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Biomedical subjects

L J White

Publications and source records attributed to L J White.

64 records · Page 4Linked to original sources
PubMed1975

The release of high-molecular-weight alkaline phosphatase and leucine aminopeptidase into the media of cultured human cells.

Using exclusion from Sepharose 4B as our criterion, we have found a high-molecular-weight form of alkaline phosphatase and of leucine aminopeptidase which are released into the culture media by the FL amnion cell line. A low-molecular-weight form of leucine aminopeptidase is also found to contribute to the total levels of this enzyme in the media. The levels of these enzymes increased during the growth cycle of the culture, paralleling the increase in cell density, suggesting that the two events may be related. This phenomen in culture suggests a possible explanation for the appearance of similar enzyme forms in patient serum and fluids originating from diseased tissue.

Alkaline Phosphatase↗
PubMedDate not supplied

The geriatric obstacle course: a training session designed to help prehospital personnel recognize geriatric stereotypes and misconceptions.

A significant proportion of ambulance transports to the Emergency Department involve elderly patients, and this use of EMS services by the elderly is expected to increase. Emergency medical technicians (EMTs) may have preconceived notions about the behavior they observe in this group of patients, who tend to be difficult to assess. To provide EMTs with the perspective from which their elderly patients view the situations in which they find themselves, we developed and implemented training scenarios in which the EMTs were required to play the role of the geriatric patient. The EMTs' evaluations of the sessions were enthusiastically positive and indicated that the course did enable them to reevaluate their attitudes toward elderly patients. It is our conviction that this type of sensitivity training is an easily implemented and highly valuable method of augmenting the facts and algorithms taught to these prehospital care providers.

Activities of Daily Living↗
PubMedDate not supplied

The structural identifiability and parameter estimation of a multispecies model for the transmission of mastitis in dairy cows with postmilking teat disinfection.

A mathematical model for the transmission of two interacting classes of mastitis causing bacterial pathogens in a herd of dairy cows is presented and applied to a specific data set. The data were derived from a field trial of a specific measure used in the control of these pathogens, where half the individuals were subjected to the control and in the others the treatment was discontinued. The resultant mathematical model (eight non-linear simultaneous ordinary differential equations) therefore incorporates heterogeneity in the host as well as the infectious agent and consequently the effects of control are intrinsic in the model structure. A structural identifiability analysis of the model is presented demonstrating that the scope of the novel method used allows application to high order non-linear systems. The results of a simultaneous estimation of six unknown system parameters are presented. Previous work has only estimated a subset of these either simultaneously or individually. Therefore not only are new estimates provided for the parameters relating to the transmission and control of the classes of pathogens under study, but also information about the relationships between them. We exploit the close link between mathematical modelling, structural identifiability analysis, and parameter estimation to obtain biological insights into the system modelled.

Animals↗
PubMedDate not supplied

Core temperature monitoring of firefighters during hazardous materials training sessions.

OBJECTIVE: To determine core temperature (Tc) elevations in hazardous materials (HazMat) technicians wearing level-A fully encapsulated, chemically resistive suits (FECRSs) during training scenarios. DESIGN: Cross-sectional, observational feasibility study with Institutional Review Board approval. SETTING: HazMat training scenarios held during the summer of 1994. Weather conditions included both rainy and sunny days, with a mean ambient temperature of 75.8 degrees F (24.3 degrees C) (range 69-83 degrees F [20.6-28.3 degrees C). PARTICIPANTS: Nine male firefighters participating in training scenarios in the Midwestern United States. INTERVENTIONS: Each volunteer swallowed a capsule containing a Tc sensor developed by the National Aeronautics and Space Administration. The capsule continuously monitored Tc and stored data in an ambulatory recorder worn under the level-A FECRS during training. RESULTS: Mean age of the volunteers was 34 years, mean weight was 92.6 kg, and average baseline Tc was 36.7 degrees C (97.1 degrees F) (range 35.3-38.2 degrees C [95.5-100 degrees F]). Time in the FECRS averaged 25.4 minutes (range 14-35 minutes). All subjects demonstrated increased Tc while in the suit; the mean Tc increase was 0.8 degree C (1.4 degrees F) (range 0.2-1.3 degrees C [0.4-2.3 degrees F]). The Tc continued to increase during wet decontamination procedures and after suit removal. Mean heat storage values (delta Tcx LBMx 3.47 kJ) were calculated, and found to be moderately elevated to 3.6 kJ/kg (range 2.1-4.6 kJ/kg). CONCLUSION: These observations support the validity and significance of implementing prophylactic measures for firefighters using protective clothing. Simple protective measures include enforced time limitations, hydration, and efforts to minimize heat buildup by avoiding both direct sunlight and unnecessary time encapsulated in the suit.

Adult↗
PubMedDate not supplied

A comparison of complementary and alternative medicine use by gynecology and gynecologic oncology patients.

Our objective was to describe and compare the use of complementary and alternative medicine (CAM) in gynecology and gynecological oncology patients. Five hundred and twenty-nine gynecology and gynecological oncology patients completed a questionnaire regarding CAM use. Overall, 56.3% of gynecology and gynecological oncology patients reported current use of CAM. Therapies used included nutritional supplements (20%), prayer as medical therapy (17%), exercise as medical therapy (12%), megavitamins (10%), and green tea (10%). While 69.5% believed CAM to be beneficial, only 31.6% discussed these therapies with their physician. The women spent a mean of $656.22 on CAM (range $0-$7,000), with 31.7% receiving some insurance reimbursement. Gynecologic oncology patients (n = 161) used CAM significantly more than gynecology patients (n = 368) (66% vs. 52%, 95% CI = 0.046-0.230, P = 0.004). Gynecological oncology patients also spent more for CAM, with a mean expenditure of $711 versus $622 by gynecology patients. Within the gynecological oncology patient group, there were 69 patients currently receiving modern medical treatments for cancer; among these patients, 58% reported using CAM; of these, 39.3% communicated their use of CAM to their physician. Patients in this group spent an average of $1,178 on CAM during their illness, with only 6.3% receiving insurance reimbursement. Benefits from CAM were perceived by 54.5% in this group. We concluded that cancer patients have a higher usage rate and expenditure for CAM, particularly while they are receiving medical therapy, and are more likely to discuss the use of alternative therapies with their physicians. CAM was perceived as helpful by patients despite the lack of scientific data about its effect.

Adult↗
PubMedDate not supplied

Prehospital use of analgesia for suspected extremity fractures.

INTRODUCTION: Pain and its control have been studied extensively in the emergency department. Numerous studies indicate that inadequate treatment of pain is common, despite the availability of myriad analgesics. It has been suggested that oligoanesthesia is also a common practice in the prehospital setting. OBJECTIVE: To assess the use of prehospital analgesia in patients with suspected extremity fracture. METHODS: Emergency medical services (EMS) call reports were reviewed for all patients with suspected extremity fractures treated from June 1997 to July 1998 in a midwestern community with a population base of 223,000. Data collected included demographic information, mechanism of injury, medications given, and field treatment. Standing orders for administration of analgesia were available and permitted paramedics to give either morphine sulfate or nitrous oxide per protocol. RESULTS: The EMS call reports were analyzed for 1,073 patients with suspected extremity fractures. The mean patient age was 47 years. Accidental injuries comprised 86.5% of those reviewed. Suspected leg fractures were most common (20%), followed by hips (18%), arms (11%), knees (10%), ankles (9%), shoulders (7.2%), hands (5.5%), and wrists (5.3%). Multiple trauma and assorted broken digits accounted for the remaining 14%. The most common mechanisms of injury were: fall (43%), motor vehicle collision (21%), and human assault (10%). Intravenous lines were placed in 9.4% of patients; 17% received ice packs; 16% received bandage/dressings; 25% received air splints; and 19% were fully immobilized. Analgesia was administered to 18 patients (1.8%): 16 patients received nitrous oxide and two received morphine. CONCLUSION: Administration of analgesics to prehospital patients with suspected fractures was rare. Prehospital identification and treatment of pain for patients with musculoskeletal trauma could be improved.

Adolescent↗
PubMedDate not supplied

Continuous core temperature monitoring of search and rescue divers during extreme conditions.

OBJECTIVES: To study the feasibility of continuously monitoring core temperatures of search and rescue divers, to compare core temperature gradients occurring during warm and cold diving events, and to identify conditions under which divers are subjected to extreme temperatures. METHODS: Between June 1994 and March 1995, emergency medical technicians (EMTs) from two midwestern dive teams volunteered to ingest an encapsulated temperature sensor developed for the National Aeronautics and Space Administration. The capsule monitored continuous core temperatures and transmitted the data to a recorder worn under the divers' dry suits. RESULTS: Twenty male EMTs, mean age 34 years and mean body weight 184 pounds, were monitored during training. Nine dives were ice dives, with ice thickness averaging 9 inches, and mean ambient temperatures of 33 degrees F. Eleven dives were warm-water dives; average water temperature was 70 degrees F and mean ambient temperature was 74 degrees F. The average time spent in the dry suit was 95 minutes, and the mean total bottom time was 15 minutes. The ice divers showed a mean increase in core temperature of 1.0 degrees C, while the warm-water divers showed a mean increase of 1.2 degrees C. Divers experiencing the most extreme fluctuations were those in the role of safety diver, regardless of the season. Divers reported more subjective discomfort during ice dives than during warm-water dives. CONCLUSIONS: Continuous monitoring of body temperature during the duration of dive operations is possible, but labor-intensive. Safety measures to protect divers from extreme core temperature fluctuations should focus on the safety diver as well as the active diver.

Adult↗
PubMedDate not supplied

National EMS Research Agenda.

Now, more than ever before, the spirit of the emergency services professional is recognized by people everywhere. Individuals from every walk of life comprehend the reality of the job these professionals do each day. Placing the safety of others above their own is their acknowledged responsibility. Rescue and treatment of ill and injured patients are their purpose as well as their gratification. The men and women who provide prehospital care are well aware of the unpredictable nature of emergency medical services (EMS). Prehospital care is given when and where it is needed: in urban settings with vertical challenges and gridlock; in rural settings with limited access; in confined spaces; within entrapments; or simply in the street, exposed to the elements. Despite the challenges, EMS professionals rise to the occasion to do their best with the resources available. Despite more than 30 years of dedicated service by thousands of EMS professionals, academic researchers, and public policy makers, the nation's EMS system is treating victims of illness and injury with little or no evidence that the care they provide is optimal. A national investment in the EMS research infrastructure is necessary to overcome obstacles currently impeding the accumulation of essential evidence of the effectiveness of EMS practice. Funding is required to train new researchers and to help them establish their careers. Financial backing is needed to support the development of effective prehospital treatments for the diseases that drive the design of the EMS system, including injury and sudden cardiac arrest. Innovative strategies to make EMS research easier to accomplish in emergency situations must be implemented. Researchers must have access to patient outcome information in order to evaluate and improve prehospital care. New biomedical and technical advances must be evaluated using scientific methodology. Research is the key to maintaining focus on improving the overall health of the community in a competitive and cost-conscious health care market. Most importantly, research is essential to ensure that the best possible patient care is provided in the prehospital setting. The bravery and dedication of EMS professionals cannot be underestimated. Images of firefighters, EMS personnel, and others going into danger while others are evacuating will remain burned in our collective consciousness. These professionals deserve the benefit of research to assist them in providing the best possible care in the challenging circumstances they encounter. With this document, we are seeking support for elevating the science of EMS and prehospital care to the next level. It is essential that we examine innovative ways to deliver prehospital care. Strategies to protect the safety of both the patient and the public safety worker must be devised and tested. There are many questions that remain to be asked, many practices to be evaluated, and many procedures to be improved. Research is the key to obtaining the answers.

Emergency Medical Services↗