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Biomedical subjects

S Jacobson

Publications and source records attributed to S Jacobson.

At least 289 records · Page 16Linked to original sources
PubMedDate not supplied

Nursing service data for research in patient care.

Nursing service records from the nontechnical medical care program, an Oklahoma statewide Medicaid long-term community care program, provided a unique data base to gather information for research purposes and program improvement. This article describes the process of developing a data collection (coding) form to extract a minimum data set and a method of training lay coders to use the form. Inherent problems associated with this process from the beginning to the end are also shared.

Abstracting and Indexing↗
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Induction of measles virus-specific human cytotoxic T cells by purified measles virus nucleocapsid and hemagglutinin polypeptides.

The measles virus polypeptide specificity of human measles virus-specific, HLA class II restricted cytotoxic T cells have been examined. Measles virus-specific CTL have been generated using purified measles virus nucleocapsid and hemagglutinin polypeptides during a primary, in vitro stimulation of bulk cultures. Both the purified preparations of measles virus nucleocapsid and hemagglutinin polypeptides were effective in stimulating a measles virus-specific CTL response. The measles virus nucleocapsid-induced CTL response could be blocked by an anti-HLA class II monoclonal antibody but not an anti-HLA class I antiserum. Moreover, considerably less measles virus nucleocapsid was required to stimulate a comparable CTL response than the measles virus hemagglutinin which suggests that the CTL response to measles virus may be skewed towards internal viral determinants of measles virus. These studies indicate that both internal and external components of measles virus are effective in inducing measles virus-specific CTL. The recognition of internal viral components may represent an important part of the T cell mediated immune response to viruses.

Antibodies, Monoclonal↗
PubMedDate not supplied

Safety and pharmacokinetics of EMLA in the treatment of postburn pruritus in pediatric patients: a pilot study.

The purpose of this study was to determine the safety and pharmacokinetics of a eutectic mixture of local anesthetics (EMLA) used to ameliorate postburn pruritus after application onto newly formed, intact skin in children. EMLA was applied once to an itchy site where healed skin had formed. Serial blood samples were collected to measure lidocaine, prilocaine, o-toluidine, and methemoglobin. Maximal plasma concentration, minimal plasma concentration, time to achieve the maximal plasma concentration, elimination half-life, and area under the concentration-time curve were calculated. Vital signs, oxygen saturation, clinical signs of hypoxia, and itch intensity were measured. Five children had 15.7 +/- 2.54 g (+/- SD) of EMLA applied to a skin surface area of 93.0 +/- 37.0 cm2. Lidocaine and prilocaine concentrations were below toxic levels; o-toluidine was not detected. Methemoglobin remained between 1 and 3%; patients did not exhibit any clinical signs of hypoxia. Mean oxygen saturation was 98.9 +/- 0.01%. The mean number of pruritic episodes and antihistamine breakthrough doses were greater in the 2 prestudy control days compared with study day 3 (P = 0.01 and P = 0.03, respectively). Skin at the site of EMLA application remained anesthetized for 12 to 13 hours. In this small pilot study, EMLA seems to be a safe, novel treatment for postburn pruritus in burned children when applied to newly healed, intact skin.

Administration, Topical↗
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Crohn's disease of the appendix: remission obtained by total parenteral nutrition.

A woman, aged 37 years, who had been suffering from advanced Crohn's disease for many years, was treated with long-term total parenteral nutrition (TPN), given in two 2-month periods at an interval of 6 months. Prior to the introduction of TPN there was inflammation of the appendix, the terminal ileum, and the entire colon. During the first period of TPN there was a temporary clinical and radiological improvement in the state of the intestinal tract, including the appendix. Two months after the first period of TPN abdominal pain recurred, and colonoscopy disclosed renewed severe inflammation of the mucosa from the cecum to the rectum. At operation, on day 45 of the second period of TPN, due to remaining stenosis of the terminal ileum, there was no longer any inflammation of the appendix, confirmed by histological examination.

Adult↗
PubMedDate not supplied

Nine year's survival with short bowel syndrome after occlusion of the superior mesenteric artery in an elderly man: a study of periods of parenteral nutrition.

A 70-year-old man with severe short bowel syndrome after acute occlusion of the superior mesenteric artery and massive intestinal gangrene was given total and supplementary parenteral nutrition for six periods of 14 to 28 days; he survived for more than 9 years and died from the effects of nutritional depletion. Studies of the blood chemistry and the urinary excretion of nitrogen and electrolytes during the six periods of intravenous nutrition showed that nutritional repletion of nitrogen and electrolytes was achieved without adverse effects on the liver function. The results suggest that intermittent total and supplementary parenteral nutrition may allow nutritional repletion and thereby prolong the survival time in the elderly patient in whom massive intestinal resection has been performed.

Aged↗
PubMedDate not supplied

Blood hemoglobin: a possible predictor of central venous catheter-related thrombosis in parenteral nutrition.

The biochemical records of 43 patients given nutritional support via a central venous catheter (CVC) for between 7 and 111 days (mean 28 days) without anticoagulant therapy were reviewed. On completion of the parenteral nutrition, phlebography was performed via the CVC. Patients developing CVC-related thrombosis (22/43, 51%) were assigned to group I and those without this phlebographic finding (21/43, 49%) to group II. The blood (B-) hemoglobin concentration before catheterization was higher in group I than in group II, the values being 121 +/- 16 (mean +/- SD) and 106 +/- 13 g/liter, respectively. An initial B-hemoglobin level above 127 g/liter showed a high positive accuracy of prediction for CVC-related thrombosis and on this basis 89% (8/9) of the patients were correctly assigned to group I, whereas an initial B-hemoglobin level below 111 g/liter showed a lower accuracy of prediction for a normal phlebographic status and on this basis 71% (12/17) of the patients were correctly assigned to group II. The specificity of the test criteria--B-hemoglobin greater than 127 and less than 111 g/liter--was high, with values of 95% (20/21) and 77% (17/22), respectively, whereas the sensitivity was low; only 36% (8/22) of group I had an initial B-hemoglobin above 127 g/liter and in group II 57% (12/21) recorded a value below 111 g/liter. It is concluded that if a patient has an initial B-hemoglobin concentration of more than 127 g/liter there is a high risk that CVC-related thrombosis will develop during parenteral nutrition lasting 1 wk or more.

Adolescent↗
PubMedDate not supplied

Serum concentration of cobalamines during total parenteral nutrition in Crohn's disease.

The vitamin B12 status was assessed by measuring the fasting serum (S-) concentration of cobalamines in a consecutive series of 12 patients with Crohn's disease (CD) given total parenteral nutrition (TPN)--nil per os--for between 21 and 97 days (mean, 49 days). At introduction of TPN the S-cobalamine concentration was less than 300 pmol/liter in four patients (group I) and more than 300 pmol/liter in eight (group II). Each day during TPN fat- and water-soluble vitamins, including 2 micrograms of cyanocobalamin, were given. In group I there was a small increase in the S-cobalamine level during the first 2 to 4 weeks of TPN, whereas in group II the values approached the middle of the reference range (190-680 pmol/liter) after 6 to 8 weeks of TPN. It would thus appear that the vitamin regimen studied, including 2 micrograms of cyanocobalamin per 24 hr, is able to maintain the S-cobalamine concentration within the reference range during 6 to 8 weeks of TPN in CD patients with no evidence of vitamin B12 deficiency, and to prevent the development of vitamin B12 deficiency during 2 to 4 weeks of TPN in CD patients with a S-cobalamine level initially below 300 pmol/liter.

Adult↗