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Biomedical subjects

S Berry

Publications and source records attributed to S Berry.

103 records · Page 6Linked to original sources
PubMed1980

Channeling health: a review of the evaluation of televised health campaigns.

This article reviews efforts to assess the effectiveness of television programs on changing health behaviors. The relatively limited literature to date has featured primarily correlational studies which permitted no causal conclusions. The few experimental studies available present a mixed picture. Numerous methodologic problems beset any effort at assessment of effectiveness. Perhaps the greatest difficulty is operationalizing a design that permits true experimental manipulation on a relevant sample without contamination. The several methodologic problems and some potential means of surmounting them are discussed.

Attitude to Health↗
PubMed1976

Postoperative impairment of mucous transport in the lung.

Impairment of mucous transport is considered significant to the postoperative development of atelectasis, but the association has never beed demonstrated in humans. Tantalum powder, which adheres to airway mucus, can be used to study mucociliary transport. The postoperative clearance of insufflated tantalum powder (mean diameter, 2.5 mum) was investigated in 25 patients. Eighteen patients underwent intra-abdominal vascular surgery and 7 undersent lower-extremity orthopedic procedures. At the completion of surgery, tantalum was insufflated into both lungs of each patient to outline a representative sample of airways from the trachea to the small bronchi. Tantalum clearance was evaluated from serial radiographs obtained immediately after insufflation, at approximately 6, 18, 26, and 48 hours later, and thereafter whenever appropriate. In the 7 orthopedic patients, clearance of tantalum was progressive and usually complete within 48 hours. Atelectasis did not occur in this group. In 14 of the 18 patients who had abdominal surgery, mucociliary clearance was markedly abnormal in that tantalum was retained for up to 6 days. Pooling of tantalum-labeled mucus occurred in dependent bronchi in 16 of these 18 patients. Pooling preceded and always accompanied radiographically visible atelectasis. Lobar atelectasis occurred in 6 patients and segmental atelectasis in 8. Tantalum-labeled mucus moved peripherally in atelectatic lobes or segments and was retained in these bronchi until re-expansion took place. Thus, impaired ciliary function and mucous transport are associated with and implicated in postoperative pulmonary atelectasis.

Aged↗
PubMedDate not supplied

An asthma management program for urban minority children.

Morbidity and mortality continue to increase for children with asthma. Minority children have disproportionately higher rates of adverse outcomes on almost all disease measures. An asthma management program for urban minority children was developed with research-based intervention strategies and insights gained from the child and family perspectives on illness and health care delivery. The goal of the intervention program was to deliver care that was culturally sensitive, focused on decreasing barriers to appropriate self-management, and committed to promoting partnerships among children, families, the health care system, and the broader community.

Adolescent↗
PubMedDate not supplied

Field evaluation of a simplified unit-dose syringe for administration of measles vaccine.

Ezeject is a plungerless syringe prefilled with lyophilized measles vaccine. Ezeject syringes were compared with standard 3-cc syringes and 10-dose measles vaccine vials in the vaccination of 884 Guatemalan infants 8-23 months of age. Vaccination was performed by experienced vaccinators and by individuals without prior vaccination experience who received 2.5-3 hours of training. The overall seroconversion rate following administration was 96%, regardless of the type of syringe used or of the experience of the vaccinator. No significant adverse events were observed in children vaccinated with the new syringes. Although incomplete emptying was noted in 87% of the Ezeject syringes used, this had no effect on the serologic response to measles vaccine. Aspiration for detection of blood before injection of the vaccine was performed significantly (P less than .001) less frequently with Ezeject than with 3-cc syringes by both experienced and inexperienced personnel. Inexperienced vaccinators administered measles vaccine significantly faster (P less than .001) with Ezeject than with 3-cc syringes, but the times were similar for experienced vaccinators. Ezeject is an acceptable alternative to standard syringes for the administration of measles vaccine. Several design modifications that would improve the handling of the device and eliminate the possibility of its reuse have been suggested.

Antibodies, Viral↗
PubMedDate not supplied

Cloning and characterization of a pectate lyase gene from Erwinia carotovora EC153.

A pel gene cloned from strain EC153 of Erwinia carotovora encoded a pectate lyase that macerated plant tissue with moderate efficiency. This gene, called pel153, was sequenced and found to possess considerable homology with a pectate lyase gene from Yersinia pseudotuberculosis. The Yersinia protein, however, was truncated at the carboxyl terminal end relative to the Erwinia gene product and had a lower isoelectric point. The Erwinia pel153 gene was overexpressed in cells of Escherichia coli, and a 56-kDa protein was observed on sodium dodecyl sulfate-polyacrylamide gels. This compares with a molecular weight of 61 kDa for the mature, secreted protein as determined from sequencing data. Southern blot analysis disclosed the presence of the pel153 gene in three different strains of E. carotovora, but mutation of the gene in strain EC153 did not affect its ability to soft-rot potato tubers.

Amino Acid Sequence↗
PubMedDate not supplied

Evidence of participation of the soluble tumor necrosis factor receptor I in the host response to intrauterine infection in preterm labor.

PROBLEM: This study was conducted to determine whether: (1) the soluble tumor necrosis factor receptor I (sTNF-rI) is present in human amniotic fluid, neonatal urine, and the feto-maternal plasma; (2) there are changes in the concentration of the sTNF-rI in amniotic fluid with gestational age; and (3) microbial invasion of the amniotic cavity (in term and preterm parturition) is associated with changes in amniotic fluid sTNF-rI concentrations. METHOD: Amniotic fluid was retrieved by amniocentesis from 185 women classified into 11 groups according to gestational age (midtrimester, preterm gestation, and term), the presence or absence of labor, spontaneous rupture of membranes and microbial invasion of the amniotic cavity. sTNF-rI was assayed with a sensitive and enzyme-linked immunosorbent assay (ELISA) validated for amniotic fluid. In addition, sTNF-rI concentrations were determined in fetal blood obtained by cordocentesis in preterm gestations (N = 24) or at the time of delivery after spontaneous labor at term (N = 10). sTNF-rI concentrations were also measured in maternal venous and cord blood and neonatal urine (n = 13). RESULTS: sTNF-rI was found to be present in all amniotic fluid samples, maternal blood and fetal blood and neonatal urine samples; sTNF-rI concentrations were higher in the midtrimester than at term (mean +/- SD: 36.2 +/- 12.2 ng/ml versus mean +/- SD: 5.56 +/- 5.72 ng/ml [P < .05]); patients with preterm labor and microbial invasion of the amniotic cavity (with intact or with ruptured membranes) had significantly higher amniotic fluid concentrations of sTNF-rI than patients without microbial invasion; in the absence of microbial invasion, parturition (both term and preterm) was not associated with changes in amniotic fluid concentrations of sTNF-rI; neonatal urine contained the highest concentrations of sTNF-rI of all biological fluids assayed including maternal and neonatal/fetal blood and amniotic fluid. CONCLUSIONS: It was concluded that sTNF-rI is a physiologic constituent of amniotic fluid, as well as of the fetal and maternal plasma; that amniotic fluid sTNF-rI concentrations decrease as a function of gestional age and increases in the concentration of the sTNF-rI are part of the host response to intrauterine infection in preterm parturition.

Adult↗
PubMedDate not supplied

Intestinal placement of pH-sensing nasointestinal feeding tubes.

Intestinal access for enteral nutrition can be achieved by spontaneous intestinal nasogastric tube passage or by endoscopic, fluoroscopic, or surgical placement methods. Each of these methods has limitations that may compromise clinical utility. pH-sensing nasointestinal feeding tubes allow active placement with minimal equipment and expertise; however, this method requires an acidic gastric pH. We sought to determine whether antiulcer regimens used at our institution would preclude intestinal pH-sensing tube placement. Twenty-five patients had 25 (81%) successful intestinal placements in 31 attempts. Observed pH values and calculated pH changes were compared within and between successful and unsuccessful groups by using a Student's t test. Initial, lowest, and final pH values did not differ significantly between groups. The pH change initial-to-lowest (4.7 +/- 0.18 vs 3.6 +/- 0.59, p < .03) and lowest-to-final (5.0 +/- 0.18 vs 3.0 +/- 0.47, p < .0001) differed significantly between groups, whereas the pH change initial-to-final did not. Cost analysis of endoscopic ($782), fluoroscopic ($341 to $382), spontaneous ($167 to $212), and pH-sensing ($162) methods revealed 3% to 79% savings when the pH-sensing placement method was used. We conclude that the antiulcer therapies used in our patient population did not preclude intestinal pH-sensing tube placement. If the pH changes from initial-to-lowest and lowest-to-final were greater than 4, successful intestinal placement occurred in 91% of attempts. Finally, the method was cost-effective at our institution.

Anti-Ulcer Agents↗
PubMedDate not supplied

pH measurements as guide for establishing short-term postpyloric enteral access.

Standard antiulcer regimens that use agents such as intravenous ranitidine (50 mg every 8 h) and/or intragastric antacids (30 ml every 4 h) do not seem to preclude use of pH-sensing feeding tubes in our patient population. The cost of placement ($174/successful tube) compared favorably (3-79% less) with the cost of other placement methods used at our institution. Immediate establishment of postpyloric access by this method can decrease delays in instituting nutritional support. Moreover, in patients at increased risk for aspiration, e.g., those with altered mental status, postpyloric tube placement may be beneficial in reducing aspiration occurrence. The equipment is portable and easy to operate, and the placement technique can be easily learned and performed at bedside by nurses and physicians. Whereas we feel that the sensitivity and specificity for intestinal placement are not sufficient to preclude a confirmatory radiograph, the sensitivity and specificity for intragastric placement in our study were both 100%. Our own policy is to obtain a confirmatory radiograph before institution of any nutritional therapy through a central access device (central venous catheter or feeding tube). However, depending on hospital or departmental policy, a radiograph may be unnecessary when intragastric placement is deemed adequate. Finally, this placement method may obviate the need for more intricate and expensive methods of feeding-tube placement.

Enteral Nutrition↗