Biomedical subjects
Publications and source records attributed to E Newman.
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With the use of an intravenous step load of calcium, a rapid (less than 30 min) process that helps regulate plasma calcium has been identified in pigs. The process appears to be calcitonin dependent, may not involve simple equilibration, and varies inversely with age, as it is virtually absent in old sheep compared with its intensity in young sheep. Based on these findings and a general model of calcium homeostasis, five classes of regulatory processes are proposed. Grade I (half time, t1/2, congruent to 15 min) is a transient and saturable response present only in young individuals and is calcitonin dependent. Grade II (1/2 congruent to 60-90 min) is parathyroid hormone and possibly calcitonin dependent. Grade III (t1/2 = 3-4 h) is parathyroid hormone dependent and probably renal in nature. Grade IV (t1/2, several hours) is vitamin D dependent and intestinal in nature. Grade V (t1/2, hours or days) is parathyroid hormone and calcitonin dependent and skeletal in nature.
Urine lactic dehydrogenase (LD) and urinary LD isoenzyme determinations were performed for 59 adult afebrile patients with spinal cord lesions. Twenty-eight were found to have a predominance of LD 1 and 2. Thirteen had positive urine cultures and 12 also had positive antibody coated bacteria (ACB). Twenty were found to have a predominance of LD 4 and 5, with a mean total urine LD activity of 175.7 mU/ml. Sixteen of this group had positive urine cultures and 12 also ACB positive. Eleven had no demonstrable LD isoenzyme with a mean total urine LD activity of 17.5 mU/ml. Eight had positive urine cultures and four were also ACB positive. Forty-six normal controls had a mean LD activity of 15.1 mU/ml. In the study population changes in U-LD occurred in the absence of bacteriuria most frequently in patients who were appliance-free or used catheterization. In the absence of bacteriuria bladder overdistention may contribute to changes in LD isoenzyme patterns.
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The intravenous injection of calcium gluconate (0.11 mM/kg body weight) into conscious thyroidectomized pigs elicits a 30% rise in both ionized and total calcium concentrations of plasma, which return to basal levels within 180 min. The administration of calcitonin (2.5-10 MRC U/kg body weight) reduces this time to 30 to 40 min which is similar to the time obtained in thyroid intact animals. These results suggest that calcitonin may be involved in the fast calcium removal processes and thus in the short-term regulating system of calcium homeostasis. Neither parathyroidectomy nor the administration of parathyroid hormone affected the time for recovery in thyroidectomized pigs, suggesting that the short-term regulation is independent on the parathyroid gland and its hormone.
Clinical urine specimens were screened for the presence of cannabinoids using the EMIT Cannabinoid Assay. Aliquots of these samples were also analyzed for 11-nor-delta 9-tetrahydrocannabinol-9-carboxylic acid (THCA), the major cannabis metabolite in urine, by a technique which combines bonded phase adsorption (BPA) and thin layer chromatography (TLC). A 100% agreement between EMIT and BPA-TLC results was observed when at least 20 mL of urine was assayed by BPA-TLC. Bonded phase adsorption coupled with thin layer chromatography appears to be a suitable technique for the confirmation of positive EMIT Cannabinoid Assay results.
The purpose of this study was to determine if a special program of patient and family education in urinary tract care would result in improved control of urinary tract infection (UTI) by spinal cord injury patients at home. The Williamson Functional Impairment Scale, modified to measure outcomes of impairment due to UTI, was applied to 54 patients in 1975 and to 21 in 1979. Patients in the latter group had completed a special urinary tract care education program of classes, reading material, written examinations, and demonstrations of acquired skills. At follow-up, only 32% of the patients in the 1975 group were asymptomatic of UTI, compared with 71% of the 1979 group. Only 5% of the patients in the 1979 group lost time from their usual daily activities, compared with 23% of the 1975 group. The improvements in impairment outcomes were not related to a reduction in the incidence of confirmed or suspected UTI (found in 63% of patients in the 1975 group and 62% of patients in the 1979 group). It is concluded that the 1979 group recognized symptoms earlier and took definitive action which resulted in less impairment and time lost due to UTI. The patient education program did result in improved urinary tract care after discharge.
Social workers play a vital role in the screening and admission of applicants to skilled nursing facilities because they provide unique attention to patients' psychosocial as well as medical needs. This article reports on a study that investigates social workers' employment in nursing homes and their actual involvement in the admission process. It also details the practices and procedures used to screen, select, and admit applicants to the facilities.
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Urine cultures and antibody-coated bacteria (ACB) tests were performed on urine specimens from 176 spinal cord injured patients at the time of annual renal function follow-up. Sixty-nine percent of the cultures were positive; and of these, 55% were positive for ACB. The highest incidence of positive ACB tests occurred in the specimens from patients with external catheters (67%), ileal diversions (63%) and suprapublic catheters (60%). The organisms which occurred most frequently as a single isolate were Escherichia coli and Pseudomonas aeruginosa; 54% of the E coli and 57% of the P aeruginosa were antibody coated. Proteus rettgeri was recovered less frequently as a single isolate but in these instances the ACB test was always positive. X-ray studies showed that 28% of patients with positive ACB tests had upper tract changes. Thirty-eight patients with positive ACB tests received treatment. After treatment, follow-up cultures from 26 (69%) of these patients showed no growth or a negative ACB test. Patients with roentgenographically abnormal tracts and positive ACB tests were found to be more resistant to treatment. Although additional studies are needed, this test at present can aid clinicians in management of urinary tract infection in spinal cord injured patients.
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Urine cultures from spinal cord injuried patients demonstrate a high incidence of bacteriuria, with patterns of bacteriuria varying with the mode of drainage. The highest incidence of positive cultures occurs in patients with indwelling or suprapubic catheters, and the lowest in patients who are appliance-free. The organisms occurring most frequently differ from those of the general hospital population as reported by Needham, Smith and Matsen. There is an increase in the incidence of Pseudomonas, Proteus and Serratia and a decrease in the occurrence of E coli and Klebsiella. Sixty-four percent of the organisms occurred in concentrations of 100,000 col/ml or greater, and 65% of all positive cultures contained multiple species of organisms. Cultures taken from urinary collecting appliances and hands demonstrate possible sources of bacteriuria and the need for careful training and education of patients and their attendants and constant monitoring of urinary tract appliance care.
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