A collision of timetables.
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Administrative Personnel↗
Biomedical subjects
J L Green
Publications and source records attributed to J L Green.
Theoretical and experimental comparison of three types of electromagnetic hyperthermia applicator.
There is evidence that heating of malignant tissue in the treatment of cancer may be beneficial and so the performance of different applicator designs needs to be established. A theoretical model of the dielectric loaded waveguide applicator is compared with models of two other applicators which depend on energy radiated from conductors carrying high frequency current. The latter are exemplified by the compact resonant patch applicator and the lightweight inductive current sheet applicator. It is shown that heating profiles and field penetration of each applicator are similar for equal radiating areas, and these results have been substantiated experimentally. Impedance match as a function of frequency and load is also compared for the three types of applicator.
Electromagnetic Phenomena↗
Effect of dose and a comparison of measures of vaccine take for oral rhesus rotavirus vaccine. The Maryland Clinical Studies Group.
Ninety-six healthy infants ages 2 to 5 months received rhesus rotavirus vaccine serotype 3 (RRV) as a single dose of 10(3), 10(4) or 10(5) plaque-forming units (pfu) in this double-blinded, placebo-controlled study. Half of the infants in each dose group were also randomized to receive either 30 ml of infant formula as buffer before vaccination or were vaccinated on an empty stomach. The incidence of fever, increased stool frequency and decreased activity level was consistently higher among infants who received RRV than those who received placebo. There was no consistent increase in incidence of symptoms as the dose of RRV was increased. Possible vaccine-related side effects were increased in older vaccinees and in those with higher pre-vaccination antibody titers. The seroconversion rate and pre to postvaccination antibody rise, evaluated by enzyme-linked immunosorbent assay and by plaque reduction neutralization, correlated well. The 10(5) and 10(4) pfu RRV dose produced significantly higher rates of seroconversion and higher antibody rises than did placebo (P less than 0.001 for 10(5) and P = 0.005 for 10(4]. The 10(3) pfu dose was no more immunogenic than placebo. In the 10(4) pfu dose group 73% of infants receiving formula as a "buffer" seroconverted compared with 36% of those not receiving formula; 63% of infants partially breast-fed or formula-fed seroconverted compared with 17% of those exclusively breast-fed. These differences in seroconversion rate were largely overcome by increasing the RRV dose to 10(5) pfu. Stool (copro IgA) antibody responses were examined; of six infants showing a copro IgA response only one had seroconverted based on enzyme-linked immunosorbent assay or plaque reduction neutralization. RRV was recovered by tissue culture more frequently from the stool in those infants who received RRV 10(5) and 10(4) pfu than among those receiving 10(3) pfu or placebo (P less than 0.001).
Administration, Oral↗
New vaccines and vaccination policies.
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Acquired Immunodeficiency Syndrome↗
Delayed ethanol analysis of breath specimens: long-term field experience with commercial silica gel tubes and breathalyzer collection.
Delayed ethanol analysis was performed on breath specimens collected with commercial silica gel tubes using multiple Breathalyzer instruments. Eleven hundred and nine results were obtained from an ethanol testing program over a five-year period. Only 2.5% of the specimens had apparent collection errors. For the valid specimens, the most frequent result was 0.11 g/210 L and the mean result was 0.14 g/210 L. For 642 specimens, delayed results were compared with direct results. Direct results were greater than delayed results for 55%, less than for 27%, and equal to for 18% of the pairs. When fixed tolerance limits of +/- 0.03 were used, 81% of the direct results were confirmed. The confirmation percentage was best in the critical range of direct results, 0.05 to 0.15 g/210 L. The collection tubes showed no substantial variability in retaining ethanol during storage and releasing ethanol for analysis.
Breath Tests↗
All visiting nurses are not alike: home health and community health nursing.
This article explores the differences between the practice of home health nursing and the practice of community health nursing which is suggested by the literature. Thirty-two nurses from three metropolitan home health agencies were surveyed; of these, 13 were randomly selected for interview in order to describe the current practice of home health-care nursing. As anticipated, home health nursing and community health nursing were found to differ significantly; the implications of this finding for nursing education are explored.
Aged↗
The preparation and use of antibody microprobes.
A new method of detecting release of neuropeptides in the central nervous system is described. Glass micropipettes are treated with gamma-aminopropyltriethoxysilane resulting in a fine outer coating of a siloxane polymer containing free amino groups. Glutaraldehyde is then used to covalently couple protein A which in turn binds antibodies to a particular peptide. Following use in the central nervous system, microprobes are incubated in a radiolabelled form of the peptide being studied and release is detected on autoradiographs as localized zones of inhibition of binding of the labelled peptide. The spatial resolution of the method is at least 100 micron. Necessary tests of the validity of the technique are also described.
Animals↗
Adverse and beneficial effects of immediate treatment of Group A beta-hemolytic streptococcal pharyngitis with penicillin.
One hundred forty-two children with presumed Group A beta-hemolytic streptococcal (GABHS) pharyngitis were enrolled in a randomized double blind prospective study comparing the consequences of immediate penicillin treatment with treatment delayed for 48 to 56 hours. One hundred fourteen of the enrolled patients were culture-positive. An adverse impact of early antibiotic therapy was noted; the incidence of subsequent infections with GABHS was significantly greater in those treated at the initial office visit with penicillin. In the month following documented evaluation of GABHS, a recurrence occurred 2 times more frequently in those treated with penicillin immediately compared with those for whom treatment was delayed 48 to 56 hours. Late recurrences (beyond 1 month but in the same streptococcal season) occurred 8 times more frequently (P less than 0.035). Delay in penicillin treatment did not increase GABHS intrafamilial spread. Symptoms of both groups were assessed for 2 days following the initiation of treatment. Both placebo-treated and penicillin-treated groups used aspirin or acetaminophen ad libitum. Penicillin was shown to reduce fever and relieve sore throat, dysphagia, headache, abdominal pain, lethargy and anorexia significantly beyond that achieved with aspirin or acetaminophen alone. Penicillin had no effect on culture-negative cases.
Adolescent↗
Randomized, single-blind evaluation of cefadroxil and phenoxymethyl penicillin in the treatment of streptococcal pharyngitis.
A total of 150 children from two pediatric practices with clinical and bacteriologic evidence of acute group A beta-hemolytic streptococcal (GABHS) pharyngitis randomly received cefadroxil monohydrate (75 children) or phenoxymethyl penicillin (75 children). Cefadroxil was given once daily, while penicillin was given three times daily. The treatment groups were similar in age, sex, race, illness severity, and acute GABHS symptomatology. Throat cultures were routine 3 to 5 days after the start of therapy and 2 and 14 days after the end of therapy. The bacterial cure rates were 90% (62 of 69) for cefadroxil-treated patients and 76% (52 of 68) for penicillin-treated patients. This difference was significant (P less than 0.04). The clinical response was satisfactory in 91% of cefadroxil-treated patients and 89% of penicillin-treated patients. We conclude that once-daily cefadroxil is at least as effective as three-times-daily penicillin in producing bacteriologic eradication and clinical symptomatic improvement in children with GABHS pharyngitis.
Cefadroxil↗
Children with influenza A infection: treatment with rimantadine.
Treatment with rimantadine of influenza in children and the potential development of resistance in clinical isolates associated with therapy have not been previously studied. We compared rimantadine to acetaminophen therapy in a controlled, double-blind study of 91 children with influenza-like illness. Of 69 children with proven influenza A/H3N2 infection, 37 received rimantadine and 32 received acetaminophen for five days. Children receiving rimantadine showed significantly greater reduction in fever and improvement in daily scores for symptoms and severity of illness during the first three days. Viral shedding also diminished significantly during the first two days but subsequently increased such that by days 6 and 7 the proportion of children shedding virus, as well as the quantity of virus shed, was significantly greater in the rimantadine group. During the seven-day study, of the 22 children in the rimantadine group with serial isolates tested, ten (45.5%) had resistant isolates compared with two (12.5%) of those with serial isolates in the acetaminophen group (P less than .03). Thus, of the total 37 children in the rimantadine group, 27% were found to have resistant isolated compared with 6% in the total group receiving acetaminophen (P less than .04). Furthermore, the mean inhibitory concentration of rimantadine increased with time in the rimantadine group (r = .4, P = .002) but not in the acetaminophen group. Rimantadine therapy, thus, appears to be significantly more effective than acetaminophen in ameliorating the clinical signs and symptoms of influenza in children. Treatment with rimantadine was also associated with increased viral shedding after the medication was discontinued and with the development of resistance in the clinical isolates, the significance of which is unknown.
Acetaminophen↗
Growth of the fetal stomach in normal pregnancies.
Fetal stomach dimensions were measured sonographically in 152 fetuses with gestational ages ranging from nine to 40 weeks. Nomograms of the mean +/- 2 standard deviations (SD) for the longitudinal, anteroposterior, and transverse diameters of the fetal stomach were generated throughout pregnancy. A linear growth function was observed across gestational age, and a high degree of correlation existed between gestational age and the transverse (r = 0.809, P less than .0001), anteroposterior (r = 0.798, P less than .0001), and longitudinal (r = 0.749, P less than .0001) diameters. These data provide a method by which variations from the norm can be assessed, and offer potential prenatal diagnosis of a variety of gastrointestinal lesions.
Embryonic and Fetal Development↗
Determination of deoxynivalenol (vomitoxin) by high-performance liquid chromatography with electrochemical detection.
A rapid method for the analysis of deoxynivalenol (DON) was developed using high-performance liquid chromatography (HPLC) with reductive electrochemical detection (ED). Deoxynivalenol produced by Fusarium roseum growing on solid cornmeal and rice substrates and from naturally contaminated wheat was extracted and quantitated via ED. DON levels in wheat were verified by gas chromatography and structurally confirmed by mass spectrometry. DON was optimally resolved by HPLC employing a radially compressed octadecylsilane column and a mobile phase of deoxygenated methanol-40 mM borate buffer (35:65) at a flow-rate of 1.0 ml/min. Under these conditions DON exhibited an average retention time of 3.6 min. Reductive ED (-1.4 V) allowed a 12-fold increase in sensitivity and greater selectivity than classical UV absorption at 224 nm. A detection limit for DON of 25 pg/microliter was achieved under these conditions. The determination of DON in crude grain extracts was hindered by extractable interfering substances, whereas ED was more functional-group selective (i.e. reduction of the carbonyl moiety). ED permits a direct quantitation of DON from crude grain extracts and may facilitate the determination of this agent and associated metabolites in biological samples.
Chromatography, High Pressure Liquid↗
Life events stress and psychosocial factors in men with peptic ulcer disease. A multidimensional case-controlled study.
We carried out a case-controlled study of multiple psychological and social factors in 49 men with complicated or uncomplicated peptic ulcer disease. Thirty-two men with renal stones or gallstones and 20 healthy men served as controls. Ulcer patients and controls experienced a similar number of potentially stressful life events. However, ulcer patients perceived their events more negatively (p less than 0.05). Ulcer patients also had significantly more personality disturbances than controls, although no one type of "ulcer personality" was found consistently. Some ulcer patients tended to be hypochondriacal complainers, overly pessimistic, and excessively dependent. Other personality disturbances were also more common in ulcer patients (e.g., immaturity, impulsivity, and feelings of social isolation and alienation). Ulcer patients had significantly lower ego strength and they had fewer friends and relatives whom they felt they could call upon in times of crisis. Finally, ulcer patients exhibited significantly more emotional distress in the form of depression and anxiety. Hypochondriasis, a negative perception of their life events, dependency, and lowered ego strength were the four variables that best discriminated ulcer patients from controls. This controlled study demonstrates a strong association between life events stress, psychosocial factors, and peptic ulcer disease.
Adaptation, Psychological↗
Nutritional screening in surgical patients.
Routine nutritional screening of patients admitted to the surgical services confirms a substantial prevalence of malnutrition. Identification of the malnourished patient and the patient who is likely to become malnourished should be done as early as possible in the hospital stay and usually requires only simple, readily available parameters. Nutritional screening is only the first step in the optimal nutritional management of surgical patients. This information should be used to determine the need for further nutritional assessment, the appropriate consultation, and nutritional therapy.
Adult↗
An update on vitrectomy surgery and retinal detachment repair in sickle cell disease.
Eighteen patients (19 eyes) with sickling hemoglobinopathies underwent vitrectomy or scleral buckling operations. The indications for surgery were tractional or rhegmatogenous retinal detachment or vitreous hemorrhage. The retina was reattached in all four patients with rhegmatogenous detachments requiring scleral buckling surgery but no vitrectomy. All had excellent visual acuity postoperatively. Four of the five patients with vitreous hemorrhage requiring vitrectomy without buckling had substantial improvement in visual acuity. In ten patients with vitreous hemorrhage with either preexisting or iatrogenic retinal breaks, rhegmatogenous detachment, or tractional detachment, the rate of improvement in visual acuity was only 50%. Problems associated with vitreous or retinal surgery in patients with sickling hemoglobinopathies include iatrogenic retinal breaks, intraocular bleeding and secondary glaucoma, anterior segment ischemia, and systemic sickling.
Adult↗
Argon endolaser.
We developed an endolaser probe that is capable of delivering argon laser light for photocoagulation of retinal breaks or vascular fronds. Energy is transmitted through a fiberoptic cord from a console outside of the surgical area to an endolaser probe inside the operating suite. The probe can be fired into fluid- or gas-filled media. With the use of this system, panretinal photocoagulation can be performed rapidly and conveniently during a vitrectomy procedure. We have also successfully managed posterior retinal tears and bleeding fibrovascular fronds with this system.
Argon↗
Degeneration of Bruch's membrane and retinal pigment epithelium.
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Adult↗
A simplified approach to the management of tangential retinal traction bands.
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Electrocoagulation↗