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Biomedical subjects

J R Kerr

Publications and source records attributed to J R Kerr.

At least 73 records · Page 4Linked to original sources
PubMed1995

Parvovirus B19 infection--persistence and genetic variation.

53 patients with acute B19 infection were studied; symptoms at acute infection were rash and arthralgia (n = 26), rash (n = 7), arthralgia (n = 16), aplastic crisis (n = 3), and intrauterine fetal death (n = 1). These patients were followed for 26-85 months (mean 57 months) and re-assessed for persistent symptoms, anti-B19 antibodies, and B19 DNA. At follow-up, 7 individuals were positive for serum B19 DNA, compared with none of the controls (2-tailed p value = 0.016). All 7 of those persistently infected were women, 3 of whom had symptoms; 1 had a chronic haemolytic anaemia (initial presentation was aplastic crisis); 1 had persistent arthralgia in both knees (initial presentation was bilateral knee arthralgia); and 1 had arthralgia in one knee and chronic fatigue syndrome (initial presentation was bilateral arthralgia in knees and shoulders). For the 7 persistently infected patients, serum from the time of diagnosis of acute B19 infection was available for 4, all of which contained B19 DNA. With single-stranded conformational polymorphism (SSCP) assay of these 11 PCR products, identical SSCP types were demonstrated in 5 of 7 follow-up isolates. In 2 of the 4 cases for which both acute and follow-up PCR product was available, the SSCP type of the follow-up product was different from that of the acute product. Two B19 virus types were demonstrated in one patient (with persistent arthralgia and chronic fatigue syndrome) at follow-up assessment.

Adolescent↗
PubMed1994

An outbreak of parvovirus B19 infection; a study of clinical manifestations and the incidence of fetal loss.

Eighty-five cases of B19 infection were diagnosed in Northern Ireland from 1984 to 1989; 65 of these occurred during 1989, the outbreak year. Of the total 85 cases, 15 had a rash, 21 had arthralgia, 47 had a rash and arthralgia, and 2 had aplastic crisis. The age range was 4-63 years with a mean of 26.9 years. Thirty cases (35%) were referred to hospital; 25 of these had arthralgia and 2 had aplastic crisis. Two thousand four hundred pregnant women at 12 weeks gestation in 1989 were screened for anti-B19 IgM; 8 were positive. Of these 8 patients, 7 progressed to delivery of a normal fetus and one had an intra-uterine death at 26 weeks gestation; no congenital abnormalities were noted in any fetus. The incidence of fetal involvement in maternal B19 infection in this study was therefore 12.5%.

Adolescent↗
PubMed1994

A comparison of oral, axillary, rectal and tympanic-membrane temperatures of intensive care patients with and without an oral endotracheal tube.

Monitoring rectal temperatures (RTs) in orally intubated, critically ill patients is common practice, as they are generally believed to be more accurate than oral temperatures (OTs). This study was designed to compare OTs of critically ill patients, with and without an endotracheal tube, using patients as their own control. Axillary (AT), tympanic membrane (TMT) and RTs of patients were also studied. Sixty-five orally intubated patients ready for extubation, ranging in age from 17 to 96 years (17 female and 48 male), were included in the study. OT, AT, RT and TMTs were taken before and after extubation. Using a t-test for paired samples, significant differences were found between both ATs and OTs measured with and without an oral endotracheal tube (P < 0.01); the differences (-0.12 and 0.08 degrees C, respectively) were not considered clinically important. Further t-tests for paired samples revealed no significant difference between TMTs and RTs pre and post extubation. Respiratory rate, presence or absence of teeth, and mouth position were shown to have no effect on OT (t-tests, P < 0.01). Analysis of variance showed no difference in OT dependent on room temperature or temperature within the endotracheal tube. It was concluded that OTs are accurate when taken in patients who are orally intubated and ready for extubation.

Adolescent↗
PubMed1994

Suppression of fungal growth exhibited by Pseudomonas aeruginosa.

Three surgery patients were monitored postoperatively, with particular reference to lung infection. In each case there was a clinical impression that Pseudomonas aeruginosa suppressed the growth of Candida albicans in patients with clinically significant lung infections from whom both of these organisms were isolated from serial sputum samples. Regrowth of C. albicans after P. aeruginosa eradication occurred in two patients, despite fluconazole therapy, to which both C. albicans isolates were susceptible. In all three patients, the strain of P. aeruginosa was found to inhibit the growth of the corresponding C. albicans strain in vitro. Further in vitro susceptibility studies revealed significant inhibition by 10 strains of P. aeruginosa of 11 strains of fungi known to infect humans; these were Candida krusei, Candida keyfr, Candida guillermondii, Candida tropicalis, Candida lusitaniae, Candida parapsilosis, Candida pseudotropicalis, Candida albicans, Torulopsis glabrata, Saccharomyces cerevisiae, and Aspergillus fumigatus.

Candida↗
PubMed1993

Computerised calculation of the true costs of antibiotic therapy.

A system for computerised calculation of the drug costs and hidden costs of antibiotic therapy is described. A previously developed method for costing antibiotic therapy was used to quantify hidden costs arising from intravenous administration, labour, serum antibiotic assays, monitoring of haematological and biochemical indices, and disposal of sharp instruments. These calculations were installed into a software system using spreadsheets (Microsoft Excel/Windows). Cost calculations were simplified as a result of automated calculation with centralised cost updating, a facility for new antibiotics, a facility for atypical regimens, availability to a number of users, password protection and a facility for multiple courses of intravenous antibiotic therapy.

Anti-Bacterial Agents↗
PubMed1993

Psychophysiological effects of back massage on elderly institutionalized patients.

An experimental design was used to measure the effects of back massage on anxiety levels of elderly residents in a long-term care institution. Twenty-one residents, 17 females and four males, participated in the study. Subjects were randomly assigned to three groups which received 'back massage with normal conversation', 'conversation only' and 'no intervention' respectively. The dependent variable, anxiety, was measured prior to back massage, immediately following, and 10 minutes later, on four consecutive evenings. The Spielberger Self-Evaluation Questionnaire (STAI), electromyographic recordings, systolic blood pressure, diastolic blood pressure (DBP) and heart rate were used as measures of anxiety. Analysis of variance was used to examine differences in group mean scores over the pre-test to post-test, post-test to delayed time interval, and pre-test to delayed time intervals, Scheffé comparisons being made where indicated. With the exception of mean DBP which showed no change from pre-test to post-test and HR which increased from post-test to delayed time interval, there was a statistically insignificant decrease in mean scores on all variables in the back massage group from pre-test to post-test and from post-test to delayed time interval. There was a statistically significant difference in the mean anxiety (STAI) score between the back massage group and the no intervention group. The difference between the back massage group and the conversation only group approached statistical significance.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

Antibiotic pharmacoeconomics: an attempt to find the real cost of hospital antibiotic prescribing.

Antibiotics account for a large part of all hospital pharmacy budgets, but the actual cost of their prescription is unknown. These costs include intravenous administration, labour, serum antibiotic assay, monitoring of haematological and biochemical indices, disposal of sharps and adverse effects. An in-house method of costing antibiotic therapy is presented, to quantify these hidden expenses. Since not only an awareness, but an accurate quantification, of hidden costs is required, a study of various hospital procedures relating directly to antibiotic therapy was undertaken in an acute medical ward; this involved the identification of particular staff members performing various procedures, consumables used and time taken. The cost of five-day courses of gentamicin, penicillin G, ampicillin, flucloxacillin, cefuroxime, ceftotaxime and erythromycin has been calculated; drug and hidden costs for each are presented graphically for comparison. The breakdown cost for gentamicin is presented to illustrate the method. The costing of adverse effects has not been attempted. We suggest that costings of this sort are used in cost-benefit analysis of antibiotic use. These calculations have been incorporated into a computer spreadsheet and this costing service will be offered to clinical areas of our hospital.

Anti-Bacterial Agents↗
PubMed1992

Technique for calculation of the true costs of antibiotic therapy.

An in-house method for costing antibiotic therapy is presented which quantifies hidden costs including costs arising from intravenous administration, labour, serum antibiotic assay, monitoring of haematological and biochemical indices and disposal of sharp instruments. A study of various hospital procedures relating directly to antibiotic therapy was undertaken in an acute medical ward, which involved determination of staff members performing various procedures, consumables used and time taken. Results of this study facilitated accurate quantification of hidden costs of i.v. antibiotic therapy in this ward. Using these results, the cost of five-day courses of gentamicin, cefuroxime, penicillin G, flucloxacillin and erythromycin were calculated. The costing of adverse effects was not attempted. It is recommended that a costing technique of this sort is used in cost-benefit analysis of antibiotic use, as the cost of the drug alone is misleading.

Anti-Bacterial Agents↗
PubMed1992

Five cases of Alcaligenes pseudobacteraemia.

A cluster of five cases of pseudobacteraemia due to the organism Alcaligenes denitrificans occurred in three hospital medical wards over a four week period. The same organism was isolated from four of twelve commercially prepared bottles for erythrocyte sedimentation tests. The most likely explanation for the outbreak is that the ESR bottles were filled prior to inoculation of blood culture bottles. The outbreak was brought to an end by advising on correct procedure.

Alcaligenes↗
PubMed1989

Utilisation of acute care hospital beds by levels of care.

An exploratory analysis of utilisation patterns of acute care hospitals in the Province of Alberta, Canada was carried out to develop a methodology for assessing bed utilisation profiles of acute care hospitals by levels of care. The utilisation of Alberta acute care hospital beds was measured in terms of primary, secondary and tertiary levels of hospital services. Patient origin-destination methodology was applied and a regionalisation perspective employed. The data used for this study were hospital separation abstracts compiled by all Alberta acute care hospitals during year 1986, this coincided with the most recent available Canadian census data. It was estimated that approximately 10-11% of Alberta beds were used for tertiary care as derived from population based utilisation rates and patient flow patterns. With respect to per capita measurement, the number of beds used per 1,000 residents was: 3.5 to 3.9 for primary, 1.2 to 1.6 for secondary, and about 0.6 for tertiary levels of care. Regression analysis revealed that the marginal cost per bed at each level was approximately 75-79, 87-88, and 201-209 thousand Canadian dollars per year in 1986 for primary, secondary and tertiary care respectively. The profiles thus estimated explained about 65% of per bed hospital cost variation.

Alberta↗
PubMed1988

Nursing education at a distance: using technology to advantage in undergraduate and graduate degree programs in Alberta, Canada.

Two applications of distance education methods at the undergraduate and graduate levels are described in this article. The experiment in graduate education employed video-conferencing to teach a course in the Master of Nursing program at the University of Alberta. Centres connected by a coaxial cable in two cities with 8-10 students in each were used. In the project which followed in undergraduate education, the Faculty of Nursing undertook to provide an entire post-R.N. degree program to centres in central and northern Alberta primarily through the use of distance methods. Arts and science courses are taken through Athabasca University and regular nursing courses in the B.Sc.N program are provided using video-enhanced teleconferencing with several centres on line along with instructors and students on the main campus in Edmonton, Alberta. Details of this very successful program are discussed in the text.

Alberta↗