Biomedical subjects
R Lowe
Publications and source records attributed to R Lowe.
Swapping over roles.
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Look who's sorry now.
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[10 years of nosocomial infections at the Santo Tomás Hospital].
The incidence of nosocomial urinary tract infections (UTI) in the medical services of Santo Tomás Hospital from 1980 to 1985 was 56% in Neurology Section, 73% in cardiology and 74% in nephrology. These percentages declined, with epidemiological surveillance, to 21%, 31% and 53% respectively, for the period between 1986 and 1990. In the surgical services the incidence of nosocomial UTI was 85% in urology and 15% in general surgery, from 1980 to 1985. The incidence remained unchanged in urology (81%) and general surgery (17%) despite epidemiological surveillance, but decreased in neurosurgery (from 55% to 37%) for the period between 1986 and 1990. Between 1985 and 1990, Staphyloccocus aureus was the most frequently isolated bacterium from surgical wounds (34%) and from patients with intravenous catheters (23%). Pseudomonas aeruginosa was the most frequently isolated bacterium in nosocomial UTI (26%) and respiratory tract infections (45%) and in patients with nosocomial septicemia, it was a species of Klebsiella.
A model research curriculum for emergency medicine.
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The proposed death certificate for South Africa. Part I. Death certificate description.
An altered 'Cause of Death' certificate is proposed. The major changes involve the use of the international format for certification of death and provision for collection of extra data, i.e. estimated age at death, sex, population group and, where relevant, the mass of an infant at birth. The new format will facilitate improved data collection and the certificate will stand international comparison.
The proposed death certificate for South Africa. Part II. Feasibility study.
The proposed new death certificate was tested in urban and rural hospitals and among general practitioners. Of the 471 death certificates returned, 70% were correctly completed. The underlying cause of death was identifiable in 86.6% of cases. The accuracy of cause of death statements was analysed in greater detail. Some items on the proposed form were not clear and needed improvement, i.e. instructions to mark an applicable answer and refer to instructions on the reverse page. The participants completed a questionnaire to assess and comment on the new form. A refined version thereof was prepared as a result of this study.
Comparative efficacy of contact lens disinfection solutions.
Using the D value method of analysis, we evaluated the relative antimicrobial effectiveness of eight contact lens disinfection solutions against a standard population of challenge organisms as defined in the Microbiological Guidelines proposed by the Food and Drug Administration (FDA). Six bacteria (Escherichia coli, Staphylococcus aureus, S. epidermidis, Streptococcus pneumoniae, Pseudomonas aeruginosa, and Serratia marcescens) and two fungi (Aspergillus fumigatus, Candida albicans) were investigated. The disinfectants included hydrogen peroxide (AOSept, MiraSept, Oxysept), chlorine-based solutions (Aerotab and Softab), soaking solutions containing synthetic, high molecular weight preservatives (ReNu and Opti-Free) and a thimerosal preserved soaking solution (Hydrocare Cleaning and Soaking Solution). The one-step hydrogen peroxide system (AOSept) was evaluated both with and without the catalytic disk. To facilitate comparison of the disinfecting solutions, we defined a new measure of performance, namely "power" of solution. This has an advantage over the "safety factor" because the solution power is independent of the size of the initial inoculum. Because different approaches to analysis may yield a wide range of D values for one set of survival data we call for adoption of a standardized approach. Our results suggest that one of the chlorine-based solutions fails to meet the FDA recommendations for bacterial challenge. Most solutions performed poorly against mycotic challenge. However, when used over longer disinfecting periods, 3% hydrogen peroxide and the Hydrocare solution gave adequate performance against fungi.
Case report: systemic lupus erythematosus (SLE) serositis mimicking acute cholecystitis.
Systemic lupus erythematosus (SLE) is a well recognized cause of an acute abdomen. What is less well recognized is that the underlying pathology can be varied. The computed tomography (CT) and ultrasound appearances of the gall-bladder in a case of SLE serositis are shown. The imaging findings were strongly suggestive of primary gall-bladder disease although at laparotomy the gall-bladder showed serosal inflammation only.
Effect of hydrogel lens wear on tear film stability.
Noninvasive break-up time (NIBUT) of the tears was measured in a controlled, randomized, double-masked study to assess: (1) the stability of the prelens tear film during wear of new high and low water content lenses and (2) the stability of the precorneal tear film following lens removal after 1 h of wear. The prelens tear film NIBUT of 6 subjects was found to be relatively constant over a 1-h wearing period, averaging 6.1 +/- 1.1 s (mean +/- SEM). These values were significantly (Scheffe's S test, p less than 0.05) lower than those recorded for the precorneal tear film before lens insertion (33.5 +/- 10.6; mean +/- SEM), although 85% of prelens tear film NIBUT's were greater than the 3-s average interblink period reported previously for soft lens wearers. After lens removal, precorneal tear film NIBUT was reduced significantly compared to prewear levels (Scheffe's S test, p less than 0.05) for up to 15 min. Application of the monomolecular growth model to the NIBUT recovery data revealed a half-time for recovery of 6.0 min, with recovery 95% complete 25.8 min after lens removal. Lens type was not a significant factor in tear film stability, either during wear or after lens removal. The basis for reduced precorneal tear film NIBUT after lens removal is unknown; however, a disruption of the mucin layer coating the corneal epithelium is the most likely mechanism. Indeed, the technique of measuring precorneal tear film NIBUT after lens removal may be a useful determinant of the extent to which contact lens wear disrupts the precorneal mucin layer, providing an indication of the susceptibility of the cornea to a variety of complications.
Factory health services in Johannesburg and Randburg.
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The human lung fibroblast cell line, MRC-5, produces multiple factors involved with megakaryocytopoiesis.
The human lung fibroblast cell line MRC-5 constitutively produces a megakaryocyte potentiator activity, identified in murine bone marrow liquid culture assays for acetylcholinesterase and megakaryocyte colony assays in the presence of low concentrations of IL-3. The production levels of this activity were increased after stimulation with the phorbol ester analog, mezerein, and the calcium ionophore, A23187. Complete purification of a protein having this activity from conditioned media of induced MRC-5 cells was achieved using gel filtration and ion exchange chromatography. The first 14 residues of the purified protein identified by amino-terminal sequencing were identical to the first 14 residues of IL-6. Recombinant human IL-6 was tested and found to promote megakaryocyte growth. IL-1 beta, another component detected in MRC-5 conditioned media, was unable to promote megakaryocyte colony formation but did reduce the concentration of IL-6 necessary to support megakaryocyte colony formation. Immunoprecipitation using rabbit antiserum prepared against IL-6 removed the megakaryocyte growth activity found in MRC-5 conditioned media. Thus, connective tissue cells such as fibroblasts in the bone marrow may co-stimulate thrombocytopoiesis via IL-6 and, possibly, via IL-1 production.
In vivo dehydration of disposable (Acuvue) contact lenses.
The in vivo dehydration of the Acuvue disposable contact lens was measured in six subjects using a contact lens refractometer. On average, the lenses dehydrated 6.2 +/- 1.9% after 20 min and 10.2 +/- 3.9% after 6 h of wear. The magnitude of dehydration is greater than has been reported for other hydrogel lens types of similar water content. This information may assist practitioners in the interpretation of clinical signs pertaining to lens behavior and associated patient symptoms.
Vogt Koyanagi Harada disease.
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Health conscious. Interview by Tim Rice.
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Foreign body-induced hemoptysis.
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Preventing accidents to pre-school children: a health visitor's view.
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