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Biomedical subjects

S Hamilton

Publications and source records attributed to S Hamilton.

At least 19 recordsLinked to original sources
PubMed1995

ICU and non-ICU cost per day.

The purpose of this study was to compare the cost of a day spent in an intensive care unit and a day spent on a general nursing unit. A descriptive design was used, based on patient level data, to examine and compare unit costs per day for each of the ICU and non-ICU portions of a patient's hospital stay. Records from 386 patients who were treated in a general medical/surgical ICU were analyzed. Records for patients who received both ICU and non-ICU care during their stay were retained. Patients were categorized according to whether they had received surgical care prior to admission to the ICU (surgical group) or had no surgical care (medical group). The groups were further divided, based on whether they were discharged from hospital (survivors), or died following transfers from the ICU (non-survivors). All four groups; surgical or medical, survivors and non-survivors, were analyzed separately. The ICU direct costs per day for survivors were between six and seven times those for non-ICU care. A one day substitution of general ward for ICU care would result in a cost reduction of $1,200 per patient for survivors. The results suggest that the savings achieved by moving a patient from ICU to non-ICU care are considerable, particularly for less severe surviving patients. In making such decisions, however, clinicians must examine prospective benefits as well as costs. If the health outcomes are not influenced, the savings from substitution are considerable, and there is a strong economic argument for substitution.

Adult↗
PubMed1995

A late Golgi sorting function for Saccharomyces cerevisiae Apm1p, but not for Apm2p, a second yeast clathrin AP medium chain-related protein.

Mammalian clathrin-associated protein (AP) complexes, AP-1 (trans-Golgi network) and AP-2 (plasma membrane), are composed of two large subunits of 91-107 kDa, one medium chain (mu) of 47-50 kDa and one small chain (sigma) of 17-19 kDa. Two yeast genes, APM1 and APM2, have been identified that encode proteins related to AP mu chains. APM1, whose sequence was reported previously, codes for a protein of 54 kDa that has greatest similarity to the mammalian 47-kDa mu 1 chain of AP-1. APM2 encodes an AP medium chain-related protein of 605 amino acids (predicted molecular weight of 70 kDa) that is only 30-33% identical to the other family members. In yeast containing a normal clathrin heavy chain gene (CHC1), disruptions of the APM genes, singly or in combination, had no detectable phenotypic consequences. However, deletion of APM1 greatly enhanced the temperature-sensitive growth phenotype and the alpha-factor processing defect displayed by cells carrying a temperature-sensitive allele of the clathrin heavy chain gene. In contrast, deletion of APM2 caused no synthetic phenotypes with clathrin mutants. Biochemical analysis indicated that Apm1p and Apm2p are components of distinct high molecular weight complexes. Apm1p, Apm2p, and clathrin cofractionated in a discrete vesicle population, and the association of Apm1p with the vesicles was disrupted in CHC1 deletion strains. These results suggest that Apm1p is a component of an AP-1-like complex that participates with clathrin in sorting at the trans-Golgi in yeast. We propose that Apm2p represents a new class of AP-medium chain-related proteins that may be involved in a nonclathrin-mediated vesicular transport process in eukaryotic cells.

Adaptor Protein Complex mu Subunits↗
PubMed1995

A comparison of intensive care unit utilization in Alberta and western Massachusetts.

OBJECTIVE: To analyze differences in intensive care unit (ICU) utilization between a Canadian province and a U.S. area. DESIGN: Retrospective data analysis of hospital discharge data and existing data from an international study of severity of illness in ICU patients. SETTING: Administrative data for the province of Alberta and the four counties of western Massachusetts for the years 1990 to 1991 were used. Detailed data on consecutive ICU admissions from two Alberta hospitals, one western Massachusetts hospital, and 24 other U.S. hospitals for 3 months in 1991 were used. MEASUREMENTS AND MAIN RESULTS: ICU use and hospital mortality rates were compared for 50,030 hospital admissions divided into 11 patient groups. ICU days per million population were two to three times as great in western Massachusetts as in Alberta. The primary reason was higher ICU incidence (percent of hospitalized patients treated in the ICU) rather than a difference in hospital admission rate or length of ICU stay. ICU incidence in western Massachusetts was significantly higher in ten of 11 patient groups--for the coronary bypass surgery group, there was no difference. The hospital mortality rate in western Massachusetts was similar to, or higher than, the mortality rate in Alberta. In Alberta, a much higher proportion of ICU patients received mechanical ventilation. For elective surgery patients, the ICU severity of illness was lower in western Massachusetts and in other U.S. hospitals than in Alberta. CONCLUSIONS: Western Massachusetts hospitalized patients are more likely to be treated in an ICU than are similar patients in Alberta. There is no evidence that the greater ICU utilization in western Massachusetts led to a lower hospital mortality rate.

Aged↗
PubMed1995

The radio-opacity of fishbones: a cadaveric study.

Lateral neck radiographs performed to localize impacted fishbones have a low sensitivity. The differing radio-opacities of the bones of various fish species may be a reason for this. A cadaver head and neck and the rib bones of 10 species of fish were used in this study. A laryngoscope was used to introduce a fishbone into the vallecula and then into the hypopharynx of the cadaver. A lateral radiograph was taken in each case. Ten control films were taken. The radiographs were independently reviewed by a consultant radiologist and otolaryngologist. The presence and position of any bone seen was noted. There was no inter-observer variation. All species of fishbone were visible. One bone was not seen by either observer. Visualization of fishbones is more dependent on position than their degree of radio-opacity. Routine radiography is recommended.

Animals↗
PubMed1995

An immunohistochemical method for the detection of tumour necrosis factor alpha in cytospins of human bronchoalveolar lavage cells.

An immunohistochemical method for assessing the level of tumour necrosis factor-alpha in alveolar macrophages obtained by brochoalveolar lavage is described. Cytospins of mixed populations of lung cells were incubated first with a monoclonal antibody to CD68 and then with a specific peroxidase-labelled second antibody in a two-step reaction for the detection of the macrophage marker CD68. A second similarly based two-step reaction for the detection of tumour necrosis factor-alpha followed. Both reactions were visualized, on completion, using different coloured peroxidase substrates which produced a third colour in the event of dual deposition of the substrates. Dual substrate deposition was indicative of alveolar macrophages positive for tumour necrosis factor-alpha. This method has provided a specific and reproducible semi-quantitative test for the presence of tumour necrosis factor-alpha in human activated alveolar macrophages, which can be performed retrospectively on clinical material. A range of concentrations of the cytokine has been demonstrated in individual samples. This dual detection method has the potential for detection of any cell-associated protein product by minor modification of the described method.

Antibody Specificity↗
PubMed1994

The triad of left hemiplegia, hemihypesthesia, and homonymous hemianopsia: implications for rehabilitation.

Patients with carotid cerebrovascular disorder can be categorized as having either right hemiplegia with various degrees of aphasia, left hemiplegia with hemihypesthesia, or homonymous hemianopsia, or the triad of left hemiplegia, hemihypesthesia and homonymous hemianopsia. The purpose of this study was to compare the functional performance of patients with each type of carotid cerebrovascular disorder before and 1 year after comprehensive rehabilitation aimed at improving communication and/or functional skills. Performance was measured using both the Barthel Index and Williams Drawing Test. On average, patients with the triad of neurologic deficits started and finished with poorer functional performance than the other patients. However, the average gain in functional scores over time was similar for all groups.

Activities of Daily Living↗
PubMed1994

Radial ray defects, renal ectopia, duodenal atresia and hydrocephalus: the extended spectrum for Fanconi anaemia.

We present two families with a striking concordance of multiple anomalies. These include duodenal and other bowel atresia, radial ray defects especially absent or vestigial thumb, renal ectopia and hydrocephalus. The presence of diagnostically raised sensitivity to mitomycin C in the first family has confirmed Fanconi anaemia. This has further increased the spectrum of abnormalities in Fanconi anaemia and highlights the importance of mitomycin C analysis if elements of this spectrum are encountered.

Bone and Bones↗
PubMed1993

Continuous and discontinuous assays for phosphotyrosyl protein phosphatase activity using phosphotyrosyl peptide substrates.

Assays for phosphotyrosyl protein phosphatase activity have been developed using the synthetic peptide Glu-Glu-Tyr(P)-Ala-Ala and its N alpha-fluorenylmethoxycarbonyl derivative (Fmoc-Glu-Glu-Tyr(P)-Ala-Ala) as substrates. Conditions for monitoring the phosphatase-catalyzed hydrolysis of the former peptide, either spectrophotometrically or fluorometrically, are reported. These continuous assays are similar in sensitivity to published assays using phosphotyrosine as substrate. A discontinuous HPLC-based assay using the intensely fluorescent Fmoc-peptide as substrate is also described. This assay is comparable in sensitivity to assays using 32P-labeled substrates and is suitable for assaying low levels of phosphotyrosyl protein phosphatase activity in crude tissue extracts.

Amino Acid Sequence↗