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Biomedical subjects

J Rooney

Publications and source records attributed to J Rooney.

36 records · Page 2Linked to original sources

New ventures create challenges for the management team.

With healthcare institutions now operating as businesses, hospitals are looking outside traditional inpatient services for new sources of capital. As a result of these ventures, the role of the management team has taken on new challenges. It is important that members of the hospital management team understand their roles in the development and implementation of these new ventures to ensure success.

Commerce↗

Financial success requires increased physician involvement.

Good relations between the hospital and its medical staff are becoming increasingly necessary as financial considerations become an overriding concern. Management is learning that physicians must become more involved in the organizational structure and cost containment efforts of the hospital so that communication lines remain open between management and the medical staff.

Conflict, Psychological↗

Detection of enteric adenoviruses by dot-blot hybridization using a molecularly cloned viral DNA probe.

Enteric adenoviruses (EAds) (candidate adenoviruses 40 and 41, subgroups F and G) have been implicated in the etiology of gastroenteritis in infants, but their clinical significance has been unclear because a rapid test to distinguish these agents from other adenovirus (Ad) types has not been available. We developed a dot-blot hybridization assay for EAd DNA using a cloned DNA fragment that has little homology to non-EAd DNAs. The dot-blot system detected less than 20 pg of EAd DNA, while showing minimal cross hybridization to representative strains from all other Ad groups. There was no detectable hybridization to extracts of samples known to contain other enteric viruses. It was further shown that low levels of EAds in specimens could be amplified by culturing for 1 day in 293 cells. Stool samples and tissue culture lysates prescreened by electron microscopy, cell culture or ELISA were tested in a blind fashion. Using endonuclease analysis as the standard for typing the isolates, we found the dot-blot system to have a 91% sensitivity and 71% specificity for detecting EAds and distinguishing them from other Ads. False-positive and equivocal dot-blot results appeared to be caused by other Ads.

Adenoviridae Infections↗

Reactogenicity, immunogenicity, and efficacy of a chick embryo cell-derived vaccine for Rocky Mountain spotted fever.

A new formalin-inactivated vaccine prepared by sucrose density gradient centrifugation of tissue culture-grown Rickettsia rickettsii was evaluated for safety and immunogenicity in a placebo-controlled, double-blind study. Most of the 52 seronegative adult vaccinees, 88% after the first and 66% after the second dose, experienced brief, mild (mostly local) reactions, but only 50% exhibited a systemic immune response to vaccination. Six unvaccinated volunteers (controls) and 16 of these vaccinees were challenged with R rickettsii one month after vaccination. Vaccine efficacy was 25%; all six controls and 12 of 16 vaccinees developed typical Rocky Mountain spotted fever. The incubation period was longer, the duration of constitutional symptoms shorter, and the height of fever lower in ill vaccinees than in controls. The vaccine provided only partial protection against Rocky Mountain spotted fever but ameliorated the illness.

Adolescent↗

Response of traumatized splenectomized patients to immediate vaccination with polyvalent pneumococcal vaccine.

In recent years the syndrome of overwhelming post-splenectomy sepsis has been increasingly reported in adults. Since more than 50% of these infections are caused by pneumococcus these post-splenectomy patients are considered a suitable group to receive the pneumococcal vaccine. Previous studies of the response obtained in post-splenectomy patients have been conflicting and we found no study that looked at the response to immediate vaccination in this group of patients. Sixteen consecutive multitraumatized patients received polyvalent pneumococcal vaccine 0.5 ml IM within 72 hours of splenectomy and 10 normal controls were given 0.5 cc polyvalent pneumococcal vaccine. Patients received an average of 19.2 units of blood and blood products; seven were on steroids for concomitant head injury. Antibody was measured by the radioimmune assay. Most of the subjects of both groups responded to at least seven of the 12 measured antigens and no patient in the control group and only one in the splenectomized group responded to all 12 antigens. When rate of response to individual serotypes was compared no difference was found between the two groups. Comparison of geometric mean fold rise and fold rise between the two groups for each of the 12 serotypes revealed essentially no difference. We conclude the response to polyvalent pneumococcal vaccine among polytrauma splenectomized patients is similar to that of normal controls, and that the vaccine can be administered immediately post-splenectomy.

Abdominal Injuries↗

Immunogenicity of Ty21a attenuated "Salmonella typhi" given with sodium bicarbonate or in enteric-coated capsules.

Ty21a, a stable attenuated mutant of Salmonella typhi, is a safe, protective oral vaccine when 3 doses of 10(9) cells in saline are taken after neutralization of gastric acidity by 1 g NaHCO3. To identify a more convenient method to administer vaccine and to determine the feasibility of immunizing with a single dose, we studied the immune response of children and adults to different formulations of Ty21a with a newly developed, sensitive, enzyme-linked immunosorbent assay (ELISA). In this ELISA, a rise in S. typhi O antibody was defined as a change in net optical density of greater than or equal to 0.15 (more than 3 SD from the mean difference in optical density in a negative control population). Three hundred and thirty-five Chilean children were given 3 doses of 10(9) Ty21a in 150 ml of milk with 0.8 g NaHCO3 or in enteric-coated capsules. In each group, 5% seroconverted by Widal O but 41% by IgG ELISA O antibody titers; mean antibody levels by group were identical. Studies were also carried out in healthy college students in a non-endemic area (U.S.A.) who had no history of prior typhoid immunization. In total, 141 U.S. adults received vaccine formulated in either one of two ways: 1) in gelatin capsules administered with two additional gelatin capsules containing a total of 0.8 gm NaHCO3 or 2) in enteric-coated capsules. Thirty-six persons received one dose, 30 got two doses and 16 ingested three doses of enteric-coated vaccines, while 44 persons receiving one dose and 15 got two doses of vaccine in the gelatin capsule formulation. Rates of seroconversion of ELISA O antibody were similar in all the groups. Ty21a vaccine was not recovered from multiple stool, jejunal fluid or blood cultures of the U.S. vaccine recipients. Based on these observations a large-scale field trial of efficacy has been initiated in 90.000 schoolchildren 6-20 years of age in Santiago, Chile, of whom one-third received one dose of enteric-coated vaccine, one-third got two doses and the remainder received placebo.

Adolescent↗

Management of phenylketonuria: South Australian experience of 13 cases.

The management and present status of 13 children with phenylketonuria detected on the fifth day of life, who have been treated by diet thereafter for five to eight years, are discussed. In all 10 cases in which there has been continuous adequate dietary control of blood phenylalanine levels, the physical, social and mental development of the children has been normal. In some of these cases there is an unexplained discrepancy between the verbal and performance IQ scores. The present policy is to continue restricting the diet indefinitely, relaxation being permitted conditionally only after the age of seven years.

Australia↗

Fitting children with glasses.

1. When fitting children for glasses, the emphasis must always be on ensuring that the glasses not only correct the visual problems but also feel and look good. Otherwise, they will not be worn. 2. There is a great value in creating an atmosphere in an optical shop that makes children want to visit. The process of visiting and selecting glasses should be fun for a child. Children's theme sections or toys are an effective method of making a visit pleasurable for a child. 3. For all the extra features an optical shop may offer, perhaps the most special are the intangibles of patience, respect, and genuine affection.

Child↗