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Biomedical subjects

S T Brown

Publications and source records attributed to S T Brown.

At least 19 recordsLinked to original sources
PubMed1999

Indinavir-associated maculopapular eruption.

Indinavir-associated adverse dermatologic reactions are rare but do occur. A 39-year-old man who was positive for the human immunodeficiency virus and had no known allergy, developed an erythematous, maculopapular eruption several hours after switching to a new triple-drug regimen consisting of stavudine, didanosine, and indinavir. The eruption completely resolved 2 weeks after he discontinued the antiretroviral combination. To preserve future treatment options, the patient was sequentially rechallenged with each agent and confirmed indinavir as the cause. The patient tolerated and responded to a new combination of stavudine, didanosine, and nelfinavir. The rapid onset of the adverse reaction suggested that it might have been immunoglobulin-E mediated. No cross-sensitivity between indinavir and nelfinavir was apparent.

Adult↗
PubMed1998

Factors that influence patient satisfaction in the emergency department.

This descriptive correlation study examined the satisfaction levels of urgent and nonurgent patients in relation to nursing care, the emergency department (ED) environment, ancillary services, and information received. The sample consisted of 28 subjects, with the majority of patients being very satisfied with nursing care. The primary area of concern was information about the length of waiting time. The satisfaction levels of ED patients with the care they receive has become increasingly important in today's health care environment. ED nurses play an important role in ensuring that patients are satisfied and receive quality care.

Adult↗
PubMed1998

Humor and pain management. A review of current literature.

The purpose of this article is to provide a review of current literature related to humor and pain management. A brief review of the benefits of humor on the body is followed by a literature review of articles on humor and pain management, including research articles and scholarly articles on the topic. Research studies on the use of humor with both acute and chronic pain will be reported. The review of scholarly unresearched articles will include articles giving guidelines for humor use, suggested humor assessment guidelines, discussion of the nurse's role with humor use, and implementation strategies via humor carts and rooms.

Holistic Nursing↗
PubMed1997

Regulation of the RAG-1 promoter by the NF-Y transcription factor.

We have cloned the RAG-1 promoter region and have determined that almost all detectable promoter activity resides within a 208-bp fragment. Sequence analysis of this promoter region has identified potential recognition motifs for a number of lymphocyte-restricted and ubiquitous transcription factors. Subsequent assays have revealed that the NF-Y transcription factor interacts with a CCAAT site within the RAG-1 promoter and appears to play an important role in the positive transcriptional regulation of this gene.

3T3 Cells↗
PubMed1996

On the etiology of Crohn disease.

Crohn disease (CD) is a chronic, panenteric intestinal inflammatory disease. Its etiology is unknown. Analogous to the tuberculoid and lepromatous forms of leprosy, CD may have two clinical manifestations. One is aggressive and fistulizing (perforating), and the other is contained, indolent, and obstructive (nonperforating) [Gi]-berts, E. C. A. M., Greenstein, A. J., Katsel, P., Harpaz, N. & Greenstein, R. J. (1994) Proc. Natl. Acad. Sci. USA 91, 12721-127241. The etiology, if infections, may be due to Mycobacterium paratuberculosis. We employed reverse transcription PCR using M. paratuberculosis subspecies-specific primers (IS 900) on total RNA from 12 ileal mucosal specimens (CD, n = 8; controls, n = 4, 2 with ulcerative colitis and 2 with colonic cancer). As a negative control, we used Myobacterium avium DNA, originally cultured from the drinking water of a major city in the United States. cDNA sequence analysis shows that all eight cases of Crohn's disease and both samples from the patients with ulcerative colitis contained M. paratuberculosis RNA. Additionally, the M. avium control has the DNA sequence of M. paratuberculosis. We demonstrate the DNA sequence of M. paratuberculosis from mucosal specimens from humans with CD. The potable water supply may be a reservoir of infection. Although M. paratuberculosis signal in CD has been previously reported, a cause and effect relationship has not been established. In part, this is due to conflicting data from studies with empirical antimycobacterial therapy. We conclude that clinical trials with anti-M. paratuberculosis therapy are indicated in patients with CD who have been stratified into the aggressive (perforating) and contained (nonperforating) forms.

Autoradiography↗
PubMed1996

Photoinactivation of bacteria. Use of a cationic water-soluble zinc phthalocyanine to photoinactivate both gram-negative and gram-positive bacteria.

The photosensitization of microorganisms is potentially useful for sterilization and for the treatment of certain bacterial diseases. Until now, any broad spectrum approach has been inhibited because, although Gram-positive bacteria can be photoinactivated by a range of photosensitizers, Gram-negative bacteria have not usually been susceptible to photosensitized destruction. In the present work, it has been shown that the Gram-negative bacteria Escherichia coli and Pseudomonas aeruginosa, as well as the Gram-positive bacterium Enterococcus seriolicida, can be photoinactivated when illuminated in the presence of a cationic water-soluble zinc pyridinium phthalocyanine (PPC). The degree of photoinactivation is dependent on both the concentration of PPC and the illumination time. In contrast, the three bacteria are not photoinactivated by illumination in the presence of a neutral tetra-diethanolamine phthalocyanine (TDEPC) or negatively charged tetra-sulphonated phthalocyanine (TSPC). Uptake studies have revealed that the lack of activity of TSPC is due to the fact that it has very little affinity for any of the organisms. However, the issue appears to be more complex than simply the gross levels of cellular uptake, since TDEPC and PPC are both taken up by the organisms but only PPC shows activity. This indicates that the localization and subcellular distribution of the phthalocyanines may be a crucial factor in determining their cell killing potential. Further analysis of the uptake data has revealed a cell-bound photosensitizer fraction, which remains tightly associated after several washings, and another weakly bound fraction, which is removed by successive washings. Analysis of the cell killing curves, carried out after successive washings of E. coli exposed to PPC, has revealed that it is the tightly associated fraction that is involved in the photosensitization. Taken together with other data, these results suggest that cationic photosensitizers may have a broader application in the photoinactivation of bacterial cells than the anionic or neutral photosensitizers commonly used in photodynamic therapy.

Dose-Response Relationship, Radiation↗
PubMed1996

A comparison of two noninvasive methods of blood pressure measurement in the triage area.

OBJECTIVE In triage of patients in the emergency department, nurses can identify conditions such as elevated blood pressure that can lead to serious health problems. It is imperative that the method used to evaluate blood pressure is dependable and accurate. The introduction of new technology may yield results that are not comparable to traditional measures. Therefore we compared the traditional auscultatory method of measuring blood pressure with the use of an automated device. METHODS The blood pressure of 100 healthy adult volunteers was measured first with the traditional cuff method and then with an automated device (IVAC model 4200). The measurements were recorded and then compared for each individual. RESULTS The mean difference between the paired systolic measurements was 4.3 mm Hg (p = 0.0001). The mean difference between the paired diastolic measurements was 1.3 mm Hg. There was a clinically significant difference (> 9 mm Hg) in 37% of the systolic readings and 26% of the diastolic readings. In 76% of those clinically significant systolic differences, the IVAC 4200 measurement exceeded the manual method. For the clinically significant diastolic differences, 58% of the IVAC 4200 measurements were greater than the manual method. CONCLUSION Clinicians must be cautious when using new technology to measure blood pressure. Results may not be comparable with results obtained with the traditional method.

Adolescent↗
PubMed1996

Consumer satisfaction with nursing care in a rural community hospital emergency department.

The article describes a study undertaken to assess patient satisfaction with nursing care in a rural hospital emergency department with respect to psychological safety, discharge teaching, information giving, and technical competence. This descriptive research utilized Davis' Consumer Emergency Care Satisfaction Scale to determine the degree to which 52 patients perceived overall satisfaction with nursing care. Findings indicated that patients were satisfied with nursing care. No statistically significant effect of gender or education level on consumer satisfaction or on any subscale was detected, but African American consumers were less satisfied with discharge teaching, which may suggest that discharge teaching should reflect the cultural diversity of consumers presenting to the emergency department. Nursing staff may need to spend more time with rural African American consumers. Staff may need to be inserviced to meet the cultural and educational needs of African Americans.

Adult↗
PubMed1994

Attitudes of baccalaureate nursing students in one school toward acquired immune deficiency syndrome.

The purpose of this descriptive study was to gather information about the attitudes of nursing students toward Acquired Immune Deficiency Syndrome (AIDS) and to determine if there was a relationship between demographic variables and the attitudes expressed. In this study the AIDS Attitude Scale developed by Shrum, Turner, and Bruce (1989) was administered to baccalaureate nursing students. The scale contained 54 items using a five-response scale and included six demographic variables. The results indicated that this sample had a positive attitude toward AIDS (mean = 73.58). Personally knowing someone with AIDS and level of knowledge of AIDS were found to significantly affect one's attitude toward AIDS. The findings of this study can assist nurse educators in planning appropriate content for AIDS education.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Third World anesthesia.

The AANA Council for Public Interest in Anesthesia has been very interested in the delivery of volunteer anesthesia overseas. This article was developed as part of the Council's volunteer anesthesia program activities, as well as in response to member inquiries concerning Third World anesthesia.

Anesthesiology↗
PubMed1993

Activities of antimicrobial agents against clinical isolates of Mycobacterium haemophilum.

Mycobacterium haemophilum, first described in 1978, can cause severe infections of skin, respiratory tract, bone, and other organs of immunocompromised patients. There is no standardized antimicrobial susceptibility test, and for the 27 reported cases, a variety of test methods have been used. This paper reports the in vitro test results for 17 isolates of M. haemophilum recovered from 12 patients in the New York City area. MICs of 16 antimicrobial agents were determined in microtiter trays containing Middlebrook 7H9 broth plus 60 microM hemin, inoculated with 10(6) CFU of the organism per ml and incubated at 30 degrees C for 10 days. Ethambutol, ethionamide, tetracycline, cefoxitin, and trimethoprim-sulfamethoxazole were inactive against initial isolates from the 12 patients. Isoniazid was weakly active with a MIC for 50% of strains tested (MIC50) of 8 micrograms/ml and a MIC90 of > 32 micrograms/ml. Three quinolones, ciprofloxacin, ofloxacin, and sparfloxacin, were moderately active with MIC50s of 2 to 4 micrograms/ml and MIC90s of 4 to 8 micrograms/ml. Amikacin and clofazamine were active with MIC90s of 4 and 2 micrograms/ml, respectively. Clarithromycin was the most active macrolide with a MIC90 of < or = 0.25 microgram/ml. The MIC90 of azithromycin was 8 micrograms/ml, and the MIC90 of erythromycin was 4 micrograms/ml. The rifamycins were active with a MIC90 of 1 microgram/ml for rifampin and one of < or = 0.03 micrograms/ml for rifabutin. For a second isolate from the skin of one patient and a isolate from an autopsy culture of the spleen of a second patient, MICs of rifampin and rifabutin were > 16 microgram/ml, whereas initial isolates were inactivated by low concentrations of the rifamycins. Both patients had been treated for several months with several antimicrobial agents, including a rifamycin.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Azithromycin, rifabutin, and rifapentine for treatment and prophylaxis of Mycobacterium avium complex in rats treated with cyclosporine.

Azithromycin, rifabutin, and rifapentine were used to treat or prevent disseminated Mycobacterium avium complex (MAC) infections produced in rats immunosuppressed with cyclosporine. Animals with bacteremic infections were treated 1 week after intravenous inoculation with 10(7) CFU of MAC with azithromycin, 100 mg/kg of body weight administered subcutaneously for 5 days and then 75 mg/kg on Monday, Wednesday, and Friday, or with rifabutin or rifapentine, 20 mg/kg administered intraperitoneally on Monday through Friday. All three drugs showed efficacy after 1 and 2 months. Rifabutin cleared the organisms from tissues more rapidly than azithromycin or rifapentine. To approximate prophylaxis, treatment was started 2 weeks before intravenous inoculation with 10(4) organisms. MAC infections were undetectable in treated animals after 4 months, while control animals had disseminated infections. These findings support the rationale for clinical trials of treatment and prophylaxis with these agents. The cyclosporine-treated rat appears to be a useful model in which to evaluate compounds for the treatment and prophylaxis of disseminated MAC infections.

Animals↗
PubMed1992

Extraneural cysticercosis presenting as a tumor in a seronegative patient.

A case of cysticercosis involving only the sternocleidomastoid muscle of an otherwise-healthy pregnant woman is presented. An enzyme-linked immunoelectrotransfer blot assay for cysticercosis was nonreactive. The clinical features of extraneural cysticercosis are reviewed with special attention to musculocutaneous involvement. The results of serological tests for such patients may not be positive and histopathology remains the only reliable method for confirming the diagnosis of cysticercosis.

Adult↗
PubMed1992

Pulmonary mycobacterial infections associated with neoplasia.

Patients with cancer are at increased risk for disease caused by mycobacteria when there is immunosuppression resulting from the underlying disease or its treatment. Pulmonary disease is usual with Mycobacterium tuberculosis or with mycobacteria other than M tuberculosis (MOTT) and atypical presentations with extrapulmonary dissemination occur frequently. No clinical features reliably distinguish between disease caused by M tuberculosis or MOTT. The incidence of M tuberculosis infection depends on a history of prior exposure in patients and on patterns of disease within hospitals and the surrounding community. Infection with different species of MOTT reflects their environmental prevalence. Diagnosis of mycobacterial infection can be clinically challenging and must be pursued aggressively. Despite recent improvements in clinical and laboratory methods, diagnosis of mycobacterial infection may take weeks. Recent increases in the incidence of M tuberculosis infection and the emergence of drug-resistant strains require heightened alertness to its diagnosis and careful epidemiological control measures to prevent continued spread of this contagion. M tuberculosis with routine antimicrobial susceptibility responds well to conventional therapy when initiated early. Prophylaxis of tuberculin positive patients is effective and should be started before immunosuppressive therapy. Guidelines for therapy of MOTT depend on the species isolated but remains poorly defined in most cases. There are several new compounds that may be useful for treatment of drug-resistant species of MOTT. New methods for the rapid diagnosis, speciation, and epidemiological investigation of mycobacterial infection are being developed, and some are available for clinical application. Nonetheless, the timely diagnosis of mycobacterial disease in patients with cancer remains a challenge of increasing clinical importance.

Antitubercular Agents↗
PubMed1991

Progressive disseminated infection with Mycobacterium avium complex after intravenous and oral challenge in cyclosporine-treated rats.

Male Sprague-Dawley rats, immunosuppressed with cyclosporine (CsA), developed disseminated infection after intravenous or oral challenge with Mycobacterium avium complex (MAC). Disseminated infection leading to bacillemia could be established after intravenous inoculation with as few as 5 x 10(3) organisms. When CsA was not given or when CsA was stopped 1 month after infection, animals cleared the bacilli from blood and tissue. Animals developed disseminated infection after oral challenge with as few as 10(6) organisms. Persistent bacillemia occurred when organisms in the spleen exceeded 10(7). Differences in virulence among strains were observed. Infected tissues showed histopathologic changes similar to those seen in patients with AIDS. The CsA-treated rat is a new model that appears useful for studies of the virulence of MAC strains and the pathogenesis of disseminated MAC infection.

Acquired Immunodeficiency Syndrome↗