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Biomedical subjects

J S Harris

Publications and source records attributed to J S Harris.

At least 73 records · Page 4Linked to original sources
PubMed1977

A new mutation affecting ribosomal RNA synthesis in Escherichia coli.

A temperature-sensitive mutant of Escherichia coli is described. At the nonpermissive temperature there is a 12-fold reduction in the rate of rRNA synthesis, while tRNA and mRNA syntheses are affected to only a slight extent. Both protein and DNA syntheses also continue at nearly the normal rate. The mutation appears to affect the synthesis of 16S and 23S rRNA equally and has no detectable affect on rRNA maturation. The temperature-sensitive lesion appears to be caused by a single point mutation lying between minutes 21 and 27. It is suggested that this mutation seems to define a new genetic locus involved in the regulation of rRNA synthesis.

Edetic Acid↗
PubMedDate not supplied

Guidelines for the management of intravascular catheter-related infections.

These guidelines from the Infectious Diseases Society of America (IDSA), the American College of Critical Care Medicine (for the Society of Critical Care Medicine), and the Society for Healthcare Epidemiology of America contain recommendations for the management of adults and children with, and diagnosis of infections related to, peripheral and nontunneled central venous catheters (CVCs), pulmonary artery catheters, tunneled central catheters, and implantable devices. The guidelines, written for clinicians, contain IDSA evidence-based recommendations for assessment of the quality and strength of the data. Recommendations are presented according to the type of catheter, the infecting organism, and the associated complications. Intravascular catheter-related infections are a major cause of morbidity and mortality in the United States. Coagulase-negative staphylococci, Staphylococcus aureus, aerobic gram-negative bacilli, and Candida albicans most commonly cause catheter-related bloodstream infection. Management of catheter-related infection varies according to the type of catheter involved. After appropriate cultures of blood and catheter samples are done, empirical i.v. antimicrobial therapy should be initiated on the basis of clinical clues, the severity of the patient's acute illness, underlying disease, and the potential pathogen(s) involved. In most cases of nontunneled CVC-related bacteremia and fungemia, the CVC should be removed. For management of bacteremia and fungemia from a tunneled catheter or implantable device, such as a port, the decision to remove the catheter or device should be based on the severity of the patient's illness, documentation that the vascular-access device is infected, assessment of the specific pathogen involved, and presence of complications, such as endocarditis, septic thrombosis, tunnel infection, or metastatic seeding. When a catheter-related infection is documented and a specific pathogen is identified, systemic antimicrobial therapy should be narrowed and consideration given for antibiotic lock therapy, if the CVC or implantable device is not removed. These guidelines address the issues related to the management of catheter-related bacteremia and associated complications. Separate guidelines will address specific issues related to the prevention of catheter-related infections. Performance indicators for the management of catheter-related infection are included at the end of the document. Because the pathogenesis of catheter-related infections is complicated, the virulence of the pathogens is variable, and the host factors have not been well defined, there is a notable absence of compelling clinical data to make firm recommendations for an individual patient. Therefore, the recommendations in these guidelines are intended to support, and not replace, good clinical judgment. Also, a section on selected, unresolved clinical issues that require further study and research has been included. There is an urgent need for large, well-designed clinical studies to delineate management strategies more effectively, which will improve clinical outcomes and save precious health care resources.

Anti-Infective Agents↗
PubMedDate not supplied

Managed occupational health.

This chapter explores the elements and techniques of managed care, managed health, and good management in general to identify key success factors in programs addressing prevention, care, disability, and rehabilitation.

Female↗
PubMedDate not supplied

Occupational medicine practice guidelines.

Practice guidelines have become accepted "rules of the road" for many illnesses and injuries. Guidelines can be the basis for performance measures if they include a development step summarizing the available evidence for efficiency and effectiveness of maneuvers, tests, and treatments. They are particularly valuable for entities that have high degrees of variance in diagnostic accuracy, testing, and treatment. Periodic revision of guidelines can keep professional knowledge bases up to date. One must keep in mind that guidelines are just that--descriptions of normative data, observed best practices, expert consensus, or high-grade evidence. While they provide benchmarks for assessment and improvement, there may be good reasons why they do not apply to some patients. However, the exercise of justifying the differences can sharpen clinical judgment and improve outcomes.

Disability Evaluation↗