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Biomedical subjects

J McGinnis

Publications and source records attributed to J McGinnis.

At least 19 recordsLinked to original sources
PubMed1996

Evaluation of a soluble fibrin assay in patients with suspected pulmonary embolism.

In order to determine the clinical utility of an enzyme immunoassay (EIA) for soluble fibrin in patients with suspected pulmonary embolism (PE), 195 unselected patients with suspected PE underwent blood sampling for measurement of plasma levels of soluble fibrin, and objective testing for PE. A soluble fibrin result of < or = 0.75 micrograms/ml showed a sensitivity of 100% for PE and a specificity of 12.8%, whereas a soluble fibrin result of < or = 1.35 micrograms/ml showed a sensitivity of 90.3% and a specificity of 49.4% for PE. The soluble fibrin assay has potential clinical utility in excluding PE.

Adolescent↗
PubMed1995

Secondary syphilis and headaches.

Secondary syphilis is associated with headaches. We describe two patients with headache from secondary syphilis and we recommended considering this in the differential diagnosis and evaluation of the headache patient.

Adult↗
PubMed1995

Pre-operative plasma levels of thrombin-antithrombin III complexes correlate with the development of venous thrombosis after major hip or knee surgery.

STUDY OBJECTIVE: To determine whether levels of thrombin-antithrombin III (TAT) in plasma, taken two weeks pre-operatively, predict the development of deep vein thrombosis (DVT) in patients undergoing major hip or knee surgery. DESIGN: Prospective cohort. SETTING: Tertiary-care referral centre, university-affiliated hospital. PATIENTS: Ninety eight consecutive patients undergoing elective hip or knee surgery. INTERVENTION: All eligible consenting patients were seen in a preoperative clinic two weeks prior to surgery and had blood taken for measurement of plasma TAT level. After surgery, they received a combination of unfractionated heparin 5000 Units 12-hourly subcutaneously, and antiembolism stockings (TEDS), as prophylaxis against DVT. Contrast venography was performed prior to discharge, and according to the results, patients were classified as having proximal (popliteal and/or more proximal) DVT (n = 12), calf DVT (n = 7) or no DVT (n = 79). MEASUREMENTS AND RESULTS: The mean TAT level was significantly higher in patients who developed DVT (5.7 micrograms/l) than in those who did not (4.1 micrograms/l), p = 0.035. Using cut-points of 3.5 and 5.5 micrograms/l for the TAT level, patients could be categorized as high, intermediate, and low risk for the development of DVT. The proportion of patients with TAT levels of > or = 3.5 micrograms/l who developed calf or proximal DVT was significantly higher than the proportion of patients with TAT levels of < 3.5 micrograms/l who developed calf or proximal DVT (p = 0.02). The proportion of patients with TAT levels > 5.5 micrograms/l who developed proximal DVT was significantly higher than the proportion of patients with TAT levels of < or = 5.5 micrograms/l who developed proximal DVT (p = 0.03). CONCLUSIONS: This study demonstrates that pre-operative TAT levels correlate with the risk of developing DVT after major orthopedic surgery. Further studies are needed to determine the reason(s) for this observation and whether rational recommendations about prophylaxis and screening for DVT can be made based on the results of a preoperative TAT level.

Adult↗
PubMed1994

Reevaluation of the sensitivity of impedance plethysmography for the detection of proximal deep vein thrombosis.

BACKGROUND: To reevaluate the sensitivity of impedance plethysmography (IPG) for proximal deep vein thrombosis (DVT) and to establish a relationship between the location and size of thrombi and the results of IPG. DESIGN: Prospective cohort study. METHODS: One hundred thirty-two consecutive patients with clinically suspected DVT underwent IPG testing and most (n = 118) underwent contrast-enhanced venography; in 14 patients, venous ultrasonography was performed and demonstrated definitive proximal DVT in which the size and extent of the thrombus could be delineated. All patients with dubious or normal ultrasound results underwent contrast-enhanced venography. All tests were performed and test results were interpreted without knowledge of the results of the other tests. Patients were considered to have proximal DVT if this was demonstrated on venography or ultrasound, calf DVT if this was demonstrated on venography, or no DVT if venography yielded normal findings. The sensitivity and specificity of IPG for DVT were calculated. RESULTS: Of the 132 patients, 40 (30%) had proximal DVT, seven (5%) had calf DVT, and 85 (64%) had no DVT. The sensitivity of IPG for proximal DVT was 65% and the specificity was 93%. Of the proximal vein thrombi, IPG detected three (23%) of 13 that involved the popliteal vein but not the superficial femoral vein and 23 (85%) of 27 proximal vein thrombi that involved the superficial femoral vein. CONCLUSIONS: Our study demonstrated that the sensitivity of IPG for proximal DVT at our center is only 65%, a figure that is much lower than those reported in earlier studies from our institution. We hypothesize that because of a change in referral practice, an increased proportion of patients with less severe symptoms are now referred to our center than in the past. These patients have thrombi that are smaller, less likely to be occlusive, and therefore less likely to yield abnormal IPG findings.

Adult↗
PubMed1993

Effectiveness of glucose monitoring systems modified for the visually impaired.

OBJECTIVE: To compare three glucose meters modified for use by individuals with diabetes and visual impairment regarding accuracy, precision, and clinical reliability. RESEARCH DESIGN AND METHODS: Ten subjects with diabetes and visual impairment performed self-monitoring of blood glucose using each of the three commercially available blood glucose meters modified for visually impaired users (the AccuChek Freedom [Boehringer Mannheim, Indianapolis, IN], the Diascan SVM [Home Diagnostics, Eatontown, NJ], and the One Touch [Lifescan, Milpitas, CA]). The meters were independently evaluated by a laboratory technologist for precision and accuracy determinations. RESULTS: Only two meters were acceptable with regard to laboratory precision (coefficient of variation < 10%)--the Accuchek and the One Touch. The Accuchek and the One Touch did not differ significantly with regard to laboratory estimates of accuracy. A great discrepancy of the clinical reliability results was observed between these two meters. The Accuchek maintained a high degree of reliability (y = 0.99X + 0.44, r = 0.97, P = 0.001). The visually impaired subjects were unable to perform reliable testing using the One Touch system because of a lack of appropriate tactile landmarks and auditory signals. CONCLUSIONS: In addition to laboratory assessments of glucose meters, monitoring systems designed for the visually impaired must include adequate tactile and audible feedback features to allow for the acquisition and placement of appropriate blood samples.

Adult↗
PubMed1991

Heparin and graduated compression stockings in patients undergoing fractured hip surgery.

Despite evidence that effective regimens are available for the prevention of venous thrombosis in fractured hip patients, many centers do not use prophylaxis. In order to evaluate the efficacy and safety of heparin and graduated compression stockings, we conducted a cohort study of 55 consecutive fractures hip patients treated postoperatively with heparin, 5,000 U every 12 h, and graduated compression stockings. The rates of venous thromboembolism and bleeding were compared with an historical cohort from Hamilton. Before discharge, 51 patients underwent bilateral venography. Deep venous thrombosis (DVT) occurred in 10 of the 51 patients (incidence of 20%); three had proximal DVT (incidence of proximal DVT was 6%). DVT was seen in 29 of the 63 control patients (incidence 46%); 19 had proximal DVT (incidence of proximal DVT was 30%). The differences in the rates of DVT and proximal DVT are statistically significant (p less than 0.01). Bleeding occurred in one patient in the treatment group (incidence 2%) and five patients in the control group (incidence 8%). This study confirms that therapy with heparin and graduated compression stockings is effective, inexpensive, and convenient for the prevention of venous thrombosis in fractured hip patients and is associated with a low bleeding risk.

Aged↗
PubMed1991

Venous thrombosis in patients who have undergone major hip or knee surgery: detection with compression US and impedance plethysmography.

To compare the sensitivity, specificity, and predictive values of compression ultrasonography (US) in postoperative orthopedic patients with those of (a) impedance plethysmography in postoperative patients and (b) compression US in symptomatic outpatients, the authors performed an investigator-blinded cohort study. One hundred thirty-four consecutive inpatients who had undergone elective knee-replacement surgery or surgery for a fractured hip and 65 consecutive outpatients with clinically suspected venous thrombosis who had undergone venography were evaluated. Compression US allowed detection of 11 of 21 (52.4%) proximal-vein thrombi but was insensitive to calf-vein thrombi in the orthopedic patients. Compression US had a significantly greater specificity and positive predictive value than impedance plethysmography for all thrombi in orthopedic patients; compression US also had greater sensitivity. The sensitivity of compression US for proximal-vein thrombi was significantly higher (92.1%) in symptomatic outpatients than in orthopedic patients. The authors conclude that compression US has significant advantages over impedance plethysmography in the detection of proximal-vein thrombi in patients who have undergone hip- or knee-replacement surgery.

Hip Joint↗
PubMed1991

Research note: evaluation of the Report Salmonella visual immunoassay for detection of salmonellae on raw poultry carcasses.

Two trials were conducted to compare the standard culture procedure and the Report Salmonella Visual Immunoassay for detection of salmonellae in rinse fluid recovered from raw poultry carcasses. Both assays were evaluated with and without preenrichment in lactose broth prior to enrichment in selenite cystine broth. Live birds were inoculated via the drinking water prior to processing to ensure a high degree of carcass contamination. Prechill carcasses were sampled using 200 mL of sterile water. Results indicated that lactose preenrichment was not necessary for salmonellae evaluation using standard culture procedures. However, the Report assay produced fewer false-negative results if lactose preenrichment was utilized.

Animals↗
PubMed1989

The triple option choice: self-selection bias in traditional coverage, HMOs, and PPOs.

Health care costs and utilization by salaried employees and their dependents at a large self-insured midwestern industrial manufacturing corporation were analyzed for the year before employees were first offered a triple option choice. Members had the option of retaining traditional Blue Cross and Blue Shield of Michigan (BCBSM) coverage or switching to either a number of health maintenance organizations (HMOs) or a number of preferred provider organizations (PPOs). Members who switched to HMOs or PPOs were generally younger and had lower average expenses and utilization rates than those who retained the traditional BCBSM plan. The results suggest that a selection bias does occur in this population, as lower cost members were more attracted to the HMOs and PPOs than were more expensive members. Implications for the corporation as well as for the drive toward managed care alternatives are discussed.

Age Factors↗
PubMed1988

The effect of chronic steroid therapy on glucose tolerance in pregnancy.

We analyzed the records of 26 pregnant patients receiving chronic steroids to assess the combined effect of pregnancy and glucocorticoid administration on glucose tolerance. Five patients (19.2%) developed diabetes mellitus, four of whom required insulin. In a pregnant control group of 1325 patients, 53 patients (4.0%) developed diabetes mellitus, five of whom required insulin. Glucose intolerance was significantly higher in the steroid-treated group (p = 0.003). Comparison with a nonpregnant steroid-treated control group (47 patients, 15% of whom developed diabetes mellitus) showed no significant different (p = 0.23) between the two. All pregnant steroid-treated patients developing diabetes mellitus began steroid therapy after conception, whereas none of the patients receiving steroid therapy before conception developed glucose intolerance (p = 0.012). There does not appear to be an additive effect of steroid treatment and pregnancy on glucose intolerance; however, all patients receiving steroids should undergo periodic glucose screening.

Adult↗
PubMed1987

Comparison of several induced molting methods on subsequent performance of single comb White Leghorn hens.

Seventy-two-week-old Single Comb White Leghorn hens were induced to molt by 11 different methods 1) to determine the utility of molt-inducing procedures that employ full feeding, limited feeding, and fasting and 2) to determine the postmolt performance of hens induced to molt by fasting to varying degrees of body weight reduction (BWR) then fed postfast, prelay (PF-PL) diets varying in nutrient density. Induced molt treatments were full feeding of 10 and 15% guar meal diets to 30% BWR; limited feeding by withholding feed to 30% BWR, except for 6-hr feeding periods on every 3rd, 4th, and 5th recurring day; fasting to 25, 30, or 35% BWR then feeding either a pullet developer ration or a fortified molt ration (FR) for 21 days. Egg production, egg weight, shell quality, Haugh unit, feed consumption, and mortality were recorded for 33 weeks. Molt treatments produced few significant differences; nonmolted control hens had overall poor performance. Full feeding of the 15% guar meal diet caused a slow cessation and reinitiation of lay with acceptable lay performance. The 10% guar meal diet reduced livability. All recurring day, limited-feeding treatments conserved feed during the first 35 days of molt induction. The 3rd and 5th recurring day-feeding treatments were particularly effective and had acceptable lay performance and feed efficiency. Neither level of BWR nor type of PF-PL diet significantly affected postmolt performance. The 30% BWR-FR induced-molt method produced superior (but not significantly) postmolt lay performance.

Animals↗
PubMed1987

Further investigations regarding the toxicity of sodium nitroprusside.

Sodium nitroprusside is a valuable vasodilator, but its use has been curtailed because of numerous reports that, in the presence of blood, nitroprusside decomposes with release of toxic cyanide. We have examined the release of cyanide in terms of the known chemistry of nitroprusside and suggest that photochemical decomposition of nitroprusside and (or) its metabolism in vivo invalidates the analytical procedure used by previous workers. We also present evidence for the stability of nitroprusside in blood, based on 13C nuclear magnetic resonance studies.

Ferricyanides↗
PubMed1985

The effect of autoclaving and enzyme supplementation of guar meal on the performance of chicks and laying hens.

Four experiments with broilers and one with laying hens were conducted to study the effects of processing and hemicellulase supplementation of guar meal (37.0% protein) on growth, feed efficiency, and egg production. Guar meal at 0, 10, and 15%, either in raw form or autoclaved at 100, 102, or 132 C for 3, 15, or 30 min, was fed alone or in the presence of 0 to 250 ppm hemicellulase. In an experiment utilizing full-term broilers, 10 and 15% autoclaved guar meal was fed in the presence of lincomycin (3.3 ppm) or in combination with lincomycin and hemicellulase (25 ppm). The laying hen experiment was conducted with 36-week-old hens for 8 weeks. They were fed the raw or autoclaved meal (102 C, 15 min) alone and in combination with 30 ppm hemicellulase. The raw guar meal depressed growth and the depression was dose-related. Autoclaving at 102 C for 15 min increased growth and feed efficiency. A higher temperature or a longer time of autoclaving failed to give any further increase in growth or feed efficiency. The lowest (16.5 ppm) hemicellulase was as effective as the highest (250 ppm) in increasing growth and feed efficiency of chicks when added to guar meal diets. Penicillin had no effect on growth or feed efficiency when added to the diet containing autoclaved guar meal in the presence of hemicellulase. Dry heating at 150 C for 6 hr or water treatment of guar meal was not effective in stimulating growth or feed efficiency. Guar meal also increased stickiness of droppings; autoclaving enhanced the effect, whereas hemicellulase prevented the sticky droppings.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1984

Nutritional studies of a carboxypeptidase inhibitor from potato tubers.

Carboxypeptidase inhibitor from potato tubers was fed to newly hatched chicks at a level equal to that present in diet containing 50% raw potato, which caused severe growth depression and 20% mortality. At this level the effects of the inhibitor on growth was small but the following effects were noted: (a) increased fecal protein (the increase mainly consisting of low molecular weight proteins); (b) poorer feed efficiency; and (c) a significant decrease in pancreatic digestive proenzyme levels, although no hypertrophy was noted. In addition, the inhibitor was not digested readily in the intestinal tract and it increased in concentration in intestinal contents as it progressed down the tract. Potato Inhibitor II, a potent trypsin inhibitor, when fed to chicks, also at the level found in a 50% raw potato diet, was severely growth depressing. It significantly increased fecal protein and caused pancreatic hypertrophy. The trypsin inhibitor may be a major growth depressing agent in raw potatoes whereas the carboxypeptidase inhibitor probably contributes little to the growth depression.

Animals↗
PubMed1984

Studies on the action of pectin in depressing the growth of chicks.

Citrus pectin (40 g/kg diet) significantly depressed weight gain and food utilisation when fed to young chicks. This effect was not associated with pathological manifestations or signs of deficiency. Feeding pectin at 40 g/kg diet did not affect the retention of energy, nitrogen, lipids or calcium, but decreased serum and liver total cholesterol and altered the glucose tolerance of chicks by retarding clearance of ingested glucose from blood. Supplementation of the pectin-containing diet with penicillin (70 mg/kg), with selected essential elements and vitamins, or increasing the energy density of the diet had no ameliorating effect on the depressed growth. Pair-feeding showed that pectin depressed food intake, reduced carcase lipid content and increased carcase moisture content.

Animal Feed↗