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Biomedical subjects

J Smith

Publications and source records attributed to J Smith.

At least 1,585 records · Page 88Linked to original sources
PubMedDate not supplied

Development of clinical guidelines for the sedation of children.

Young children may be unwilling or unable to cooperate if they are required to remain motionless for a prolonged period of time. In the hospitalized child, investigative procedures perceived as painful or threatening may need the administration of a sedative. Clinical guidelines, within a large teaching hospital NHS trust in the North of England, were implemented in an attempt to reduce the diversity of the practices of healthcare professionals caring for the child requiring sedation. The guidelines were formulated by a multidisciplinary team and, in conjunction with active dissemination strategies, resulted in a change in practice that included: (1) improved communication and cooperation between departments, (2) implementation of starvation times before the administration of a sedative, and (3) the appropriate referrals to a senior paediatrician to seek advice if contraindications to sedation were identified. Audit was integral to the process, facilitating the comparison of actual practice with the standards developed from the guidelines and ensuring a continuous monitoring programme.

Clinical Protocols↗
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Chimeric restriction enzymes: what is next?

Chimeric restriction enzymes are a novel class of engineered nucleases in which the non-specific DNA cleavage domain of Fokl (a type IIS restriction endonuclease) is fused to other DNA-binding motifs. The latter include the three common eukaryotic DNA-binding motifs, namely the helix-turn-helix motif, the zinc finger motif and the basic helix-loop-helix protein containing a leucine zipper motif. Such chimeric nucleases have been shown to make specific cuts in vitro very close to the expected recognition sequences. The most important chimeric nucleases are those based on zinc finger DNA-binding proteins because of their modular structure. Recently, one such chimeric nuclease, Zif-QQR-F(N) was shown to find and cleave its target in vivo. This was tested by microinjection of DNA substrates and the enzyme into frog oocytes (Carroll et al., 1999). The injected enzyme made site-specific double-strand breaks in the targets even after assembly of the DNA into chromatin. In addition, this cleavage activated the target molecules for efficient homologous recombination. Since the recognition specificity of zinc fingers can be manipulated experimentally, chimeric nucleases could be engineered so as to target a specific site within a genome. The availability of such engineered chimeric restriction enzymes should make it feasible to do genome engineering, also commonly referred to as gene therapy.

DNA Restriction Enzymes↗
PubMedDate not supplied

Chimeric restriction enzyme: Gal4 fusion to FokI cleavage domain.

Gal4, a yeast protein, activates transcription of genes required for metabolism of galactose and melibiose. It binds as a dimer to a consensus palindromic 17-base pair DNA sequence. It is a member of the third family of proteins that contain zinc-mediated peptide loops that interact specifically with nucleic acids. Gal4 has a very distinctive zinc coordination profile and mode of DNA-binding. Here, we report the creation of a novel site-specific endonuclease by linking the N-terminal 147 amino acids of Gal4 to the cleavage domain of FokI endonuclease. The fusion protein is active and under optimal conditions, binds to a 17 bp consensus DNA site and cleaves near this site. As expected, the cleavage occurs on either side of the consensus binding site(s).

Base Sequence↗
PubMedDate not supplied

Viral and chemical tracer movement through contrasting soils.

Land treatment of animal or human waste can result in chemical and microbial contamination of shallow ground water and/or water-ways. We investigated the fate of a host-specific Salmonella bacteriophage and a nonreactive chemical (Br-) tracer when applied to large intact lysimeter soil cores (500 mm diam. by 700 mm high). The soils included a poorly drained Gley Soil and well-drained Pumice, Allophanic, and Recent Soils. A depth of 30 mm of water containing the bacteriophage and Br- was applied to the soil at a rate of 5 mm h(-1) followed by up to about 1.8 pore volumes of simulated rainfall. Resulting leachates, collected continuously over at least one pore volume were analyzed for the bacteriophage and bromide (Br-) tracers. Bromide moved uniformly through the Pumice and Allophanic Soils with peak concentrations at about 1 pore volume, while the bacteriophage was detected only at trace levels or not at all. In contrast, both Br- and bacteriophage tracers moved rapidly through Gley and Recent Soils, appearing early in the leachate and then tailing off. Such flow patterns in the Gley and Recent Soils are indicative of bypass flow. Coarse soil structure in the Gley Soil, and finger-flow due to water repellency in the sandy Recent Soil are considered responsible for the observed bypass flow in these two soils. Allophanic and Pumice Soils have finer, more porous soil structure leading to a predominance of matrix flow over bypass flow. This study suggests vertical movement of viruses varies significantly with soil type.

Animals↗
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Topical tobramycin and gentamicin sulfate in the treatment of ocular infections: multicenter study.

Tobramycin is an aminoglycoside antibiotic newly marketed for topical ophthalmic use. In a double-masked, multicenter study, tobramycin and gentamicin sulfate, the latter an established topical aminoglycoside, were evaluated in the treatment of patients with bacterial infections of the external eye. Efficacy was determined by resolution of signs and symptoms and the follow-up impression made by the physician. A quantitative, bacterial assay of the conjunctiva and skin-lash margin before and after treatment was used to determine the antimicrobial effectiveness of the two antibiotics. The results of the study, involving 511 patients, indicate that tobramycin is significantly more effective than gentamicin sulfate clinically, and the former exhibits a greater antibacterial efficacy, in the eye, against the combined conjunctival pathogens. On the conjunctiva, Staphylococcus aureus is significantly more susceptible to tobramycin than gentamicin sulfate. Although the solutions are equally safe, tobramycin ointment is associated with a significantly lower frequency of adverse reactions than gentamicin sulfate ointment. This may be due to the preservative used in gentamicin ophthalmic ointment, methyl and propyl paraben.

Anti-Bacterial Agents↗
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Automated lamellar keratomileusis in situ for myopia.

BACKGROUND: Keratomileusis in situ, particularly automated lamellar keratoplasty, is a commonly performed technique of keratomileusis in the United States. METHODS: A single center consecutive series of 152 eyes undergoing keratomileusis in situ for myopia was analyzed. Spherical equivalent refractions were compared before and after surgery. The standard nomogram supplied with the automatic corneal shaper (Chiron Vision Corp, Irvine, Calif) was used. The mean of preoperative myopia treated was -9.30 +/- 3.10 diopters (D) (range, -5.12 to -22.75 D). RESULTS: Of the 144 eyes with 1 month follow up, 30 (21%) were within 0.50 D of the planned correction at 1 month, 54 (38%) were within 1.00 D, and 97 (67%) were within 2.00 D. At 6 or more months follow up, 51 of 68 eyes (75%) achieved uncorrected visual acuity of 20/40 or better and 13 of 68 (19%) 20/20 or better when eyes with macular degeneration and amblyopia were removed. Forty-six of 78 eyes (59%) with 6 months or greater follow up required retreatment procedures to correct residual myopia or astigmatism. Multiple regression analysis explained 40% of the variation between attempted correction and postoperative results. An overall 5% shift of refraction in the myopic direction occurred between 1 and 6 months. Of the 110 eyes with both 1- and 3-month examinations, the spherical equivalent refraction changed between these time intervals by 1.00 D or more in 54 (49%) eyes; and 11 (31%) eyes changed by 1.00 D or more between the 3- and 6-month examinations. Although 6% of eyes lost 2 or more lines of spectacle-corrected visual acuity, 11% gained 2 or more lines. CONCLUSION: Myopic keratomileusis in situ using the automated lamellar keratoplasty technique appears to be a safe and most effective procedure to reduce moderate to high myopia. However, the predictability of the procedure needs improvement.

Adolescent↗
PubMedDate not supplied

Breast cancer screening in older African-American women: qualitative research findings.

PURPOSE: The purpose of this study was to gain a better understanding of the cultural meanings that shape the breast cancer screening behavior of older African-American women. DESIGN: Qualitative research methods elicited social and cultural themes related to breast cancer screening. SETTING: Focus group interviews were conducted in the natural settings (churches, etc.) of older African-American women. SUBJECTS: Interviews were conducted with 132 members from 14 social networks of older African-American women. MEASURES: A focus group guide asked about 1) perceived risk of breast cancer, 2) behavioral intentions about breast cancer screening, 3) health seeking behavior, and 4) social support. RESULTS: For older African-American women: other health concerns are of more concern than breast cancer; age is generally not recognized as a risk factor for breast cancer; fear of finding breast cancer and its social consequences are salient barriers to mammography; they tend to rely on breast self-exam rather than mammography to detect a breast problem; cost may be more an issue of competing priorities than cost per se; the tradition is to go to doctors for a problem, not prevention; and women in their own social networks are important sources of social support for health concerns. CONCLUSIONS: These data offer explanations for mammography screening in older African-American women and emphasize the strength of naturally existing sources of social support for designing interventions to increase breast cancer screening.

Black or African American↗
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Crossing the divide.

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Faculty, Nursing↗
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Streamlining pre-operative assessment in orthopaedics.

The author was appointed to create a 'pre-admission clerking system' in an orthopaedic department. The management objective was to reduce the numbers of patients whose surgery was cancelled. In this article the author describes the holistic assessment which has resulted in fewer operations being cancelled and reduced length of stay.

Humans↗
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Pulmonary rehab.

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Breathing Exercises↗
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Comparisons of venous and diabetic plantar ulcer shape and area.

That diabetic plantar ulcers are "round-like" and venous ulcers are "irregularly" shaped is well known. However, these notions have not been quantified or substantiated systematically. In this retrospective analysis, geometric parameters--including area (A), perimeter (p), and shape factor (SF)--of 255 venous and 305 plantar ulcers have been determined using length (L) and width (W) in specific calculation models; these calculations then were compared with computer planimetry. Length was the maximum dimension and width was the maximum dimension perpendicular to length. Results show that venous ulcers, when compared with plantar ulcers, have significantly smaller shape factors and smaller W/L ratios. An optimized calculation model (A = KoLW) then was used, in which Ko was adjusted to minimize root-mean-square (rms) error among venous and plantar ulcers. Values of Ko differed for venous (Ko = 0.67) and plantar (Ko = 0.73) ulcers, with no significant overall paired-differences in actual vs. calculated area. Overall, these models correctly identified 91.8% of venous and 95.1% of plantar ulcer areas within 20% of actual areas. If venous ulcer SF was > 0.35, 3% of the ulcers exceeded the 20% error limit; if SF was < or = 0.35, then 56% exceeded the 20% error. If plantar ulcer SF was > 0.65, no ulcers exceeded the 20% error limit; if SF was < or = 0.65, 15% did. These findings provide quantitative data of absolute and comparative ulcer shapes and clarify the impact of shape on area assessment accuracy when estimated by simple length by width measures.

Anthropometry↗