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Biomedical subjects

T L Turner

Publications and source records attributed to T L Turner.

At least 19 recordsLinked to original sources
PubMed2000

Contact lens electroretinography in preterm infants from 32 weeks after conception: a development in current methodology.

AIM: To assess the feasibility of using a contact lens electrode to record the electroretinogram (ERG) in preterm infants less than 35 weeks after conception. METHODS: The ERG was recorded from seven very low birthweight preterm infants on a total of 14 occasions using an infant monkey contact lens electrode. Age at recording the first ERG ranged from 23 to 51 days (gestational age 32-34 weeks), and weight ranged upwards from 1100 g. RESULTS: No complications were observed. With advancing age and maturity the dark adapted rod threshold decreased, indicating increased retinal sensitivity. CONCLUSIONS: Contact lens recording of the ERG from extremely small immature preterm infants is a practicable and well tolerated procedure. This method of recording the ERG will enable further evaluation of retinal development in this vulnerable population.

Birth Weight↗
PubMed1996

The Practice Environment Project. A process for outcome evaluation.

OBJECTIVE: Evaluating the practice environment is essential to determine if the practice environment is conducive to the delivery of quality patient care. The Practice Environment Project (PEP) was created to provide a framework for current and ongoing evaluation of the practice environment. BACKGROUND: Major changes in the delivery of patient care services have focused attention on the evaluation of the effectiveness of these changes. The extent and type of change may vary throughout an institution. The identification of core variables to assess the effectiveness of these changes sets the framework for ongoing evaluation of new unit-based models for delivery of services. METHODS: In part 1, quantitative data were collected from nursing staff members (job satisfaction, collaboration with physicians, autonomy), physicians (quality of nursing care, collaboration with nurses), and patients (satisfaction with nursing care). In part 2, focus groups were held with nursing personnel to discuss factors that affected the provision of services. Unit-based action plans were developed to manage barriers to the delivery of services. RESULTS: Patients and physicians reported a high degree of satisfaction with patient care. Physicians reported a higher level of collaboration with nurses than that reported by nurses. Nurses reported a high degree of autonomy in practice, however, in other areas of job satisfaction (development and recognition), they suggested areas for improvement. CONCLUSIONS: The PEP created a mechanism to evaluate the current state-of-the-practice environment by identifying core elements for evaluation of work redesign. It also provided a framework for managing barriers that disrupted the delivery of patient care services.

Focus Groups↗
PubMed1995

Identification of chromosome 21 materials using the whole chromosome 21 specific library.

The chromosome in situ suppression hybridization or chromosome painting technic was applied to confirm and eliminate the markers involving chromosome 21 segments using a chromosome 21 DNA library. The library ATCCLL21SNO2 was amplified, directly biotinylated using the polymerase chain reaction. The results demonstrated a translocation of chromosome 21 material on chromosome 2 and X and eliminate the origin of the marker. Thus, the technique provides an important tool to complement the conventional G-banding technic.

Abnormalities, Multiple↗
PubMed1993

Umbilical cord clamping and preterm infants: a randomised trial.

OBJECTIVE: To investigate the clinical effects of regulating umbilical cord clamping in preterm infants. DESIGN: A prospective randomised study. SETTING: The Queen Mother's Hospital, Glasgow. SUBJECTS: 36 vaginally delivered infants over 27 and under 33 weeks' gestation. INTERVENTION: Holding the infant 20 cm below the introitus for 30 seconds before clamping the umbilical cord ("regulated" group, 17 patients), or conventional management ("random" group, 19 patients). MAIN OUTCOME MEASURES: Initial packed cell volume, peak serum bilirubin concentrations, red cell transfusion requirements, and respiratory impairment (assessed by ventilatory requirements, arterial-alveolar oxygen tension ratio over the first day in ventilated infants, and duration of dependence on supplemental oxygen). RESULTS: There were statistically significant differences between the two groups in mean initial packed cell volume (regulated group 0.564, random group 0.509) and median red cell transfusion requirements (regulated group zero, random group 23 ml/kg). 13 infants from each group underwent mechanical ventilation and showed significant differences in mean minimum arterial-alveolar oxygen tension ratio on the first day (regulated group 0.42, random group 0.22) and in median duration of dependence on supplemental oxygen (regulated group three days, random group 10 days). Differences in final outcome measures such as duration of supplemental oxygen dependence and red cell transfusion requirements were mediated primarily through arterial-alveolar oxygen tension ratio and also packed cell volume. CONCLUSIONS: This intervention at preterm deliveries produces clinical and economic benefits.

Bilirubin↗
PubMed1990

Increased concentrations of D-dimers in newborn infants.

The concentrations of D-dimers (the D fragments of fibrinogen) were measured in blood from 15 preterm infants, and 45 born at full term, to establish normal ranges. The adult normal range is less than 0.25 mg/l; 31 of the 60 infants (52%) had values less than 0.25 mg/l, in 16 (27%) they were 0.25-0.5, in eight (13%) 0.5-1, in three (5%) 1-2, and in two (3%) 2-4. D-dimer concentrations measured during the neonatal period should be interpreted with caution.

Fibrin Fibrinogen Degradation Products↗
PubMed1990

Biotin labeling of red cells in the measurement of red cell volume in preterm infants.

Determination of circulating red cell volume (RCV) in anemic preterm infants is, in theory, a better indicator of transfusion needs than Hb concentration. Our study reports the results of RCV measurement using biotin labeling of red cells on 40 occasions in preterm infants of 25-34 wk gestation. In 20 infants, who had estimations made within 24 h of birth, the RCV varied between 17.7 and 66 mL/kg. Twenty measurements were made at a later age at the time of a blood transfusion. RCV values were between 13.1 and 41.5 mL/kg before transfusion. In 13 infants, RCV was determined simultaneously using two methods, biotin and dilution of autologous HbF with donor HbA at transfusion. There was no significant difference between the results of RCV estimations using these two methods. Our study demonstrates that biotin labeling is an effective method for determining RCV in preterm infants.

Biotin↗
PubMed1988

Definitive estimate of rate of hemoglobin switching: measurement of percent hemoglobin F in neonatal reticulocytes.

The transition from fetal to adult erythropoiesis starts at 32-36 wk postconception. The rate of this switchover has been controversial. Studies of globin chain synthesis by reticulocytes in vitro have indicated gradual switching with a time for 50% reduction in fetal Hb synthesis ("half-time") of more than 6 wk. This may not accurately reflect fetal/adult Hb synthetic balance in vivo. By contrast, histochemical studies and also indirect mathematical analysis of postnatal changes in circulating fetal Hb and adult Hb may imply abrupt patterns of switching with half-times of less than 1 wk. We have resolved this discrepancy by direct measurement of the changing proportions of fetal and adult Hb in reticulocytes prepared by flourescence activated cell sorting from 10 full-term cord and 45 preterm postnatal blood samples. This method overcomes problems both of extrapolation from in vitro measurements and of mathematical analysis. We find a gradual transition from fetal Hb to adult Hb synthesis. The half-time is approximately 16-18 wk. Values of fetal Hb in reticulocytes were on average higher than predicted from in vitro synthesis studies. We find considerable individual variation. Infants differ in their switching behaviour, many showing prolonged dependence on fetal Hb.

Age Factors↗
PubMed1987

The prophylactic use of ticarcillin/clavulanate in the neonate.

A combination of ticarcillin and clavulanic acid (ratio 15:1) was given prophylactically to 24 newborn infants at risk of infection. Serum and urine concentrations of ticarcillin and clavulanic acid were measured after the first parenteral dose. Fifteen of 22 organisms isolated from the infants were sensitive to the drug. The pharmacokinetic profile was satisfactory and the combination was well tolerated.

Bacterial Infections↗
PubMed1986

Outbreak of Salmonella eimsbuettel in newborn infants spread by rectal thermometers.

Over a six-week period there were 25 episodes of Salmonella eimsbuettel infection in newborn infants, mothers, and staff in a modern maternity hospital with 3600 annual deliveries. The probable source was a mother and her child, and the organism was spread by rectal thermometers in the labour suite and one of the wings (wards). When the thermometers were withdrawn from use and correctly disinfected the outbreak in babies ceased. Environmental cross-infection of staff was halted by closure, cleaning, and disinfection of the clinical area mainly affected. Some babies had diarrhoea but quickly recovered, and none came to harm. The infected staff had no symptoms and returned to duty after three negative cultures. Measurement of temperature is still an important observation in the care of newborn infants, but for everyday care it is recommended that rectal thermometry be discontinued and replaced by axillary measurement.

Cross Infection↗
PubMed1986

Determination of red-cell mass in assessment and management of anaemia in babies needing blood transfusion.

A new method for the rapid determination of red-blood-cell mass (RCM) in infants needing blood transfusion is described. RCM is estimated from the fall in the baby's fetal haemoglobin level resulting from transfusion of a known mass of adult-haemoglobin-containing red cells. In severe blood loss and refractory anaemias in preterm infants, in addition to the red-cell deficit, the plasma volume is low, leading to a falsely high haematocrit of about 0.30, which conceals a deficiency of 50-70% in circulating red cells. Red-cell transfusion in such infants based on haematocrit often fails to restore RCM to normal, leading to repeated transfusions. The frequency of transfusions may be reduced by giving enough red cells fully to correct the deficiency based on RCM estimation.

Adult↗
PubMed1980

Maternal vitamin D intake and mineral metabolism in mothers and their newborn infants.

Pregnant women receiving daily supplements of 400 IU (10 microgram) of vitamin D2 from the 12th week of pregnancy had plasma calcium concentrations higher at 24 weeks but similar at delivery to those in control pregnant women who did not receive the supplements. Infants of the women receiving the supplements had higher calcium, lower phosphorus, and similar magnesium concentrations on the sixth day of life and a lower incidence of hypocalcaemia than infants of the control women. Plasma concentrations of 25-hydroxycholecalciferol, which showed a seasonal variation, were higher in mothers and infants in the treated group. Cord-blood calcium, magnesium, phosphorus, and 25-hydroxycholecalciferol concentrations correlated with maternal values at delivery. Breast-fed infants had higher calcium and magnesium and lower phosphorus and 25-hydroxycholecalciferol concentrations than artificially fed infants. A defect of dental enamel was found in a high proportion of infants (many of whom had suffered from hypocalcaemia) born to the control women. These results suggest that vitamin D supplementation during pregnancy would be beneficial for mothers, whose intake from diet and skin synthesis is appreciably less than 500 IU of vitamin D daily.

Blood Proteins↗
PubMed1977

Magnesium therapy in neonatal tetany.

104 infants with symptomatic hypocalcaemia were randomly allocated to treatment with calcium gluconate, phenobarbitone, or magnesium sulphate. Infants treated with magnesium sulphate had higher plasma-calcium concentrations after 48 hours' treatment and fewer convulsions during and after the treatment period. Magnesium sulphate is recommended as the treatment of choice in symptomatic neonatal tetany whether or not there is hypomagnesaemia.

Administration, Oral↗