Biomedical subjects

Robert Pratt

Publications and source records attributed to Robert Pratt.

10 recordsLinked to original sources

PubMed2006

A diastereoselective radical cyclization approach to substituted quinuclidines.

A new, concise, and flexible approach to novel quinuclidines has been developed, which employs a phosphorus hydride mediated radical addition/cyclization reaction in the key step. 1,7-Diene 5 reacts with diethyl thiophosphite in an efficient and diastereoselective radical addition/cyclization reaction to give trisubstituted piperidines 4ab. Piperidines 4ab are subsequently converted into 2,5-disubstituted quinuclidines using S(N)2-type cyclizations. Finally, the resulting quinuclidines are shown to undergo novel Horner-Wadsworth-Emmons-type (HWE-type) reactions to give unsaturated quinuclidines 21a and 21b, which have structures similar to that of (-)-quinine 1.

Cyclization↗

PubMed2006

Beating the bug.

Explore the source record for details and available documents.

Computer-Assisted Instruction↗

PubMed2006

Spinal accessory nerve monitoring with clinical outcome measures.

We conducted a prospective study of 11 patients to (1) determine the feasibility of electrophysiologic monitoring of the spinal accessory nerve (SAN) during modified radical neck dissection, (2) determine whether a threshold increase in current is required to stimulate the SAN by comparing the amount of current on initial identification of the SAN and the amount of current after completion of the dissection prior to closure, and (3) determine whether clinical outcome measures of shoulder syndrome at 72 hours and 45 days postoperatively are affected by a threshold increase. We found that 3 of 11 patients (27.3%) experienced significant threshold increases (>0.4 mA) on completion of the dissection. Of 8 patients who completed a shoulder syndrome evaluation, 3 (37.5%) had scapular winging, mild to moderate pain, and less than 90% of shoulder abduction. Two of 3 patients with shoulder syndrome had a threshold increase on electrophysiologic monitoring. We conclude that electrophysiologic monitoring of the SAN is feasible. It did not identify a threshold increase in more than 70% of patients. Electrophysiologic integrity of the SAN did not completely correlate with clinical outcome measures for shoulder syndrome.

Accessory Nerve↗

PubMed2004

CEP11004, a novel inhibitor of the mixed lineage kinases, suppresses apoptotic death in dopamine neurons of the substantia nigra induced by 6-hydroxydopamine.

There is much evidence that the kinase cascade which leads to the phosphorylation of c-jun plays an important signaling role in the mediation of programmed cell death. We have previously shown that c-jun is phosphorylated in a model of induced apoptotic death in dopamine neurons of the substantia nigra in vivo. To determine the generality and functional significance of this response, we have examined c-jun phosphorylation and the effect on cell death of a novel mixed lineage kinase inhibitor, CEP11004, in the 6-hydroxydopamine model of induced apoptotic death in dopamine neurons. We found that expression of total c-jun and Ser73-phosphorylated c-jun is increased in this model and both colocalize with apoptotic morphology. CEP11004 suppresses apoptotic death to levels of 44 and 58% of control values at doses of 1.0 and 3.0 mg/kg, respectively. It also suppresses, to approximately equal levels, the number of profiles positive for the activated form of capase 9. CEP11004 markedly suppresses striatal dopaminergic fiber loss in these models, to only 22% of control levels. We conclude that c-jun phosphorylation is a general feature of apoptosis in living dopamine neurons and that the mixed lineage kinases play a functional role as up-stream mediators of cell death in these neurons.

Animals↗

PubMed2004

Lessons from the genome sequence of Neurospora crassa: tracing the path from genomic blueprint to multicellular organism.

We present an analysis of over 1,100 of the approximately 10,000 predicted proteins encoded by the genome sequence of the filamentous fungus Neurospora crassa. Seven major areas of Neurospora genomics and biology are covered. First, the basic features of the genome, including the automated assembly, gene calls, and global gene analyses are summarized. The second section covers components of the centromere and kinetochore complexes, chromatin assembly and modification, and transcription and translation initiation factors. The third area discusses genome defense mechanisms, including repeat induced point mutation, quelling and meiotic silencing, and DNA repair and recombination. In the fourth section, topics relevant to metabolism and transport include extracellular digestion; membrane transporters; aspects of carbon, sulfur, nitrogen, and lipid metabolism; the mitochondrion and energy metabolism; the proteasome; and protein glycosylation, secretion, and endocytosis. Environmental sensing is the focus of the fifth section with a treatment of two-component systems; GTP-binding proteins; mitogen-activated protein, p21-activated, and germinal center kinases; calcium signaling; protein phosphatases; photobiology; circadian rhythms; and heat shock and stress responses. The sixth area of analysis is growth and development; it encompasses cell wall synthesis, proteins important for hyphal polarity, cytoskeletal components, the cyclin/cyclin-dependent kinase machinery, macroconidiation, meiosis, and the sexual cycle. The seventh section covers topics relevant to animal and plant pathogenesis and human disease. The results demonstrate that a large proportion of Neurospora genes do not have homologues in the yeasts Saccharomyces cerevisiae and Schizosaccharomyces pombe. The group of unshared genes includes potential new targets for antifungals as well as loci implicated in human and plant physiology and disease.

Animals↗

PubMedDate not supplied

Health department costs of managing persons with suspected and noncounted tuberculosis in New York City, Three Texas counties, and Massachusetts.

OBJECTIVES: To describe persons with suspected (did not meet the national tuberculosis [TB] surveillance case definition) and noncounted TB (met the TB case definition but transferred and were counted by another jurisdiction) and estimate costs incurred by public health departments for managing them. METHODS: We reviewed TB registry, medical records, budgets, bills, salaries, organizational charts, and travel/activity logs from the year 2000 at health departments in New York City (NYC), three Texas (TX) counties (El Paso, Hidalgo, and Webb), and Massachusetts (MA). We also interviewed or observed personnel to estimate the time spent on activities for these patients. RESULTS: In 2000, NYC and MA had more persons with suspected (n = 2,996) and noncounted (n = 163) TB than with counted (n = 1,595) TB. TX counties had more persons with counted TB (n = 179) than with suspected (n = 55) and noncounted (n = 15) TB. Demographic and clinical characteristics varied widely. For persons with suspected TB, NYC spent an estimated $1.7 million, with an average cost of $636 for each person; TX counties spent $60,928 ($1,108 per patient); and MA spent $1.1 million ($3,330 per patient). For persons with noncounted TB, NYC spent $303,148 ($2,180 per patient), TX counties spent $40,002 ($2,667 per patient), and MA spent $84,603 ($3,525 per patient). CONCLUSIONS: Health departments incurred substantial costs in managing persons with suspected and noncounted TB. These costs should be considered when allocating TB program resources.

Health Care Costs↗

PubMedDate not supplied

Prevention and control of viral hepatitis.

Viral hepatitis is a common disease caused by various hepatotropic viruses. An awareness of the characteristics and transmission patterns of these viruses will help nurses to understand the diverse clinical outcomes of infection and develop effective patient education and infection prevention and control strategies.

Acute Disease↗

PubMedDate not supplied

Health care-associated infections in primary and community care.

The National Institute for Clinical Excellence recently published guidelines for preventing health care-associated infections (HAIs) in primary and community care (NICE, 2003). These were commissioned by the Department of Health and NICE to complement previously published guidelines for preventing HAIs in hospitals (Pratt et al, 2001). The new guidelines aim to facilitate a seamless approach to using the best evidence for infection prevention practices as patients transfer between primary and secondary health care services. This article discusses the need for the guidelines and describes the methods used to develop them.

Benchmarking↗

PubMedDate not supplied

Preventing health care-associated infections during enteral feeding.

IN the late 1980s, enteral feeding became common practice in hospitals for patients who were unable to feed themselves. It was therefore inevitable that those requiring long-term artificial feeding--that is, for more than 30 days--would continue this practice at home.

Enteral Nutrition↗

PubMedDate not supplied

Catheter-associated urinary tract infections: primary care guidelines.

In primary and community health care settings, long-term (> 28 days) urinary catheterisation (LTC) is most commonly used in managing older people and those with neurological conditions. Studies suggest that in the UK LTC is used in 0.5 per cent of people aged 75 or over (Kohler-Ockmore and Feneley, 1996) and in four per cent of people receiving domiciliary care (Getliffe and Mulhall, 1991). Most health-care associated infections (HAIs) are caused by indwelling urinary catheters (Stamm, 1998). Many of these infections are serious and lead to significant morbidity. In acute care facilities, 20-30 per cent of catheterised patients develop bacteriuria, of whom two to six per cent develop symptoms of urinary tract infections (UTIs) (Stamm, 1998).

Anti-Infective Agents, Urinary↗