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Biomedical subjects

L Zimmerman

Publications and source records attributed to L Zimmerman.

At least 73 records · Page 4Linked to original sources
PubMed1976

Determination of endogenous middle molecules in normal and uremic body fluids.

Methods have been developed which allow the separation and quantitation of middle molecules in biological fluids. The methods involve a newly developed high speed gel filtration technique (HSGF) combined with gradient ion exchange chromatography (GEC). The solutes were detected at 254 an 206 nm. The molecular weight range of the fractions isolated by HSGF was assessed with standards of known molecular weight. By the HSGF method normal and uremic plasma and urine were separted into 10 to 11 peaks based upon differences in molecular size. One of these peaks, no.7, which was present in uremic plasma but not detected in non-uremic plasma contained middle molecules (mol wt 1000-2000). Amino-acid analysis before and after acid hydrolysis showed this peak to contain a mixture of peptides. Using the GEC method peak 7 was further separated into 7-8 new peaks (7a,b,c, etc.). Plasma from six normal subjects and six non-uremic patients with various diseases yielded only two peaks, 7f and g, whereas urine from normal subjects, and plasma and urine from uremic patients contained all or most of these peaks. Amino-acid analysis of peak 7c, which was frequently found prominent in severly uremic patients indicates that it consists of a small peptide chain containing 8-10 amino acids.

Chromatography, Gel↗
PubMed1969

Permeability of Serratia marcescens to some inorganic salts.

The physical interactions between Serratia marcescens and solutions of NaCl, CaCl(2), CaI(2), NaI, and Na(2)HPO(4) plus NaH(2)PO(4) were examined. Dilute (0.017 n) salt solutions did not cause cells to lose water, as evidenced by the unchanged weight of centrifugally packed cells. The cells preferentially adsorbed the cations and repelled the anions of most salts in these solutions. Concentrated (1.71 n) salt solutions markedly reduced the weight and water content of centrifugally packed cells, although these cells took up considerable amounts of salts. More than 90% of the water in the packed-cell pellets was available for the solution of NaCl at 4.2 to 4.4% concentration. The observation that salts apparently penetrated the cells freely and yet caused extensive dehydration was not readily compatible with conventional concepts of solute-induced plasmolysis. Alternative hypotheses to explain the data included the following. First, the cells lost weight and water to concentrated salt solutions through a nonosmotic competitive dehydration, causing a shrinkage of the protoplasmic gel. The shrinkage of the cell wall was limited because of the rigidity of its mucopeptide layer; therefore, a space appeared between the cell wall and the cell membrane. Second, cells may have equilibrated their water activity with that of their environment by two mechanisms: (i) the loss of water by plasmolysis or competitive dehydration, and (ii) alterations in cell permeability that admitted previously excluded solutes to the cell interior. Possibly, the correct explanation of the observations reported here involves elements of all three hypotheses, plasmolysis, competitive dehydration, and permeability alterations.

Calcium Chloride↗
PubMed1966

Toxicity of copper and ascorbic acid to Serratia marcescens.

Zimmerman, Leonard (Fort Detrick, Frederick, Md.). Toxicity of copper and ascorbic acid to Serratia marcescens. J. Bacteriol. 91:1537-1542. 1966.-Neutral solutions of ascorbic acid were antibacterial to Serratia marcescens at low but not at high population densities. The toxicity of ascorbate was eliminated by metal-sequestering treatments, and was restored only by the addition of trace amounts of copper salts. Copper-ascorbate was equally toxic under aerobic or anaerobic conditions; its toxicity was abolished by (i) chelating agents that sequestered the copper, (ii) metal-complexing agents that bound to the cells but did not sequester copper, and (iii) iron salts in the presence of air. On the basis of these observations, the toxic effects of copper-ascorbate were attributed to its reaction with vital Fe-containing cellular components.

Anti-Bacterial Agents↗
PubMedDate not supplied

Functional status outcomes of patients with a coronary artery bypass graft over time.

OBJECTIVE: To examine functional status outcomes among patients with a coronary artery bypass graft (CABG) over time (ie, at baseline; 3 months, 6 months, and 12 months after surgery) and the impact of selected patient characteristics (ie, age, sex, comorbidities, and cardiac rehabilitation participation) on functional outcomes. DESIGN: A prospective, repeated-measures design was used to examine functional status in patients with a CABG over time. SETTING: A midwestern community hospital and regional cardiac referral center was the setting for enrolling patients with a CABG. OUTCOME MEASURES: Functional status outcomes were measured by using the Medical Outcomes Study (MOS) Short Form 36 (SF-36) and Modified 7-Day Activity instruments. METHODS: Baseline data were obtained by patient interview in the hospital setting after CABG surgery. At 3 months, 6 months, and 12 months after surgery, telephone interviews were conducted to administer research instruments. RESULTS: Baseline scores on 7 of the 8 subscales of the MOS SF-36 were significantly lower than at 3 months, 6 months, or 12 months after surgery. Role-emotional functioning baseline scores were not significantly lower than 3-month scores; however, baseline scores were significantly lower than 6-month and 12-month scores. Three-month subscale scores were also significantly lower than 6-month or 12-month scores except for the subscales measuring social and general health functioning. Functional status as measured by the Modified 7-Day Activity tool did not demonstrate any significant differences between 3-month, 6-month, or 12-month activity levels. There were no significant differences by age group on any of the 8 subscales of the MOS SF-36 instrument. Women and subjects with more than 1 comorbidity had a significantly lower preoperative level of physical functioning. Cardiac rehabilitation participants had lower preoperative scores on role-emotional functioning than subjects who were not in rehabilitation. CONCLUSION: Findings from this study can assist nurses and other health care workers to gain a perspective of the recovery and rehabilitation trajectory of patients with a CABG. The results of the study provide a basis for determining areas of functional limitations during recovery from CABG surgery. Study results can also be the foundation for evaluating outcomes of patients with a CABG when specific interventions (eg, pain management, psychosocial support, physical strengthening, fatigue management) are implemented during hospitalization, home recovery, and rehabilitation to target optimal psychosocial and physiologic functioning of patients with a CABG.

Activities of Daily Living↗
PubMedDate not supplied

The effects of music interventions on anxiety in the patient after coronary artery bypass grafting.

OBJECTIVE: To examine the influence during the early postoperative period of selected nursing interventions on mood and anxiety of patients undergoing heart surgery. DESIGN: Prospective, repeated measures, quasiexperimental, random assignment. SETTING: The cardiovascular intensive care and progressive care units of a midwestern community hospital were used as the setting for this study. PATIENTS: Ninety-six patients who underwent elective, heart bypass surgery; the mean age of the subjects was 67 years, with an age range of 37 to 84 years. Most subjects were men (n = 65, 68%). OUTCOME MEASURES: Physiologic measures of anxiety and mood include blood pressure and heart rate. Additional measures included the use of Spielberger's state-trait anxiety inventory (STAI) and patient verbal ratings of both mood and anxiety with use of a numeric rating scale (NRS). INTERVENTION: Patients were randomly assigned to one of three groups: (1) music therapy, (2) music-video therapy, or (3) scheduled rest group. Subjects in the groups received their assigned 30-minute intervention at two episodes on postoperative days 2 and 3. Subjects had physiologic measures of blood pressure and heart rate measured immediately before the intervention and at 10-minute intervals throughout the intervention. Mood and anxiety were evaluated by having subjects use a NRS (i.e., 0 to 10) to give rating of mood and anxiety immediately before and after each session. Anxiety was further measured with the STAI. A baseline measure of STAI was taken before surgery; patients also completed the "state" anxiety tool before the intervention session on postoperative day 2 and on completion of the session on postoperative day 3. RESULTS: With use of an analysis of covariance (ANCOVA), subjects' mood ratings showed significant improvement in mood among subjects in the "music intervention" group after the second intervention when controlling for the preintervention rating of mood, F(2, 87) = 4.33, p = 0.016. However, no significant differences were reported for anxiety ratings as measured by the NRS and state anxiety instruments. With use of repeated measures analysis of variance (ANOVA), there were no significant interactions between the intervention groups and time for any of the physiologic variables. However, there were significant main effects over time for heart rate and systolic and diastolic blood pressure, which indicated a generalized physiologic relaxation response. CONCLUSIONS: Although none of the three interventions was overwhelmingly superior, the overall response by all intervention groups demonstrated a generalized relaxation response. It is also important to note that there was reduced anxiety and improved mood within all three groups.

Adult↗
PubMedDate not supplied

Otolaryngic osteopathology in 14th century mid-america. The crow creek massacre.

Over 486 people were massacred and buried communally at the Crow Creek Village Site, South Dakota, about 1350 AD. Osseous pathology in the craniofacial area of the victims' skeletons is reviewed and compared to data from other indigenous skeletal populations past and present. The Crow Creek mastoid x-rays are analyzed and compared to four other studies which span over 1000 years of Dakota Territory history. Findings regarding external auditory canal exostoses in the different groups are compared. Unusual findings in the craniofacial area are assessed. Insight into longitudinal epidemiology in one portion of the U.S. is possible through this study.

Adolescent↗
PubMedDate not supplied

The efficacy of advanced life support: a review of the literature.

INTRODUCTION: Jurisdictions throughout the United States and some other parts of the world have invested substantial time and resources into creating and sustaining a prehospital advanced life support (ALS) system without knowing whether the efficacy of ALS-level care had been validated scientifically. In recent years, it has become fashionable for speakers before large audiences to declare that there is no scientific evidence for the clinical effectiveness of ALS-level care in the out-of-hospital setting. This study was undertaken to evaluate the evidence that pertains to the efficacy of ALS-level care in the current scientific literature. METHODS: An extensive review of the available literature was accomplished using computerized and manual means to identify all applicable articles from 1966 to October, 1995. Selected articles were read, abstracted, analyzed, and compiled. Each article also was categorized as presenting evidence supporting or refuting the clinical efficacy of ALS-level care, and a list was constructed that pointed to where the preponderance of the evidence lies. RESULTS: Research in this field differs widely in terms of methodological sophistication. Of the 51 articles reviewed, eight concluded that ALS-level care is not any more effective than is basic life support, seven concluded that it is effective in some applications but not for others, and the remainder demonstrated effectiveness. The strongest support for ALS-level care was in the area of responses to victims of cardiac arrest, whereas somewhat more divergent findings related to trauma or non condition-specific studies. CONCLUSIONS: While not unanimous, the predominant finding of recent research into the clinical effectiveness of advanced life support demonstrates improved effectiveness over basic life support for patients with certain pathologies. More outcomes-based research is needed.

Emergency Medical Services↗
PubMedDate not supplied

Marketing guidelines for medical group practice.

For some groups, patients are no longer available in an endless supply. Administrators are learning that they must respond to changing market situations in order to maintain their group's fair share of the market.

Group Practice↗
PubMedDate not supplied

Pain and psychological distress in patients undergoing autologous bone marrow transplantation.

The major goal of this descriptive study with repeated measures was to better understand the pain and psychological distress of patients undergoing autologous bone marrow transplantation (ABMT). A second goal was to gain insight into potential treatment strategies by examining the pattern of locus of control and coping strategies used by the subjects. The sample was composed of 17 people (12 men and 5 women) diagnosed with Hodgkin's lymphoma and pretreated with high-dose chemotherapy prior to ABMT. Data collection instruments were the Pain-O-Meter (POM) (Gaston-Johansson, Omaha, NE), the State-Trait Anxiety Inventory (STAI), the Beck's Depression Inventory (BDI), the Multidimensional Health Locus of Control (MHLC), and the Coping Strategy Questionnaire (CSQ). The instruments were administered two days prior to the ABMT and 5, 10, and 20 days following the ABMT. The data were analyzed using descriptive statistics and an ANOVA for repeated measures. The study showed that the patients experienced a low-grade, persistent pain that was multifocally located. Mild to moderate anxiety and depression were present throughout the hospitalization. The patients used inadequate coping strategies and reported that they had little ability to control or decrease their pain. These findings indicate a need for clinicians to develop treatment strategies to deal with pain and psychological distress experienced by patients undergoing ABMT.

Adaptation, Psychological↗
PubMedDate not supplied

Factors influencing patient entrance into a cardiac rehabilitation program.

The purpose of this descriptive pilot study was to identify factors that influence patient participation in a cardiac rehabilitation program. Thirty-nine patients who were admitted to a midwestern hospital with a coronary problem and who were candidates for cardiac rehabilitation completed the Patient Entrance Into a Cardiac Rehabilitation Program (PECRP) questionnaire. The PECRP evaluates a subject's responses to Health Belief Model-based statements. Analysis by t test revealed significant differences for perceived benefits and barriers, indicating that patients who participated in a cardiac rehabilitation program perceived more benefits and fewer barriers to entering such a program than those who did not. No significant differences were found between groups for perceived susceptibility and perceived severity constructs. Analysis of demographic variables revealed significant differences for income and marital status on the perceived benefits and barriers construct, indicating that those who had an income greater than $20,000 and those who were married perceived more benefits and fewer barriers than those whose income was less than $20,000 and who were not married. Nursing implications for these patients are discussed, particularly those related to patient teaching before discharge.

Adult↗