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Biomedical subjects

S Morgan

Publications and source records attributed to S Morgan.

At least 73 records · Page 4Linked to original sources
PubMed1997

A comparison of the BioStar Strep A OIA rapid antigen assay, group A Selective Strep Agar (ssA), and Todd-Hewitt broth cultures for the detection of group A Streptococcus in an outpatient family practice setting.

In some studies the BioStar Strep A OIA (optical immunoassay) has yielded inconsistent results, although originally it was reported to be more sensitive than conventional culture for the detection of group A Streptococcus (GAS). The Group A Selective Strep Agar with 5% sheep blood (ssA) incubated anaerobically has been reported to be more sensitive than conventional culture in the detection of GAS. We compared the BioStar Strep A OIA GAS rapid antigen detection kit to anaerobic culture on ssA with and without preincubation in Todd-Hewitt broth (THB) for the detection of GAS. From September 1995 through January 1996, throat swabs were collected in duplicate from 75 children (< or = 18 years) and 188 adults (> 18 years) who presented with pharyngitis in the outpatient University of New Mexico Family Practice Clinic. Thirty-one (12%) of the 263 cases were positive for GAS by culture and/or broth. Compared with anaerobic culture on the ssA, with and without preincubation in THB, the sensitivity, specificity, positive predictive value, and negative predictive value of the BioStar Strep A OIA were 77, 62, 22, and 95%, respectively. Compared with enrichment in THB followed by subculture on ssA and anaerobic incubation, the sensitivity, specificity, positive predictive value, and negative predictive value of direct culture on ssA and anaerobic incubation were 79, 99, 98, and 96%, respectively. All isolates were serologically grouped. The BioStar Strep A OIA is as sensitive as direct culture on ssA incubated anaerobically, but the low specificity and low positive predictive value when the OIA is used in low prevalence populations could lead to unnecessary antibiotic treatment.

Adult↗
PubMed1997

Client-centred approach to student nurse education in mental health practicum: an inquiry.

This project utilized constructive feedback from clients of mental health facilities as a means of facilitating student nurse learning in three clinical environments. Three questionnaires were utilized to elicit and evaluate the impact of this feedback with a sample of 43 students and 74 client participants. The inquiry demonstrated that clients are willing to participate in students learning and believe that they can contribute towards it. Students also believed that clients have a valuable role to play in their learning, although they note caution in regards to client selection.

Attitude to Health↗
PubMed1997

Preventive care for patients following myocardial infarction. The Wessex Research Network (WReN).

OBJECTIVE: We aimed to assess general practice care for patients following a myocardial infarction (MI). METHOD: A structured review was carried out of general practice records of patients identified from hospital administration data. A total of 266 survivors following MI were identified from the discharge data of 13 hospitals in Southern England and registered with 71 GPs belonging to the Wessex Research Network. Median time since hospital discharge was 2.1 years. The main outcome measures were the provision of appropriate preventive care, including cardiac rehabilitation, drug therapy, and lifestyle advice for modifiable risk factors. RESULTS: Basic care was provided to nearly all patients; 253 (95.1%, 95% Cl 91.8-97.4) had blood pressure documented after their MI, 216 of 234 patients eligible for aspirin (92.3%; 88.1-95.4) had been recommended treatment, and the provision of advice on smoking cessation was documented for 27 of 33 continuing smokers (81.8%; 64.5-93.0). However, only 73 of 236 patients eligible to attend a structured rehabilitation programme (30.9%; 25.0-36.8) were documented as having received rehabilitation. Of 89 patients with heart failure following MI, 33 (37.1%; 27.1-48.0) had no record of having been offered treatment with an ACE inhibitor. Total cholesterol measurement was documented for only 144 patients (54.1%; 48.1-60.1). We estimate that there is still the potential to prevent between 4 and 9 deaths in this group of 266 surviving patients in the next 2 years by further improving the quality of follow-up care. CONCLUSIONS: Preventive care in patients with proven ischaemic heart disease in general practice remains haphazard, even among doctors enthusiastic to participate in research and to audit their quality of care. As general practitioners we should ensure that we are providing high quality preventive care to patients with clinical disease before we focus on the even more demanding task of primary prevention.

Adult↗
PubMed1997

Role of nitric oxide in modulating the long-term renal and hypertensive actions of norepinephrine.

We have previously reported that nitric oxide (NO) plays an important role in protecting the renal vasculature from acute norepinephrine-induced vasoconstriction. The purpose of this study was to determine the importance of this interaction between NO and norepinephrine in long-term control of renal hemodynamics and arterial pressure. To achieve this goal, we examined the effects of an intrarenal infusion of norepinephrine (NE) (0.1 microgram.kg-1.min-1) for 7 days in conscious, chronically instrumented control dogs and in dogs pretreated with a synthesis inhibitor, L-NAME (3 micrograms.kg-1.min-1 intrarenally). Both groups of dogs also received captopril (15 micrograms.kg-1.min-1) plus angiotensin I] intravenously to clamp the renin-angiotensin system throughout the protocol. In control dogs (n = 6), intrarenal infusion of NE decreased renal plasma flow by 9% (134 +/- 10 to 122 +/- 14 mL/min) and glomerular filtration rate by 16% (49 +/- 4 to 41 +/- 5 mL/min) while having no effect on mean arterial pressure (100 +/- 3 to 98 +/- 4 mm Hg). In marked contrast, in dogs pretreated with intrarenal L-NAME (n = 9), NE decreased renal plasma flow by 37% (129 +/- 8 to 81 +/- 16 mL/min) and glomerular filtration rate by 32% (47 +/- 3 to 32 +/- 5 mL/min) while increasing mean arterial pressure from 104 +/- 5 to 113 +/- 6 mm Hg. The results of this study demonstrate that NO plays an important role in modulating the long-term actions of NE on renal function and arterial pressure.

Adrenergic alpha-Agonists↗
PubMed1996

Glutamic acid decarboxylase autoantibody assay using 125I-labelled recombinant GAD65 produced in yeast.

We describe a new method for measuring autoantibodies (Ab) to the 65 kDa isoform of glutamic acid carboxylase (GAD65). In particular, GAD65 without the hydrophobic N-terminal region has been produced in yeast, purified, labelled with 125I and reacted with GAD65 Ab. Antibody bound 125I-GAD65 is then precipitated by the addition of solid phase protein A. With the assay, GAD65 Ab were detected in 59 of 71 (83%) islet cell antibody (ICA) positive IDDM patients and in 8 of 23 (35%) ICA negative IDDM patients (overall 67 of 94 (71%) of IDDM patients). Low concentrations of GAD65 Ab were also detected in 2/98 (2%) healthy blood donors and 1/27 (4%) Graves' disease patients had a high level of antibody. GAD65 Ab were not detected in any of 10 Hashimoto's thyroiditis, 20 Addison's disease or 19 myasthenia gravis sera. There was good agreement between the 125I assay and the current reference method based on 35S-labelled full-length GAD65 (produced by in vitro transcription/translation reaction) and solid phase protein A (r = 0.91, n = 108). Overall, our 125I assay showed sensitivity, precision and disease group specificity at least as good as any assay so far described. These features, combined with a simple assay protocol and the convenience of 125I counting and handling indicate that the method is suitable for routine GAD65 Ab measurements.

Adult↗
PubMed1996

Acceleration of cheese ripening.

The characteristic aroma, flavour and texture of cheese develop during ripening of the cheese curd through the action of numerous enzymes derived from the cheese milk, the coagulant, starter and non-starter bacteria. Ripening is a slow and consequently an expensive process that is not fully predictable or controllable. Consequently, there are economic and possibly technological incentives to accelerate ripening. The principal methods by which this may be achieved are: an elevated ripening temperature, modified starters, exogenous enzymes and cheese slurries. The advantages, limitations, technical feasibility and commercial potential of these methods are discussed and compared.

Cheese↗
PubMed1996

Detection of viable Vibrio cholerae by reverse-transcriptase polymerase chain reaction (RT-PCR).

The use of conventional PCR can amplify target DNA from both viable and nonviable cells of Vibrio cholera. Detection of only viable microbial pathogens in biological samples, especially clinical and food samples, is usually desired to ensure positive test results are associated with active agents, and not the remains of dead cells. Positive identifications caused by nonliving causative agents may lead to misguided decisions concerning the effectiveness of treatment, and whether patient treatment should be continued or whether the food should be discarded. Consequently, this work was directed toward development of a reverse-transcriptase polymerase chain reaction (RT-PCR)-based in vitro DNA amplification method, which specifically detects only viable cells. Total RNA from both viable and nonviable cells was purified by using a FastPrep Cell Disrupter ([symbol: see text]Bio 101/Savant) and FastRNA extraction reagents ([symbol: see text]Bio 101). The purified RNA was treated with DNase I (RNase-free) to avoid any amplification from the contaminating target DNA. An RT-PCR approach using this rapid and effective method for RNA purification showed amplification of the target mRNA only from the viable cells. The sensitivity of detection of viable cells of V. cholerae was > or = 10(3), which is well within the minimum number of cells (10(5)-10(6)) required for infection. The use of a reliable prokaryotic RNA extraction method followed by RT-PCR amplification of the target mRNA can be used for specific detection of viable microbial pathogen, such as V. cholerae.

Base Sequence↗
PubMed1996

The role of intra-operative duplex imaging in arterial reconstructions.

BACKGROUND: This study is a cost-benefit analysis of a less invasive method of intra-operative duplex imaging compared with the use of intra-operative angiogram (including C-arm fluoroscopy) in arterial reconstruction. METHODS: From September 1994 to May 1995, 93 intra-operative duplex imaging studies were performed. Duplex scanning results were recorded for carotid endarterectomy (35), iliac balloon angioplasty and stent placement (12), and infra-inguinal bypass (46). Average cost and time were calculated for each type of study. RESULTS: Thirty-four carotid endarterectomy patients (97%) had normal duplex findings. Three (9%) underwent intra-operative angiogram due to abnormal duplex findings and post-operative neurological deficit. In iliac balloon angioplasty and stent placement cases (12), both intra-operative duplex and C-arm post-stent angiography yielded comparable results in both normal (11) and abnormal (1) studies. In infra-inguinal bypass cases (46), 2 had abnormal duplex findings of the native vessels. Average time and cost required to perform intra-operative duplex studies is significantly less than that required for intra-operative angiogram or C-arm studies. CONCLUSION: Compared with traditional intra-operative angiography, the use of intra-operative duplex imaging is less expensive, less invasive, quicker, and equally accurate when used as an adjunct to access surgical results of arterial reconstructions.

Angioplasty, Balloon↗
PubMed1996

Gods, daemons and banshees on the journey to the magic scroll: the use of myth as a framework for reflective practice in nurse education.

This paper reports the use of a mythic journey scenario within a student nurse groupwork session. This approach was introduced as a means to facilitate personal and interpersonal sharing and self-knowledge. These processes are held as important for the development of critical reflective process as a cornerstone of contemporary nursing practice. The use of myth invoked a coherent and supportive student environment within which previously reticent students appeared confident enough to contribute and explore their educational experience in nursing. The mythic allegoric process also identified some poignant themes and enemies, common across the student body. Monsters no less!

Adaptation, Psychological↗
PubMed1996

Limbal autotransplantation in the acute and chronic phases of severe chemical injuries.

We present the results of six cases of severe chemical burn of the eye treated by limbal autotransplantation. Three cases were treated in the acute phase, and three in the chronically scarred, healed phase. In five of the six cases, the stability of the ocular surface was markedly improved, resulting in two of the three acute cases in full recovery of normal vision, and in the three chronic cases in improved comfort and reduced corneal opacity and vascularity. In two chronic cases, visual acuity was improved and in one, limbal autotransplantation was followed by successful penetrating keratoplasty. Limbal autotransplantation is a valuable procedure in the rehabilitation of the unilateral, severely chemically burned eye. The indications, techniques, complications and results of this procedure are discussed.

Acute Disease↗
PubMed1996

Effect of a sliding scale protocol for heparin on the ability to maintain whole blood activated partial thromboplastin times within a desired range in hemodialysis patients.

A prospective, randomized and open study was conducted to evaluate the ability of an individualized heparin dosing protocol to achieve and maintain whole blood activated partial thromboplastin times (WBAPPT) within a predetermined range in hemodialysis patients. Thirty-one hemodialysis outpatients who received a total of 99 dialyses were studied. Systemic heparinization was achieved with a loading dose and a continuous infusion. WBAPPT, used as a monitoring parameter for heparin therapy, was measured at 5 minutes and 1, 2, 3 and 3 1/2 hours after the start of heparinization. An initial heparin loading dose of 50 u/kg dry weight was used, with a continuous infusion of 15 u/kg/h and a sliding scale to adjust infusion rates to target WBAPPT in the goal range of 150-190 seconds. Individual heparin loading doses for subsequent treatment sessions were titrated to achieve the lowest dose which would still result in clear dialyzers at the end of hemodialysis. There was a high degree of interindividual variability in heparin requirements. A loading dose of 20-25 u/kg placed the majority (72.4%) of the patients within the 150-190 seconds range at the 5 min WBAPPT measurement. The sliding scale method was effective in keeping about 60% of the WBAPPT within the desired range throughout the rest of the hemodialysis session. As the loading or total doses were increased, the incidence of clear dialyzers increased. In conclusion, this heparin protocol is effective for individualizing heparin doses to achieve therapeutic WBAPPT in hemodialysis patients.

Anticoagulants↗
PubMed1995

Epstein-Barr virus isolates with the major HLA B35.01-restricted cytotoxic T lymphocyte epitope are prevalent in a highly B35.01-positive African population.

An influence of cytotoxic T lymphocyte (CTL) response over Epstein-Barr virus (EBV) evolution was first suggested by the finding that virus isolates from highly HLA-A11-positive Oriental populations were specifically mutated in two immunodominant A11-restricted CTL epitopes. Here we turn to a second HLA allele, B35.01 and show that B35.01-restricted CTL responses in Caucasian donors reproducibly map to a single peptide epitope, YPLHEQHGM, representing residues 458-466 of the type 1 EBV nuclear antigen 3A protein (B95.8 strain). In this case, however, most EBV isolates from a highly B35.01-positive population (in The Gambia) either retained the CTL epitope sequence or carried a mutation (P-->S at position 2) which conserved antigenicity; changes leading to reduced antigenicity (Y-->N at position 1) were found in only a minority of cases. Furthermore, CTL recognizing the YPLHEQHGM epitope could be reactivated from the blood of some B35.01-positive Gambian donors by in vitro stimulation with the synthetic peptide, indicating that epitope-specific immunity does exist in this population. Possible differences between the A11-based and B35.01-based studies are discussed.

Amino Acid Sequence↗
PubMed1995

Ethnic differences in psychological functioning among black and Latino sexually abused girls.

Psychological assessments were conducted for Black and Latino sexually abused girls aged 8 to 13 years. Latino girls received significantly higher scores for depression than the Black girls. These differences in depression appeared to be related to ethnic differences in the circumstances of the abuse. Latino girls were abused at a younger age; more likely to be abused by a relative; and more likely to have had a sibling abused. Latinos were also more likely to report high levels of family conflict and somewhat lower levels of maternal support. Ethnicity was also found to be related to psychological functioning independently of the impact of other factors such as the circumstances of the abuse. Cultural and social factors that may influence psychological functioning subsequent to sexual abuse among Black and Latino girls are identified and discussed.

Adaptation, Psychological↗
PubMed1995

A dramatic experience in mental health nursing education.

This paper examines aspects of a drama project in which a play Syncing Out Loud was produced for Mental Health Week. The project sought to raise community awareness about schizophrenia, as well as to provide an alternative educational experience for students enrolled in a preregistration nursing program. The programs conceptual approach is discussed. Particular referenced is made to the use of drama as a educational tool which can develop experiential sensitivity to the issues and concerns of health service consumers. The experiences of students involved in Syncing Out Loud are examined.

Education, Nursing, Baccalaureate↗
PubMed1995

Remote communication from a mobile terminal: an adjunct for a computerized intensive care unit order management system.

OBJECTIVES: To develop and implement a fully mobile computer terminal that interfaces with our computerized intensive care unit (ICU) local area network and order management system. This system can provide access to the entire network and to order review and entry and during ICU bedside rounds. DESIGN: Descriptive report. SETTING: Surgical ICU in Department of Veterans Affairs Medical Center. SYSTEM CONFIGURATION: A parallel local area network was configured for the remote mobile computer system. A proprietary remote transmission system (Altair II, Motorola) was used. This high-throughput system minimizes interference and errors by using licensed, nonshared, radiofrequency spectra. CONCLUSION: The resulting mobile system is an economical and time-efficient adjunct to an established ICU computerized network and order management system. Clinical working bedside rounds are now routinely conducted with the mobile terminal, providing immediate access to full network resources.

Computer Terminals↗
PubMed1995

Genetic analysis of 20 families with autosomal dominant adult polycystic kidney disease from South West Thames Region.

Twenty families with autosomal dominant polycystic kidney disease from S. W. Thames Region were analysed using markers for chromosome 16p13.3, the site of the common mutation (PKD1). Six families gave a negative lod-score for 3'HVR, the most informative distal marker. This could be explained in four cases by recombination events. Of the two families where this was not an explanation, one, of Italian origin, was unequivocally unlinked for all markers, and the other was more likely to be non-PKD1 than linked to 16p13.3. The Italian family was ascertained through the Blood Pressure Unit, and the other via the Genetic Clinic. No members of either family had ever attended a renal clinic. The remaining 18 families either came via renal clinics, or had at least one member attending such a centre.

Adult↗