation of therapy, were significantly more frequent in the pivmecillinam group. No significant effects on liver function were found. In subsequent patients treated in a non-comparative manner with 200 mg pivmecillinam three times daily, the incidence of side effects was markedly reduced with no loss of efficacy.

Amdinocillin Pivoxil↗
PubMedDate not supplied

Descriptive analysis of multiple response topographies of challenging behavior across two settings.

Time-based lag sequential analyses were conducted on 23 topographies of challenging behavior shown by five young people with severe mental retardation across two settings. Potential behavioural functions were identified for 21 of the 23 behaviors. Responses classes, including two or more distinct behaviors, were identified for four of the five participants. Two participants showed evidence of two functionally distinct response classes; for one person each response class included both self-injurious and stereotypic behaviors. For 9 of the 11 behaviors for which data were available, the hypothesised function of behaviors was consistent across settings. For one person, data suggested that the function of one self-injurious behavior was contextually determined. Cross-validation with brief experimental analyses resulted in agreement on the general behavioral function for 12 of the 14 instances in which both approaches positively identified a potential function for a behavior. Implications for future research and practice are discussed.

Adolescent↗
PubMedDate not supplied

The prevalence of challenging behaviors: a total population study.

A total population study was undertaken in two areas of England to identify the situation and characteristics of people reported to exhibit challenging behaviors. We found that: (1) challenging behaviors are shown by 10-15% of people with mental retardation who are in contact with educational, health or social care services for people with mental retardation; (2) the most common forms of challenging behaviors reported were 'other' behavior (shown by 9%-12% of all people screened), aggression (7%), destructive behavior (4%-5%) and self-injury (4%); (3) the majority of people identified showed two or more of these four general forms of challenging behavior; (4) approximately two-thirds of the people identified were boys/men; (5) close to two-thirds of the people identified were adolescents or young adults; (6) approximately 50% of the people identified as showing more demanding challenging behavior were living with their families; (7) people who showed more demanding challenging behavior were more likely to need greater levels of assistance in eating, dressing and washing, be incontinent and have more restricted expressive and receptive communication.

Adolescent↗
PubMedDate not supplied

Predicting the persistence of severe self-injurious behavior.

Information was collected on 95 people with mental retardation who had been identified seven years previously as showing severe self-injurious behavior. At follow up 71% of participants were still showing self-injurious behavior of a severity which presented a management problem for care staff. The occurrence of specific topographies of self-injury was extremely stable among the group showing persistent self-injury. Finally, self-injury status at follow-up was predicted with 76% accuracy by a logistic regression model containing three variables: site of injury (higher persistence being shown by people exhibiting head directed self-injury); reported (greater) stability of self-injury when first identified; and (younger) age.

Adolescent↗
PubMedDate not supplied

Progress and outcomes for children with autism receiving parent-managed intensive interventions.

Parent-managed behavioral interventions for young children with autism are under-researched. We analyzed data from 66 children served by 25 different early intervention consultants. After a mean of 31.6 months of intervention IQ scores had not changed (N = 22). Vineland adaptive behavior scores had increased significantly by 8.9 points (N = 21). No children aged > 72 months attained normal functioning, i.e., IQ > 85 and unassisted mainstream school placement (N = 42). Progress for 60 children across 12 months was found for mental age (5.4 months), adaptive behavior (9.7 months), and language (5.1 months). The interventions did not reproduce results from clinic-based professionally directed programs. The effectiveness of the parent-managed intervention model as it has developed and the adequacy of professional services in that model are discussed.

Autistic Disorder↗
PubMedDate not supplied

Staff stressors and staff outcomes in services for adults with intellectual disabilities: the Staff Stressor Questionnaire.

This paper reports on the development, psychometric properties, and validity of a self-report measure designed to assess potential stressors among staff in services for people with intellectual disabilities, the 33-item Staff Stressor Questionnaire (SSQ). A questionnaire including the SSQ and scales measuring staff outcomes was administered to 512 staff across seven services for people with intellectual disabilities. The SSQ was factor analyzed to produce seven subscales reflecting different potential stressors for staff: user challenging behavior; poor user skills; lack of staff support; lack of resources; low-status job; bureaucracy; and work-home conflict. The SSQ subscales showed adequate internal reliability in terms of Cronbach's alpha and mean inter-item correlations. Associations between SSQ subscale scores and different staff groups, and patterns of associations between SSQ subscales and a range of staff outcomes, provided evidence suggestive of the face-, construct-, and criterion-related validity of the questionnaire. The SSQ shows promise as a measure for assessing potential stressors for staff in services for people with intellectual disabilities. Further studies to examine the reliability, validity, and utility of the SSQ are recommended.

Adult↗