Severity scoring in intensive care.
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Biomedical subjects
Publications and source records attributed to S J Scott.
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Human neutrophils treated with pertussis toxin had decreased functional responses to several agents including zymosan-treated serum, heat-aggregated immunoglobulin, platelet-activating factor, and fMet-Leu-Phe. Responses affected include superoxide generation and release of lysozyme. The degree and type of inhibition was dependent on the individual receptor and the cellular response studied. Measurement of intracellular calcium levels with quin-2 showed that both fMet-Leu-Phe- and platelet-activating factor-mediated increases in quin-2 fluorescence were diminished as a result of pertussis toxin treatment. fMet-Leu-Phe-mediated calcium uptake was also inhibited. However, under conditions where fMet-Leu-Phe-mediated effects on cell function were completely abolished, only a partial inhibition of 3,4,5-trimethoxybenzoic acid 8-(diethylamino)octyl ester (TMB-8) sensitive calcium uptake was observed. A study of the linked reactions of chemotaxis, capping, and shape change revealed that chemotaxis was inhibited regardless of the chemoattractant utilized (zymosan-treated serum, fMet-Leu-Phe, and platelet-activating factor) and the associated reactions of Con A capping and fMet-Leu-Phe- or Con A-mediated shape change were reduced in pertussis toxin-treated cells. Our results suggest that multiple mediators of inflammation act through a pertussis toxin-sensitive GTP-binding protein that regulates the mobilization of internal calcium as well as calcium uptake and is, in addition, a key control element of shape change, capping, and chemotaxis.
In 1983 Congress adopted the most significant change in the Medicare program since its inception in 1965. Along with measures to ensure the solvency of the Social Security System into the next century, Congress approved a system of prospective payment for hospital inpatient services, whereby hospitals are paid a fixed sum per case according to a schedule of diagnosis related groups (DRGs). The program will be phased in over a four-year period that began October 1, 1983. Several types of hospitals and distinct part units of general hospitals are excluded from the system until 1985, when Congress will receive a report on a method of paying them prospectively. Information used to calculate the DRG rates was published September 1, 1983, as part of the interim final regulations. Other third party payers, such as state Medicaid systems and insurance companies, are considering converting to this method of payment, and several have adopted it. The implications for occupational therapy include a greater emphasis on reducing hospital length of stay, expanding outpatient care, increasing productivity, and a trend toward documentation and accounting consistent with computer technology.
A case of pyogenic orchitis due to infection with Salmonella enteritidis ser. Paratyphi B is discussed. Unlike previously reported cases of Salmonella orchitis, this patient developed infection by bacteremic spread and not by direct extension from the epididymis. Therapy with chloramphenicol resulted in an excellent clinical response.
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A patient with severe hypothermia (core temperature of 22.2 C) and ventricular fibrillation had manual cardiopulmonary resuscitation for 3 1/2 hours while various rewarming technics raised her temperature to a level permitting successful electrical cardioversion. Laboratory testing revealed disseminated intravascular coagulation and several endocrinologic abnormalities. The need for prolonged, aggressive resuscitative measures and the possible role of corticosteroids in the management of profound hypothermia are discussed.
Instruction in self-examination for early signs of orofacial cancer was given to over 450 persons attending a large county fair in western New York State. Participants received one-on-one instruction from dentists or specially trained dental hygienists according to a protocol designed to detect abnormalities of the oral cavity, cervical lymph nodes, and major salivary glands, as well as facial skin cancers. This method of personal instruction was judged feasible for large-scale application.
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