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Biomedical subjects

R Matthews

Publications and source records attributed to R Matthews.

At least 91 records · Page 5Linked to original sources
PubMed1989

Effects of intravenous metoprolol on global and regional left ventricular function after coronary arterial reperfusion in acute myocardial infarction.

Coronary reperfusion in myocardial infarction improves infarct zone motion, but its effect on the global ejection fraction has been less consistent. The directional movement of the ejection fraction is determined by the opposing influences of improved infarct zone motion and diminishing hyperkinesia in the noninfarct zone. Noninfarct zone hyperkinesia has been attributed to catecholamine stimulation, the Frank-Starling mechanism or intraventricular interactions that unload noninfarcted segments. To investigate the influence of catecholamine stimulation, 9 men presenting with a first myocardial infarction (mean age 53 +/- 13 years) were studied. Coronary reperfusion was accomplished less than 4 hours after the onset of myocardial infarction. Radionuclide ventriculography was then performed before and immediately after the intravenous administration of 15 mg of metoprolol. End-diastolic volume did not change, but end-systolic volume increased 28% after metoprolol (p = 0.041). The ejection fraction decreased from 55 +/- 13% before metoprolol to 45 +/- 14% after its administration (p = 0.002). There was no effect of intravenous metoprolol on infarct zone motion, whereas motion in the noninfarcted segment decreased (p = 0.002). The patients underwent repeat ventriculography after receiving metoprolol, 100 mg orally twice a day for 9 days. Infarct zone motion improved (p less than 0.002) and the ejection fraction increased to 55 +/- 12% (p less than 0.02). Normal zone motion did not change. Thus, compensatory hyperkinesia is at least in part caused by catecholamine stimulation. Conclusions regarding the effects of reperfusion on global ventricular performance can be influenced by the timing of ejection fraction determinations relative to metoprolol therapy.

Adult↗
PubMed1989

Assessment of DNA fingerprinting for rapid identification of outbreaks of systemic candidiasis.

DNA fingerprinting was assessed as an improved typing system for Candida albicans aimed at speeding the implementation of cross infection control measures in outbreaks of systemic candidiasis. The study was carried out with 45 previously characterised isolates from five different outbreaks and with 96 unrelated isolates from a mixed control population. Sixteen different genotypes were produced. Results were obtainable within days, reproducibility was high, and there was good discrimination among different outbreaks. Compared with existing typing systems DNA fingerprinting provides a robust system that may be used rapidly to identify outbreaks of nosocomial candidiasis in laboratories with no specialist skill in typing C albicans.

Candida albicans↗
PubMed1989

Anionic salivary proteins associated with connective tissue disorders: sialated tissue kallikreins.

Parotid saliva was collected from 32 patients with rheumatoid arthritis, 10 with systemic lupus erythematosus, three with mixed connective tissue disease, 12 with progressive systemic sclerosis, two with primary Sjögren's syndrome, and four with Raynaud's syndrome. Tissue kallikreins were measured by radioimmunoassay, and saliva samples were subjected to isoelectric focusing followed by immunoblotting or silver staining. The results showed that the saliva of patients with connective tissue diseases contained increased amounts of immunoreactive tissue kallikrein. In addition, there was an increase in the multiple forms of anionic tissue kallikreins, resulting mainly from a shift in their distribution towards that of higher sialic acid content and lower isoelectric point. These changes were most obvious in patients with systemic lupus erythematosus. Novel or unusual glycosylation may explain the occurrence of increased amounts of anionic salivary proteins in connective tissue diseases.

Adolescent↗
PubMed1988

Candida and AIDS: evidence for protective antibody.

Clinical observation and animal models of candidosis suggest that, although T lymphocytes are important in preventing superficial candidosis, defence against systemic candidosis depends upon humoral immunity. An antibody response to the immunodominant 47 kD antigen of Candida albicans is invariably associated with recovery. The presence of this antibody in patients with chronic mucocutaneous candidosis and the acquired immunodeficiency syndrome (AIDS) could account for the rarity of disseminated candidal infection in these conditions. Polyclonal B cell activation may be responsible for the frequency with which this antibody is produced in AIDS. Antibody to the 47 kD antigen could be useful in the treatment and prevention of systemic candidosis, though not in the superficial candidosis of AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Characterisation and cellular localisation of the immunodominant 47-Kda antigen of Candida albicans.

The 47-Kda component of Candida albicans is an immunodominant antigen in the serology of systemic candidosis. Immuno-electronmicroscopy with an affinity-purified antibody to the 47-Kda antigen showed that it was present in the cytoplasm and cell wall of both yeast and mycelial cells. It was found in discrete areas on the inner and outer borders of the cell wall and was mainly located within the wall rather than exposed on the outer surface. Sometimes it appeared to be in channels across the cell wall. In the cytoplasm, it was usually near the cytoplasmic membrane and occasionally appeared in vesicular areas. It was not detected in the nucleus or mitochondria. The 47-Kda antigen did not bind to Concanavalin A, and antigenicity was lost after protease digestion. Peptide mapping suggested that the antigen was highly conserved between different strains of C. albicans.

Antibodies, Fungal↗
PubMed1988

Diagnosis of systemic candidiasis by an enzyme-linked dot immunobinding assay for a circulating immunodominant 47-kilodalton antigen.

A dot immunobinding assay based on the detection of the immunodominant 47-kilodalton (kDa) antigen of Candida albicans is described for the serological diagnosis of systemic candidiasis. It was compared with a reverse passive latex agglutination test and a dot immunobinding assay with total unfractionated hyperimmune serum to C. albicans. Use of the 47-kDa antigen-specific probe increased both the sensitivity and specificity of the assay system. Patients with systemic candidiasis were detected earlier in the course of the infection. The rate of detection of systemic C. albicans infections in neutropenic patients was 77% compared with 55% with total antibody in the dot immunobinding assay and 29% with the latex test. All three assay systems were positive in over 73% of infected patients who were not neutropenic. The 47-kDa antigen-specific probe was relatively specific to C. albicans. Antibody probes to the immunodominant antigens of other yeasts might be incorporated in the same dot immunobinding assay to detect systemic candidiasis caused by other species of yeasts.

Antibodies, Fungal↗
PubMed1988

Evaluating basic nursing skills through group video testing.

The skills/assessment course is the initial clinical experience for students and they are quite naive in their role expectations. Benner (1982 and 1987) refers to the transition stages of "novice" to "expert" in nursing. Although the major focus of the group video testing situation was to solve time constraints, the incorporation of professional nursing judgment was addressed in the process. The group effort, patient scenarios, critiques, visual performance, and analysis found in the group video testing method may expedite this transition of the "novice" to "competent" and eventual "expert" practitioner.

Clinical Competence↗
PubMed1988

Comprehensive family practice clerkship in a minority institution.

A comprehensive family practice clerkship program at Howard University College of Medicine has been conducted since 1970. This institution is one of three predominantly black institutions offering a family practice program. The senior clerkship is mandatory and at least 20 to 25 percent of each class elect to participate in a four-to six- week family practice preceptorship. As a result of the clerkship's success, over 50 percent of the program's graduates actively practice in primary medical manpower shortage or medically underserved areas.

Black or African American↗
PubMed1988

Visual push: a sensitive measure of dynamic balance in man.

Forty-six subjects aged 17 to 79 years who had not fallen in the previous year were exposed to an illusory visual stimulus while they stood on a force platform, with or without the introduction of a polyurethane foam pad under their feet to reduce proprioception. The amplitude of sway obtained in this way was not correlated to age, but the sway path in the anteroposterior plane increased logarithmically with increase in age. The method proved to be more sensitive than similar measures obtained without the illusory visual stimulus.

Adolescent↗
PubMed1987

Kyrle's disease.

Kyrle's disease is a chronic, genetically determined, hyperkeratotic disorder occurring in the middle forties. We report fourteen cases of this disorder in a population of 1.5 million over a period of 15 years. We observed a female/male ratio of 6:1. Straw-colored keratotic plugs and flat scale show a marked predisposition for the calf, the tibial region, and the posterior part of the thigh. They vary in size from 1 to 4 mm, and there is occasional plaque formation. No koebnerization or pruritus was noted, and no statistically significant association with hepatic, renal, or diabetic disorders could be demonstrated. Microscopic features showed a consistent pattern of keratotic plug formation, with the plug sitting in an invaginated atrophic epidermis, and underlying dermal histiocyte and lymphocyte aggregation. All lesions contained orthokeratosis and parakeratosis, with some sections showing abnormal keratinization. Sodium dodecylsulfate gel electrophoresis did not demonstrate the presence of abnormal keratin bands.

Adult↗
PubMed1987

Four outbreaks of nosocomial systemic candidiasis.

Candida albicans has recently been described as a cause of nosocomial infection. This paper reports four further outbreaks occurring over a 12-month period in England. There were 13 systemic cases and 6 deaths. The outbreaks were defined by morphotyping and the new technique of immunoblot fingerprinting. Control of the outbreaks was produced by the implementation of strict cross-infection control policies without recourse to systemic chemoprophylaxis.

Adolescent↗
PubMed1986

Fingerprinting Candida albicans.

A new method of typing Candida albicans based on immunoblotting is described. Isolates were disrupted by a mixture of enzymic pretreatment with alpha-mannosidase followed by sonication. They were then stained using a modified ELISA system by a rabbit hyperimmune serum raised against a single isolate, C. albicans NCTC 3153. The 190 isolates examined from the London Hospital produced 16 different types. Type 1 accounted for 43% of the isolates and was the commonest type outside the intensive care unit. Type 2 caused an outbreak of systemic candidosis on the intensive care unit. The technique was much more sensitive than the serotyping and morphotyping methods and lacked the phenotypic variability of the biotyping procedure previously used to define the outbreak. The gel-to-gel variation precludes its use in large scale epidemiological work. Its value lies in identification of outbreaks so that they can be controlled by the introduction of measures to prevent cross-infection.

Animals↗
PubMed1986

Behaviour problems in specific reading retarded and general reading backward children: a longitudinal study.

A sample of 453 Australian children was followed over the first three years of schooling. Behaviour problems were assessed at the beginning of the first year at school and at the end of the second and third years. At the end of the third year the children were classified as specific reading retarded, general reading backward or normal. At school entry backward readers were found to have behaviour problems, principally relating to attentional deficit. It was concluded that this factor may play a causative role in their reading difficulty. Retarded readers, on the other hand, showed no evidence of behaviour problems.

Antisocial Personality Disorder↗
PubMed1986

Cognitive factors at school entry predictive of specific reading retardation and general reading backwardness: a research note.

A sample of 453 Australian children was followed over the first three years of schooling. A broad range of cognitive skills was assessed at the beginning of the first year at school and at the end of the third year the children were classified as retarded, backward or normal readers. At school entry, backward readers were found to be deficient in a broad range of cognitive skills, as might be expected given their lower IQs. Retarded readers, however, were found to be deficient on a more limited range of tasks, mainly involving early literacy and phonological processing skills. The implications of these findings for theories of cognitive deficit in reading retardation are discussed.

Child↗
PubMed1986

Correlation of immunologic and nutritional status with infectious complications after major abdominal trauma.

Examination of the response of injured patients' lymphocytes to the mitogen phytohemagglutin in a defined medium provides a mechanism to define the relationship between alteration in immune function and septic complications. Lymphocytes from 30 victims of gunshot wounds to the abdomen were examined. Response to mitogen was measured by incorporation of [3H]-thymidine as a function of lymphocyte concentration, with a constant amount of mitogen phytohemagglutinin and a standard incubation period. A saturation curve was obtained, and lymphocyte response was expressed as the concentration necessary for half-maximal incorporation of radioactive label, L1/2. Lymphocyte transformation was compared with that found in a group of 50 healthy volunteers. On arrival in the emergency center, the in vitro lymphocyte response of patients was markedly diminished. There were seven patients for whom a lymphocyte curve could not be generated, i.e., L1/2 greater than 1 X 10(6). For the other 23 patients, L1/2 = 4.75 X 10(5) (SEM - 7.5 X 10(4)) compared with L1/2 = 1.5 X 10(5) (SEM - 5 X 10(4)) for normal volunteers (p less than 0.01). Measurement of skin test response, white blood cell count, anthropometric measurements, and albumin level were not predictive of patient course. In contrast the in vitro lymphocyte viability corresponded to the degree of injury, and recovery of lymphocyte function was associated with improvement in the patient's clinical course.

Abdominal Injuries↗
PubMed1985

Leaching of zinc compound from rubber stoppers into the contents of automatic atropine injectors.

This report describes how a material within the cartridge of an automatic injector contaminated its contents. On prolonged storage, a formulation that contained atropine produced lethality in mice. The toxic material originated from zinc compounds that were present in the rubber stopper and plunger of the container and that subsequently leached into the formulation. The contents of cartridges that contained greater than or equal to 0.75 mg/mL of solubilized zinc were lethal to at least 20% of the mice tested; those that contained 0.42 mg/mL showed no lethality. The problem resulted from the physicochemical properties of the rubber, not the concentration of zinc used in the vulcanization process.

Animals↗