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Biomedical subjects

J L Gray

Publications and source records attributed to J L Gray.

63 records · Page 4Linked to original sources
PubMedDate not supplied

Antibiotic misuse in two clinical situations: positive blood culture and administration of aminoglycosides.

Antibiotic use was examined among randomly and prospectively selected cohorts of 79 patients with a positive blood culture and 88 patients given aminoglycosides for a variety of reasons. Appropriateness of antibiotic use was judged daily for each agent according to specific criteria of misuse. For patients with a positive blood culture, 14.3% of antibiotic-days were judged inappropriate in some regard, while for patients given aminoglycosides, 10.2% of antibiotic-days were thought to be inappropriate. The patterns of misuse were similar for the two groups despite disparate selection criteria. The unnecessary use of antibiotics was the single most common type of misuse in both groups, but errors in dosing collectively accounted for nearly one-half of antibiotic misuse. These results suggest that a variety of factors are responsible for misuse of antibiotics. Although the data presented do not allow conclusions about the optimal methods for control of antibiotic misuse, they imply that a multifaceted approach is probably required.

Ampicillin↗
PubMedDate not supplied

Modulation of myofibroblast proliferation by vascular prosthesis biomechanics.

Cyclic deformation in vitro modulates smooth muscle cell proliferation. Different degrees of cell deformation occur in vivo on grafts of different compliance. This study evaluates the influence of prosthetic biomechanics on cell proliferation. Two types of composite 80% bioresorbable PG910/20% polypropylene (PP) aortic grafts differing only in the elasticity of the PP were implanted into rabbits. After PG910 resorption, prosthetic biomechanics were determined by PP (% elongation: Group 1, 101 +/- 6 versus Group 2, 63 +/- 4). Killing was performed at 1, 2, 3, and 6 months, and patency, dynamic compliance, mitotic index (MI), and inner capsule thickness (ICT) were determined. Initially all parameters were identical. After PG910 resorption (1-2 months), significant differences were seen. At late analysis, Group 1 MI was significantly greater than Group 2 (3 months: 4.67 +/- 2.5 versus 3.11 +/- 2.5 [p < 0.02]; 6 months: 4.11 +/- 2.3 versus 2.67 +/- 0.9 [p < 0.005]). Inner capsule thickness in Group 1 was also significantly greater than Group 2 (3 months: 219 +/- 20 versus 129 +/- 40 [p < 0.05]; 6 months: 220 +/- 50 versus 130 +/- 40 [p < 0.05]). Dynamic compliance differed at 2 months (p = 0.057). Patency was worse in Group 1 (p = NS). In vivo cellular proliferative activity is directly related to mural cyclic deformation induced by altered biomechanical graft characteristics.

Anastomosis, Surgical↗