Care of the acutely ill older adult: Part one. Catastrophic illness: how it feels.
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Adaptation, Psychological↗
Biomedical subjects
D Schwartz
Publications and source records attributed to D Schwartz.
Learning is a two-way street: reciprocity and rewards.
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Aged↗
[Blood triglycerides in a professional group].
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Adult↗
Within-subject variability and the importance of abstinence period for sperm count, semen volume and pre-freeze and post-thaw motility.
The within-subject variability of semen sperm count (n), volume (v), total number of spermatozoa (N) and pre-freeze (mo) and post-thaw (m1) motility was studied on 564 ejaculates from 98 normal subjects after an abstinence ranging from 1 to 5 days. After logarithmic transformation of n, v and N, the within-subject variances for each variable were found to be similar for all subjects; the within-subject centered distributions were nearly normal and 95% confidence intervals were calculated. These three variables appeared to increase linearly with the length of abstinence. For both mo and m1, the within-subject variances were also similar for all subjects and this without logarithmic transformation. Their respective within-subject centered distributions were normal; mo and m1 were not influenced by the length of abstinence during the period studied.
Humans↗
Between and within subject correlations and variances for certain semen characteristics in fertile men.
Between subject and within subject variances and correlations for different semen characteristics have been determined for a population of 315 fertile men who provided one or more ejaculates within an abstinence period of 1 to 5 days. The semen characteristics measured were sperm count, semen volume, pre-freeze motility and post-thaw motility. An approach via a decomposition of the variance or via a decomposition of correlation leads essentially to the same conclusions i.e. the within subject factors are not negligible but are less important than the between subject ones. Thus there is broad evidence for overall differences in the quality of the ejaculate from one subject to the other but not for different ejaculates of the same subject.
Adult↗
Study of sperm morphologic characteristics in a group of 833 fertile men.
For the 13 abnormalities under consideration, the mean percentages were found to be the following: irregular head (15.2), microcephalic (9.8), elongated head (5.9), coiled tail (5.8), bent tail (4.7), thin head (4.6), cytoplasmic remains (3.2), macrocephalic (1.6), short tail (1.1), no tail (0.6), duplicate tail (0.5), duplicate head (0.4), lysis (0.4). In so far as the group studied is representative, the results obtained may be considered as "norms" with the 90th percentiles showing the upper limit of the "normal". The same mean percentages were found by MacLeod and Gold (1951) for the five abnormalities they had identified. The length of abstinence preceding the collection of the ejaculate was found to have no influence on the percentage of abnormal forms.
Age Factors↗
Conception rate according to semen characteristics in a series of 15 364 insemination cycles: results of a multivariate analysis.
The study was undertaken on 1438 ejaculates from 342 donors. The sperm count, volume, prefreeze and postthaw motility were evaluated for each ejaculate and the morphology for the first ejaculate of each donor. The success rate was found to increase steadily with the sperm count, prefreeze and postthaw motility. For the volume and percentage of all abnormal forms, the success rates are stable up to 5,5 ml and 40% respectively and then decrease. Among all the abnormal forms considered, only the microcephalics and irregular heads were found to be linked to the success rate. As most of the studied characteristics are correlated, a multiple stepwise regression was completed in order to determine the proper role of each variable. The most predictive variable is the postthaw motility. The second variable is the percentage of microcephalics. The other variables bring no further information. In particular, at a given postthaw motility, the prefreeze motility and consequently, the loss in motility have no influence on the success rate.
Buffers↗
Abortion rate in A.I.D. and semen characteristics: a study of 1345 pregnancies.
A study undertaken on 1345 pregnancies resulting from artificial insemination with donor showed an 18% risk of abortion. This figure is the same as that admitted for natural reproduction. It does not depend on any of the classically studied semen characteristics and in particular remains invariant whatever the postthaw motility, the factor most strongly linked to conception rate. Two results, well known from the literature, i.e. the increased abortion rate mentioned in natural reproduction when the sperm is of poor quality and the high incidence of repeated abortions when sperm quality is particularly good are discussed. The first of these results cannot be considered as being established in a statistically significant way. The second may result from different sources of bias, some of which are identified. In essence a high frequency of abortions signifies simply a high frequency of pregnancies, it is therefore not surprising that the semen is in this case particularly good.
Abortion, Habitual↗
Atriopeptins as cardiac hormones.
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Amino Acid Sequence↗
Transplantation of hepatocytes: an in-vitro and in-vivo study in canines.
We isolated and transplanted hepatocytes in the canine, large animal model to evaluate hepatocyte yield and purity as well as the optimal site for hepatocyte engraftment (i.e., the spleen or the portal bed). We obtained viable, pure, single hepatocyte suspensions that were readily preserved at 4 degrees C in University of Wisconsin (UW) solution for up to 3 days. Both intrasplenic and portal vein injection were well tolerated, with minimal recipient morbidity and mortality when 1-2 x 10(9) hepatocytes were injected into immunosuppressed allogeneic hosts. We noted the embolization of hepatocytes into the parenchyma of the native liver within 7 days of intrasplenic transplantation that produced a mild reversible derangement of liver function and histology. These results warrant consideration prior to clinical trials of hepatocyte transplantation in man.
Adenosine↗
Congenital toxoplasmosis presenting as isolated acute chorioretinitis in the neonate.
We describe a neonate with congenital ocular toxoplasmosis that presented as isolated, acute bilateral retinochoroiditis. Although toxoplasmic retinochoroiditis is not rare, it is quite unusual to diagnose congenital toxoplasmosis based on isolated bilateral retinochoroiditis in an otherwise healthy neonate. Bilateral retinochoroiditis can be caused by syphilis, herpes virus, cytomegalovirus, and toxoplasmosis. Because specific treatments now exist for these conditions, it is important to establish proper diagnosis so that treatment can be initiated promptly. The differential diagnosis, work-up, and management of retinochoroiditis in the newborn is presented and discussed.
Chorioretinitis↗
Total retinal detachment in a preterm infant treated with ECMO. Extracorporeal membrane oxygenation.
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Extracorporeal Membrane Oxygenation↗
[Some considerations concerning the concept of risk in public health (author's transl)].
The use of risk in Public Health consists schematically of two steps: the calculation of risk, and then action intended to reduce it. The calculation, taking into account the largest possible number of risk factors, can produce a risk value adjusted to the individual. Action was, in past, directly oriented by risk factors which caused the risk. But, now, that the approach to risk has become more indirect by taking into consideration predictive factors without a causative role, their use in action to reduce risk requires discussion. Thus it has seemed necessary to examine the situation in several pathological fields; substantial differences in uses of risk values were found according to the field taken into consideration. The point in common remains the attempt of an ideal approach guided by an overall assessement of cost and effectiveness, involving the cost of determining the risk and the advantages and costs of the resulting action.
Costs and Cost Analysis↗
The outcome of non-selective vs selective nitric oxide synthase inhibition in lipopolysaccharide treated rats.
UNLABELLED: Nitric oxide (NO), generated by inducible nitric oxide synthase (NOS) following lipopolysaccharide (LPS) administration, produces renal failure through autoinhibition of glomerular endothelial NOS activity. Preadministration of selective iNOS inhibitors abolishes this effect. Although nonselective NOS inhibitors further decrease GFR, current clinical trials investigate the effect of nonselective NOS inhibition in septic patients. The goals of our study were to determine whether treatment with selective NOS inhibitors can reverse the decrease in GFR in LPS treated rats with already established renal failure and to define the outcome of LPS treated rats following nonselective NOS inhibition. Four hours following the administration of LPS (4 mg/kg), we measured creatinine clearance (CrCl) before and after the administration of either L-NIL (selective iNOS inhibitor, 3 mg every 20 minutes) or saline. Selective iNOS inhibition attenuated the decrease in blood pressure [ CONTROLS: 105 +/- 6 to 98 +/- 5, LPS: 92 +/- 5* to 83 +/- 4*, LPS + L-NIL: 88 +/- 6* to 94 +/- 6 mm Hg; *p < 0.05, vs controls (n = 6)], and reversed the decrease in GFR after LPS [ CONTROLS: 2.21 +/- 0.13 to 2.07 +/- 0.11, LPS: 0.82 +/- 0.18* to 0.66 +/- 0.22*, LPS + L-NIL: 0.76 +/- 0.15* to 1.86 +/- 0.15 ml/min; *p < 0.05 vs controls (n = 6)]. We next studied the effect of complete non-selective NOS inhibition (L-NAME 200 mg, 2 hours after LPS) on LPS treated rats. All (6/6) animals treated with both LPS and L-NAME died within 2 hours following LPS, while rats treated with either LPS, L-NAME, or LPS + L-NIL survived. Histologic studies performed in all experimental groups were unremarkable. Overnight mortality was studied using smaller doses of L-NAME. All LPS + L-NAME (10/10) and 1/10 LPS treated rats died. L-NAME, control, and LPS + L-NIL animals survived. The characteristic histologic findings in LPS + L-NAME rats were diffuse ischemic changes, most importantly acute myocardial infarction. IN CONCLUSION: Selective iN-OS inhibition might prove to have clinical application as it prevents the decrease in GFR following LPS, even after renal failure is established. Treatment with a non selective NOS inhibitor in septic patients should be reconsidered.
Analysis of Variance↗
A long transition.
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Education, Nursing, Graduate↗
Model preceptorship, 1948.
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Education, Nursing↗
Metabolism of 2-acetylaminofluorene in isolated rabbit pulmonary cells. Evidence for the heterogeneous distribution of monooxygenase activity in lung tissue.
The regiospecific hydroxylation of 2-acetylaminofluorene (2-AAF) has been used to monitor monooxygenase activity in isolated rabbit lung cells. Following isolation, the cells were separated into seven different fractions according to size by centrifugal elutriation. Macrophages were recovered from the lungs by lavage and examined in parallel with the parenchymal cell populations. The resulting fractions were assayed for 2-AAF hydroxylase activity and were examined for the presence of endothelial cells (angiotensin-converting enzyme), alveolar type II cells (modified Papanicolaou stain), polymorphonuclear leukocytes (modified Papanicolaou stain), bronchiolar Clara cells (nitro blue tetrazolium stain), and ciliated cells (phase contrast microscopy). Highest hydroxylase activities were seen in the cell fraction containing the largest percentage of Clara cells. The activity profiles provided evidence for a population of cells not correlating with either alveolar type II cells or Clara cells possessing substantial monooxygenase activity. The alveolar macrophage almost exclusively hydroxylated 2-AAF in the 9-position and the cell fraction containing the higher percentage of endothelial cells metabolized 2-AAF the least. Pretreatment with 2,3,7,8-tetrachlorodibenzo-p-dioxin preferentially induced the 7-hydroxylation of 2-AAF and either did not alter or decreased the rate of formation of the other hydroxy metabolites. An exception was seen in fraction 1 where 2,3,7,8-tetrachlorodibenzo-p-dioxin induced the hydroxylation of 2-AAF to all products except 3-hydroxy-AAF. Evidence is presented for the presence of a cell type(s) not identifiable as either the Clara or alveolar type II cell with considerable monooxygenase activity.
2-Acetylaminofluorene↗