Some arguments on the pro side.
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Blastocyst↗
Biomedical subjects
P Quinn
Publications and source records attributed to P Quinn.
Susceptibilities of neonatal respiratory isolates of Ureaplasma urealyticum to antimicrobial agents.
Twenty-one neonatal respiratory isolates of Ureaplasma urealyticum were serotyped, and their susceptibilities to ciprofloxacin, gentamicin, chloramphenicol, erythromycin, azithromycin, and doxycycline were tested. Most patient strains were Ureaplasma urealyticum bv. parvum. Chloramphenicol, doxycycline, and azithromycin had the lowest MICs. This data may be useful when designing prophylactic or therapeutic trials of antibiotics for chronic lung disease of the newborn.
Anti-Bacterial Agents↗
Detection of Ureaplasma urealyticum in endotracheal tube aspirates from neonates by PCR.
A PCR-based test was optimized for the detection of Ureaplasma urealyticum from neonatal respiratory specimens, with primers directed against the multiple-banded antigen gene (L. J. Teng, X. Zheng, J. I. Glass, H. Watson, J. Tsai, and G. H. Cassell, J. Clin. Microbiol. 32:1464-1469, 1994). Endotracheal tube aspirates (225) from 103 low-birth-weight neonates (<1,250 g) were taken, when possible, at days 0, 4, and 14 after birth and examined by culture and by PCR. Of 77 specimens positive by either method, 73 were detected by PCR and 60 were detected by culture. Overall, 36% of the neonates were positive for U. urealyticum by either method. Of 16 patients with PCR-positive-culture-negative results, 13 had positive cultures at another sampling point, and one additional patient had a twin with positive cultures. Of 11 patients with day 0 specimens positive by PCR alone, 9 subsequently became culture positive, demonstrating the utility of this test in early detection. Multiple serovars were present in over 50% of positive specimens, with serovars 3 and 14 in combination being most prevalent. The amplicon size generated from the specimen by PCR correctly predicted the biovars isolated in over 85% of positive specimens. Thus, this PCR test was valuable in allowing early detection of U. urealyticum in neonatal respiratory specimens, as well as in providing biovar information.
Humans↗
Glucose and phosphate--important or unimportant in culture media for embryos?
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Culture Media↗
Recurrent synovial chondromatosis treated with meniscectomy and synovectomy.
Synovial chondromatosis is a rare benign intraarticular metaplasia of synovium. This process may result in the production of detached particles of highly cellular cartilage in the involved joint spaces. It is most often reported in the larger joints of the body including the knee, hip, elbow, and ankle. Since Axhausen in 1993 reported the first case affecting the temporomandibular joint, several articles have been listed in the literature regarding the presentation, diagnosis, and management of this form of an arthropathy. This is a case of a recurrent synovial chondromatosis that was approached with a meniscectomy and a complete synovectomy.
Arthroscopy↗
Nationwide survey of fluoroscopy: radiation dose and image quality.
PURPOSE: To determine the average abdominal entrance air kerma, low-contrast sensitivity, and spatial resolution in upper gastrointestinal tract fluoroscopy in the United States. MATERIALS AND METHODS: A random sample of fluoroscopic facilities was selected to be surveyed for the Nationwide Evaluation of X-ray Trends program. Measurements were performed by using a newly developed fluoroscopic phantom. The surveys were conducted by state radiation control personnel. RESULTS: Average air kerma rates 1 cm above the tabletop, free in air, were 43 mGy/min (n = 340). The rate increased to 64 mGy/min when a 1.6-mm-thick copper filter, which simulated the use of barium contrast medium, was added to increase attenuation. The average entrance air kerma, free in air, for radiographs was 3.4 mGy, and an average of 12 radiographs were obtained per examination. Of 352 facilities surveyed, 306 (87%) were able to resolve wire mesh with 20 or more lines per inch. Of 339 facilities for which percentage contrast could be calculated, 192 (57%) had minimum percentage contrast values of 4% or more. CONCLUSION: Spatial resolution for fluoroscopy is adequate for most of the facilities surveyed, but a substantial proportion of facilities could not visualize low-contrast test objects, which strongly suggests image quality problems.
Data Collection↗
3M NATN Joint Award 1996. Bradford's direct access hysteroscopy service.
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Female↗
Developing a direct access outpatient hysteroscopy service.
This article describes the development and running of an outpatient hysteroscopy service. The authors highlight the reasons why the service was seen as feasible and the benefits which patients and staff have found since its inception.
Female↗
Beneficial effects of coculture with cumulus cells on blastocyst formation in a prospective trial with supernumerary human embryos.
PURPOSE: We reported previously on the use of coculture with cumulus cells in insemination medium for the development of human embryos in vitro. Here we describe a prospective trial to determine if this procedure has a significant beneficial effect. METHODS: On the day after insemination, zygotes were randomized for culture in either a fresh drop of medium without (- cum) or were left in their insemination drop with (+ cum) cumulus cells. Embryos with the best morphological quality were replaced on the third day of development at the eight-cell stage. The remaining embryos were cultured for a further 3 days and cryopreserved if they reached the fully expanded blastocyst (FEB) stage. Three different culture media were used over the period of this study. RESULTS: In 11 patients, supernumerary embryos were available only for continued culture in +cum and three patients had embryos cultured in only -cum. Thirty-nine other patients had embryos assigned to both +cum and -cum treatments. In the +cum group, 98 blastocysts developed from 216 embryos cultured for 6 days (45%), and this was significantly greater (P < 0.01) than the 48 blastocysts from 156 embryos (31%) developing in the absence of cumulus cells. In basal HTF medium (HTF medium with EDTA and glutamine) and basal XI HTF medium (similar to basal HTF but devoid of glucose and phosphate), culture of embryos with cumulus cells produced significantly more FEBs than in the absence of cumulus cells. There was no significant difference between the two culture treatments when regular HTF medium was used. Preliminary results indicate that pronectin-coated dishes provide a good substratum for cumulus cell attachment and embryo development. CONCLUSIONS: The culture of human embryos with their cumulus cells in insemination drops of medium produces a significantly greater proportion of FEBs than when the zygotes are transferred to fresh culture drops devoid of cumulus cells. This is the first report of a significantly higher blastocyst rate with coculture in which a real comparison has been made between two culture treatments which differ only in the presence or absence of homologous cumulus cells in insemination drops.
Blastocyst↗
Effect of preemptive acetaminophen on postoperative pain scores and oral fluid intake in pediatric tonsillectomy patients.
Postoperative pain is a significant problem that continues to be undertreated in the pediatric population. Preemptive administration of analgesics has recently emerged as a method to enhance pain management associated with surgery. The purpose of this study was to compare postoperative pain scores, rescue analgesic use, and oral fluid intake in children who received acetaminophen preoperatively to children who received postoperative acetaminophen. The sample consisted of 28 children, 2-8 years of age, scheduled for elective tonsillectomy. Children were randomized into the control or the experimental groups. Anesthesia induction and maintenance were standardized. The experimental group received 15 mg/kg of oral acetaminophen preoperatively, and the control group received 20 mg/kg of rectal acetaminophen postoperatively. Pain was scored with the FLACC (faces, legs, activity, cry, consolability) behavioral assessment tool. Scores were significantly lower for the experimental group at 30 minutes after awakening and significantly lower for the control group at 240 minutes (P < .05). Eight patients (57%) in the control group and only 4 (28%) in the experimental group required rescue morphine postoperatively. Total postoperative morphine was not significantly different between groups. There were no differences in time to initial oral fluid intake and total oral fluid intake postoperatively. Incidence of nausea and vomiting was high in both groups (64-78%). These results provide evidence that preemptive acetaminophen may enhance analgesia in pediatric tonsillectomy patients. Preoperative acetaminophen is a safe, quick, and inexpensive intervention that can readily be incorporated into anesthesia practice.
Acetaminophen↗
Does prenatal exposure to influenza in mice induce pyramidal cell disarray in the dorsal hippocampus?
Epidemiological studies point to an association between prenatal exposure to influenza and later schizophrenia. Such studies are consistent with neuropathologic reports demonstrating cytoarchitectural abnormalities in the hippocampus and parahippocampal gyrus suggestive of second trimester developmental anomalies. The hypothesis that prenatal exposure to influenza in the second trimester may induce hippocampal pyramidal cell disarray in mice was investigated. Between days 9-16 of pregnancy, 35 Balb/c mice were intranasally inoculated with either a mouse-adapted or non mouse-adapted pool of Influenza A/Singapore/1/57 (H2N2), and 10 controls were inoculated with normal saline. Offspring were sacrificed on day 21 postpartum. Microscopic examination of the CA1-CA2 junctional areas in the offspring of mice exposed to influenza failed to demonstrate excess pyramidal cell disarray when compared with influenza-free, age matched controls. There was evidence that disarray was greater among those exposed on day 13 of pregnancy. Analyses of the data by sex and severity of maternal infection failed to reveal any significant effects.
Animals↗
Enhanced results in mouse and human embryo culture using a modified human tubal fluid medium lacking glucose and phosphate.
PURPOSE: Because various recent studies in both human and laboratory animals have indicated an influential role of glucose and phosphate in embryonic development, this study was initiated to assess the effect of culture medium lacking glucose and phosphate on human IVF. RESULTS: Initial studies with mouse zygotes indicated a significant improvement in embryonic development in both a F1 hybrid and a random-bred "two-cell block" strain, using a modified HTF medium which contained EDTA and glutamine (Gln) and also with a similar medium which lacked glucose and phosphate. Subsequently, a prospective randomized trial of human IVF has begun in which infertile patients are sequentially assigned to have IVF using one of three media. The three media are regular HTF, HTF containing EDTA and Gln (referred to as Basal HTF), and HTF with EDTA and Gln but devoid of glucose and phosphate ions (referred to as Basal XI HTF). CONCLUSIONS: Initial results indicate that Basal XI HTF medium, a modified form of HTF containing EDTA and glutamine but devoid of glucose and phosphate, greatly improves the in vitro development of mouse and human embryos over HTF and Basal HTF medium.
Animals↗
Successful human in vitro fertilization using a modified human tubal fluid medium lacking glucose and phosphate ions.
OBJECTIVE: To determine the effect of medium with or without glucose and phosphate on the fertilization and development of human oocytes. DESIGN: Sequential allocation of alternate patients to one of two treatment groups. SETTING: Private practice infertility programs. PATIENTS: Ten couples requesting treatment for infertility. INTERVENTIONS: Gametes from each couple were collected, washed, and incubated in one of two culture media under investigation. MAIN OUTCOME MEASURES: Number of oocytes collected, fertilized, cleaving, replaced, and implanting in each patient. Development of any supernumerary embryos to fully expanded blastocysts in vitro. RESULTS: There was a significant increase in the proportion of transferred embryos implanting in the group of patients whose gametes were handled in medium devoid of glucose and phosphate. All other comparisons of factors that may have influenced implantation rates between the two groups of patients were not significantly different. CONCLUSIONS: High rates of fertilization, cleavage, implantation, and development of supernumerary human embryos to the blastocyst stage in vitro were obtained with a modified human tubal fluid medium containing ethylenediaminetetraacetic acid and glutamine but devoid of glucose and phosphate ions. A prospective randomized trial is necessary to evaluate the clinical significance of these observations.
Body Fluids↗
Cumulus cell co-culture--efficacy?
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Cells, Cultured↗
A comparison of 5 days of dirithromycin and 7 days of clarithromycin in acute bacterial exacerbation of chronic bronchitis.
The safety and efficacy of dirithromycin and clarithromycin were compared in a single-blind, multicentre study of patients with acute bacterial exacerbation of chronic bronchitis (AECB). Patients received either dirithromycin, 500 mg once daily for 5 days, or clarithromycin, 250 mg twice daily for 7 days. A total of 212 patients entered the study, of whom 191 qualified for efficacy analysis. Favourable post-therapy clinical and bacteriological response rates for qualified patients (95 dirithromycin and 96 clarithromycin) were similar: 89.5% and 68.8% for dirithromycin vs 94.8% and 71.9% for clarithromycin. At late post-therapy evaluation, favourable clinical and bacteriological response rates were achieved in 98.8% and 96.2% of dirithromycin patients and 95.3% and 93.3% of clarithromycin patients, respectively. These differences were neither statistically nor clinically significantly different. Both drugs had similar efficacy against Haemophilus influenzae and both were well tolerated. Dirithromycin, administered as a single daily dose for just 5 days resulted in complete compliance in all but four patients. In clarithromycin-treated patients, requiring a 7-day course of twice-daily treatment, compliance was less satisfactory, with 12 patients failing to comply, though the between-group difference was not statistically significant. It can be concluded that 5 days of dirithromycin, 500 mg once daily is as safe and effective as 7 days of clarithromycin, 250 mg, twice daily in the treatment of AECB.
Acute Disease↗
Social work and disability management policy: yesterday, today, and tomorrow.
Although social work has traditionally been involved with persons with disabilities, our position in the area of disability policy has been less evident. This article presents a brief review of the history of policy toward those with disabilities along with a summary of some philosophical perspectives which undergird those policies. A Disability Systems Case Manager is proposed as a solution to the morass of conflicting rules and regulations currently applied by numerous governmental, vocational, and welfare agencies. This manager would operate from the Structural Paradigm which recommends an initial examination of a client's environment for impediments to successful functioning before focusing on the client's potential vulnerabilities or problems.
Disability Evaluation↗
Synthesis of surface sphingomyelin in the plasma membrane recycling pathway of BHK cells.
Sphingomyelin, which has been degraded at the BHK cell surface by exogenous sphingomyelinase, is converted back into sphingomyelin with kinetics similar to those of plasma membrane recycling. Resynthesis of sphingomyelin under these conditions proceeds at a rate about 4-fold higher than normal biosynthesis of sphingomyelin. Neither resynthesis of sphingomyelin nor its return to the surface is inhibited by brefeldin A (BFA), which is a potent blocker of vesicular transport through the Golgi but has no effect on plasma membrane recycling. However, resynthesis of plasma membrane sphingomyelin is greatly decreased in cells undergoing mitosis or energy depletion, where endocytosis is inhibited. We conclude that the main site of surface sphingomyelin synthesis in BHK cells could be in recycling endosomes and not in the Golgi apparatus as proposed previously. We also suggest a model pathway by which cholesterol may reach the plasma membrane via recycling endosomes.
Animals↗