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Biomedical subjects

K McGee

Publications and source records attributed to K McGee.

31 records · Page 2Linked to original sources

[Prehospital thrombolysis in the acute phase of myocardial infarction. Apropos of cases handled by the mobile intensive care unit,Argenteuil (Val-d'Oise) from 1988 to 1991].

We have studied prehospital thrombolytic therapy in acute myocardial infarction administered by the mobile intensive care unit of the Argenteuil hospital (Val d'Oise), between 1988 and 1991, after having detailed the protocol used. Our results confirm the effectiveness of thrombolysis, showing a rapid improvement of pain and ST segment in 50% of cases. There is a significant saving of time between pain and thrombolysis when the treatment is started during the prehospital phase. At present, in accordance with Isis 3 study results, Streptokinase is the drug of choice with rtPA being reserved for cases with contraindications for Streptokinase.

Adult↗

Post-herniorrhaphy urinary retention: a randomized prospective study.

Urinary retention is a known complication of inguinal herniorrhaphy. Bladder distension due to vigorous fluid administration is believed to contribute to this problem. Our hypothesis is that fluid restriction will lower the incidence of urinary retention, post-herniorrhaphy. From January 1989 through March 1991, 113 male patients entered the study. Sixty patients (Group I) received unlimited iv fluids (1294 +/- 58 ml) and 9 patients (15%) developed urinary retention. Fifty-three patients (Group II) received 500 ml or less by protocol (485 +/- 2 ml) and 5 of these patients developed retention (9%). Thus, fluid restriction lowered the incidence of urinary retention post-herniorrhaphy but the difference did not reach statistical significance. In addition age over 60 years approached significance as a risk factor for postoperative urinary retention.

Aged↗

Antigenic cross-reactions among immunoglobulin of diverse vertebrates (elasmobranchs to man) detected using xenoantisera.

1. Antisera raised in rabbits and goats against intact immunoglobulins or their constituent light and heavy chains from man, mouse and the galapagos shark (Carcharhinus galapagenesis) were tested for their reactivity with immunoglobulins of elasmobranchs, other lower vertebrates and eutherian and prototherian mammals. 2. Xenoantisera directed against human heavy chain isotypes allowed the serological identification of IgM and IgG immunoglobulins in the echidna (Tachyglossus aculeatus), a monotreme which is one of the most primitive species of extant mammals. 3. The antisera to heavy chains reacted to varying degrees with purified immunoglobulins of non-mammalian species, including the chicken, teleost fish and elasmobranchs in a fashion that was specific for immunoglobulins, but was not related to defined human isotypic markers. 4. The reactions of some antisera seem to skip species known to possess homologous immunoglobulins. 5. Antisera directed against isotypic markers of human kappa and lambda light chains reacted with shark light chains in a manner that was specific for light chain determinants but was not isotype-related. 6. Antisera directed against heavy chains of either sharks or mammals reacted with heavy chains, but not with light chains of diverse species. 7. A rabbit antiserum specific for shark light chain reacted with human and murine monoclonal lambda chains and with two synthetic peptides corresponding to human V lambda Fr3 and Fr4 sequences. 8. These results establish that a variety of antigenic markers including conformational and linear determinants can be shared among immunoglobulins of vertebrates species that had an ancestral divergence more than 400 million years ago.

Amino Acid Sequence↗

Hemodynamic and catecholamine response to isoflurane versus droperidol in complement to fentanyl anaesthesia.

Droperidol (0.03 mg.kg-1 to 0.25 mg.kg-1) with fentanyl has been reported to be less efficient than volatile agents in the prevention of haemodynamic responses to surgery. The aim of this study was to investigate the use of high-dose droperidol in complement to fentanyl in comparison with isoflurane and fentanyl anaesthesia. Thirty patients undergoing laryngectomy were studied. Systolic blood pressure (SBP), heart rate (HR) and plasma catecholamines were analysed both during anaesthesia and during recovery. During surgery, SBP epinephrine (E) levels did not change in either group. HR was slightly lower during droperidol fentanyl anaesthesia. Norepinephrine (NE) levels were significantly higher in the droperidol group than in the isoflurane group (P less than 0.05). During recovery, in both groups, SBP increased by 20% whereas E levels increased by 65%. NE levels increased post-operatively in both groups, but this rise was significantly higher in the droperidol group (P less than 0.01). It is concluded that the two techniques contribute to the haemodynamic stability during surgery, but do not prevent haemodynamic instability during recovery.

Anesthesia, General↗

Carbon dioxide monitoring during high frequency jet ventilation for direct laryngoscopy.

To improve ventilation monitoring during direct laryngoscopy, we have developed a high frequency jet ventilator which allows the aspiration of tracheal gas for carbon dioxide analysis (PtCO2) through the injector after stopping the ventilator. In 41 patients undergoing direct laryngoscopy, PaCO2 and PtCO2 were measured simultaneously during high frequency jet ventilation under general anaesthesia. PtCO2 and PaCO2 correlated significantly (r = 0.88), but PtCO2 underestimated PaCO2 by 0.84 (SD 0.72) kPa. The arterial to tracheal PCO2 difference was influenced by airway obstruction.

Anesthesia, General↗

Failure to find Ca2(+)-dependent proteinase (calpain) activity in a plant species, Elodea densa.

Five and nine-tenth kg of Elodea densa (Anacharis), a common aquarium plant, was extracted, and the extract was subjected to column chromatographic procedures that successfully purify the two Ca2(+)-dependent proteinases (calpains) and their protein inhibitor (calpastatin) from a variety of animal tissues. Although these procedures purified a protein having 55- and 16-kDa polypeptides, neither this protein nor any of the other chromatographic fractions contained detectable proteinase or calpastatin activity. Moreover, the purified 55- and 16-kDa polypeptides did not react on immunoblots with polyclonal antibodies that were monospecific for the calpains or calpastatin. We conclude that Elodea densa contains no calpain nor calpastatin at the level of 4 micrograms per g plant protein (1 part per 250,000), which was the sensitivity of our assay.

Actins↗

[Caudal anesthesia in children: two-year retrospective study].

Caudal anesthesia has been used on a daily basis for two years in the Department of Anesthesia of Saint-Vincent-de-Paul Hospital. A retrospective study on 231 children was done to specify the procedures, the indication and the dosage of local anesthetics.

Anesthesia, Caudal↗

COAD (clinical outcome assessment documentation) charting: using the quality improvement process to meet the new JCAHO nursing standards.

The shortage of nurses has prompted departments across the nation to examine nursing practices in individual healthcare facilities and to initiate changes where relevant. Saint Thomas Hospital, a 571-bed tertiary-care facility, developed a number of strategies designed to allow nurses to focus on skills consistent with professional practice and to reassign technical and clerical duties to other members of the healthcare team. One of the changes implemented was the clinical outcome assessment documentation (COAD) system, which communicates the plan of care without the use of a separate form, expedites charting times, and eliminates duplication. This system also facilitates the documentation of the patient's progress toward outcome-oriented goals. Evaluation of the COAD system after implementation showed improvement in documentation of the nursing process, staff satisfaction with the system, and compliance with the Joint Commission's 1991 nursing standards.

Hospital Bed Capacity, 500 and over↗

A faculty on the move into the community.

Faculty at the University of Rochester School of Nursing initiated a curricular redesign to prepare students for the evolving demands of the health care job market and the changing nature of the nursing profession. The concept of the "Learning Community" serves as the metaphor for the new vision of clinical education: a set of collaborative and dynamic relationships of students, faculty, clinicians, health care consumers and institutional and community sites with the mutual responsibility for the education of students and the health of all partners. Students experience firsthand the new capabilities required of professionals in the new context of health care as more than illness care.

Clinical Competence↗