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Biomedical subjects

M Taylor

Publications and source records attributed to M Taylor.

At least 379 records · Page 21Linked to original sources
PubMed1997

Titrated intravenous opioids from the same syringe: an infection risk?

OBJECTIVE: (1) To compare the rate of contamination of syringes prepared under laminar flow conditions in pharmacy with those prepared by nurses in the emergency department; (2) to determine whether the time elapsed since preparation or number of doses given affected the contamination rate; (3) to determine whether any adverse effects resulted from bacterially contaminated drugs. METHODS: Prospective, blinded trial exploring the effect of method of preparation, time since preparation, and number of doses given on contamination rates and infective adverse events associated with bacterially contaminated specimens. RESULTS: The rate of bacterial contamination was 12% (95% confidence interval 6% to 18%). There was no difference in contamination rate in respect of method of preparation, number of doses given, or time since preparation. No infective complications were identified. CONCLUSIONS: Abandonment of titrated intravenous opioids is not justified by the results. However, there is concern about the use of this technique of pain control for immunocompromised patients and those with prosthetic heart valves.

Analgesia↗
PubMed1997

Inheritance of larval resistance to permethrin in Aedes aegypti and association with sex ratio distortion and life history variation.

The genetic mechanisms that confer larval permethrin resistance were investigated in two strains of Aedes aegypti, vectors of yellow fever and dengue hemorrhagic fever. Larval resistance to permethrin in an Ae. aegypti field-collected resistant Couva (R) strain was associated with the sex-determining locus by analysis of backcrosses to the susceptible Rockefeller (S) strain. The median lethal concentrations (LC50s) of these strains were 23.1 (95% confidence interval = 22.0-24.3) and 2.2 (2.0-2.3) parts/billion of permethrin, respectively. The estimated resistance ratio (RR) for the R strain was 10.8 (10.3-11.4) compared with the S strain. Resistance was inherited as partly recessive (dominance [D] = -0.31) with an estimated RR of 2.3 (2.1-2.4) in the F1 hybrids when the R parent was male. There were also significantly male-biased sex ratios for this cross. In contrast, inheritance was slightly dominant (D = 0.19) with an estimated RR of 4.1 (3.8-4.4) when the R parent was female, and no significant sex ratio bias of progeny was observed. Analysis revealed a strong paternal-strain effect in bioassay mortality, sex ratio, egg hatch, and fecundity. A maternal-strain effect was also evident for bioassay mortality. Similarly, a strong maternal by paternal strain interaction was also evident for sex ratio. Progeny of single-family backcrosses of F1 hybrids to R were statistically homogeneous for sex ratio, duration of oviposition, fecundity, and hatch rate. A significant increase in male bias was found for only one backcross to R, after treatment with permethrin. In contrast, complex patterns of inheritance of life histories were observed among backcrosses to S. Backcrosses to S had greater mean fecundities, shorter mean times to the start of oviposition, and shorter mean oviposition periods than did backcrosses to R. Hatch rates were statistically homogeneous among backcrosses, but all strikingly reduced relative to the parental generation. Times of start and duration of oviposition were highly negatively correlated with fecundity (first gonotropic cycle only) and rate of egg hatch. Females with lower fecundities had lower hatch rates, and there was a threshold of approximately 80 eggs per female, below which no eggs hatched. Generally all backcrosses had higher LC50s than expected from single-locus inheritance. Association between sex bias and inheritance of resistance was apparent, but no single genetic linkage model based on current understanding of sex chromosome genetics was consistent with these observations. These results may have epidemiologic importance considering that permethrin-soaked bed nets are being used in many countries to control the biting activity of disease vectors.

Aedes↗
PubMed1997

Evaluation of the Heart and Stroke Foundation of Canada Research Scholarship Program: research productivity and impact.

OBJECTIVE: To compare the research productivity, and its impact, of individuals awarded research scholarships from the Heart and Stroke Foundation of Canada (HSFC) with that of a parallel group of unsuccessful applicants during the funding years 1980/81 to 1989/90 inclusive. Research productivity was defined as the number of peer reviewed publications, and impact was evaluated from the number of publications cited; the number of citations per publication; the number of citations per individual; and the impact score. STUDY SELECTION: Data were collected on 192 individuals. Cohorts were defined as successful and unsuccessful individuals entering the system in the same year. The study comprised 10 separate cohorts. Data were collected on yearly publications and citation counts for each individual. These data, along with journal impact factors, were obtained from the Institute for Scientific Information. CONCLUSIONS: During the 10 years of the study, individuals funded by the HSFC published more papers, more of their papers were cited, and they received more citations per individual than the unfunded comparison group. This consistency in multiple indicators provides strong evidence that funded individuals are more productive and that their work has a greater impact on the body of knowledge in this area. Although this study cannot unequivocally show a direct causal relation between funding and research success, the trend as shown by the indicators studied suggests a beneficial effect.

Analysis of Variance↗
PubMed1997

Cost of latex device-related occupational illness, workmen's compensation and legal issues.

In the United States, health care workers who become sensitised to latex face substantial problems. Their careers may prematurely come to an end, leaving them with a long struggle to achieve adequate compensation. This paper outlines some of those problems, and the actions necessary by employers, employees and worker disability groups to prevent future problems.

Career Mobility↗
PubMed1997

Phase II trial of gemcitabine and weekly cisplatin for advanced non-small cell lung cancer.

Single-agent gemcitabine, when given in doses of > or = 1,250 mg/m2 weekly x 3 with a 1-week break, induces responses in approximately 20% of untreated patients with non-small cell lung cancer. This phase II study was undertaken to determine the efficacy of weekly administration of gemcitabine 1,500 mg/m2 combined with cisplatin 30 mg/m2 x 3 with a rest period of 1 week. Patients younger than 75 years were eligible if they had stage III/IV non-small cell lung cancer, a life expectancy > or = 12 weeks, hemoglobin > or = 10 g/dL, absolute granulocyte count > or = 10(9)/L, platelets > or = 100 x 10(9)/L, hepatic enzymes no more than three times the upper limit of normal, and serum creatinine < or = 130 micromol/L. There were 22 men and 18 women, with a median age of 60 years; 35 had a performance status of 0 or 1. Pathology included adenocarcinoma in 22 patients, squamous cell carcinoma in nine, large cell carcinoma in seven, and mixed non-small cell lung cancer in two. Six patients had stage III and 34 had stage IV tumors. Of the 39 patients eligible for response evaluation, partial remission was seen in 10, for an overall response rate of 26% (95% confidence interval, 12% to 41%). The median duration of response was 19 weeks (range, 7 to 32+ weeks). Grade 3/4 anemia was seen in 11 patients, and 21 patients required red blood cell transfusions. Grade 3/4 neutropenia occurred in 22 patients and grade 3/4 thrombocytopenia in 21 patients. One patient experienced febrile neutropenia Hematologic toxicity, particularly thrombocytopenia, was cumulative over time. Nonhematologic toxicity was modest, but one patient stopped therapy because of a grade 2 skin rash and one stopped because of a grade 4 pulmonary toxicity, both of which were thought to be related to gemcitabine. The modest activity of weekly gemcitabine and weekly cisplatin seen in this trial does not suggest in vivo synergy for these two agents as administered using this schedule and these doses.

Adult↗
PubMed1997

The relation between individual differences in fantasy and theory of mind.

The relation between early fantasy/pretense and children's knowledge about mental life was examined in a study of 152 3- and 4-year-old boys and girls. Children were interviewed about their fantasy lives (e.g., imaginary companions, impersonation of imagined characters) and were given tasks assessing their level of pretend play and verbal intelligence. In a second session 1 week later, children were given a series of theory of mind tasks, including measures of appearance-reality, false belief, representational change, and perspective taking. The theory of mind tasks were significantly intercorrelated with the effects of verbal intelligence and age statistically controlled. Individual differences in fantasy/pretense were assessed by (1) identifying children who created imaginary characters, and (2) extracting factor scores from a combination of interview and behavioral measures. Each of these fantasy assessments was significantly related to the theory of mind performance of the 4-year-old children, independent of verbal intelligence.

Age Factors↗
PubMed1997

Alternatives to conventional hormone replacement therapy.

Alternative medicines have become "mainstream" in their popularity and economic size. The most highly promoted and popular types of alterative medicines used for menopause are discussed, including mineral and vitamin supplements, phytoestrogens, natural hormones, and botanical/plant medicines.

Adult↗
PubMed1997

Comparison of the PK(15)- and WEHI 164 (clone 13)-based bioassays for detection of porcine tumor necrosis factor.

OBJECTIVE: To determine relative sensitivities of the PK(15)- and WEHI 164(13)-based bioassays for detection of tumor necrosis factor alpha (TNF). SAMPLE POPULATION: Recombinant human, murine, and porcine INF, and serum from pigs given endotoxin IV. PROCEDURE: Two cell lines were used as targets for recombinant human, murine, and porcine TNF cytotoxicity bioassays. Pigs were given sublethal doses of endotoxin to obtain serum samples containing high activity of porcine TNF. Serum TNF activity was tested, using both cell lines. Viable cells were detected by addition of dimethylthiazol diphenyltetrazolium bromide after 18 to 20 hours' incubation with samples containing TNF. RESULTS: The 2 cell lines tested had different sensitivities to human, murine, and porcine TNF. Compared with WEHI 164(13) cells, PK(15) cells were 50 times less sensitive to murine TNF and 15 times less sensitive to human TNF. However, PK(15) cells were 4 times more sensitive to recombinant porcine TNF and 15 times more sensitive to porcine serum containing TNF. CONCLUSIONS: The PK(15) cell line was more sensitive to porcine TNF-mediated lysis than was the WEHI 164(13) cell line. The PK(15)-based TNF bioassay will be especially useful for study of infectious disease processes in swine, particularly where low activity of TNF exists.

Animals↗
PubMed1997

The role of creative control and culture in children's fantasy/reality judgments.

Young children's ability to differentiate fantasy from reality has been seriously underestimated because of methodological problems and overgeneralization from children's performance in situations in which they had no control over the content of the fantasy and/or were presented with misleading information. It is important to keep in mind that there are many types of fantasy-reality distinctions, and that cultural context plays an important role in the interpretation given to children's activities.

Adult↗
PubMed1997

Hypertension treatment compliance: what do patients want to know about their medications?

While poor drug compliance is a significant impediment to the effective treatment of hypertension, knowledge of what patients wish to know about their medications in order to improve compliance is very limited. To develop a preliminary understanding of patients' medication requirements and expectations, a simple 30-item questionnaire was developed and administered to 66 patients who were either taking antihypertensive drugs, or about to commence antihypertensive drug treatment. Ninety percent of patients wanted to know about all possible side effects of medications as well as the most likely side effects. Ninety-six percent wanted to know if their drug treatment would keep them well. In addition, most patients wanted to avoid multiple medications, were concerned about the prospect of life-long treatment, and were worried about potential drug interactions. Effects of the drugs on their lifestyles as well as any lifestyle changes required to augment drug therapy were other issues of concern. The elderly were less interested in many of these issues. A strong desire for further knowledge about their disease was noted in most subjects (82%). If compliance with medication therapy is to be improved, a better understanding of patients' concerns and fears about medications is required, particularly in a relatively asymptomatic disease like hypertension.

Adolescent↗
PubMed1997

Variation in labial shoulder geometry of metal ceramic crown preparations: a finite element analysis.

Recent studies have highlighted variations in the geometry of teeth prepared to receive metal ceramic crowns, particularly in the region of the labial shoulder, where shoulder designs have often involved less reduction than is recommended. Using two-dimensional finite element analysis, this study subjected crowns, superimposed upon preparations with clinically common labial margin designs, to loads of 200N in three different directions. The resultant stress distribution within the labial marginal porcelain was examined. Results imply that variations in the marginal preparation geometry of metal ceramic crowns influenced the stress response of the finished crown. Within the limits of this study, a crown constructed a 1.3mm chamfer preparation appeared to have the best response to a simulated load applied to the palatal/incisal surface, at 45 degrees to the long axis.

Crowns↗
PubMed1996

Prospective surveillance for perioperative venous thrombosis. Experience in 2643 patients.

BACKGROUND: Patients who undergo neurosurgical procedures are at high risk for perioperative deep vein thrombosis (DVT) and pulmonary embolism (PE), which have been reported in 6% to 43% of these patients. OBJECTIVES: To (1) determine the utility of prospective DVT surveillance in patients who undergo neurosurgical procedures by using venous duplex ultrasound scanning (VDUS), (2) assess the efficacy of DVT prophylaxis (elastic stockings and intermittent pneumatic compression), (3) identify subgroups of patients who are at higher risk, and (4) determine whether DVT surveillance would reduce the incidence of fatal PE. DESIGN: All patients had undergone preoperative VDUS of both lower extremities, and postoperative VDUS was performed on days 3 and 7, and weekly thereafter until patients were ambulatory or discharged. PATIENTS: During a 5-year period, 2643 patients who underwent neurosurgical procedures were enrolled in prospective DVT surveillance. SETTING: University-affiliated community hospital. RESULTS: Acute DVT was diagnosed in 147 (5.6%) of the 2643 patients. Eighty-one percent of the patients with acute DVT were asymptomatic at the time of diagnosis. Deep vein thrombosis developed de novo in the proximal veins in 98% of the patients. Patients in whom a craniotomy was done had a significantly higher risk for DVT (7.7%, P = .006), and patients who underwent cervical or lumbar spinal surgical procedures had a significantly lower risk (1.5%, P < .001). Among those patients in whom a craniotomy was performed for treatment of a tumor and who had DVT, 87% had malignant neoplasms. Significant lower-extremity neuromotor dysfunction was present in 69% of all patients with DVT, and this finding predominated among patients with DVT in the subgroups with a lower risk. A PE was diagnosed in 5 patients (0.19%) while they were hospitalized, and a PE was fatal in 2 (0.07% of all patients). CONCLUSIONS: Most perioperative DVTs were clinically silent and formed spontaneously in proximal venous segments where there would be a risk for a PE. The overall incidence of DVT (5.6%) was low, suggesting effective DVT prophylaxis. Patients who underwent spinal surgical procedures were at a significantly lower risk for DVT, and future surveillance is not indicated in this patient group unless other conditions exist (paralysis, malignancy). Patients in whom a craniotomy was performed had a significantly higher risk of DVT, particularly when other risk factors existed. The low incidence of a fatal PE (0.07%) reflected that early detection and treatment of proximal DVT were facilitated by prospective VDUS surveillance in these patients.

Adolescent↗
PubMed1996

Dopamine D2 receptor occupancy in vivo by the novel atypical antipsychotic olanzapine--a 123I IBZM single photon emission tomography (SPET) study.

We have studied striatal D2 dopamine binding in schizophrenic patients treated with the novel atypical antipsychotic drug, olanzapine. 123I iodobenzamide (IBZM) single photon emission tomography (SPET) was used to estimate striatal dopamine D2 receptor binding in vivo. Patients were recruited from a prospective, double blind controlled trial of olanzapine versus haloperidol treatment. In vivo striatal D2 binding data from olanzapine treated patients (n = 6) were compared with previously reported data from typical antipsychotic responsive (n = 10); clozapine (n = 10); and risperidone (n = 6) treated patient groups. Mean % Brief Psychiatric Rating Scale score (BPRS) improvement following olanzapine treatment was 49% (SD 44). The hypothesis that clinical improvement in olanzapine treated patients would be associated with higher mean striatal D2 binding of 123I IBZM (reflecting lower levels of D2 occupancy) than typical antipsychotic (1.25 +/- 0.05) or risperidone (1.24 +/- 0.04) treatment was confirmed. Olanzapine treated patients had similar levels of striatal D2 binding in vivo (1.41 +/- 0.06) as those treated with clozapine (1.49 +/- 0.04). This preliminary evidence suggests olanzapine is another atypical antipsychotic drug in which therapeutic response is not associated with a high degree of striatal D2 receptor occupancy in vivo.

Adult↗
PubMed1996

Failure to induce defecation in rats exposed to fixed-time schedules of liquid food delivery.

Previous studies have found that defecation increases in rats exposed to fixed-time schedules of dry food delivery. The purpose of the present study was to examine whether increases in defecation could be induced in rats exposed to fixed-time schedules of liquid food delivery. Eight rats were exposed to fixed-time 30-, 60-, and 120-s schedules of liquid food delivery. None of the subjects excreted significantly more fecal boli under the fixed-time schedules than during massed-food control sessions in which an equivalent amount of food was presented at the beginning of the sessions. Thus, the present findings identify a previously unknown constraint on schedule-induced defecation in rats.

Animals↗