Cerebral energy metabolism can be measured non-invasively in unanesthetized neonatal rats with 31P NMR spectroscopy. Using this technique, serial changes in high energy phosphates were determined from the right cerebral hemispheres of 7 day postnatal rat pups during a hypoxic-ischemic insult known to produce focal brain injury. During 3 h of hypoxia-ischemia the concentration of ATP dropped to 33 +/- 8% of prehypoxic (baseline) levels, phosphocreatine (PCr)/Pi decreased from 1.5 +/- 0.51 to 0.16 +/- 0.06, while pH decreased nominally by 0.2 units. After 2.5 h of recovery in air, ATP returned to 75 +/- 10% of baseline levels, PCr/Pi rose to 1.1 +/- 0.28, and pH returned to its normal value of 7.16 +/- 0.06. This model was used to test the efficacy of the adenosine deaminase inhibitor, 2-deoxycoformycin (DCF) as a potential neuroprotective drug. The data for the drug- and saline-treated populations were analyzed by integrating ATP and Pi/PCr levels over specific time intervals, expressing it relative to baseline levels, and modeling it with cubic splines. Pretreatment with 500 micrograms/kg DCF shows a small, but statistically significant, preservation of both ATP and phosphorylation potential during hypoxia and initial recovery. Brain water content (edema) at 42 h recovery was apparently associated with both mean ATP and mean Pi/PCr in the last 2 h of hypoxia-ischemia. When ATP fell below 70% of baseline, brain edema was evident at 42 h of recovery. This methodology is suitable for extension to human infants.

Adenosine Triphosphate↗

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Suppression of the human mucosal-related colonic microflora with prophylactic parenteral and/or oral antibiotics.

The purpose of this investigation was to assess the effects of preoperative administration of parenteral antibiotics with or without concomitant preoperative administration of oral antibiotics on the colonic mucosal-related microflora. Thirty-one patients were studied in a prospective fashion. Group A patients (n = 8) had colonoscopic mucosal biopsies performed after mechanical bowel preparation. Group B patients (n = 5) received neomycin and erythromycin (NE), 1 g each following mechanical bowel preparation, at 1, 2, and 11 p.m. the evening prior to either elective colon resection (n = 2) or prior to colonoscopic biopsy (n = 3). Emergent trauma patients who had left colon or sigmoid perforations due to gunshot wounds requiring segmental resection comprised group C (n = 7). These patients received cefoxitin or cefotetan 2 g intravenously preoperatively. Individuals in group D (n = 11) all had elective left hemicolectomies or sigmoid resections due to nonobstructing malignancies. These patients underwent the same regimen as group B patients in addition to receiving intravenous cefoxitin perioperatively. Quantitative and qualitative bacterial cultures as well as scanning electron microscopy (SEM) were used to study the mucosa-associated flora. Tissue for culture and SEM were obtained from the pathologic specimen immediately after removal. The interval between the dosage of parenteral antibiotics to tissue removal was 3 hours in both groups. Anaerobic and aerobic counts were suppressed the greatest in patients receiving both oral and parenteral antibiotics (p = 0.0001). Mean anaerobic counts decreased from 3.4 X 10(7) in group A to 1.8 X 10(2) (mean cfu/g) in group D patients. Mean aerobic counts in group A decreased from 3.7 X 10(6) to 64 (mean cfu/g) in group D.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗

PubMedDate not supplied

Colonic lymphoid nodules: another cause of the red ring sign.

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Aged↗

PubMedDate not supplied

Gastric syphilis: an unusual endoscopic appearance.

Explore the source record for details and available documents.

Adult↗

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Mycoses caused by Candida lusitaniae.

Candida lusitaniae, a fungus with a low incidence of infection in immunocompetent people, is emerging as an opportunistic pathogen in immunocompromised hosts. This yeast is generally resistant to amphotericin B and may present therapeutic difficulties. C. lusitaniae may be misidentified as one of several other fungal species, including Candida tropicalis, Candida parapsilosis, and even Saccharomyces cerevisiae. As judged by in vitro antifungal susceptibility testing, minimal inhibitory concentrations of antifungal agents other than amphotericin B are achievable, but fungicidal levels are not. When encountered in blood or other body sites, C. lusitaniae should be carefully considered as a potential pathogen.

Aged↗

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Intracellular acidosis during and after cerebral ischemia: in vivo nuclear magnetic resonance study of hyperglycemia in cats.

In vivo 31P nuclear magnetic resonance spectroscopy was used to monitor the time course of intracellular pH in cat cerebral cortex subjected to global cerebral ischemia under control and hyperglycemic pretreatment conditions. Transient (16 minutes) global cerebral ischemia was induced in 14 cats using an inflatable cervical cuff combined with systemic arterial hypotension. Six cats were pretreated with infusion of 1.5 g/kg glucose prior to ischemia. Relative concentrations of high-energy phosphate metabolites and intracellular pH were continuously monitored before, during, and for 2 hours after cerebral reperfusion. During ischemia, intracellular pH fell to the same level and followed a similar time course in both groups. However, during initial reperfusion in the hyperglycemic group, there was a severe further decline (p less than 0.003) in intracellular pH. We suggest that the increased neurologic deficit and mortality found in hyperglycemic animals subjected to cerebral ischemia may be attributed to this transient severe tissue acidosis.

Acidosis↗

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Nursing model encourages care planning.

After examining the pitfalls of nursing care plans done in a medical model format, a system based entirely on the nursing model was developed in a 500-bed acute care hospital. By centering the format, the structure, and the education around the patient problems treated by nurses, the nurses in this hospital began to do care plans for the purpose of improving patient care rather than for compliance with the Joint Commission on Accreditation of Healthcare Organizations' regulations. The system has led to more knowledgeable nurses and a more autonomous and rewarding practice setting.

Humans↗

PubMedDate not supplied

Evaluation of the operational capabilities of a new extrathoracic negative pressure device for use in newborn infants.

We evaluated the operational capabilities of a new negative pressure incubator from Chelmsford, England prior to its use in our Neonatal Intensive Care Unit (NICU). Successful manufacturer's testing had already been completed. Teams of respiratory therapists and a biomedical engineer evaluated two identical units using 22 criteria, and results were scored on a pass/fail basis. The device passed our evaluation; we found it to be well built and reliable, with a wide range of rate, inspiratory time, peak negative inspiratory pressure and negative expiratory extrathoracic pressure settings. It did not pass criteria involving pressure monitor reliability, pressure relief, suction unit alarms, ease of service and service manual. This device may be used as a ventilator for intubated or non-intubated infants, in tandem with positive pressure mechanical ventilation replacing positive end-expiratory pressure with negative end-expiratory pressure, or alone in the continuous negative extrathoracic pressure mode.

Animals↗

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Standards-their impact upon the economics of instrumentation development.

The potential impact of the medical device amendments bill pending before Congress is analyzed in terms of its possible effects on 27 specific biomedical instrumentation and equipment markets. Characteristics, business opportunities, and growth potentials are evaluated for three tiers of device manufacturers, resulting in the development of several scenarios. The "most likely" scenario, according to the author, will result in strong growth for biomedical equipment and device markets but an uneven effect upon market participants.

Biomedical Engineering↗