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S Yates

Publications and source records attributed to S Yates.

At least 19 recordsLinked to original sources
PubMed2004

Tazobactam-induced haemolytic anaemia, possibly caused by non-immunological adsorption of IgG onto patient's red cells.

A patient with pneumonia was treated with Tazocin (piperacillin/tazobactam). However, the expected haemoglobin (Hb) increment after transfusion was not achieved. Plasma bilirubin and lactate dehydrogenase were raised. The direct antiglobulin test (DAT) was positive (4+) for immunoglobulin G (IgG) only, but no RBC antibodies were demonstrable in the plasma or an eluate from the patient's RBCs. Drug-induced haemolysis was suspected. After discontinuing Tazocin administration, Hb and bilirubin levels returned to expected values. The patient's plasma gave a positive (3+) indirect antiglobulin reaction only with RBCs pretreated with tazobactam. However, random patient plasmas also gave weak (+/- to 1+) reactions, indicating non-immunological adsorption of IgG onto RBCs rather than specific anti-tazobactam antibodies. Subsequently, plasma samples with varying IgG levels (0.8-89.7 g L(-1)) were tested against RBCs pretreated with tazobactam. The amount of plasma IgG non-immunologically adsorbed onto the drug-coated RBCs was found to correlate directly with the plasma IgG level. The patient had a high plasma IgG level (41.6 g L(-1)) which explains why the antiglobulin test was stronger with the patient's plasma than with random plasma samples. Previous reports (Garratty & Arndt, (1998) British Journal of Haematology, 100, 777-783; Arndt & Garratty (2000) Transfusion, 40, 29S) suggested that non-immunological coating of RBCs with IgG may affect RBC survival; our results would support that suggestion. This is the first reported case of haemolytic anaemia associated with tazobactam.

Adolescent↗
PubMed2004

Guidelines for the use of fresh-frozen plasma, cryoprecipitate and cryosupernatant.

The indications for transfusing fresh-frozen plasma (FFP), cryoprecipitate and cryosupernatant plasma are very limited. When transfused they can have unpredictable adverse effects. The risks of transmitting infection are similar to those of other blood components unless a pathogen-reduced plasma (PRP) is used. Of particular concern are allergic reactions and anaphylaxis, transfusion-related acute lung injury, and haemolysis from transfused antibodies to blood group antigens, especially A and B. FFP is not indicated in disseminated intravascular coagulation without bleeding, is only recommended as a plasma exchange medium for thrombotic thrombocytopenic purpura (for which cryosupernatant is a possible alternative), should never be used to reverse warfarin anticoagulation in the absence of severe bleeding, and has only a very limited place in prophylaxis prior to liver biopsy. When used for surgical or traumatic bleeding, FFP and cryoprecipitate doses should be guided by coagulation studies, which may include near-patient testing. FFP is not indicated to reverse vitamin K deficiency for neonates or patients in intensive care units. PRP may be used as an alternative to FFP. In the UK, PRP from countries with a low bovine spongiform encephalopathy incidence is recommended by the Departments of Health for children born after 1 January 1996. Arrangements for limited supplies of single donor PRP of non-UK origin are expected to be completed in 2004. Batched pooled commercially prepared PRP from donors in the USA (Octaplas) is licensed and available in the UK. FFP must be thawed using a technique that avoids risk of bacterial contamination. Plastic packs containing any of these plasma products are brittle in the frozen state and must be handled with care.

Adult↗
PubMed2004

How well do we investigate patients with suspected subarachnoid haemorrhage? The continuing need for cerebrospinal fluid investigations.

OBJECTIVE: To demonstrate the extent of compliance with established guidelines for the investigation of suspected subarachnoid haemorrhage (SAH) and the implications of non-compliance. DESIGN: Prospective observational study of practice in three hospitals in the Trent region. SETTING: One teaching hospital with a tertiary neuroscience referral centre and two large district general hospitals. PARTICIPANTS: 50 consecutive patients from each centre referred for suspected SAH with negative computed tomography. MAIN OUTCOME MEASURES: Diagnosis of SAH confirmed or excluded according to guidelines. RESULTS: When the data from the three centres were combined (n = 150 computed tomography negative cases) cerebrospinal fluid (CSF) investigation was not performed in 60/150 (40%). In the 90 cases where CSF studies were performed SAH was confirmed in 11 (12%). CONCLUSION: There is significant non-compliance in following the established guidelines for the investigation of SAH at the centres studied. As the primary cause of non-traumatic SAH is ruptured aneurysm, which is associated with high morbidity and mortality from second haemorrhage, this highlights a major source of concern for clinical governance.

Adolescent↗
PubMed2004

Outbreak of isoniazid resistant tuberculosis in north London.

BACKGROUND: A description is given of a major outbreak of isoniazid monoresistant tuberculosis (TB) chiefly in north London, including prisons. The earliest case was diagnosed in 1995 with most cases appearing after 1999. METHODS: Confirmation of a local cluster of cases was confirmed by restriction fragment length polymorphism (RFLP IS6110) typing or "rapid epidemiological typing" (RAPET). Further cases were found by retrospective analysis of existing databases, prospective screening of new isolates, and targeted epidemiological case detection including questionnaire analysis. RESULTS: By the end of 2001, 70 confirmed cases in London had been linked with a further 13 clinical cases in contacts and nine epidemiologically linked cases outside London. The epidemic curve suggests that the peak of the outbreak has not yet been reached. Cases in the outbreak largely belong to a social group of young adults of mixed ethnic backgrounds including several individuals from professional/business backgrounds. Compared with other cases of TB reported to the enhanced surveillance scheme in London during 1999-2001, the cases are more likely to be of white (26/70 (37%) v 1308/7666 (17%)) or black Caribbean ethnicity (17/70 (24%) v 312/7666 (4%)), born in the UK (41/70 (59%) v 1335/7666 (17%)), and male (52/70 (74%) v 4195/7666 (55%)). Drug misuse and/or prison detention are factors common to many cases. CONCLUSIONS: The investigation of the outbreak revealed significant problems on an individual patient and population based level including difficulties with contact tracing, compliance, and the risk of developing multidrug resistance. This incident has demonstrated the value of molecular strain typing in investigating an extensive outbreak of TB. This is the first documented outbreak involving a UK prison.

Adolescent↗
PubMed2001

Quantitative detection of hepatitis B virus DNA by real-time nucleic acid sequence-based amplification with molecular beacon detection.

We have developed a hepatitis B virus (HBV) DNA detection and quantification system based on amplification with nucleic acid sequence-based amplification (NASBA) technology and real-time detection with molecular beacon technology. NASBA is normally applied to amplify single-stranded target RNA, producing RNA amplicons. In this work we show that with modifications like primer design, sample extraction method, and template denaturation, the NASBA technique can be made suitable for DNA target amplification resulting in RNA amplicons. A major advantage of our assay is the one-tube, isothermal nature of the method, which allows high-throughput applications for nucleic acid detection. The homogeneous real-time detection allows a closed-tube format of the assay, avoiding any postamplification handling of amplified material and therefore minimizing the risk of contamination of subsequent reactions. The assay has a detection range of 10(3) to 10(9) HBV DNA copies/ml of plasma or serum (6 logs), with good reproducibility and precision. Compared with other HBV DNA assays, our assay provides good sensitivity, a wide dynamic range, and high-throughput applicability, making it a viable alternative to those based on other amplification or detection methods.

Centrifugation, Density Gradient↗
PubMed2001

Finding your funny bone. Incorporating humour into medical practice.

BACKGROUND: Many people confuse seriousness with professionalism. Humour enables you to separate who you are from the difficult work you do. OBJECTIVE: To illustrate ways humour and fun can be incorporated into day to day working life. DISCUSSION: People are more productive, cooperative and flexible when they have fun at work. Becoming a humour consumer of tapes, jokes, TV shows, movies or funny books, strengthens your sense of humour, relieves stress and improves relationships.

Australia↗
PubMed2001

Does a lipid clinic increase compliance with National Cholesterol Education Program Treatment Guidelines? Report of a case-matched controlled study.

Despite a national effort to promote measurement of cholesterol levels in adults, previous studies have shown that poor control is the norm. We sought to determine the effects of implementation of a structured lipid treatment program. Forty-one clinic-managed patients were matched with similar control patients. Clinic patients had more risk factors overall and therefore lower low-density lipoprotein (LDL) goals. They had significantly greater LDL reduction after the 6-month visit, resulting in a lower final LDL level. The percentage of patients reaching the LDL goal recommended by the National Cholesterol Education Program (NCEP) was the primary endpoint of the study. The NCEP guidelines were followed more frequently within the clinic, and significantly more clinic patients were treated to NCEP LDL goal than control patients. When indicated, medication was more frequently used and titrated in clinic patients. This study shows the efficacy of an organized lipid treatment clinic in management of dyslipidemia.

Cholesterol, LDL↗
PubMed2000

Cognition after coronary artery surgery is not related to postoperative jugular bulb oxyhemoglobin desaturation.

During the early postoperative period after coronary artery bypass grafting (CABG) surgery, many patients experience jugular bulb oxyhemoglobin desaturation (SjO(2) < 50%). We sought to determine whether SjO(2) during cardiopulmonary bypass and the early postoperative period influenced long-term cognitive performance after CABG surgery. One hundred two patients completed a battery of cognitive tests the day before and 3 mo after CABG surgery. A General Cognitive Score was generated from these tests as an overall measure of cognitive function. Intraoperatively, SjO(2) was determined by intermittent blood sampling, and postoperatively, the area under the curve of SjO(2) < 50% and time was calculated from continuous reflectance oximetry. No significant correlations between cognitive performance and either intra- or postoperative SjO(2) were found. Preoperative cognitive performance was the main determinant of cognition at 3 mo (r(2) = 0.83, P<0.001), and palpable atheroma of the ascending aorta made a small, but significant, contribution to a decline in cognition (r(2) = 0.018, P = 0.001).

Aged↗
PubMed1998

Interaction of p59fyn kinase with the dynein light chain, Tctex-1, and colocalization during cytokinesis.

The protein tyrosine kinase p59fyn (Fyn) plays important roles in both lymphocyte Ag receptor signaling and cytokinesis of proB cells. We utilized yeast two-hybrid cloning to identify the product of the tctex-1 gene as a protein that specifically interacts with Fyn, but not with other Src family kinases. Tctex-1 was recently identified as a component of the dynein cytoskeletal motor complex. The capacity of a Tctex-1-glutathione S-transferase fusion protein to effectively bind Fyn from cell lysates confirmed the authenticity of this interaction. Tctex-1 binding required the first 19 amino acids of Fyn and integrity of two lysine residues within this sequence that were previously shown to be important for Fyn interactions with the immunoreceptor tyrosine-based activation motifs (ITAMs) of lymphocyte Ag receptors. Expression of tctex-1 mRNA and protein was observed in all lymphoma lines analyzed, and immunofluorescence confocal microscopy localized the protein to the perinuclear region. Analysis of a T cell hybridoma revealed prominent colocalization of Tctex-1 and Fyn at the cleavage furrow and mitotic spindles in cells undergoing cytokinesis. Our results provide a unique insight into a mechanism by which Tctex-1 might mediate specific recruitment of Fyn to the dynein complex in lymphocytes, which may be a critical event in mediating the previously defined role of Fyn in cytokinesis.

Animals↗
PubMed1994

School health delivery programs throughout the United States.

This is the second of a two-part series on School-based and School-linked Health Centers. Through NASN's Board of Directors, various models of health service delivery were examined, and leaders in school nursing interviewed from five different sites. The first article, which appeared in the February 1994 issue of the Journal of School Nursing, addressed the purpose of integrating traditional school health services with newer models of health service delivery, depicted possible models and considered some of the issues of this union.

Delivery of Health Care↗
PubMed1994

The practice of school nursing: integration with new models of health service delivery.

The leadership of the NASN recognizes the growth of the school-based and school-linked health center movement, and the interest of school nurses in this topic. The following is the first of two articles devoted to the integration of traditional school health services and school-based or school-linked health centers or clinics. The purpose of these articles is to increase general knowledge about "integrated, comprehensive school health programs," as well as promote an awareness of important opportunities that exist in the school-based/school-linked health center movement for school nurses. This article reviews the purpose of integration, depicts possible models of school-based/school-linked health centers, and considers some of the issues of this model. The April issue will highlight various school health delivery programs.

Comprehensive Health Care↗
PubMed1992

Enteric-coated charcoal as a means of blinding studies comparing bismuth and H2-receptor antagonists.

Clinical trials comparing H2-receptor antagonists and bismuth-containing regimens in ulcer healing, ulcer relapse, or dyspepsia have not been double-blind, because bismuth darkens stools. This study was designed to determine whether enteric-coated charcoal could darken stools of subjects taking an H2-receptor antagonist without interfering with absorption of the drug. Twelve healthy volunteers participated in a randomized, double-blind, crossover trial of oral ranitidine (300 mg at bedtime) alone, ranitidine plus bismuth (30 ml Pepto-Bismol four times daily), and ranitidine plus enteric-coated charcoal (four tablets daily). Mean stool colors both with ranitidine plus charcoal and with ranitidine plus bismuth were significantly darker than with ranitidine alone, but were not significantly different from each other. Blood levels of ranitidine during the 10 h after its administration did not differ significantly among the three regimens. We conclude that enteric-coated charcoal can be used to blind clinical trials comparing an H2-receptor antagonist (e.g., ranitidine) and a bismuth regimen.

Administration, Oral↗
PubMed1988

Judging maturity in the courts: the Massachusetts consent statute.

This study examined the Case Summary Questionnaires completed by attorneys representing minors at judicial consent for abortion hearings in Massachusetts and filed with the Women's Bar Association. The 477 Case Summaries filed between December 1981 and June 1985 were analyzed to provide a more systematic account of how the judicial consent statute is applied in the courtroom. After hearings which typically lasted 12 minutes, only nine minors were judged immature. No evidence for a discernible pattern justifying these rulings emerged from an examination of petitioner and court characteristics such as age, length of hearing, number of weeks pregnant, or presiding judge. Further, 11 lawyers privately reported they found their clients immature. In only one instance, however, did the lawyer and judge identify the same adolescent. The findings add to a growing body or research that calls into question the ability of the consent statute to protect the best interest of the minors involved.

Abortion Applicants↗
PubMed1987

Audience response as a heuristic cue in persuasion.

Previous research on the persuasive impact of an overheard audience has yielded conflicting results. In this study, we attempted to understand such audience effects within the framework of the heuristic model of persuasion. Subjects listened to an audiotaped persuasive message that conveyed arguments of either high or low quality and that was responded to by either an enthusiastic or an unenthusiastic overheard audience. In addition, subject involvement (high vs. low) was varied. Consistent with predictions, the audience response cue influenced postmessage opinions only under low involvement; under high involvement, only argument quality affected persuasion. Analyses that took into account subjects' need for cognition supported the additional hypothesis that individuals lower in need for cognition would be more responsive to the audience manipulation under low involvement. Thought-listing data and regression analyses provided further support for the heuristic model.

Adult↗