Search PubMed⌕ Search

Biomedical subjects

S Young

Publications and source records attributed to S Young.

At least 163 records · Page 9Linked to original sources
PubMed1995

Effect of selective bowel decontamination with norfloxacin on spontaneous bacterial peritonitis, translocation, and survival in an animal model of cirrhosis.

Selective bowel decontamination with the orally administered quinolone antibiotic, norfloxacin, has been shown to suppress gut gram-negative bacteria and help prevent gram-negative infections in cirrhotic patients who are at high risk of bacterial infection. Because this drug does not eradicate gram-positive organisms, it is conceivable that gram-positives could replace the suppressed gram-negatives in the gut and lead to subsequent infection. Also the effect of norfloxacin on translocation (as defined by culture positivity of mesenteric lymph nodes) has received little attention. In this study, the effect of oral norfloxacin on translocation, bacterial peritonitis, and survival was investigated in an animal model of carbon tetrachloride-induced cirrhosis and ascites. Treated rats received daily doses of orally administered norfloxacin from the onset of cirrhosis until they died or were killed. Controls received no antibiotic. Norfloxacin led to a reduction in bacterial peritonitis from 70% in untreated cirrhotic controls to 28% in treated cirrhotic rats; these data were statistically significant (P = .012). There was no effect on overall translocation rate (28% with norfloxacin vs. 50% without norfloxacin) (P > .1). Gram-positives were isolated in 100% of the bacterial peritonitis episodes and in 71.4% of culture-positive mesenteric lymph nodes in treated animals compared with only 25% of peritonitis episodes and 10% of culture-positive mesenteric lymph nodes of untreated cirrhotic controls (P < .01 for peritonitis and P < .05 for translocation). The survival rate was not different between groups (P > .1).(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1995

Where does it hurt? An interdisciplinary approach to improving the quality of pain assessment and management in the neonatal intensive care unit.

Identifying a premature infant's response to noxious stimuli and knowing when it is appropriate to intervene are major issues for the caregiver. After completing a pilot study, the staff of a 42-bed neonatal intensive care unit targeted improved pain assessment and management for further analysis. Using a series of Plan, Do, Check, and Act cycles they designed a stepwise set of interventions that resulted in the improved assessment and management of the neonate in pain.

Academic Medical Centers↗
PubMed1994

[The chemical working environment among car painters in Bergen].

Official guidelines have been prepared for the working environment in Norwegian spraylacquering garages, in order to reduce the incidence of symptoms and diseases related to exposure to organic solvents. 11 garages were visited to see if the guidelines were being followed. All the sprayers (n = 28) were examined by questionnaire about the occurrence of acute symptoms connected to the central nervous system, the skin, the eyes and the airways during work, and about their use of personal protective equipment. All the garages had specially ventilated rooms for the lacquering procedure, and all the workers used personal respiratory protective equipment. The sprayers did not report more acute symptoms than a control group of office workers employed in the same companies.

Air Pollutants, Occupational↗
PubMed1994

An epitope on carcinoembryonic antigen defined by the clinically relevant antibody PR1A3.

The monoclonal antibody PR1A3 has been used successfully for in vivo imaging of colorectal cancers, and several properties associated with this antibody, including minimal reactions of the antibody with circulating antigen in patients' sera, differentiate it from anti-carcinoembryonic antigen (CEA) antibodies used in similar studies. However, the antigen bound by PR1A3 was identified as CEA by analysis of somatic cell hybrids and by antigen expression from yeast artificial chromosomes, cosmids, and cDNA clones. The molecular weight, presence of a glycosyl-phosphatidylinositol anchor, elevation of surface expression by gamma-interferon, and N-terminal amino acid sequence all confirmed the antigen identification as CEA. A series of biliary glycoprotein-CEA hybrid proteins was produced which demonstrated that the epitope bound by the antibody was at the site of membrane attachment and involved parts of the glycosyl-phosphatidylinositol anchor and the B3 domain of CEA to form a conformational epitope. Access to this epitope, although possible when the antigen was on the cell surface, appeared to be blocked when CEA was released from the cell. The nature and location of the epitope on CEA are proposed to be responsible for the unique properties of the antibody.

Animals↗
PubMed1994

A tiered healthcare system for persons in police custody--the use of a forensic nursing service.

In February 1992 the healthcare programme for persons held in police custody within the Melbourne metropolitan area was restructured. This was undertaken as a joint exercise between Police, the Health Department and the Office of Corrections as a response to the need to develop an efficient and cost effective healthcare delivery system. A tiered medical response was instituted, utilising a forensic nurse for the primary medical contact with forensic physicians providing medical consultation and support as necessary. Criteria were developed regarding the delineation of duties appropriate for the forensic nurse and for the forensic physician. The nurses were provided with transport, communication and basic medical supplies enabling a flexible response to requests for medical attention and for the nurse to perform triage, a basic medical assessment and administer appropriate treatment. Over the 15-month period since inception over 3000 consultations have been performed by the forensic nurses. The service has been commended by police, doctors working in the prison system, forensic physicians and community groups. A comprehensive review has demonstrated the efficiency and reliability of such a service. Costs in providing the service have not increased. We conclude that a forensic nursing service is of considerable benefit in complementing a range of services provided by forensic medical officers in a metropolitan setting.

Journal Article↗
PubMed1994

Flow limitation during tidal expiration in symptom-free infants and the subsequent development of asthma.

During a longitudinal study of lung function and airway responsiveness in a cohort of healthy infants, we identified a subgroup of symptom-free infants at the age of 1 month with flow limitation during tidal expiration. We report a 2-year follow-up of 252 infants who were first studied at 1 month of age. Maximal flow at functional residual capacity (VmaxFRC) was measured from a forced expiratory flow-volume curve by the rapid thoracic compression technique. The pattern of tidal breathing was assessed with the ratio of the time to reach maximal expiratory flow during expiration to the total expiratory time (Tme/Te ratio). Histamine inhalation challenge was used to determine the level of airway responsiveness. Compliance and resistance of the total respiratory system were measured from a passive expiration after occlusion at end inspiration. Data regarding the family history of asthma, atopy, and parental smoking were obtained by questionnaire. Flow limitation was considered present when the forced expiratory flow did not exceed tidal flow at functional residual capacity. Nineteen infants were identified with flow limitation at 5 weeks of age; all had a family history of asthma, atopy, and/or parental smoking. These 19 infants were compared with 35 infants with no family history of asthma or parental smoking and 38 gender-, history-, and age-matched control infants without flow limitation during tidal expiration. At the age of 1 month, the flow-limited group had reduced VmaxFRC, Tme/Te, and respiratory compliance and increased respiratory resistance. At 6 and 12 months of age, although no longer flow limited, these infants still had significantly reduced lung function and increased airway responsiveness. Flow limitation in early life was also significantly associated with the development of physician-diagnosed asthma by the age of 2 years (odds ratio, 7.4; 95% confidence interval, 1.4 to 35.2). Infants with abnormal lung function soon after birth may have a genetic predisposition to asthma or other airway abnormalities that predict the risk of subsequent lower respiratory tract illness.

Asthma↗
PubMed1994

Thoracic lymphangioma in adults: CT and MR imaging features.

OBJECTIVE: Lymphangiomas are rare benign tumors most often seen in childhood. When they occur in adults, radiologic diagnosis can be difficult. A retrospective study of the CT and MR appearances of thoracic lymphangiomas in adult patients was performed in order to describe the range of radiologic features of these tumors. MATERIALS AND METHODS: Cases of adult lymphangioma at three institutions were identified in the records of 19 patients, predominantly female, 18-67 years old. RESULTS: The most common CT appearance was a smoothly marginated cystic mass. Unusual features included calcification, spiculated margins, and homogeneous soft-tissue attenuation. The majority of cases were located in the anterior or superior mediastinum. Unusual locations included the pericardium, pulmonary hilum, and pulmonary parenchyma. Signal characteristics on MR images varied. CONCLUSION: The radiographic appearance of lymphangiomas in the chest in adult patients is varied. The diagnosis cannot be suggested on the basis of radiologic studies alone.

Adult↗
PubMed1994

Integrated care at the bedside: job description consensus.

A Nursing Career Pathway Committee developed a differentiated nursing model based upon the Midwest Alliance in Nursing competencies. Two distinct and complementary roles provide direct nursing care: the Registered Nurse in the Associate Role and the Registered Nurse in the Primary Role. Through a differentiated nursing demonstration project, the need for changes in the "charge nurse" role became apparent. Opportunities for growth and participation, regardless of position held, are presented. Agencies without "clinical ladders" will be intrigued with this fresh approach for rewarding nurses who provide direct care.

Career Mobility↗
PubMed1994

An observational study of the NSW parent-held record in a GP setting.

Despite recent studies having found that doctors report high use of the parent-held record (PHR), there are no studies in the literature that investigated the actual use, as opposed to reported use, of the PHR by doctors in a general practice setting. This study aimed to clarify some aspects of the actual use of the PHR by doctors in the authors' general practice setting, and by other doctors seen by the clients. The findings were encouraging in showing an increased use of the PHR linked to increased awareness. But the study also showed there is much room for improvement in educating general practitioners and other health workers about the potential benefits of the PHR.

Child, Preschool↗
PubMed1993

Characterization of the genes controlling the biosynthesis of the polyketide phytotoxin coronatine including conjugation between coronafacic and coronamic acid.

Pseudomonas syringae pv. glycinea PG4180 produces a chlorosis-inducing phytotoxin, coronatine (COR), which consists of a polyketide component, coronafacic acid (CFA), which is coupled via amide bond formation to coronamic acid (CMA), an ethylcyelopropyl amino acid (aa) derived from isoleucine. P. syringae pv. syringae strains PS51 and PS61, which do not synthesize coronafacoyl compounds (conjugates between CFA and aa), acquired the ability to produce CFA and COR when transformed with p4180A, a 90-kb indigenous plasmid in PG4180. Tn5 mutagenesis indicated that the COR biosynthetic genes in PG4180 are clustered within a 30-kb region on p4180A. The phenotype of selected COR-defective mutants was determined by supplying them with CFA and CMA and by complementation studies with cloned DNA from the COR biosynthetic cluster. Using this approach, the regions encoding CFA and CMA synthesis and coupling activity were localized to the 24-, 12.5- and 2.3-kb regions of the cluster, respectively. Mutants in a 6-kb region required the addition of both CFA and CMA for COR synthesis, which may indicate a regulatory role for this part of the cluster. PS51 and PS61 transconjugants containing cloned DNA from the coupling region produced COR when supplied with CFA and CMA, indicating that coupling activity was cloned and expressed in bacteria lacking the COR biosynthetic cluster.

Amino Acids↗
PubMed1993

Outcome of patients with diabetes mellitus and acute myocardial infarction treated with thrombolytic agents. The Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) Study Group.

OBJECTIVES: This study was designed to assess outcome in patients with diabetes who received thrombolytic therapy and to determine whether differences in angiographic characteristics may account for the worse outcome observed in diabetic patients. BACKGROUND: Patients with diabetes are known to have a worse outcome after acute myocardial infarction than that of patients without diabetes. METHODS: Clinical and angiographic characteristics of the 148 patients with diabetes and the 923 patients without diabetes in the Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) trials were examined and analyzed. RESULTS: Patients with diabetes tended to be older (median age 59 vs. 56 years) and to have a higher incidence of hypertension and hyperlipidemia and a lower incidence of cigarette smoking. Patients with diabetes had significantly more severe anatomic disease (66% vs. 46% had multivessel disease, p < 0.0001), similar global left ventricular ejection fraction (49% vs. 51%) and worse noninfarct zone ventricular function (-0.13 vs. 0.32 SD/chord, p = 0.02) than that of nondiabetic patients. Angiographic patency rates at 90 min after thrombolytic therapy were similar in patients with and without diabetes (initial 90-min patency 71% vs. 70%). Diabetic patients had nearly twice the in-hospital mortality rate (11% vs. 6%, p < 0.02) and a higher incidence of pulmonary edema (11% vs. 4%, p = 0.001). Diabetic women had an especially high in-hospital mortality rate (21%). No retinal hemorrhages were observed. Although diabetes as an unadjusted variable was predictive of in-hospital (p < 0.02) and long-term (p = 0.003) mortality, after adjustment for baseline clinical and angiographic characteristics, diabetes was not found to have an independent influence on mortality. CONCLUSIONS: Patients with diabetes after myocardial infarction have a worse outcome than that of patients without diabetes despite similar rates of infarct vessel patency. However, diabetes was not found to be an independent risk factor for increased mortality. These findings suggest that diabetes itself is not a major risk factor for poor early outcome after thrombolytic therapy for myocardial infarction; rather, the secondary effects such as more extensive coronary artery disease account for the worse outcome.

Aged↗
PubMed1993

The effect of age on oxygen desaturation during histamine inhalation challenge in normal infants.

Arterial oxygen saturation (SaO2) is usually measured during inhalation challenges in infants as desaturation has been demonstrated with provoked bronchoconstriction. We wished to examine whether measurement of SaO2 would provide a simple noninvasive indicator of respiratory function (RF) changes occurring during inhalation challenge in infants. Histamine inhalation challenges were performed longitudinally in 22 normal healthy infants at 4 and 26 weeks of age. RF was measured by calculating maximum forced expiratory flow at functional residual capacity (VmaxFRC) using the rapid thoracic compression technique. Airway responsiveness was assessed using histamine; the provoking concentration (PC) was that which caused a fall in VmaxFRC of at least 40% from baseline. The provocative concentration for an exact fall of 40% in VmaxFRC (PC40) from baseline was derived by linear interpolation. SaO2 was continuously monitored by pulse oximetry. One month old infants had higher SaO2 levels throughout the inhalation challenge in comparison to their SaO2 levels at 6 months of age. Significant falls in SaO2 were observed at the PC at both ages. However, at the age of 26 weeks the infants had greater median falls in SaO2 [PC, 4.5% (95%CI: 3.0, 7.0)] compared to the response at age 4 weeks [3.0% (95%CI: 1.0, 4.0) (P < 0.01)]. Median falls in VmaxFRC at the PC were not different between the ages. These results indicate an age-dependent discordance between airway and SaO2 response in healthy infants during histamine-induced bronchoconstriction.

Age Factors↗