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At least 469 records · Page 26Linked to original sources
PubMed2000

Transient abnormal neurologic signs (TANS) in a longitudinal study of very low birth weight preterm infants.

OBJECTIVE AND METHODS: In the Bonn Longitudinal Study (BLS), the course of neurologic development was analysed with regard to transient abnormal neurologic signs (TANS). Abnormal neurologic signs (ANS) are defined when present in at least one developmental area at one examination. From birth to adulthood (mean 23 years) 108 preterm infants, 81% of very low birth weight (VLBW) were examined with regard to their psychological, neurologic and physical development: 62 appropriate for gestational age (AGA), 46 small for gestational age (SGA), 27 with postnatal catch-up growth of head circumference (group A) and 19 without catch-up (group B); 73 full terms served as controls. The dropout rate was 7.6%. RESULTS: ANS showed a great inter- and intraindividual variability. Episodes of neurologic abnormalities changed with those of normality. ANS reappeared when new abilities developed. ANS were observed mainly during the first year. The incidence was higher in preterms (AGA 49%, SGA A 63%, SGA B 61%) than in full terms (15%). Transient ANS (TANS) were diagnosed in 42% of AGA, 63% of SGA A, 33% of SGA B preterms and 12% of full terms. The recovery rate, i.e., the TANS to ANS percentage, was higher in AGA (86%), SGA A (100%) and full terms (82%) than in SGA B (55%) preterms. CONCLUSION: It is impossible to predict early on whether ANS will be transient, i.e. TANS. Longitudinal analyses are needed. The outcome depends on recovery from or persistence in ANS.

Blindness↗
PubMed2002

Spectrofluorometric determination of naproxen in tablets.

A rapid, selective, sensitive and simple fluorescence method was developed for the direct determination of naproxen in tablets. The tablets were triturated, dissolved in either NH(3) or NaOH solution, sonicated, filtered and then direct fluorescence emission was read at 353 nm (exciting at 271 nm). In order to validate the method the results were compared with those obtained by the USP XXIV NF 19 Pharmacopeia reference method (high performance liquid chromatography). The slope, intercept and variances which are associated with the regression coefficient calculated with bivariate least square (BLS) regression indicate that both methods are statistically comparable. The recoveries were excellent, except in tablets containing the antibiotic tetracycline. In this latter case a correction procedure is necessary.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1996

Performance of a system to determine EMS dispatch priorities.

Inappropriate use of emergency medical services (EMS) for nonemergencies strains EMS resources and limits efficiency. Protocol-driven dispatch systems attempt to correct the imbalance that exists between demand and available resources by prioritizing 911 calls. This study compared dispatch priority decisions with apparent patient need, based on emergency department (ED) presentation, by matching 320 ED charts with corresponding EMS dispatch and run information. The priorities assigned by the system based on dispatch information were compared with those assigned by a three-member panel of physicians based on ED presentation. The physicians and dispatchers agreed on the need for advanced life support (ALS) versus basic life support (BLS) transport 74% of the time. There was only 43% agreement on the more detailed 4-level classification system. The system assigned the highest level of dispatch utilizing combined ALS and first responders to a significantly greater degree than did the physicians. It was concluded that protocol systems for setting dispatch priorities utilize EMS resources to a higher degree than actually required based on ED presentation.

Emergencies↗
PubMed1998

A method to reduce response times in prehospital care: the motorcycle experience.

This study compared the response times of a motorcycle and a standard ambulance in a congested urban emergency medical services (EMS) setting. The study was performed in Taipei, Taiwan, a densely populated urban area. A basic life support (BLS) motorcycle (without defibrillation capability) and an advanced life support (ALS) ambulance were based at three study hospitals and simultaneously dispatched when there was a perceived need for ALS ambulance transport. Over a 3-month period, prehospital personnel evaluated 307 medical and trauma emergencies. Time data were insufficient for analysis in 33 cases, leaving a study population of 274. Response times of the motorcycle and the ambulance were prospectively assessed and compared. During rush hours, the response times of the motorcycle and ambulance were 4.9+/-3.0 minutes and 6.3+/-3.4 minutes (P < .05), respectively, and in non-rush hours, 4.2+/-2.1 minutes and 5.1+/-2.5 minutes (P < .05), respectively. Using motorcycles to transport EMTs to the emergency scene significantly reduced response time compared with a standard ambulance in a congested urban setting. Large prospective studies are required to determine the impact on patient outcome of shorter EMS response times using motorcycles. EMS motorcycles appear feasible and deserve consideration to help expedite prehospital care in other systems in densely populated cities.

Ambulances↗
PubMed2006

[New therapeutic approaches to autoimmune diseases].

Over the past decade, new biological therapies have been developed to treat systemic autoimmune diseases. These new treatments, which target various steps of the immune response, include: B lymphocyte (BL) inhibitors, such as anti-CD20 monoclonal antibodies, BlyS antagonists, and tolerogens that inhibit specific BLs that produce pathogenic antibodies; inhibitors of costimulation between antigen-presenting cells and T lymphocytes (TL), such as monoclonal antibodies against CD40 ligand and CTLA4-Ig (abatecept); TL antagonists, which can inhibit proliferation of autoreactive T cells; cytokine antagonists; chemokine and adhesin antagonists, which inhibit trafficking of immunocompetent cells to target organs. These new approaches are based on a deeper understanding of the autoimmune response.

Antibodies, Blocking↗
PubMed1996

Knowledge of resuscitation.

This paper describes an exploration of nurses' levels of knowledge over 6 months following a resuscitation workshop. Two concurrent but separate studies were run in the acute specialties of cardiac services and intensive care. The tools used were three identical questionnaires distributed at 3-monthly intervals, using the United Kingdom and European Resuscitation Council's guidelines (BLS Working Part of the ERC 1992) as the standard. The results of the questionnaire were supported by a semi-structured interview and workshop evaluation. The results show that initially knowledge levels were poor but that an increase in knowledge was observed over the 6 months. The results prompt recommendations in the form of education, clinical practice and further research.

Cardiac Surgical Procedures↗
PubMed1997

Cardiac arrest: the skills of the emergency nurse practitioner.

This paper seeks to explore the skills that the Emergency Nurse Practitioner (ENP) should have in relation to cardiopulmonary resuscitation (CPR). No specific literature was found relating to the role of the ENP in CPR. Therefore, three literature searches were carried out and the findings used to suggest skills in which the ENP should be competent. As demand for community based minor injuries units (MIUs) grows, development of an independent role for ENPs should reflect their unique relationship with patients. These patients may have illnesses in addition to the injuries with which they present. If a patient collapses in cardiac arrest, the prompt and correct response of the ENP would be the most important factor in increasing the patient's survival chances (European Resuscitation Council 1992a & b, Handley & Swain 1994). The majority of sudden cardiac arrests are caused by ventricular fibrillation (VF) (Royal College of Physicians 1987). Therefore, competence in defibrillation is one area of nursing role expansion which should be adopted by an ENP during the role transition. This should be supported by biannual training in Basic Life Support (BLS) to ensure that ENPs are able to manage cardiac arrests effectively. Nationally recognized training is recommended in order to facilitate ENP movement between Trusts.

Cardiopulmonary Resuscitation↗
PubMed2002

Role of genetic and epigenetic changes in Burkitt lymphoma.

All Burkitt lymphomas (BLs) carry reciprocal chromosomal translocations that activate the c-myc oncogene through juxtaposition to one of the immunoglobulin (Ig) loci. Many BL carry point mutation in the p53 tumor suppressor gene or other defects in the p14ARF-MDM2-p53 pathway, and inactivation of the p16INK4a gene by promoter methylation or homozygous deletion. This indicates that disruption of both the pRb and p53 tumor suppressor pathways is critical for BL development. Alterations of other genes, including Bax, p73, and BCL-6, may provide further growth stimulation and apoptosis protection. Thus, BL development involves multiple genetic and epigenetic changes that drive cell cycle progression and avert cell death by apoptosis.

Animals↗
PubMedDate not supplied

Doctor-based basic cardiopulmonary resuscitation course: an alternative to the conventional approach.

United Christian Hospital initiated a doctor-based cardiopulmonary resuscitation (CPR) Program. It is a two-hour, focused, adult CPR course, suitable for adults of different age groups and of different educational levels. The course was rated highly by the participants. Most trainees acquired CPR knowledge and skills, and had confidence to perform CPR. This type of training could improve the rate of bystander CPR for out-of-hospital cardiac arrest patients in this region. Avoiding the complexity and pass-fail psychology that is used in the traditional CPR training curriculum, it can be an alternative to the traditional four-hour instructor-based Basic Life Support (BLS) course.

Adult↗
PubMedDate not supplied

Collegiate-based emergency medical services (EMS): a survey of EMS systems on college campuses.

INTRODUCTION: Collegiate-based emergency medical systems (CBEMS) are a unique model for the delivery of prehospital care. The National Collegiate Emergency Medical Services Foundation (NCEMSF) was founded to serve as a resource for CBEMS groups. The purpose of this investigation is to describe the current state of CBEMS organizations. METHODS: The NCEMSF maintains a Web-based, data collection system to gather data on CBEMS organizations. Collegiate-based emergency medical services are defined as emergency medical services in a university or college campus setting. The abstracted data from the NCEMSF registry were analyzed using descriptive statistics. RESULTS: The NCEMSF registry contained data on 175 groups, and 145 groups were identified as providing CBEMS. The levels of service provided by the groups were: (1) first responder, 8.3%; (2) basic life support (BLS) 66.2%; (3) intermediate life support (ILS) 4.8%; (4) advanced life support (ALS), 9.7%; and (5) combination BLS/ALS, 8.3%. Transport capabilities were provided by 31.7% of the CBEMS. The average response time was estimated at 2.6 minutes (95% confidence interval (CI), 2.35-2.91 minutes). Early defibrillation using a automated external defibrillator (AED) or ALS was available by 75.9% (95% CI, 68.8-83.0) of CBEMS. Service to the community beyond the campus was provided by 21.3% of CBEMS groups. Forty-eight percent of the services operate 24 hours/day, seven days/week. The average call volume per year was 568 responses (95% CI, 315-820), and the groups averaged 29 (95% CI, 25-34) members. During the past five years, an average of 4.3 new CBEMS groups were formed per year. Eleven of the CBEMS are based at international schools.

Emergency Medical Services↗
PubMedDate not supplied

Epidemiology of pediatric EMS practice: a multistate analysis.

OBJECTIVE: To describe the epidemiology of pediatric emergency medical services (EMS) practice in a large patient population from several geographic areas. DESIGN: Retrospective computer analysis of EMS databases from four states using a common data set and analysis system. SETTING: Pennsylvania, Tennessee, Mississippi, and Nevada (except Clark County), 1990 through 1992. METHODS: All patient-care reports of patients 14 years old and younger were extracted from the EMS databases and analyzed for the following factors: age, gender, date, elapsed prehospital times, incident type, mechanism of injury, call disposition, illness or injuries encountered, severity of illness/injury (by abnormal vital signs), and basic life support (BLS) and advanced life support (ALS) treatment delivered. RESULTS: A total of 1,512,907 patient care reports were reviewed. Those of 61,132 children were extracted for analysis. These children comprised about 4% of prehospital responses. Male subjects predominated (56%), and children aged 7 through 14 years represented 46% of cases. Most calls occurred in the evening and daylight hours. Children were transported by ambulance in 89% of cases, and care was refused in 7.7%. Mean response time was 9 +/- 16 minutes, mean scene time 12 +/- 14 minutes, and mean transport time 14 +/- 20 minutes. Traumatic incidents predominated at 42%, with motor vehicle accidents and falls the most common mechanisms. Blunt injuries accounted for 94% of trauma, whereas respiratory problems, seizures, and poisoning/overdose were the most common medical problems. Vital signs were obtained in 56% of cases. Abnormal vital signs were noted in 21% of these, and the presumptive causes were similar in distribution to those of the general population, with the addition of cardiac arrest. The most commonly used treatments were spinal immobilization, oxygen administration, intravenous access and several ALS medications. An ALS capability was available in more than half the runs, but ALS treatment was delivered in only 14% of those cases. Outcome data were not available. CONCLUSION: This multistate analysis of pediatric EMS epidemiology confirms findings reported in smaller regional studies, with several exceptions. Excessive scene times were not noted. Few children had serious disorders as evidenced by abnormal vital signs. An ALS treatment, when available, was used infrequently. These findings have implications for EMS planners and educators.

Adolescent↗
PubMed2006

Mechanically tunable three-dimensional elastomeric network/air structures via interference lithography.

We show how to employ an interference lithographic template (ILT) as a facile mold for fabricating three-dimensional bicontinuous PDMS (poly(dimethylsiloxane)) elastomeric structures and demonstrate the use of such a structure as a mechanically tunable PDMS/air phononic crystal. A positive photoresist was used to make the ILT, and after infiltration with PDMS, the resist was removed in a water-based basic solution which avoided PDMS swelling or pattern collapse occurring during the ILT removal process. Since the period of the structure is approximately 1 microm, the density of states of gigahertz phonons are altered by the phononic PDMS/air crystal. Brillouin light scattering (BLS) was employed to measure phononic modes of the structure as a function of mechanical strain. The results demonstrate that the phononic band diagram of such structures can be tuned mechanically.

Air↗
PubMed1998

No evidence of WT1 involvement in a Burkitt's lymphoma in a patient with Denys-Drash syndrome.

BACKGROUND: We previously reported the case of a patient affected with Denys-Drash syndrome (DDS), who developed disseminated EBV-related Burkitt's lymphoma (BL) after kidney transplantation. Here, we describe the molecular characterisation of the WT1 gene in the constitutional and tumour DNA of this patient. PATIENTS AND METHODS: WT1 exons 2 to 10 were sequenced in constitutional and tumour DNAs. By Southern blotting the latter was also investigated for the presence of gene rearrangements. Gene expression analysis in tumour cells was performed by reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS: A germline missense mutation affecting one of the zinc finger domains of the gene, and previously reported in other DDS cases, was observed. No alterations of the constitutionally wild-type WT1 allele and no expression of the gene were observed in BL cells. A small group of BLs from other paediatric patients showed a variable expression of WT1. CONCLUSIONS: Our findings indicate that WT1 is unlikely to be involved in the onset of BL in our case. However, a possible role of the gene in at least a subset of these lymphoproliferative diseases may be suggested.

Abnormalities, Multiple↗
PubMed2001

The prognostic significance of day 3 embryo cleavage stage on subsequent blastocyst development in a sequential culture system.

PURPOSE: To determine prognostic significance of blastomere number on Day 3 of culture upon subsequent blastocyst (BL) development. METHODS: A retrospective analysis was conducted in 37 IVF subjects undergoing standard protocols and BL transfer after sequential embryo culture in P1 and BL media. RESULTS: Of Day 3 embryos containing 7 or more blastomeres, 68.9% (186/270) developed into BL compared to embryos containing 4-6 blastomeres, 38.1% (56/147), P < 0.0001. The majority of BL, 68.9% (168/244), were observed on Day 5. Extended Day 6 culture represented 31.1% (76/244) of all BLs. CONCLUSIONS: The observation of 7 or more blastomeres on Day 3 yielded a significantly greater likelihood of BL development. Embryos containing 4-6 blastomeres are still relatively likely to progress to a BL. Extended culture to Day 6 still yields a significant proportion of BL. Cell cleavage stage on Day 3 appears to be a useful prognostic indicator of subsequent BL development.

Adult↗
PubMed2002

Teaching hospital physicians' skills and knowledge of resuscitation algorithms are deficient.

BACKGROUND: The resuscitation skills of 78 on-call physicians in a tertiary referral center were evaluated in a simulated sudden cardiac arrest (SCA). METHODS: The study subjects consisted of physicians whose on-call duty included handling emergency situations. First they were drawn without warning to a simulated witnessed cardiac arrest (ventricular fibrillation (VF)). They were provided with two nurses and all the equipment and medicine needed to treat SCA. Second, they were asked to write the current treatment protocols for basic life support (BLS) and VF. RESULTS: The median time to defibrillation was 2.38 min, and only 31% of the physicians were able to use the defibrillator correctly. Thirty per cent treated asystole according to the guidelines of the time. Twenty-four per cent were able to return the spontaneous circulation and the median time to ROSC (return of spontaneous circulation) was 5.75 min Only 25% of the physicians wrote the guideline for treatment of VF and basic life support correctly or nearly correctly. CONCLUSION: Regular resuscitation education should be compulsory to all physicians responsible for on-call duties in hospitals. Hospitals should have at least one employee part-time responsible for this duty.

Cardiopulmonary Resuscitation↗
PubMed2001

c-myc overexpression activates alternative pathways for intracellular proteolysis in lymphoma cells.

Burkitt's lymphoma (BL) is a highly malignant B-cell tumour characterized by chromosomal translocations that constitutively activate the c-myc oncogene. Here we show that BL cells are resistant to apoptosis and do not accumulate ubiquitin conjugates in response to otherwise toxic doses of inhibitors of the proteasome. Deubiquitinating enzymes and the cytosolic subtilisin-like protease tripeptidylpeptidase II are upregulated in BLs, and could be rapidly induced by the overexpression of c-myc in normal B cells carrying oestrogen-driven recombinant Epstein-Barr virus. Apoptosis was induced by inhibiting tripeptidylpeptidase II, suggesting that the activity of this protease may be required for the survival of BL cells. We thus show that there is a regulatory link between c-myc activation and changes in proteolysis that may affect malignant transformation.

Aminopeptidases↗
PubMed1986

Burkitt-like lymphoma in an English child: characterisation of tumour biopsy cells and of the derived tumour cell line.

An eight year old English boy presented with an abdominal undifferentiated 'Burkitt-like' lymphoma. Lymphoma cells from ascitic fluid were cultured on a human embryo fibroblast feeder layer and, after a short lag period, a cell line (DH-BL) was established which, like the original tumour, was both negative for the Epstein-Barr nuclear antigen (EBNA) and expressed a monoclonal pattern of surface immunoglobulin (alpha lambda). DH-BL also possessed the Burkitt-related 8:14 chromosome translocation in all metaphases analysed; no other chromosomal abnormalities were present. The cell surface phenotype of the original biopsy cells and the cultured tumour cells in early passage were investigated using a panel of monoclonal antibodies to B lineage-associated antigens. These antibodies had recently been used to characterise African 'endemic' Burkitt's lymphoma (BL) biopsy cells and their derived cell lines. The cell surface phenotype of this English EBNA negative Burkitt-like lymphoma biopsy was indistinguishable from that previously shown by biopsies of EBNA positive endemic BLs. It therefore appears that both the endemic and sporadic forms of BL, as illustrated by this case, may be derived from the same subset of progenitor cells.

Abdominal Neoplasms↗
PubMed2002

Dietary magnesium intake in type 2 diabetes.

BACKGROUND: Magnesium deficiency is common in type 2 diabetes and may have a negative impact on glucose homeostasis and insulin resistance, as well as on the evolution of complications such as retinopathy, thrombosis and hypertension. OBJECTIVE: To assess the dietary magnesium intake of patients with type 2 diabetes in Zurich, Switzerland and to compare the magnesium intake of diabetic and non-diabetic subjects. DESIGN: The magnesium intake of 97 randomly selected patients with type 2 diabetes and 100 healthy, non-diabetic controls matched for age and sex was estimated using a diet history method. During winter and summer periods, mean daily magnesium intakes were calculated from detailed information given by the test subjects about their eating habits over the previous 2 months. The calculations were performed using EBIS, a computer program based on a German nutrient data base (BLS 2.3), with food items specific to Switzerland added or directly analysed when necessary. RESULTS: The mean+/-s.d. daily magnesium intake of the male diabetic and male control subjects was 423.2+/-103.1 and 421.1+/-111.0 mg, respectively. The mean daily magnesium intake of the female diabetic and female control subjects was 419.1+/-109.7 and 383.5+/-109.7 mg, respectively. There were no significant differences in daily magnesium intake between the diabetic and the non-diabetic subjects and mean intakes in both groups exceeded Swiss recommended dietary intakes. CONCLUSIONS: Dietary intake of magnesium appears sufficient in Swiss adults with type 2 diabetes and is unlikely to contribute to the aetiology of magnesium deficiency. SPONSORSHIP: The Swiss Federal Institute of Technology, Zurich, Switzerland.

Adult↗