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Biomedical subjects

A Allen

Publications and source records attributed to A Allen.

At least 37 records · Page 2Linked to original sources
PubMed1991

Older age and elevated blood pressure are risk factors for intracerebral hemorrhage after thrombolysis.

Intracerebral hemorrhage is an important concern after thrombolytic therapy for acute myocardial infarction, but risk factors are controversial. Accordingly, we assessed risk factors in 107 treated patients of whom 4 had intracerebral hemorrhage. Intracerebral hemorrhage occurred at a mean of 25 hours (range 3.5 to 48) after therapy and was fatal in 2 patients. Significant differences were found between patients with and without intracerebral hemorrhage for age (77 +/- 7 vs 62 +/- 11 years, p less than or equal to 0.01), and initial (161 +/- 23 vs 135 +/- 23 mm Hg, p less than or equal to 0.03) and maximal (171 +/- 30 vs 146 +/- 20, p less than or equal to 0.02) systolic blood pressures. Initial and maximal diastolic blood pressures also tended to be higher (101 +/- 25 vs 86 +/- 16, p less than or equal to 0.07; 104 +/- 24 vs 90 +/- 13, p less than or equal to 0.06). Differences did not achieve significance for comparisons of gender, height, weight, site of infarction, time to therapy, specific thrombolytic agent used, concomitant therapy, interventions and partial thromboplastin time. It is concluded that age (greater than or equal to 70 years) and elevated blood pressure (greater than or equal to 150/95 mm Hg) are important risk factors for intracerebral hemorrhage. The overall balance of benefit and risk of thrombolysis should continue to be assessed by large mortality trials.

Age Factors↗
PubMed1991

Cisplatin and novobiocin in the treatment of non-small cell lung cancer. A Southwest Oncology Group study.

Novobiocin, a commercially available oral antibiotic, inhibits DNA topoisomerase II in a manner shown in cell culture to enhance the cytotoxicity of alkylating agents and cisplatin. Thirty-six patients were entered on a Phase II trial using high-dose cisplatin (100 mg/m2 on days 1 and 8 for four cycles) after steady-state dosing with novobiocin (1000 mg or four 250-mg capsules every 12 hours for six doses, four of which were administered before each dose of cisplatin). One patient remains on study and cannot be evaluated for response. No complete responses were seen. Three patients (8%) had partial responses and an additional patient had an unconfirmed partial response. The median survival time of all patients was just less than 7 months. These results are comparable with those of other concurrent Southwest Oncology Group (SWOG) Phase II and III trials of high-dose cisplatin in non-small cell lung cancer (NSCLC). Novobiocin plasma levels were obtained for three patients and were approximately 50% of the optimal concentration as reported in cell culture for potentiation of cytotoxicity. It was concluded that an optimum test of novobiocin as a modulator of cytotoxicity may require the availability of an intravenous preparation.

Administration, Oral↗
PubMed1991

Pigeon breeders' lung: pigeon intestinal mucin, an antigen distinct from pigeon IgA.

Antigens identified by indirect immunofluorescence staining and specific for sera from patients with pigeon breeders' lung or healthy pigeon breeders, have been isolated from pigeon intestinal mucus. Two antigenic peaks, one pigeon intestinal mucin and the other IgA, were separated by equilibrium centrifugation of water-soluble mucus in a caesium chloride density gradient. Antigenic positive material was identified by a modified double-sandwich ELISA, by inhibition of haemagglutination of turkey erythrocytes and by gel diffusion. Antigenic-positive material co-fractionated on gel-filtration with purified intact and papain digested pigeon mucin, both free of IgA. These studies demonstrate antibodies to two quite different antigens are associated specifically with sera from pigeon breeders, a novel antigen pigeon intestinal mucin and the previously documented pigeon IgA.

Animals↗
PubMed1991

Autoradiographic localization and effects of exogenous radioactively labelled surfactant in the lung of the prematurely delivered fetal rabbit.

Adult rabbit lung surfactant was radioactively labelled with [3H]palmitate and isolated by centrifugation. This material was instilled into the trachea of fetal rabbits prematurely delivered on the 27th gestational day. A similar preparation of unlabelled surfactant was used to measure the effects on pressure-volume characteristics in lungs of 27th day fetuses. Tissue sections were prepared from the lungs of all animals and morphometric and autoradiographic determinations made. Surfactant instillation improved pressure-volume relationships in fetal rabbit lungs. Histologically, although only the middle right lobe seemed to show significant qualitative improvement in expansion after surfactant treatment, quantitative assessment indicated that the surfactant preparation had significantly increased the mean alveolar cross-sectional areas in all three lobes of right lungs. In addition, distribution of autoradiographic grains indicated that 8-25% were located over the alveolar spaces while approximately half this percentage was present over tissue at the level of the alveolus. These results indicate that intratracheal instillation of surfactant supplements the endogenous surfactant at the level of the alveolus.

Animals↗
PubMed1991

Low-glycemic index foods improve long-term glycemic control in NIDDM.

OBJECTIVE: To compare high- and low-glycemic index (GI) diets in the treatment of non-insulin-dependent diabetes mellitus (NIDDM). RESEARCH DESIGN AND METHODS: Sixteen subjects with well-controlled NIDDM and normal lipid profile, 10 of whom continued oral hypoglycemic medication, participated in the study. A diet that emphasized low-GI foods (e.g., porridge, pasta) was compared with a high-GI diet (e.g., processed cereals, potatoes). The GI of the low-GI diet was 15% lower than the high-GI diet (77 +/- 3 vs. 91 +/- 1) but otherwise similar in macronutrient composition and fiber, as determined by a 4-day weighed record. The diets were instituted under instruction from a dietitian who visited subjects at home on a weekly basis. Body weight was maintained within 1-2 kg. RESULTS: Glycemic control was improved on the low-GI diet compared with the high-GI diet (statistically significant findings, P less than 0.05). Mean glycosylated hemoglobin at the end of the low-GI diet was 11% lower (7.0 +/- 0.3%) than at the end of the high-GI diet (7.9 +/- 0.5%), and the 8-h plasma glucose profile was lower (area under the curve above fasting 128 +/- 23 vs. 148 +/- 22 mmol.h-1.L-1, respectively). Mean fasting plasma glucose, total cholesterol triglycerides, and lipoproteins did not show important differences. CONCLUSIONS: A low-GI diet gives a modest improvement in long-term glycemic control but not plasma lipids in normolipidemic well-controlled subjects with NIDDM.

Blood Glucose↗
PubMed1991

Nursing editors back words with money.

During their Ninth Annual Meeting, international nursing editors were told of the visit of Norah Casey, editor of Nursing Standard, to Romania on behalf of the Care for Romania Appeal. She found children dying of acquired immunodeficiency syndrome, malnutrition, and other diseases. Through the Appeal nurses are being sent to care for the children and to provide education for their care givers.

Child↗
PubMed1991

Risk management: a proactive process.

Successful risk management is a proactive process designed to prevent litigation and possible loss of assets. Some examples of standards of care and legal implications for nurses in ambulatory and PACU units are discussed. Suggestions are made regarding specific risk management issues.

Humans↗
PubMed1991

Physicians' plan for health care reform.

Numerous proposals have been made for health care reform during the last decade. Still, the richest health care system in the world offers little or nothing to millions of Americans. The quality of nursing practice is threatened by calls for rationing of health care resources and cost control. The Canadian system for national health care is frequently cited as a model for health care reform in the United States. Physicians for a National Health Program have designed a plan similar to that of Canada. This article presents an overview of the physicians' proposal and suggests its comparison with that of the Pepper Commission.

Delivery of Health Care↗
PubMed1991

Extension of the role of the postanesthesia care unit specialist: problem or plus?

The scope of services and responsibilities of the nursing staff in the PACU are expanding. The flexibility of the PACU and the diversity of the usual postanesthesia population, along with the availability of monitoring technology and nursing expertise, make the unit vulnerable to expansion of its mission. Even with all of its advantages, the PACU is not the ideal environment for many patients. The implications of extended use of the PACU are discussed in the following article.

Humans↗
PubMed1991

Rationing health care resources: who will set limits?

Hospitals faced with additional reductions in Medicare and Medicaid reimbursements are discontinuing unprofitable services and programs. Nurses and physicians are finding that the patient's care plan is often dictated by economic considerations rather than what they believe to be beneficial. This article provides an overview of the problems and considerations involved in the rationing of health care resources.

Adult↗
PubMed1991

Right to die, freedom of choice, and assisted death: implications for nurses.

Nurses face many moral, ethical, and legal issues in an environment where biologic life can be maintained long after cognitive function has ceased. Highly publicized cases involving the right to die and assisted suicide have brought attention to the right of self-determination regarding medical treatment. A brief discussion of these issues is offered and some questions posed.

Ethics, Nursing↗
PubMed1990

[Plasma anticholinergic activity and cognitive function in geriatric patients].

This study evaluated the putative impact of circulating anticholinergic equivalents on cognitive functional performance in non-demented geropsychiatric inpatients. Standard rating instruments were administered to measure memory functions, concentration and overall functional competency. Anticholinergic plasma activity was assayed, using a radioreceptor technique with tritiated quinuclidinyl benzilate as the active reagent. None of the cognitive tests employed indicated a statistically significant change in the subjects' quantifiable level of cognitive performance. All changes in anticholinergic activities were related to adjustments in psychotherapeutic medications. The possible role of reversal of pseudodementing features is discussed as well as the potential for monitoring anticholinergic activity when treating elderly individuals with more than one centrally active medication having anticholinergic properties.

Aged↗
PubMed1990

On-the-job injury: a costly problem.

Musculoskeletal injuries, including back disorders, rank second among work-related injuries in the United States. Back pain is an expensive problem that is difficult to treat. Studies show that workers with the greatest prevalence of back, shoulder, and knee injuries are employed in the health care industry. The PACU is an area where staff members are especially vulnerable to musculoskeletal injuries. Expenses related to on-the-job injury add significantly to the cost of health care. This article focuses on the problem and offers some suggestions for reducing the incidence of work-related injuries.

Back Pain↗
PubMed1979

Comparison of interwave latencies of brain stem auditory evoked responses in narcoleptics, primary insomniacs and normal controls.

A study of brain stem auditory evoked responses (BAER) was carried out in 10 narcoleptics, 10 primary insomniacs and 10 normal controls to determine if a neurophysiologic abnormality could be detected in these primary sleep disorders. The mean interpeak conduction times of Wave I-III, III-V and Iv were compared between the following groups: normal controls awake and in monitored sleep; narcoleptics awake and in monitored sleep, normal controls awake and narcoleptics awake; normal controls awake and insomniacs awake; narcoleptics awake and insomniacs awake; narcoleptics with cataplexy (n = 6) awake and narcoleptics without cataplexy (n = 4) awake. No significant differences were found which suggests that these sleep disorders represent dysfunctions which do not involve brain stem structures subserving the BAER.

Adult↗