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Biomedical subjects

R Gorman

Publications and source records attributed to R Gorman.

18 recordsLinked to original sources
PubMed1996

Adjustment of birth weight standards for maternal and infant characteristics improves the prediction of outcome in the small-for-gestational-age infant.

OBJECTIVE: Birth weight is a function of gestational age. Various maternal and infant characteristics also affect birth weight. This study sought to adjust for these factors to better define abnormal growth. STUDY DESIGN: Maternal and infant characteristics from normal pregnancies were correlated with birth weight. A formula was developed and applied to a second group in which we compared perinatal outcomes in normally grown infants with those who were small for gestational age. We compared outcomes between small-for-gestational-age infants defined by the formula with those defined by conventional tables. RESULTS: Infants defined by the formula as small-for-gestational-age were more likely to have morbidity and mortality than those who were normally grown (p < 0.001). Small-for-gestational-age infants defined by the formula had more deaths and adverse outcomes than those defined by gestational age. CONCLUSION: Adjusting birth weight standards for maternal and infant characteristics may improve the prediction of adverse outcomes.

Adult↗
PubMed1995

Expert system for management of urinary incontinence in women.

The purpose of this nursing informatics and outcomes research study was to determine the effectiveness of an expert system for disseminating knowledge to ambulatory women health care consumers with urinary incontinence. Clinical knowledge from the Agency for Health Care Policy and Research (AHCPR) patient guideline for urinary incontinence and research literature for behavioral treatments provided the knowledge base for the expert system. Two experimental groups (booklet and expert system) and one control group were utilized. Study results suggest the use of an expert system as one effective communication means for disseminating clinical information in an advisory capacity to ambulatory women with urinary incontinence.

Adult↗
PubMed1994

Colonization of intestinal bacteria in the normal neonate: comparison between mouth and rectal swabs and small and large bowel specimens.

Seventy-four New Zealand white rabbit pups were divided into four groups: group I, 2 days of age (n = 9); group II, 3 to 5 days of age (n = 24); group III, 6 to 8 days of age (n = 27); and group IV, 10 to 13 days of age (n = 14). Mouth swabs (MS), rectal swabs (RS), small bowel specimens (SB), and large bowel specimens (LB) were obtained from each rabbit, incubated for 24 hours in thioglycolate broth, and plated on blood agar in aerobic and anaerobic environments. After 24 hours, growth on blood agar plates were observed. All MS specimens and all but one RS specimen showed positive growth. Growth of both LB and SB specimens increased significantly with age (P < .04). In addition, SB growth was significantly less than RS or MS growth in groups I, II, and III (P < .05). LB growth was significantly less than RS or MS growth in group I (P < .01) and tended to be less in groups II and III (62.5% v 100% and 93% v 100%, respectively). These data show that nearly half of normal rabbits under 6 days of age have sterile small and large intestines despite almost 100% growth from rectal and mouth swabs. These findings partially explain the absence of spontaneous bacterial translocation in young rabbit pups (under 4 days of age) and have important implications for the prophylaxis and treatment of neonatal sepsis.

Animals↗
PubMed1992

Research priorities of VA nurses: a Delphi study.

The purpose of this study was to conduct a Delphi survey of a sample of Gainesville Veterans Affairs Medical Center staff and head nurses. The study consisted of three rounds of questionnaires completed by the nurses as they identified and narrowed the most pressing nursing research questions. Results indicated that in five of the six clinical settings, despite investigators' instructions to identify clinical nursing research questions, administrative research questions were identified and ranked consistently higher in priority than clinical research questions. The single exception was in home care, where clinical questions received the highest priority. This phenomena may suggest that institutional constraints interfere with nurses' full expression of their clinical practice.

Attitude of Health Personnel↗
PubMed1991

Decline in spindle support to alpha-motoneurones during sustained voluntary contractions.

1. To address whether the muscle spindle support to alpha-motoneurones is maintained during prolonged isometric voluntary contractions, the discharge of eighteen muscle spindle afferents, originating in the dorsiflexors of the ankle or toes, was recorded from the common peroneal nerve in eight subjects. Isometric contractions were generally sustained for 1 min, usually below 30% of the maximal voluntary dorsiflexion force. 2. Once the afferent had been identified, subjects were instructed to dorsiflex the foot slowly to recruit the spindle ending, to continue the ramp contraction until a predetermined target force was reached, and then to hold that force until requested to relax. 3. Five muscle spindle afferents maintained a constant discharge frequency during the hold phase of the isometric contraction. Following relaxation of the contraction two spindle afferents from tibialis anterior, exhibited a post-contraction discharge despite the absence of detectable electromyographic activity (EMG). 4. The discharge frequency of most of the spindle afferents (72%) declined progressively during the isometric contraction. The mean firing rates had declined to two-thirds of those at the onset of the contraction by 30 s, and to half after 1 min. The decline in spindle firing rate commenced during the ramp phase of the contraction and was statistically significant by 10 s, when force was held constant. The extent of the decline was greater for those units with the higher initial firing rates and for those units studied after many preceding contractions. 5. In the same contractions a progressive increase in EMG was required to maintain force and consequently the change in EMG was inversely related to the change in spindle discharge. While many mechanisms may contribute to the decline in spindle discharge during a sustained isometric contraction, it is argued that the result will be a progressive disfacilitation of alpha-motoneurones, which may contribute to the decline in motor unit firing rates during a sustained contraction.

Adult↗
PubMed1989

Interference of automated electroencephalographic processing by an endocardial pacemaker.

This article reports a patient with an endocardial pacemaker undergoing a carotid endarterectomy in whom cerebral function was monitored by using processed electroencephalography (EEG). The EEG was processed by means of aperiodic analysis. The pacemaker generated an artifact that was identified on the processed EEG display and on the raw EEG display. During the time of carotid cross-clamping, a loss of EEG activity was noted on careful examination of the processed EEG and confirmed by referring to the raw EEG. Nevertheless, because of the presence of the artifact, the activity edge remained essentially constant despite the change in underlying EEG activity. The cross-clamp was released based on the observed change in EEG activity, yielding a return to baseline EEG activity. The surgeon elected to shunt the patient. The patient awoke without neurologic sequelae. This case serves to demonstrate the importance of referring to the raw EEG signal and the limitations of the activity edge in the presence of artifact.

Carotid Artery Diseases↗
PubMed1987

Toluidine blue in the corroboration of rape in the adult victim.

Objective physical evidence to corroborate a claim of rape is frequently absent. Genital lacerations are considered evidence that rape has occurred. In this study, toluidine blue dye, a nuclear stain, was used to detect vaginal lacerations. The detection of vaginal lacerations in reported rape victims increased from one in 24 to 14 in 24 with toluidine application. Toluidine blue increases the detection of perineal lacerations in adult rape victims and the presence of lacerations is supportive of the documentation of rape.

Adult↗
PubMed1985

Relationship of thromboxane generation to the aggregation of platelets from humans: effects of eicosapentaenoic acid.

A non-linear relationship between the percent aggregation of human platelets and the amount of TXB2 generated requires investigators to use caution when using the data to assess antiplatelet regimens. The relationship approximates a hyperbola with a roughly linear relationship from 0 to 70% aggregation and 0 to 50 ng TXB2 per ml of platelet-rich plasma. Above these values, the amount of TXB2 produced may increase up to 500 ng per ml of platelet-rich plasma with no clear relationship to the observed platelet function of aggregation. Also, appreciable inhibition of TXB2 formation can occur at high TXB2 levels with no detectable decrease in aggregation. Thus, assessment of antiplatelet regimens using TXB2 formation alone are unlikely to be interpretable without reference to this non-linear property of platelet function. We applied this concept when evaluating a study of forty subjects with dietary supplements of 1.8 g or 2.7 g of ethyl eicosapentaenoate (20:5n-3) for four weeks. There was a moderate, but statistically significant decrease in average values for the percent aggregation (60 +/- 15 to 45 +/- 30) and thromboxane production (51 +/- 30 to 33 +/- 31 ng/ml). Although the differences in mean values were slight relative to the overall standard deviations, reductions of platelet function were clearly evident in 31 of 40 subjects when paired results were examined relative to the recognized hyperbolic relationship.

Blood Platelets↗
PubMed1984

Development of a gas chromatographic-mass spectrometric method using a stable isotope internal standard for quantitation of thromboxane B2.

Tetradeuterated 19, 19',20,20'-2H4-thromboxane B2 was synthesized and used as a stable isotope internal standard for the development of a gas chromatographic/mass spectrometric (GC/MS) method to quantitate thromboxane B2. Quantitation was based on the detection of fragment ions at m/z 301 for thromboxane B2 and m/z 305 for the corresponding tetradeuterated internal standard. At m/z 301/305 a response equivalent to a protium/deuterium ratio of 0.2% thromboxane B2 could be measured with a standard deviation of 15% when 100 nanograms of the tetradeuterated internal standard was analyzed. For measurement of cellular biosynthesis of thromboxane B2 in whole blood or platelet rich plasma, the internal standard and naturally occurring thromboxane B2 were i) isolated by solvent extraction, or sequestration to XAD-2 columns; ii) purified by reversed phase high performance liquid chromatography; and iii) converted to methoxime methyl ester trimethylsilyl ethers prior to analysis. A limited comparison was made using both radioimmunological and mass spectrometric quantitation of thromboxane B2.

Animals↗
PubMed1980

Outbreak of meningococcal disease in a family.

An outbreak of three cases of meningococcal disease occurring in a family of 14 is presented. Three of the children, between the ages of 10 months to 10 years, were hospitalized. Two of them showed positive signs of meningitis, and one had evidence of bacteremia. Neisseria meningitidis was isolated from a blood sample of one patient and a CSF sample of another. The organism was also recovered from the nasopharyngeal secretion of four other adult members of the family. All three hospitalized children were treated with parenteral penicillin and responded well to therapy. The rest of the family was treated with oral rifampin, and subsequent cultures of the nasopharynx were negative.

Carrier State↗
PubMed1979

9,11-Iminoepoxyprosta-5,13-dienoic acid is a selective thromboxane A2 synthetase inhibitor.

9,11-Iminoepoxyprosta-5,13-dienoic acid inhibits the thromboxane A2 synthetase in platelet and lung microsomal enzyme preparations and in intact platelets. It does not inhibit the protaglandin I2 synthetase in aorta or lung microsomes and intact Balb 3T3 fibroblasts. In lung microsomes, which contain both enzymes, 9,11-iminoepoxyprosta-5,13-dienoic acid inhibits only thromboxane A2 formation and augments prostaglandin I2 formation. This inhibitor is more selective than other reported prostaglandin endoperoxide analogs which inhibit the platelet thromboxane synthetase.

Animals↗