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Biomedical subjects

E Larson

Publications and source records attributed to E Larson.

At least 55 records · Page 3Linked to original sources
PubMed1994

The Cognitive Abilities Screening Instrument (CASI): a practical test for cross-cultural epidemiological studies of dementia.

The Cognitive Abilities Screening Instrument (CASI) has a score range of 0 to 100 and provides quantitative assessment on attention, concentration, orientation, short-term memory, long-term memory, language abilities, visual construction, list-generating fluency, abstraction, and judgment. Scores of the Mini-Mental State Examination, the Modified Mini-Mental State Test, and the Hasegawa Dementia Screening Scale can also be estimated from subsets of the CASI items. Pilot testing conducted in Japan and in the United States has demonstrated its cross-cultural applicability and its usefulness in screening for dementia, in monitoring disease progression, and in providing profiles of cognitive impairment. Typical administration time is 15 to 20 minutes. Record form, manual, videotape of test administration, and quizzes to qualify potential users on the administration and scoring of the CASI are available upon request.

Aged↗
PubMed1994

Exclusion of certain groups from clinical research.

Recent evidence indicates that certain groups such as women, ethnic minorities, the elderly, and the poor may be underrepresented in clinical research. A review was conducted of 754 approved research protocols from one tertiary care center over a 2-year period (1989, 1990) to examine demographic characteristics of subjects. Most protocols (81.4%) included both men and women; 56.6% included people over age 65. About three-fourths described exclusionary criteria. Exclusions for which a justification was least frequently explicated were for age (44.9%), socioeconomic status (42.9%), and race (38.1%). In nursing protocols, only 26.6% included a justification for age. In this study, the elderly, poor and ethnic minorities were found to be excluded without identifiable justification from research protocols. While such disparities must be corrected, there are certain research design considerations that should be taken into account to assure that research questions are answered in the most efficient manner for the most representative group.

Adolescent↗
PubMed1994

HIV infection, exercise, and immune function.

Decreased physical endurance is viewed by both HIV-infected people and their primary nurses as a major healthcare problem. There is a widespread belief among HIV-infected people that the way to improve their endurance is through exercise. Yet healthcare providers are divided about the role of exercise. This paper presents an overview of decreased endurance as a major problem in this population, with a review of the literature on exercise in healthy and chronically-ill populations, including those with HIV infection, and its effect on immune function.

Adolescent↗
PubMed1993

Infection control and bone marrow transplantation.

BACKGROUND: Bone marrow transplantation for the treatment of malignancies is on the increase. Unfortunately, there are no well-validated infection control guidelines for this highly susceptible population. METHODS: Literature was reviewed concerning infection risks and interventions to decrease risks for bone marrow transplant recipients. RESULTS: Definitive information was generally lacking. However, basic "common sense" infection control recommendations for bone marrow transplantation were made in the following areas: air ventilation systems, design issues, environmental services, patient care issues, barrier precautions, nosocomial surveillance, and discharge planning. Recommendations must be tailored to each facility or setting. CONCLUSION: We conclude that validation of many of these recommendations is necessary to provide optimum care for bone marrow transplant recipients.

Adult↗
PubMed1993

Effects of a protective foam on scrubbing and gloving.

OBJECTIVE: To test the effects of a skin protectant on surgical scrub and glove integrity. DESIGN: Forty-nine healthy adult volunteers were assigned (12 subjects per group) to apply a protective foam (DermaMed; Benchmark Enterprises, Salt Lake City, Utah) in conjunction with surgical scrub in one of the following formulations: 70% isopropyl alcohol, a liquid detergent base containing 4% chlorhexidine gluconate, a liquid detergent base containing 7.5% povidone-iodine, or a nonantimicrobial liquid soap (control). According to a standard protocol, subjects performed a surgical scrub on 3 days (every other day). Foam was applied after surgical scrub on day 1 and before surgical scrub on day 3. No foam was applied on day 2. Subjects were gloved for 2 hours after surgical scrub. SETTING: Laboratory setting. RESULTS: On all test days, there were significant differences in bacterial reduction by products (chlorhexidine gluconate or alcohol > povidone-iodine > control). When controlling for baseline counts and products used, there were no significant differences in colony-forming unit counts on hands with or without foam immediately after scrubbing or at 2 hours after scrub on gloved or ungloved hands, nor were there differences in glove leakage rates when foam was on hands. CONCLUSIONS: Such protectants can be used without detrimental effects to scrub effectiveness or glove integrity.

1-Propanol↗
PubMed1993

Immunologic benefits of breast milk in relation to human milk banking.

A review of the immunologic benefits of human milk is presented, with emphasis on the antiviral properties of human milk. These properties are so important to infant health that the World Health Organization has restated its recommendation. "In all populations, irrespective of HIV infection rates, breast-feeding should continue to be protected, promoted, and supported." Infection control procedures are described for human milk banking, which should be supported as an immunologically beneficial feeding alternative for infants.

Breast Feeding↗
PubMed1993

Role of infection control practitioners in human immunodeficiency virus testing. APIC Bloodborne Pathogens Committee.

BACKGROUND: As a result of the HIV epidemic, the role of the ICP has changed; acute care settings have developed a variety of policies regarding patient and health care worker (HCW) HIV testing and issues related to the HIV-infected HCW. APIC conducted a survey to determine the extent to which ICPs were involved in HCW and patient HIV testing and counseling, the prevalence of routine HIV testing for patients, institutional policies on HIV testing of patients and HCWs, and the management of HIV infected HCWs. METHODS: In 1990, a questionnaire was sent to ICPs in a simple random sample of 1300 acute care hospitals (approximately 20%) in the United States. RESULTS: Response rate was 52.8%. Of the 686 respondents, 54.8% provided counseling to the HCW after an exposure incident. ICPs were involved not only in HIV testing and counseling for patients and HCWs but also in institutional policy development for HIV-related issues. Most facilities (73.8%) obtained written consent for testing from the patient after an employee exposure. When a direct care giver was known to be HIV positive, 61.5% of the respondents evaluated each case individually. CONCLUSIONS: The ICP has a significant role in the development and implementation of institutional policies on HIV testing and counseling and on the management of HIV-infected workers. These findings affirm the need for APIC to provide educational opportunities on the issues related to HIV testing and counseling.

AIDS Serodiagnosis↗
PubMed1993

Leakage of latex and vinyl exam gloves in high and low risk clinical settings.

The purpose of this study was to compare leakage rates of used latex and vinyl examination gloves from high and low risk clinical units. A total of 4838 latex and 1008 vinyl examination gloves were collected and tested by the Food and Drug Administration (FDA) watertight leak test: three brands of latex [Brand A: n = 2920; Brand B: n = 284; Brand C: n = 1634; and one brand of vinyl gloves (Brand D: n = 1008]. Seventy percent of latex gloves and 46.7% of vinyl gloves were collected from the high risk units. In general, there were no significant differences in leakage rates for vinyl gloves between high and low risk units. However, latex gloves leaked significantly more often at stress levels 2 and 3 from the high risk units as compared to the low risk units (X2 = 24.6, p < .0001). Regardless of level of stress and duration worn, 85.3% (860/1008) of used vinyl gloves and 18.4% (891/4838) of used latex gloves leaked, p < .001). There were significant differences in leakage rates between the three brands of latex gloves (Brand A, 9.8%; Brand B, 25.1%; Brand C, 30.9%, p < .001). Although latex gloves leaked slightly more frequently as stress level increased, glove material (latex or vinyl) and brand of glove were the most important predictors of leakage.

Equipment Failure↗
PubMed1993

Recycling of surfactant lipid and apoprotein-A studied by electron microscopic autoradiography.

Recycling of lipid and apoprotein components by lung epithelium appears to be a key part of the metabolism of surfactant, but many details of this process are poorly understood, including its efficiency and which intracellular pathways participate. We chose electron microscopic autoradiography to track time-dependent changes in the intracellular location of [methyl-3H]-choline dipalmitoyl phosphatidylcholine or 125I-labeled apoprotein-A that were incorporated into liposomes and instilled intratracheally into rats or added to cultures of freshly isolated rat lung type II cells. At times from 2 to 120 min after the start of labeling, lungs or cells were fixed and processed for autoradiography. We found a time-dependent uptake of lipid and apoprotein by type II cells and by macrophages but not by other lung cell types. There was a time-dependent incorporation of lipid and apoprotein label into lamellar bodies, but the labels appeared in other intracellular compartments without a convincing time-dependent relationship to lamellar bodies. Although all type II cell organelles received some lipid-bound label, the apoprotein-bound label was not found within electron-dense multivesicular bodies (d-MVB). Selective lack of apoprotein label in d-MVB indicated a segregation of lipid and apoprotein labels and suggested a unique role for the d-MVB, possibly as a degradation pathway. Our results also provided conclusive morphological evidence of surfactant lipid and apoprotein recycling by type II cells.

1,2-Dipalmitoylphosphatidylcholine↗
PubMed1993

Increasing the wearing time of vinyl urinary drainage bags by decontamination with bleach.

The purpose of this study was to determine the safety of 4 week re-use of vinyl urinary leg and bed bags in the acute rehabilitation setting when decontaminated daily with a dilute bleach (sodium hypochlorite) rinse. Patients requiring urinary bags (n = 54) were randomly assigned to Control (C) and Experimental (E) groups. C's bags were replaced weekly; E's only after four weeks. Both groups received identical daily bag decontamination and weekly urine and bag cultures. No significant differences were found between groups with ANCOVA, controlling for baseline urine cultures, age, number of days catheterized, and use of antibiotics. Thirty different organisms were cultured in urine and bags; when the procedure was done daily, all bag cultures showed only minimal contamination (0-100CFU/mL). Bacterial growth (4.4% of leg bags) > 100CFU/mL was found only when the daily decontamination procedure had been omitted. In fact, 57% of leg bags and 76.5% of bed bags returned with no growth. We conclude that it is safe and cost effective to reuse vinyl urinary leg and bed bags for four weeks.

Adult↗
PubMed1992

Calcium supplementation decreases rectal epithelial cell proliferation in subjects with sporadic adenoma.

The results of three small clinical trials examining the effect of calcium carbonate supplementation on the proliferation cytokinetics of the rectal epithelium in subjects with a current history of sporadic adenoma are reported. In six subjects, a daily administration of 1500 mg of calcium carbonate for 90 days failed to significantly suppress thymidine labeling in normal-appearing mucosa of the rectum. However, a daily dose of 2000 mg of calcium significantly (P = 0.008) altered mucosal proliferation in a second set of six subjects after a 30-day trial. Finally, a placebo-controlled trial of calcium (2000 mg) was conducted in which 20 subjects were randomized to groups receiving a 4-week intervention with calcium (or placebo), followed by the alternative treatment (placebo or calcium). The results of the study show a marked suppression of rectal proliferation during the calcium phase of the study but not during the placebo phase. This study adds to accumulating evidence showing that calcium supplementation regulates the proliferative behavior of colonic epithelium in the individual at high risk for colon cancer. Longer term trials of calcium supplementation will ascertain whether a continuing benefit from increasing dietary calcium translates into inhibition of adenoma recurrence.

Adenoma↗
PubMed1992

Lack of care giver hand contamination with endemic bacterial pathogens in a nursing home.

Prevalences of Clostridium difficile and multiply resistant Staphylococcus aureus (MRSA) were determined in nursing staff and residents of a 233-bed long-term care facility. Twenty of 38 (52.6%) patients in the long-term care ward and three of 69 (4.3%) in the skilled-nursing ward were colonized with MRSA; 16 of 48 (33%) patients in the long-term care ward and seven of 52 (13%) in the nursing home ward were colonized with C. difficile. None of the 79 staff members whose hands were cultured had chronic C. difficile hand carriage and MRSA was present on only three of 79 (3.9%). Over a 6-month period, 128,000 pairs of gloves were worn. Since C. difficile and MRSA are rarely present on washed hands of care providers, appropriate handwashing and gloving should make a significant contribution to reducing the spread of these agents in long-term care facilities.

Adult↗