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Biomedical subjects

J Burns

Publications and source records attributed to J Burns.

At least 127 records · Page 7Linked to original sources

1995 outlook.

Competition is transforming the healthcare marketplace, and providers are scrambling to emphasize their cost-effectiveness as well as their dedication to high quality. Modern Healthcare takes a look at what lies ahead in the varied sectors of the healthcare industry.

Antitrust Laws↗

Gamma delta T cells participate in the immune response against activated, myelin basic protein-specific, human T cells.

gamma delta T cells are over-represented in some multiple sclerosis (MS) parenchymal lesions and in the cerebrospinal fluid (CSF) of individuals with early MS. In this investigation we studied the T cell-T cell interactions between human, myelin basic protein-reactive T cells and peripheral blood mononuclear cells (PBMC) isolated from MS and control subjects. We detected brisk proliferation by PBMC in response to activated, but not resting, MBP-specific T cells. The magnitude of proliferation approached that induced by superantigens and was distinctly greater than the response to standard recall antigens. Examination of the responding T cells revealed predominant expansion of T cells using gamma delta rather than alpha beta T cell receptors. This finding suggests that the accumulation of gamma delta T cells noted in some MS parenchymal lesions may represent recruitment by activation markers expressed by other T cells in these lesions. The response to activated but not resting MBP-specific T cells may parallel observations that protective T cell vaccination in experimental encephalomyelitis is more effective using activated rather than resting, myelin-specific T cells.

Cell Division↗

A necropsy and histomorphometric study of abnormalities in the course of the vertebral artery associated with ossified stylohyoid ligaments.

AIMS: To establish whether abnormalities in the course of the vertebral artery occur and whether they are relevant to arterial injury associated with head and neck movements. METHODS: Twenty vertebral arteries were carefully dissected at necropsy and abnormalities in course were noted, along with any other bony or cartilaginous cervical anomalies. The effect of head and neck movement on these vessels was studied before a detailed histomorphometric examination was undertaken on sections of the excised arteries. RESULTS: Five vessels had an abnormal course. One vessel entered the transverse foramina of the fifth cervical vertebra rather than the sixth, but was otherwise normal. In two subjects both vertebral arteries were abnormal in the upper cervical portion with, in each case, a straight left vertebral artery and a right vertebral artery with a deficient loop, closely applied to the atlanto-axial joint. Both of these subjects also had completely ossified stylohyoid ligaments and the arteries visibly stretched with modest head and neck movements. Histology revealed variable degrees of smooth muscle disarray in the tunica media of two of the arteries with loop deficiencies. The circumference of one of the straight arteries was smaller than expected but in all other measured histomorphometric parameters these vessels appeared normal. CONCLUSIONS: Vertebral artery loops are deficient in a number of subjects. This finding is important given the recently described biomechanical susceptibility of the vertebral artery to longitudinal extension and may explain the smooth muscle changes, in that this may represent attempts at arterial wall remodelling. Subjects with such loop deficiencies may be more susceptible to a variety of head and neck insults and such abnormalities should be sought at necropsy in subjects who die as a result of fatal vertebral artery injury.

Adult↗

Las Vegas: bright lights, big profits.

The Las Vegas area is one of the fastest-growing regions in the country, a trend that's helping to keep the market's healthcare providers in the chips. Both the area's for-profit and not-for-profit hospitals are busy developing projects to meet the needs of the surging population.

Catchment Area, Health↗

Clinical and molecular epidemiology of acinetobacter infections sensitive only to polymyxin B and sulbactam.

A nosocomial outbreak of infections due to imipenem-resistant Acinetobacter baumannii occurred in a New York hospital after increased use of imipenem for cephalosporin-resistant klebsiella infections. We identified all A baumannii isolates over 12 months, reviewed corresponding patient records, and compared strains with different antibiotic susceptibility patterns by restriction endonuclease analysis. Environmental surveillance cultures were done before and after institution of control measures. 59 patients harboured imipenem-resistant A baumannii, and 18 were infected. Isolates from patients were resistant to all routinely tested antibiotics, including imipenem. Further studies showed susceptibility to polymyxin B and sulbactam. These isolates were identical by restriction endonuclease analysis to A baumannii isolates susceptible to imipenem alone, or to imipenem and amikacin, but differed from broadly susceptible isolates. Surveillance cultures showed hand and environmental colonisation by imipenem-resistant strains. Infection and colonisation were eliminated by intensive infection control measures, and irrigation of wounds with polymyxin B. Increased use of imipenem against cephalosporin-resistant klebsiella may lead to imipenem resistance among other species, particularly acinetobacter. Such resistance appears to derive from a prior multi-resistant clone, in contrast to one which retains susceptibility to several antibiotics.

Acinetobacter↗