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Biomedical subjects

M Simpson

Publications and source records attributed to M Simpson.

At least 55 records · Page 3Linked to original sources

Working towards dependency scoring in critical care.

One of the main disadvantages of dependency scoring in the intensive care unit, is that popular scoring systems such as the Intensive Care Register (ICR) fail to take into account many of the most important factors that contribute to patient dependency. Factors such as counselling of patients and their families, setting up for certain procedures and dealing with an agitated patient, for example, all contribute to the overall dependency of the patients; and ultimately influence the level of nursing support required. It is with these thoughts in mind that a system of dependency scoring has been developed for the intensive care unit (ICU). The system outlined here is designed to be used in conjunction with the ICR, thus providing a more accurate and realistic measure of dependency; while still maintaining a vital link to a well established system.

Consciousness↗

Measurement of dentin permeability and wetness by use of the Periotron device.

The ability of the Periotron device to measure changes in dentin permeability and wetness was evaluated by use of extracted human teeth in vitro. Pulpal pressures were varied from zero to 40 cm H2O for simulation of different pulpal tissue pressures. Non-physiologic pulpal pressures of 703 cm H2O were used for comparison of dentin permeability measurements made with the Periotron device with those made using micropipettes. Measurements made with the Periotron device correlated well with methods used previously for measurement of dentin permeability. The shear bond strength of Scotchbond 2/Silux was measured 24 h after being bonded to dentin held at zero pulpal pressure. There was an inverse correlation between the shear bond strengths of Scotchbond 2/Silux and Periotron values, suggesting that increased wetness decreases the bond strength of that system. The Periotron device offers a new, simple, convenient measure of dentin surface wetness which may be useful in dentin bonding studies.

Adhesiveness↗

Human immunodeficiency virus type 1 detected in all seropositive symptomatic and asymptomatic individuals.

Between February 1987 and October 1988, peripheral mononuclear blood cells (PBMC) from 409 adult individuals antibody positive by Western (immuno-)blot for human immunodeficiency virus type 1 (HIV-1) (56 acquired immunodeficiency syndrome [AIDS] patients, 88 patients with AIDS-related complex, and 265 asymptomatic individuals) were consecutively cultured for HIV-1 or tested for the presence of HIV-1 DNA sequences by a polymerase chain reaction assay (PCR). We isolated HIV-1 or detected HIV-1 DNA sequences from the PBMC of all 409 HIV-1 antibody-positive individuals. None of 131 healthy HIV-1 antibody-negative individuals were HIV-1 culture positive, nor were HIV-1 DNA sequences detected by PCR in the blood specimens of 43 seronegative individuals. In addition, HIV-1 PCR and HIV-1 culture were compared in testing the PBMC of 59 HIV-1 antibody-positive and 20 HIV-1 antibody-negative hemophiliacs. Both methods were found to have sensitivities and specificities of at least 97 and 100%, respectively. In contrast, the sensitivities of serum HIV-1 antigen testing in AIDS patients and asymptomatic seropositive patients were 42 and 17%, respectively. Our ability to directly demonstrate HIV-1 infection in all HIV-1 antibody-positive individuals provides definitive support that HIV-1 antibody positivity is associated with present HIV-1 infection. Moreover, the sensitivities and specificities of PCR and culture for the detection of HIV-1 appear to be equivalent, and both methods are superior to testing for HIV-1 antigen in serum for the direct detection of HIV-1.

AIDS-Related Complex↗

Intertrochanteric femoral fractures. Mechanical failure after internal fixation.

In a prospective study we assessed the causes of mechanical failure in a series of 230 intertrochanteric femoral fractures which had been internally fixed with either a sliding hip screw or a Küntscher Y-nail. The overall rate of mechanical failure was 16.5%; cutting-out of the implant from the femoral head was the cause in three-quarters of the instances. Implants placed posteriorly in the femoral head cut out more often (27%) than those placed centrally (7%). The cut-out rate was also determined by the quality of the fracture reduction, but age, walking ability and bone density (assessed by the Singh grade and metacarpal indices) had no significant influence. We conclude that these fractures should be reduced as accurately as possible and it is imperative that the implant is placed centrally within the femoral head.

Aged↗

Immunoassays and nucleic acid detection with a biosensor based on surface plasmon resonance.

A technique based on surface plasmon resonance is described which can be used to detect changes of refractive index that occur when one partner of a molecular binding pair diffuses from solution to bind the other partner which is immobilised on a silver surface. Results for the molecular binding pairs; protein-antibody, hapten-antibody and DNA-DNA are described. Instrumentation necessary for implementation of the technique is detailed. Immunoassay of proteins and haptens is possible in less than one minute with a sensitivity of 10(-9) mol/l. Hybridisation of 10 fmoles of a 97 base target sequence on the 1 mm2 area of detection to an immobilised oligonucleotide probe can be detected in less than five minutes. Advantages of the technique include the ability to record the kinetics of binding reactions in "real time" and the lack of labels in this simple assay format. Methods of improving the sensitivity are discussed.

Animals↗

Malignant fibrous histiocytoma in a cat.

A large proliferative soft tissue mass found on the forelimb of an adult cat was identified as a malignant fibrous histiocytoma through cytologic and histologic examinations. This is a rare tumor of mesenchymal cell origin, which has been previously reported in cats, dogs, horses, and human beings. In this cat metastasis to the local lymph node was found.

Animals↗

Suppression of human peripheral blood mononuclear cell function by methadone and morphine.

Recent studies have shown that in vitro exposure of peripheral blood mononuclear cells (PBMC) to morphine results in suppressed respiratory-burst activity of monocytes and impaired interferon-gamma (IFN-gamma) production by lymphocytes. To investigate the potential in vivo effect of an opiate on these cell functions, PBMC were obtained from patients maintained on methadone. These freshly isolated mononuclear cells had a significantly impaired capacity to generate superoxide anion (O2-) in response to phorbol myristate acetate (PMA), while production of IFN-gamma by concanavalin A-stimulated cells was intact. After cell culture for 48 h, the defective O2- generating capacity was sustained. Also, culturing PBMC from healthy controls in the presence of methadone or morphine at concentrations as low as 10(-12) M caused significant suppression of PMA-stimulated O2- release. Because reactive oxygen intermediates produced by PBMC may participate in host defense against opportunistic pathogens in AIDS, these results underscore the need for investigations of the biological consequences of opiate-mediated immunosuppression.

Adult↗

Bone mineral content and body size 65 to 100 weeks' postconception in preterm and full term infants.

A total of 36 preterm and 22 full term infants were weighed and measured at 65 to 100 weeks' postconception. It was found that the preterm infants were on average significantly lighter by 1008 g and shorter by 3.8 cm than those born at full term. Despite the smaller size of preterm infants, mean values of bone mineral content in the mid-forearm were not significantly different between the two groups. In contrast, near 40 weeks' postconception the mean bone mineral content observed in 35 of the preterm infants was significantly smaller than that observed in eight of the full term infants. Our results suggest that there is a phase of rapid mineral accretion between 40 and 60 weeks' postconception. This 'catch up' in mineral accretion reduces the perinatal mineralisation deficit that might otherwise persist into childhood.

Body Height↗

Bone mineral accretion rate and calcium intake in preterm infants.

Thirty six preterm infants (20 boys) of 25 to 32 weeks' gestation were observed from birth to around 40 weeks' postconception. When oral feeding became possible, nine received mother's own breast milk (group B), 15 formula feed (group F), and 12 formula feed supplemented with calcium (5 ml 10% calcium gluconate/100 ml feed) and phosphorus (0.5 ml 17% potassium phosphate similarly) (group S). All received a daily supplement of 400 IU vitamin D. Intakes of calcium, phosphorus, vitamin D, energy, and fluid volume were recorded. When oral feeding started, and near 40 weeks' postconception, bone mineral content of the forearm was measured by photon absorptiometry; weight and crown-heel length were also measured. After logarithmic transformation of the measurements, there were no significant intergroup differences between the mean rate constants for weight or crown-heel length describing growth during the observation period. The mean rate constant for mineral accretion (M) was significantly higher in group S than in both the others. Pooling all data, M was significantly correlated with calcium intake but not with any other variable. Mineral supplementation of feed can reduce but not cure osteopenia of prematurity.

Bone Diseases, Metabolic↗

Communicative competence in a group of visually impaired children.

Aspects of verbal and non-verbal communicative competence of five visually-impaired six and seven year old children were investigated. The Profile of Communicative Appropriateness (Penn, 1983) was used to assess communicative competence in one discourse interaction with a known interlocutor (mother). The results indicated that the subjects were predominantly appropriate in terms of verbal communication, and predominantly inappropriate in terms of non-verbal communication. Severity of visual impairment influenced performance in terms of non-verbal communication. Research and therapeutic implications are discussed.

Blindness↗

Pressure sores: a plan for primary care prevention.

Pressure sores are a preventable cause of increased morbidity, mortality, and treatment cost. Prevention begins with a knowledge of risk factors, both external and internal, and specific interventional measures for each. Management is best implemented using a team: the physician, nurse, nurse's aide, rehab nurse, physical therapist, dietitian, and occupational therapist, with an informed physician as team director. New management tools available include risk factor assessment scales to help in targeting resources.

Aged↗

Sodium dependent D-[3H]aspartate binding in cerebral cortex in patients with Alzheimer's and Parkinson's diseases.

The sodium dependent binding of D-[3H]aspartate to the high-affinity glutamate uptake system was used as a marker of glutamate-releasing terminals in the cerebral cortex of brains from patients with Alzheimer-type dementia (ATD) and Parkinson's disease (PD). Sodium-dependent D-[3H]aspartate binding was reduced in the ATD patients but not in the PD patients. Within the PD patients no association was observed between sodium-dependent D-[3H]aspartate binding and the presence of dementia. In contrast choline acetyltransferase activity was reduced in both the ATD and the PD patients. The present results suggest that changes in the cortical cholinergic system can occur independently of the cortical glutamate system. The glutamatergic deficit in ATD may contribute to some of the clinical differences between the dementia of ATD and PD.

Aged↗

Norfloxacin in the treatment of uncomplicated gonococcal infections.

Norfloxacin, an oral fluoroquinolone antibacterial, is active in vitro against a variety of gram-positive and gram-negative pathogens, including both penicillinase-producing and non-penicillinase-producing strains of Neisseria gonorrhoeae. An earlier study demonstrated that a two-dose regimen of norfloxacin was as effective as standard therapy with spectinomycin for treating gonococcal urethritis, including infections caused by penicillinase-producing organisms. In this randomized study of treatment for uncomplicated gonococcal infection in men and women, three oral treatment regimens were compared: patients received either two doses of norfloxacin (600 mg twice daily), a single dose of norfloxacin (800 mg), or a single-dose ampicillin (3.5 g)/probenecid (1.0 g) regimen (as recommended by the Centers for Disease Control). All three treatment regimens achieved similar cure rates. Although the number of patients treated was too small to yield statistically significant conclusions, it appears that norfloxacin may be slightly better treatment for rectal and pharyngeal gonococcal infections than ampicillin and probenecid. Additionally, norfloxacin was well tolerated in this study. Thus, based on a review of these data, norfloxacin appears to be an alternative, single-dose, oral treatment regimen for uncomplicated gonococcal infection.

Adult↗