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Biomedical subjects

A Ambrose

Publications and source records attributed to A Ambrose.

15 recordsLinked to original sources
PubMed2005

Enumeration and antibiotic resistance patterns of fecal indicator organisms isolated from migratory Canada geese (Branta canadensis).

Thermotolerant fecal indicator organisms carried by migratory waterfowl may serve as reservoirs of antibiotic resistance. To determine the extent to which such antibiotic resistance markers were present in migratory Canada geese (Branta canadensis) on the Maryland Eastern Shore, we isolated Enterococcus spp. and Escherichia coli from fresh feces and examined the antibiotic resistance profiles of these bacteria. Samples were obtained in October 2002, January 2003, and March 2003. Thermotolerant E. coli counts ranged from 0 to 1.0x10(7) colony forming units (CFU)/0.1g (g-1) wet weight of feces, whereas Enterococcus spp. counts ranged from 1.0x10(2)-1.0x10(7) CFU g-1 wet weight of feces. Primary isolates of each indicator organism were tested against a panel of 10 antibiotics. Greater than 95% of E. coli isolates were resistant to penicillin G, ampicillin, cephalothin, and sulfathiazole; no E. coli were resistant to ciprofloxacin. Enterococcal isolates showed highest resistance to cephalothin, streptomycin, and sulfathiazole; no enterococci were resistant to chloramphenicol. The tetracyclines, streptomycin, and gentamycin provided the greatest discrimination among E. coli isolates; chlortetracycline, cephalothin, and gentamycin resistance patterns provided the greatest discrimination between enterococcal strains. Multiple antibiotic resistance (MAR) profiles were calculated: fall (E. coli=0.499; enterococci=0.234), winter (E. coli=0.487; enterococci=0.389), and spring (E. coli=0.489; enterococci=0.348). E. faecalis and E. faecium, which are recognized human nosocomial pathogens, were cultured from winter (44 and 56%, respectively) and spring (13 and 31%, respectively) fecal samples.

Animal Migration↗
PubMed2001

Double-blind, placebo-controlled cross-over study of oral pilocarpine for the prevention of chemotherapy-induced oral mucositis in adult patients with cancer.

This study aimed to investigate the effect of oral pilocarpine (OP) in reducing the incidence of chemotherapy-induced oral mucositis. 32 adult cancer patients completed a total of 82 courses of chemotherapy in which either OP or placebo was given prophylactically in a double-blind cross-over design to prevent mucositis. Mucositis was documented in 20 out of 41 courses in which patients were given placebo, whereas mucositis was documented in only six out of 41 courses when patients were given OP (P<0.005). OP treatment was found to significantly reduce the mucositis score when assessed by the method of Donnelly and colleagues (Donnelly JP, Muus P, Schattenberg A, De Witte T, Horrevorts A, De Pauw BE. Bone Marrow Transplant 1992, 9, 409-413). Using this score, all patients scored a total of 52 when they were given the placebo versus eleven when they were treated with OP (P<0.001). A similar reduction in mucositis score was noticed using the World Health Organization (WHO) mucositis score; the total patient score was 25 for the placebo-treated group versus 6 for the OP group (P<0.001). We therefore conclude that oral pilocarpine is highly effective in the prevention of oral mucositis when given prophylactically to adult patients receiving a variety of cancer chemotherapy regimens.

Adult↗
PubMed2001

Source of improvement in balance control after a training program for ankle proprioception.

Previous research on healthy individuals reported improvements in balance control following a purported ankle proprioception-training program. The training may have resulted in a general rather than a specific enhancement of ankle proprioception. To test this hypothesis, subjects were constrained at the hips and trunk with a custom-made thoracolumbosacral orthosis and performed a one-leg standing test with eyes closed and head tilted back, so that they had to rely primarily on their ankle musculature to keep their balance. Subjects were retested after training on the BAPS three times a week for 4 weeks, following the training recommendations of the manual. Subjects' bodies were not constrained during the training. Analysis showed that subjects made improvements during training in performing more difficult tasks on the board. On the one-leg test, however, there were no improvements in sway velocity, number of touchdowns, or falls relative to pretest scores. Improvements observed during training likely resulted from diffuse enhancement of proprioception in other body segments such as the knees, hips, spine, and upper extremities. A training program in control of general balance does not specifically target ankle proprioception.

Adult↗
PubMed2000

Autopsy in elderly psychiatric inpatients: a retrospective review of autopsy findings of deceased elderly psychiatric inpatients in north Cheshire 1980-1996.

In this 17-year review of death certificates of elderly inpatients of a large psychiatric hospital in North Cheshire, the frequency, trend and value of performing autopsies were examined. Details of death certificates were compared with certificates issued after post-mortem examination to see whether an autopsy yielded any additional or relevant information about conditions that are not directly related to death but might well be of importance to public health. The rate of post-mortem examination, at 9.5% of total hospital deaths, did not show any significant trend over most of the review period. The vast majority of autopsies examined had been requested by the coroner and not by the clinicians. The review showed that an autopsy may be of some value in providing more information regarding any underlying causes of death in elderly psychiatric patients, but has no value in ensuring higher rate of the recording of conditions such as dementia, in particular Alzheimer's disease. Selective hospital autopsy in elderly psychiatric patients to verify, neuropathologically, the clinical diagnosis of Alzheimer's disease, will improve our diagnostic accuracy and provide valid statistics to be used in estimating prevalence, trends, risk factors and for use in all aspects of future research into Alzheimer's disease.

Aged↗
PubMed2000

Detention of elderly psychiatric inpatients under section 5(2) of the Mental Health Act 1983.

Emergency detention of elderly psychiatric inpatients appears to have attracted very little or no attention in published studies. In this retrospective review, all applications of sections 5(2) and 5(4) of the Mental Health Act 1983, detaining elderly inpatients in North Cheshire between 1985 and 1997 were reviewed. Forty-three percent of elderly inpatients under s.5(2) regained their voluntary status, while 57% were detained under another section by the end of the 72 hours (p < 0.05). Duration in hospital prior to applying s.5(2), clinical diagnosis of functional mental illness and use of s.5(4) appear to increase the likelihood of converting s.5(2) into other sections. The high rate of non-conversion of s.5(2) in the elderly to s.2 or 3 may imply that in almost half of the cases, emergency detention may have been used to control isolated incidents of disturbed behaviour in otherwise co-operative patients. Educating doctors and nurses in guidance put forward by the Code of Practice (1993) remains, probably, the main key to a better use of emergency holding powers.

Aged↗
PubMed1998

Diagnosis and differentiation of congenital diaphragmatic hernia from other noncardiac thoracic fetal masses.

This retrospective study was designed to evaluate individual sonographic parameters that might help differentiate congenital diaphragmatic hernia (CDH) from other noncardiac thoracic masses such as cystic adenomatoid malformation of the lung (CAML) and congenital lobar emphysema (CLE) prenatally. Twenty-four cases of CDH, CAML, and CLE detected during prenatal ultrasound and documented postnatally (with surgical, autopsy, or radiological proof) were identified through extensive chart and record review. The hard copy gray-scale images were retrospectively reviewed for imaging characteristics that may differentiate the three entities. Additionally, the prospective diagnosis during prenatal ultrasound was also compared with the postnatal diagnosis. The most reliable indicators in our retrospective review included confident visualization of a diaphragmatic defect (92.3/100.0 PPV/NPV, p< or =0.002) and/or localization of the stomach within the chest as well as the presence of severe cardiac deviation (both 92.3/62.5 PPV/NPV, p< or =0.01). Other sonographic indicators (including the presence of cystic areas, side and size of the lesion and the presence of polyhydramnios) offered lower levels of sensitivity and specificity. Prospective diagnosis during real-time assessment was also integral, offering >80% sensitivity and specificity (p< or =0.001). Accurate prenatal diagnosis of CDH is difficult despite the relative frequency of this lesion. The classic triad of a thoracic mass accompanying a displaced heart, absence of a normally positioned fluid-filled stomach and polyhydramnios, although seen with CDH, may not adequately differentiate this entity from other noncardiac fetal thoracic masses. Realtime assessment remains integral to the appropriate diagnosis.

Cystic Adenomatoid Malformation of Lung, Congenita↗
PubMed1998

HIV positive tests at Coronial Services in Victoria 1989-1996: lessons for HIV surveillance.

Results of routine testing at other sites can supplement surveillance of the HIV epidemic in Australia which is largely based upon voluntary testing. Since 1989, systematic onsite HIV testing has been undertaken on all bodies taken to the Victorian Institute of Forensic Medicine (VIFM). Information was collected on all cases of HIV infection detected at VIFM between 1989 and 1996, and matched to surveillance databases. In 8 years, 75 people were diagnosed with HIV; all except one were male. The age range was 14-70 years, mean 37.4 years. The major causes of death were suicide 35%, AIDS 21%, drug toxicity 16%, natural causes 12% and injury 7%. The major exposure categories were male homosexual 51%, male bisexual 11%, homosexual/bisexual IDU 16%, IDU other 8%, and haemophiliac 7%. For only two was exposure information unavailable. Seropositivity for anti-HCV and HBsAg was 37% and 11% respectively. The deceased was recorded as having HIV/AIDS on the police report in 73% of cases, and at least 90% of subjects had been diagnosed with HIV prior to their death. The study suggests there is relatively little undiagnosed HIV infection in Victoria, that HIV infection has not moved outside traditional risk groups, and that many tests for HIV are undertaken using false namecodes. Many patients could not be matched on the HIV/AIDS databases, identifying a problem with HIV surveillance systems in Victoria, and the need to capture all information on HIV positives detected at VIFM.

AIDS Serodiagnosis↗
PubMed1994

The trypanocidal effect of Cannabis sativa constituents in experimental animal trypanosomiasis.

The effect of Cannabis sativa on trypanosome-infected rats was examined. An aqueous extract of the seeds administered at a dose of 50 mg/kg/d cured animals infected with Trypanosome brucei brucei of blood stream parasites. Six fractions eluted from the crude extract by column chromatography were assessed for trypanocidal properties. Of these, only 2 fractions retained trypanocidal activity by curing mice infected with T brucei brucei.

Animals↗
PubMed1986

The effects of fetal exchange transfusion with a red blood cell substitute.

Isovolemic exchange transfusion in the fetal lamb in utero was performed with the use of Fluosol-DA (20%), a perfluorochemical erythrocyte substitute. With maternal hyperoxygenation, a physiologic PO2 was maintained in the fetal lambs, although the total fetal oxygen content decreased as the hematocrit dropped. Because of the oxygen-carrying properties of the perfluorochemical emulsion, the fraction of fetal oxygen carried in the dissolved state increased significantly when compared with that in controls that received saline solution.

Animals↗
PubMed1985

Thrombotic thrombocytopenic purpura in early pregnancy.

Thrombotic thrombocytopenic purpura during pregnancy in which both mother and fetus have survived has been an exceedingly rare occurrence, due at least in part to the difficulty in distinguishing this uncommon disease from hematologic complications of preeclampsia. In the nonpregnant patient, the use of plasma infusion or exchange plasmapheresis as therapy of choice has resulted in a dramatic increase in survival. By using more specific criteria than the classical clinical pentad, the diagnosis of thrombotic thrombocytopenic purpura during pregnancy can be made with greater accuracy. The first known instance of the successful use of exchange plasmapheresis leading to the survival of both mother and fetus in thrombotic thrombocytopenic purpura clearly not secondary to preeclampsia is reported.

Adult↗
PubMedDate not supplied

End-tidal carbon dioxide monitoring for weaning patients: a pilot study.

This research pilot study evaluates the usefulness of capnography for patients being weaned from mechanical ventilation in a medical intensive care unit (MICU). The hypothesis that capnography would allow for more rapid weaning from mechanical ventilation, and require fewer arterial blood gases (ABGs) during the process, was found to be untrue. Several implications for critical care nursing practices were derived from the literature review and findings of this study.

Adult↗