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Biomedical subjects

L McDonald

Publications and source records attributed to L McDonald.

At least 19 recordsLinked to original sources
PubMed1995

Grief support in accident and emergency nursing: a literature review 1985-1993.

On completing a wide ranging review of literature related to Accident and Emergency (A & E) nursing, the authors chose to focus upon grief support. The literature ranges from personal experiences to large scale research. A table of studies is included to clarify major research findings in this area. The article concludes by recommending long term support for bereaved relatives and research to demonstrate the value of support for relatives in the community.

Emergency Nursing↗
PubMed1995

Emotional availability in infants' relationships with multiple caregivers.

Emotional availability was rated in infants' relationships with significant caregivers over a nine-month period. Infant responsivity to and involvement of caregivers was found to be related to individual sensitivity, while each relationship appeared to be unique, and not based on the nature of the infants' relationships with their mothers.

Caregivers↗
PubMed1995

Calciphylaxis.

Explore the source record for details and available documents.

Aged↗
PubMed1992

Organization and early results of a shared antenatal care programme.

The organization and function of a public hospital based shared antenatal care programme is described. The programme has proved to be popular with pregnant women and local practitioners and currently 24% of public antenatal patients attending the hospital are cared for in this way. The study presents the results of management of 1,000 consecutive low risk patients whose antenatal care was shared between hospital doctors at the Royal Women's Hospital, Melbourne and local practitioners. Two hundred and twenty patients did not complete the programme because of social factors, medical diseases or pregnancy complications. The 780 patients who did complete the programme had a lower Caesarean section rate than the overall hospital population (8.3% compared with 18.5%) and a lower perinatal mortality rate (6.4 compared with 20.5 per 1,000 births). It is essential that patients are carefully assessed at their hospital booking visit before embarking on such a programme. Equally, careful assessment by local practitioners is important as abnormalities such as essential hypertension may be overlooked at the initial hospital assessment or may arise between the hospital visits.

Community Health Services↗
PubMed1991

Role of gastric colonization in the development of pneumonia in critically ill trauma patients: results of a prospective randomized trial.

Critically ill trauma patients were entered in a prospective, randomized trial to determine the role of gastric colonization in the development of pneumonia. Trauma patients admitted to the SICU were randomized to receive antacids (n = 27), continuous IV cimetidine (n = 32), or sucralfate (n = 30). Quantitative nasogastric tube (NGT) cultures were obtained biweekly and correlated with gastric pH, the incidence of pneumonia, and the incidence of pneumonia caused by an organism previously isolated from the stomach (percentage of gastric source of pneumonia--% GSP). Patients receiving antacids had a significantly greater pH than those receiving cimetidine (5.6 +/- 1.03 vs. 4.7 +/- 1.03; p = 0.006). However, there was no significant difference between the overall incidence of pneumonia, the percentage of NGT isolates greater than 10(6)/ml, or the % GSP. The gastric bacteriology of the three subgroups was nearly identical, with Candida albicans, Enterococci, and beta-hemolytic Streptococci being the most frequently isolated organisms. Gastric growth of organisms preceding their appearance in the blood occurred in 5 of 89 (5.6%) patients. These results suggest that 1) in trauma patients, the incidence of pneumonia is not increased by the use of stress ulcer prophylactic agents that elevate gastric pH; 2) increases in gastric pH progressively increased the number of intragastric bacteria but this did not correlate with an increased incidence of % GSP; and 3) while organisms in the upper intestinal tract may be pathogens for pneumonia, they are uncommonly a source of bacteremia in seriously injured patients.

Adolescent↗
PubMed1988

Phase I clinical and pharmacokinetic study of mitoxantrone given to patients by intraperitoneal administration.

On the basis of its high degree of cytotoxicity against fresh human ovarian cancers and its relative lack of vesicant activity, mitoxantrone administered by the i.p. route was studied in a Phase I and pharmacokinetic trial. Thirty-three patients with good performance status and diagnoses of metastatic or recurrent ovarian (31 patients) and colon (two patients) cancers were treated with 12- to 38-mg/m2 doses, administered by the i.p. route every 4 wk for up to ten treatment courses. Mitoxantrone doses were escalated at 2- to 3-mg/m2 increments in groups of three to 11 patients. Thirty-eight mg/m2 (by i.p. dwell without removal) were considered the maximally tolerated dose in that, of eight treated patients, four experienced severe leukopenia and six experienced severe abdominal pain. Response to i.p. mitoxantrone was evaluable in 17 patients. None of seven patients with clinically measurable intraabdominal or pelvic tumor masses responded; however, in three (50%) of six patients with nonmeasurable disease, there was normalization of previously elevated serum CA-125 concentrations for 3, 17, and 24 mo. Additionally, two (50%) of four patients who underwent third-look laparotomies were found to have greater than 75% reductions in i.p. tumor masses with response lasting 24 and 25 mo. At 38 mg/m2, mitoxantrone was associated with a mean concentration.time product of 100 micrograms.h/ml in the i.p. space and of 0.071 micrograms.h/ml in plasma, yielding an i.p./plasma area under the curve ratio of 1408. We conclude that chemical peritonitis is the dose-limiting toxicity of i.p. administered mitoxantrone and that a dose of 23 mg/m2 every 3 to 4 wk should be used in future Phase II trials in ovarian cancer patients with minimal residual intraabdominal and pelvic disease following second-look laparotomy.

Adult↗
PubMed1988

Copper and very low birthweight babies.

Serum concentrations of copper and ceruloplasmin were measured in 24 very low birthweight babies. They were high in those weighing less than 1000 g, and critically ill or receiving intravenous nutrition, and normal in those with bone disease, neutropenia, or oedema. Care is needed to maintain adequate concentrations without toxicity.

Ceruloplasmin↗
PubMed1988

Pharmacokinetics and metabolism of retinol administered at a chemopreventive level to normal subjects.

Thirteen subjects between the ages of 50 years and 70 years were administered a daily 25,000 IU dose of retinol for 9 months. Two subjects experienced mild skin dryness, headaches, and/or alopecia. There were no significant changes in serum chemistries. High performance liquid chromatography assays for plasma retinol revealed no evidence of drug accumulation; however, there was a significant increase in the plasma concentration-versus-time curve for retinyl palmitate concentrations between the first and subsequent sampling days (P = 0.009). The mean skin retinol and retinyl palmitate concentrations in 7 retinol-treated subjects (131.7 and 15.9 ng/g, respectively) were not significantly different from those observed in 13 age-matched controls (118.9 and 25.5 ng/gm, respectively).

Adipose Tissue↗
PubMed1986

Mapping thyrotropin beta subunit gene in man and mouse.

Thyrotropin (TSH) is composed of two subunits: alpha and beta. Previously, we have mapped the TSH alpha gene to human chromosome 6 and mouse chromosome 4. In this study we have located the human TSH beta gene on chromosome 1 and the mouse TSH beta gene to chromosome 3. These data suggest that the TSH beta gene lies in a conserved linkage group with the genes for amylase 1 and 2, nerve growth factor, and the protooncogene Nras.

Animals↗
PubMed1985

Genes for insulin I and II, parathyroid hormone, and calcitonin are on rat chromosome 1.

Insulin, parathyroid hormone, and calcitonin are polypeptide hormones that regulate important physiological processes in target tissues. Rat genes encoding each hormone were chromosomally assigned to rat chromosome 1. Both rats and mice have two insulin genes (I and II). However, in contrast to mice in which insulin I and II are asyntenic, rat insulin I and II were both localized to chromosome 1. This study identifies a conserved syntenic group on rat chromosome 1, and implies that mouse insulin I and II genes were chromosomally separated after rats and mice diverged 20-35 million years ago.

Animals↗
PubMed1985

Localization of the human prealbumin gene to chromosome 18.

A human liver cDNA library was screened using an oligonucleotide probe based on the amino acid sequence of human prealbumin. The cDNA insert of one positive clone was sequenced and found to contain the entire coding sequence of human prealbumin plus untranslated 5' and 3' regions. This cDNA was used to probe DNA from a panel of mouse/human somatic cell hybrids. Only those hybrids containing human chromosome 18 showed the human-specific hybridization pattern, thereby localizing the human prealbumin gene to this chromosome.

Amino Acid Sequence↗
PubMed1985

Prevention of metabolic alkalosis induced by gastric fluid loss using H2 receptor antagonist.

Gastric fluid loss is a common cause of metabolic alkalosis. We studied various acid-base parameters in 20 patients undergoing continuous nasogastric (NG) suctioning for periods ranging from 3 to 17 days. Ten patients received cimetidine 300 mg intravenously every 6 hr (cimetidine-treated group). The remaining 10 patients received an antacid compound through the NG tube (control group). The rise in plasma bicarbonate concentration was significantly greater in the control group as compared to the cimetidine-treated group. As expected, gastric acid output was considerably lower in the cimetidine-treated group than in the control group. We conclude that cimetidine administration may be used in preventing metabolic alkalosis associated with gastric fluid loss by inhibiting gastric secretion of HCl.

Adolescent↗
PubMed1985

Biochemical and neuropsychological effects of elevated plasma phenylalanine in patients with treated phenylketonuria. A model for the study of phenylalanine and brain function in man.

Phenylketonuria provides a human model for the study of the effect of phenylalanine on brain function. Although irreversible mental retardation is preventable through newborn diagnosis and dietary phenylalanine restriction, controversy exists regarding the effects of increased concentrations of phenylalanine in older patients. We have studied ten older, treated, phenylketonuric patients using a triple-blind, multiple trials, crossover design. Each patient was tested at the end of each of three 1-wk periods of high or low phenylalanine intakes. Tests included a repeatable battery of neuropsychological tests, analysis of plasma amino acids, and measurement of urine amino acids, phenyl organic acids, dopamine, and serotonin. In all 10 patients plasma phenylalanine rose (900-4,000 microM). In 9 of 10 patients there was an inverse relationship between plasma phenylalanine and urine dopamine excretion. When blood phenylalanine was elevated, these patients had prolonged performance times on neuropsychological tests of higher but not lower integrative function. Urinary serotonin fell during phenylalanine loading in six patients. The concentration of phenylacids in the urine was not proportional to the plasma phenylalanine at concentrations below 1.5 mM. In one patient, neither performance time nor dopamine excretion varied as blood phenylalanine rose or fell. We interpret these data as follows: blood phenylalanine above 1.3 mM impairs performance on neuropsychological tests of higher integrative function, this effect is reversible, and one mechanism may involve impaired biogenic amine synthesis.

Adolescent↗
PubMed1984

An evaluation of two-dimensional echocardiography in the diagnosis of hypertrophic cardiomyopathy.

Various anatomical and functional features of hypertrophic cardiomyopathy are analyzed in view of the data provided by two-dimensional echocardiography. Measurement of septal thickness is crucial, and is best done by a combination of M-Mode and 2-D echo. Two types of systolic anterior movement of the mitral valve (SAM) are observed and are related to the degree of subvalvular gradient. The specificity of these patterns of SAM is analyzed. The functional anatomy of the mitral valve in relation to the presence and degree of mitral regurgitation shows that although the presence and type of SAM are important, there are other causes of mitral regurgitation in hypertrophic cardiomyopathy unrelated to SAM. We emphasize the fact the 2-D echo cannot "diagnose" hypertrophic cardiomyopathy except when cardiac hypertrophy plus SAM involving the body of the mitral valve is seen; in the remaining cases, 2-D echo confirms/suggests the clinical diagnosis.

Cardiomyopathy, Hypertrophic↗
PubMed1983

The mechanism of mitral regurgitation in dilated left ventricle.

To assess the mechanism of mitral regurgitation in ventricular dilatation, 24 patients with dilated cardiomyopathy (13 with and 11 without mitral regurgitation) and 10 normal individuals were studied by two-dimensional echocardiography. Left ventricular dimensions and mitral ring diameters in systole and diastole were measured in the long-axis section, and systolic interpapillary muscle distance in the short-axis section. The results showed: Mitral ring diameter is increased in most patients with dilated cardiomyopathy. Neither increased ring diameter, reduced ring contraction, nor decreased interpapillary muscle distance determine the presence of mitral regurgitation. The only difference between those patients with and without mitral regurgitation was the degree of left ventricular dilatation (p less than 0.05).

Adult↗