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Biomedical subjects

J Robinson

Publications and source records attributed to J Robinson.

At least 397 records · Page 22Linked to original sources
PubMed1988

Total parenteral nutrition: a concurrent drug utilization review.

University Hospital, a 428-bed tertiary care teaching hospital, treats approximately 150 patients annually with TPN. Currently used are three standard TPN base formulae which are ordered by physicians using preprinted TPN order forms. A concurrent Drug Utilization Review (DUR) was conducted on TPN treatment of 30 patients, to examine adherence to the current TPN protocol. Criteria for evaluation included ruling out enteral feeding, indications for TPN use, duration of therapy, monitoring of laboratory values, and caloric delivery. Physician and dietician estimation of caloric needs were compared to calories actually ordered by the physician. The number of pharmacist interventions and TPN bags wasted were also determined. Results could not be obtained with respect to ruling out enteral feeding and indications for TPN therapy due to inadequate information. The five-day minimum for duration of TPN therapy established in the DUR criteria was not attained in 23 percent (7/30) of patients. Seventy-seven percent of laboratory monitoring tests were completed. Results indicate wide disparities in caloric calculation and delivery; only 45 percent (10/22) of the patients who were ordered TPN met the physician's caloric goal. A number of recommendations were made to improve the TPN protocol and TPN therapy.

Adult↗
PubMed1987

Aeromonas cytotonic enterotoxin cross reactive with cholera toxin.

Isolation by affinity chromatography from crude culture filtrate of Aeromonas sobria of protein that cross reacted with cholera toxin (CT) revealed a toxin that produced fluid accumulation in rat ileal loops and in infant mice and caused rounding of Y1 adrenal cells. All these activities were neutralised by antiserum to CT. There was no haemolytic or cytotoxic activity associated with this CT-cross reactive cytotonic enterotoxin. CT-cross reactive material detected in enzyme linked immunosorbent assay (ELISA) was produced by 25% of Aeromonas isolates from faeces of children with or without diarrhoea-26% of A. sobria, 20.0% of A. hydrophila and 24% of A. caviae tested gave positive ELISA results. Most strains that produced this cytotonic enterotoxin but no cytotoxic enterotoxin were isolated from children without diarrhoea. Toxin preparations from Aeromonas spp. that completely inhibited adenosine-5'-diphosphate-induced platelet aggregation, an effect related to elevation of intracellular cAMP, were, with one exception, cross reactive with CT in ELISA.

Aeromonas↗
PubMed1987

ORG 10172: a low molecular weight heparinoid anticoagulant with a long half-life in man.

ORG 10172 is a heparinoid with mean molecular weight 6500 daltons. Intravenous bolus injections of ORG 10172 were compared with placebo and heparin injections in 91 separate studies in 83 healthy male subjects. 6400 units ORG 10172 produced a mean maximum change of 14.7 s in kaolin cephalin time (c.f. greater than 120 s for 5000 units heparin). Changes in prothrombin time were minimal (1.6 s for 6400 units ORG 10172 and 4.5 s after 5000 units heparin). A dose-related increase in bleeding time occurred after ORG 10172 and at high doses (greater than 3200 units) some secondary bleeding, which was never serious, occurred at between 1 and 4 h after incision. A dose-dependent reduction in ex vivo platelet adhesiveness was found at 10 min after ORG 10172 injection. ORG 10172 promoted a much smaller release of lipoprotein lipase as compared with heparin. The effect of ORG 10172 on plasma factor Xa activity (one measure of its action) was described by a biexponential decay with a mean distribution half-life of 2.34 (s.e. mean 0.16) h and mean disposition half-life of 17.6 (s.e. mean 1.1) h. It thus has a much longer duration of effect than heparin. There was a linear relationship of plasma anti-Xa response to increasing dose although there was some variability only partly explained by differences in body weight or surface area. ORG 10172 administration by bolus intravenous injection was well tolerated and there was no evidence of adverse effects on clinical chemistry or haematology tests.

Adolescent↗
PubMed1987

The relevance of research to the ward sister.

This paper addresses the relevance of research to practice under two headings using a policy analysis perspective. Firstly, the relationship of knowledge to action is considered within the context of a piece of longitudinal research into the welfare of children in hospital. The general difficulties of research application are discussed in terms of the different problem perceptions and time scales held by the policy makers who commission research, and the researchers themselves. The example cited demonstrates a useful compromise. The practical consequences arising from the distinct epistemological premises which underpin research into the natural and social worlds of nursing are considered. Secondly, the constraints on achieving research-based action are described briefly in terms of the resources of time, manpower and funding. It is concluded that an awareness of both conceptual and practical issues is essential in order to comprehend fully the complexity of, and the necessity for, a range of research approaches to nursing issues.

Child↗
PubMed1987

Does conception before marriage matter?

Data from the 1970 British Births survey were used to compare 1380 births conceived before marriage (women who were delivered less than 6 months after marriage) with 13,845 births to women who had been married for at least 6 months before delivery. Infants in the premarital conception group were at increased risk because of maternal youth, primiparity and maternal health behaviour such as smoking. Once these factors had been taken into account there was no residual risk of perinatal death or low birthweight. There was a slight excess of preterm deliveries.

Adolescent↗
PubMed1987

Nonpsychotic patients referred to a consultation service.

In order to examine characteristics of nondangerous and nonpsychotic patients referred to a consultation service, the authors administered self-rating scales and questionnaires to fifty referred medical patients and nonreferred controls. Recalled abuse in childhood appeared a stronger predictor for referral than some other commonly researched ones such as parental death, divorce or separation in childhood or recent losses. Anxiety, hostility and depression were significantly higher in referred patients, whereas hypochondriacal attitudes did not differ between the two groups. The findings appear to have implications for treatment.

Adolescent↗
PubMed1987

Biotyping as a method of screening for enterotoxigenic Escherichia coli.

A scheme of biotyping described originally for E. coli isolated from urine was used to investigate enterotoxigenic (ETEC) and non-enterotoxigenic (non-ETEC) fecal E. coli. Primary biotype was determined by fermentation of raffinose, sorbose and dulcitol and decarboxylation of ornithine. Failure to ferment sorbose correlated best with enterotoxicity; 95.5% of ETEC and less than 40% of non-ETEC did not ferment sorbose. The sensitivity compares favourably with reported results of the use of polyvalent antisera for recognition of serotypes associated with ETEC, although specificity was lower using biotyping. Strains included in our study were mainly from Australia, New Zealand or Indonesia and we do not know if our observations apply to E. coli isolated elsewhere. If failure to ferment sorbose proved to be a characteristic of most ETEC, this reaction offers the possibility of developing selective media to increase the yield of ETEC from primary plates for laboratories in which gene probe techniques for recognition of ETEC are not available.

Bacteriological Techniques↗
PubMed1987

Care in the community: support for informal carers of chronically ill and disabled people.

This paper describes a developmental programme established in Great Britain which seeks to improve information, training and education for informal carers, for health care professionals, and for the general public. It discusses the need for such a programme, in the light of community care policies and previous research concerning informal carers. The underlying philosophy of the programme is outlined, together with details of the educational strategy being implemented and evaluated.

Chronic Disease↗
PubMed1987

Occurrence of renal tubular dysfunction in lupus nephritis.

We prospectively evaluated 30 patients who presented with active systemic lupus erythematosus (SLE) for the presence of tubular abnormalities. All patients fulfilled the American Rheumatology Association criteria for SLE. When appropriate, a renal biopsy was performed. Of the 30 patients studied, 12 had no abnormal tubular study results, whereas 18 patients had some form of defect in the handling of potassium, sodium, or hydrogen ions. Eight patients had distal renal tubular acidosis (dRTA) due to an isolated proton secretory defect. Five had dRTA of the gradient or acid back-leak type. Two had an unresponsive voltage-dependent form of dRTA; one had a responsive voltage-dependent form of dRTA. One individual had hyporeninemic hypoaldosteronism and one had dRTA plus hypoaldosteronism. Clinically, patients with the abnormal tubular study results more often presented with nephritis or nephrotic sediment, peripheral edema, or anemia. Renal biopsies failed to demonstrate any difference in glomerular histologic findings and calculated activity, chronicity, or interstitial indexes. We conclude that SLE may be associated with a variety of tubular defects.

Acidosis, Renal Tubular↗
PubMed1987

The presence of clonogenic cells in high-grade malignant lymphoma: a prognostic factor.

A culture system has been developed that promotes growth of clonogenic lymphoma cells of some patients with intermediate and high-grade malignant lymphoma. The formation of colonies in bone marrow, lymph nodes, and peripheral blood samples is best supported by human plasma. Colony formation of some patients was dependent upon growth factors, which in this study were added in the form of medium conditioned by phytohemagglutinin (PHA)-stimulated leukocytes (PHA-LCM). Some gave rise to lymphoma colonies without PHA-LCM but improved their frequency with PHA-LCM; others were completely independent of PHA-LCM. Colonies grown in primary cultures were routinely recloned and propagated as Epstein-Barr virus (EBV)-negative cell lines with stable B cell phenotype. The cell lines showed the same immunoglobulin rearrangement pattern as that observed in the primary lymphoma sample. In addition, a significant clinical correlation was observed between culture data and clinical outcome. Survival of patients who formed lymphoma colonies at any time during their clinical course was significantly shorter than survival of patients who did not give rise to colonies (P = 0.0009). The same observation was made when the survival assessment was performed for the subset of patients studied at diagnosis (P = 0.0014).

Adult↗
PubMed1986

Interstitial deletion of (17)(p11.2p11.2) in nine patients.

We describe a new and distinct syndrome involving an interstitial deletion of short arm of chromosome 17 in nine unrelated patients (six males; three females) ranging in age from 3 months to 65 years. In eight patients, a deletion of a portion of band 17p11.2 was associated with a striking similar phenotype including brachycephaly, midface hypoplasia, prognathism, hoarse voice, and speech delay with or without hearing loss, psychomotor and growth retardation, and behavior problems. The one patient with a complete deletion of band 17p11.2 was more severely affected with facial malformations, cleft palate, and major anomalies of cardiac, skeletal, and genitourinary systems; the patient died at age 6 months. Careful cytogenetic analysis including high-resolution techniques will be important for the further identification of patients with this previously unrecognized deletion syndrome.

Abnormalities, Multiple↗
PubMed1986

Haemagglutination patterns of Aeromonas spp. related to species and source of strains.

The study included 138 A. sobria and 182 A. hydrophila isolated in Perth from samples of diarrhoeal or non-diarrhoeal faeces or from domestic water. Strains were grouped in relation to agglutination of human, horse, rat and guinea pig erythrocytes and the effect of sugars on haemagglutination. Agglutination of red cells of all four species (primary group 1) was most commonly associated with A. sobria, particularly those strains isolated from faeces of patients with diarrhoea. Most A. hydrophila associated with diarrhoea also belonged to group 1 but A. hydrophila from non-diarrhoeal stools or from water most commonly agglutinated human and guinea pig cells but not horse erythrocytes (primary groups 2 and 3). Fucose-resistant haemagglutination (FRHA) of strains in primary group 1 occurred with about 68% of the strains of A. sobria associated with diarrhoea. Mannose-resistant haemagglutination (MRHA) was limited to 29% of strains of A. sobria associated with diarrhoea. The predominance of primary group 1 among strains of Aeromonas spp. associated with diarrhoea and the proportion of these strains showing FRHA suggest that haemagglutination of cells from human, horse, rat and guinea pig, particularly if fucose-resistant, should be considered in a search for characteristics, which possibly contribute to virulence of Aeromonas spp.

Aeromonas↗
PubMed1986

Induction and enhancement of progressive motility in hamster caput epididymal spermatozoa.

Progressive motility was induced in hamster caput epididymal spermatozoa incubated in Tyrodes medium containing 50 mM theophylline, 1.0% Fraction V bovine serum albumin, and 15% (v/v) heat-treated human seminal plasma. Under these induction conditions, however, the maximum percent of caput spermatozoa exhibiting progressive motility (21%) and the time during which motility was sustained (120 min) were significantly less (p less than 0.05) than that of controls from the cauda epididymidis. Moreover, in contrast to caudal spermatozoa, the majority of the induced caput spermatozoa exhibited some degree of flagellar bending at the neck or midpiece. In subsequent experiments the procedure for motility induction was modified to achieve levels of motility in caput spermatozoa equivalent to those observed for caudal spermatozoa. The addition of 5 microM diamide, a sulfhydryl oxidant, to the induction medium prevented the flagellar angularity observed in induced caput sperm preparations. The percentage of caput spermatozoa induced to progressive motility was increased to levels characteristic of caudal spermatozoa (48%) by the addition of hamster caudal epididymal fluid (CEF) to the induction medium. Finally, the viability of the induced caput spermatozoa was significantly enhanced (p less than 0.05) by the removal of Fraction V albumin from the induction medium. In the presence of CEF and in the absence of albumin, 50% of the caput spermatozoa acquired progressive motility and sustained this motility for 4 h. Moreover, when fatty acid-free, charcoal-extracted albumin instead of Fraction V albumin was utilized in the induction procedure, a maximum of 43% of the caput spermatozoa acquired progressive motility and maintained this motility for 4 h, suggesting that the decreased sperm viability observed in the presence of Fraction V albumin was due to a contaminant of albumin, possibly fatty acids. The studies described herein demonstrate for the first time that immature quiescent caput epididymal spermatozoa can be induced to acquire progressive and sustained motility equivalent to that observed in mature caudal epididymal spermatozoa.

Animals↗