Anisomycin. II. Biosynthesis of anisomycin.
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Anti-Bacterial Agents↗
Biomedical subjects
K Butler
Publications and source records attributed to K Butler.
A supportive-expressive group intervention for women with a family history of breast cancer: results of a phase II study.
BACKGROUND: Evidence suggests that there are significant psychological and behavioural sequelae associated with having a family history of breast cancer (BC) which can interfere with comprehension of risk estimates. PURPOSE: The purpose of this study was to develop, standardize and do preliminary testing of a group intervention designed to address the emotional impact of having a family history of BC. METHODS: This study is a single-arm pilot design with pre- and post-measures of perceived risk, psychosocial distress, knowledge and screening practices. RESULTS: The primary study outcome measure of risk comprehension was significantly improved by 70%, according to our predetermined criteria for success. In addition, the most important secondary measures of psychosocial functioning, such as cancer-related distress (p=0.025), depression (p=0.05), anxiety (p=0.005) and unresolved grief (p=0.034) were significantly improved. CONCLUSION: The results of this initial pilot study are encouraging; however, further research is required, using a randomized controlled study design to evaluate the relative contribution of this intervention to the successful modification of risk comprehension, enhanced psychological functioning, and to promote optimal screening adherence.
Adaptation, Psychological↗
Rotavirus infection in hospitalised children: incidence and impact on healthcare resources.
BACKGROUND AND AIMS: In anticipation of vaccine development this study sought to determine the incidence, disease burden and associated financial burden of rotavirus (RV) infection, in hospitalised children. METHODS: Prospective observational study in two Dublin paediatric centres. RESULTS: Of 663 confirmed infections, 485 (73%) patients were hospitalised with community acquired (CA) RV; 178 (27%) cases were hospital acquired (HA) RV. A total of 243 (50%) children were < 12 months of age, with peak incidence in the 6 to < 12 month age group. CA RV resulted in utilisation of 2,305 bed days, with a median bed stay of three days (range 1-91), representing a minimum cost of Euro176,637 per year to the hospitals. When nosocomial spread and secondary cases are included, this increases to Euro258,695 per year. CONCLUSION: CA RV infection accounted for 1% of all admissions during the study period at a minimum cost of Euro728.40 per case. A safe and effective vaccine could reduce morbidity and advantage children by allowing redeployment of healthcare resources to other critical areas.
Child↗
Empiric therapy with amphotericin B in febrile granulocytopenic patients.
The early diagnosis of invasive fungal infection in granulocytopenic patients remains unreliable. Granulocytopenic patients who are persistently or recurrently febrile despite therapy with appropriate antibacterial agents are at high risk for the development of such infection. Two randomized clinical trials demonstrated that the empiric administration of amphotericin B to persistently or recurrently febrile granulocytopenic patients decreased the frequency, morbidity, and mortality of invasive fungal infection; these effects were especially marked in profoundly granulocytopenic patients who were not receiving antifungal prophylaxis. Current studies continue to indicate that prompt empiric administration of amphotericin B to persistently or recurrently febrile granulocytopenic patients ensures earlier treatment of deep mycoses. The roles of newer antifungal triazole compounds and of liposomal and lipid complexes of amphotericin B in empiric antifungal therapy must be investigated further in thoughtfully designed, randomized clinical trials.
Agranulocytosis↗
In vitro and in vivo performance evaluation of a totally implantable electrohydraulic left ventricular assist system.
The biolized electrohydraulic left ventricle assist devices were tested in 14 calves with an average survival time of 162 days and as long as 250 days without the use of anticoagulants. In vitro, the system pumped 4.1 L/min at a low 4.8 mmHg fill pressure with a mean afterload of 100 mmHg and rate of 46 bpm. A flow rate of 13.5 L/min was observed at 155 bpm and 110 mmHg afterload. Motor frequency and current increased with increasing flow rate (162 Hz, 0.67 amp at 2.5 L/min; 484 Hz, 2.43 amp at 13.5 L/min). Flow rate did not change significantly with afterload pressure. The complete system was implanted in a 100 kg calf. Synchronization of the blood pump with the natural heart was demonstrated at heart rates of 85 to 167 bpm. The synchronized flow rate varied from 6 to 10.5 L/min despite the considerable heart rate changes and stroke variations. The system hemodynamic performances were acceptable and met NIH requirements.
Animals↗
Long-term mechanical circulatory support system reliability recommendation: American Society for Artificial Internal Organs and Society of Thoracic Surgeons: long-term mechanical circulatory support system reliability recommendation.
Jointly developed by members of the American Society for Artificial Internal Organs and the Society of Thoracic Surgeons along with staff from the Food and Drug Administration, the National Heart, Lung and Blood Institute and other experts, this recommendation describes the reliability considerations and goals for Investigational Device Exemption and Premarket Approval submissions for long-term, mechanical circulatory support systems. The recommendation includes a definition of system failure, a discussion of an appropriate reliability model, a suggested in vitro reliability test plan, reliability considerations for animal implantation tests, in vitro and animal in vivo performance goals, the qualification of design changes during the Investigational Device Exemption clinical trial, the development of a Failure Modes Effects and Criticality Analysis, and the reliability information for surgeons and patient candidates. The document will be periodically reviewed to assess its timeliness and appropriateness within five years.
Clinical Trials as Topic↗
Nurse-aid management of ear and nose emergencies: 1.
Ear, nose and throat emergencies cause a great deal of discomfort and distress and in certain cases may compromise safety. They therefore demand skilful intervention on the part of the nurse aider. In this article, the first of a two-part series, the nurse-aid management of ear problems will be described. The next article in the series will concentrate on the nose.
Ear↗
Nurse-aid management of ear and nose emergencies: 2.
There are many disorders that affect the nose and interfere with its normal functioning. This article, the second in a two-part series, examines the common disorders and outlines the nurse-aid management.
Emergency Nursing↗
Nurse-aid management of children. 1: Accidents.
The three main ways in which the safety of children may be compromised are accidents, breathing difficulties and collapse. This article, the first in a two-part series, will describe the nurse-aid management of children following accidents.
Accidents↗
Nurse-aid management of children. 2: Breathing difficulties and collapse.
The first article in this series described the nurse-aid management of children following accidents. This article will discuss the nurse-aid management of children with breathing difficulties and those who have collapsed.
Airway Obstruction↗
Study of educational deficits as the cause of hospital admission for diabetes mellitus in a community hospital.
Seventy-eight consecutive patients admitted to a community hospital for diabetic complications over a 1-yr period were interviewed in regard to circumstances resulting in their hospitalization. Based on this interview, patients were categorized as to the cause for admission into three groups: (1) educational deficits; (2) psycho-socio-economic deficits; and (3) unavoidable hospital admission. Twenty-seven percent of the patients had a specific educational deficit which was judged to be responsible for their hospitalization; an additional 20% of patients had combined education and psycho-socio-economic deficits accounting for their admission.
Diabetes Complications↗
Genetic conditions in the Irish Roma gypsy population.
Roma gypsy represent a new Irish ethnic minority population with a distinct cultural and racial heritage. There is a strong Roma tradition of consanguinity, which can increase the likelihood of having a child affected by an autosomal recessive disorder. We describe 6 patients from the Roma community who had presented with 4 different autosomal recessive conditions not previously seen in the Irish population, Chronic Granulomatous Disease, HMSN-Russe, and two multiple malformation syndromes.
Child↗
Transmission, diagnosis, and treatment of HIV infection in children.
AIDS is one of the leading causes of death in children. Although children of all ethnic groups are affected, there is an overrepresentation of cases among minority children. Most cases of pediatric HIV infection are acquired by vertical transmission of infection from mother to infant. Factors that appear to increase the risk of vertical transmission include an advanced stage of maternal disease and absence of maternal gp120 antibody. Progression of the disease is more rapid in vertically infected children than in adults. In children older than 15 months of age, as in adults, diagnosis of infection is usually made when HIV antibody is detected in the serum. In children younger than 15 months, this is not reliable because the presence of maternal antibody can result in a positive antibody test. While pharmacotherapy for pediatric AIDS patients is similar to that for adults, care must be taken when considering dosage and route of administration.
Acquired Immunodeficiency Syndrome↗
Stat! How would you manage this patient? Accidental injury?
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Child Abuse↗
Group B streptococcus (GBS) colonisation among expectant Irish mothers.
Group B streptococci (GBS) have been recognised for more than three decades as a serious cause of perinatal morbidity and neonatal mortality. The aim of this study was to accurately determine the prevalence of GBS carriage and the serotype distribution among pregnant Irish women. 504 women attending antenatal clinics had two swabs (one perianal and one low vaginal) taken in the last four weeks of their pregnancy. These were placed in Todd Hewitt broth and then subcultured onto solid media. Serotyping of the isolates was performed by the Central Public Health Laboratory, London. GBS colonised women were treated with prophylactic antibiotics in labour and their infants received prophylaxis for 48 hours. 129 women (25.6%) were found to be asymptomatically colonised with GBS. Dual site screening (low-vaginal and perianal) identified 5% more GBS carriers than one site would have done. Serotypes identified included types I (30%), II (17%), III (30%), IV (1%) and V (9%). GBS colonisation is very common in Irish pregnant women and therefore a strategy for management in pregnancy ought to be developed in order to reduce the recognised occurrence of neonatal morbidity and mortality caused by this organism.
Adolescent↗