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Biomedical subjects

A M Clarke

Publications and source records attributed to A M Clarke.

At least 73 records · Page 4Linked to original sources
PubMed1986

A general systems approach to the patient, hospital staff, family, and community: implications for health care services.

This article concerns the application of a general systems concept to the health care system. A system consists of a set of interacting components which are interrelated and interdependent, and function as a unit. In order to identify some of the significant influences on the patient who has been hospitalized, this general systems concept has been applied to health care systems at a number of open systems levels in which he or she participates. These are the body-mind system of the patient (an organism); the patient-hospital staff system (an organization); the system relating the patient to his or her family (a group); and the patient-community system. Analyses of the strategic parts of these systems, their mutual dependencies and the processes which link them, together with their functions, have implications for both hospital-based health-care professionals and hospital administrators. These analyses are generalizable across these four levels of systems. Their implications have importance for health care services.

Community Health Services↗
PubMed1986

Thirty years of child psychology: a selective review.

A selective review of the literature in child psychology over the last 30 years reveals substantial changes in methodology, in analysis and the interpretation of findings. Evidence on the multifactorial nature of development is drawn from genetic/environmental research, longitudinal studies and a consideration of potential long-term effects of early experience, including planned intervention. It is increasingly recognized that individuals play some part in causing their own development, via ongoing transactional processes. Eight themes form the basis for discussion, including the belated emergence of Piaget's theory and the changing outlook for the mentally retarded. In addition, the explosion of research upon infancy and the growing influence of behavioural psychology are noted.

Child↗
PubMed1986

High frequency hearing in jaundiced rats.

All 8 pups in a homozygous-by-heterozygous rat mating were studied using brainstem auditory-evoked responses to clicks and to tone pips at 10, 15, 20, and 25 kc/s. Rats expressing the jaundice trait (N:4) had normal BSAER for click thresholds and latencies of Waves I-IV; however, to tone pips stimulating predominantly the more basal portions of the cochlea. Although thresholds were unaffected, there were mild prolongations of latencies of Waves II-IV representing central conduction time; the prolongation in one jaundiced rat reached significance re controls. Furthermore, amplitude of Waves II-IV to the louder tone pips were about 20% lower for the jaundiced rats. Jaundiced rats may be adequate models for central conduction delay found in human neonatal hyperbilirubinemia when species differences are controlled.

Acoustic Stimulation↗
PubMed1985

The effect of a hospital-based counseling service on the physical recovery of surgical and medical patients.

This study evaluated the effects of a hospital-based counseling service on the physical recovery of surgical and medical patients. Their recovery was measured in terms of days on antibiotics, days to return to normal temperature, normal pulse and oral intake, and days on intravenous (IV) feeding. The effects of the sex, age, seriousness of physical problem, recovery rate, and digestive vs. genital system involvement of patients on these recovery measures were also monitored. Seriousness of physical problem proved to be the best predictor of patient recovery but, when its effects were controlled for, some beneficial effects of the counseling were observed.

Adolescent↗
PubMed1985

Sex differences in the psychological reactions of medical and surgical patients to crisis intervention counseling: sauce for the goose may not be sauce for the gander.

The psychological reactions of 259 female and 130 male medical and surgical patients were examined. Both when they were discharged and when they were followed up 12 months later, women who received crisis intervention counseling during their hospitalisation showed the predicted psychological gains when compared with non-counseled women. They expressed fewer feelings of helplessness and more of competence in the short term and fewer feelings of anxiety and helplessness in the long term. Men showed some improvements in the short term but fewer in the long term when, although they later expressed more feelings of competence, there were also more of helplessness. Women and men also showed the predicted benefits of counseling similarly in fewer indirect expressions of anger on both occasions. They also showed less anxiety on discharge and fewer depressive feelings on follow-up. Explanations of the sex differences in terms of sex role stereotypes, the extent of each patient's crisis and possible methodological artefacts were considered.

Adolescent↗
PubMed1985

In-vitro activity of pefloxacin compared to enoxacin, norfloxacin, gentamicin and new beta-lactams.

The in-vitro activity of pefloxacin was compared with that of norfloxacin, enoxacin, nalidixic acid, gentamicin, cefotaxime, ceftazidime and, where appropriate, other beta-lactams against a total of 363 recent clinical isolates. An agar dilution procedure was used to determine MICs and two inocula (10(4) and 10(6) cfu) were used throughout. Pefloxacin inhibited 90% of isolates of Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, indole-positive Proteus spp., Enterobacter spp., Shigella sonnei, Salmonella typhi, Campylobacter jejuni, Staphylococcus aureus and Haemophilus influenzae at less than or equal to 0.5 mg/l. Serratia marcescens and Providencia stuartii were somewhat more resistant, 2 mg/l of pefloxacin being required to inhibit 90% of isolates of these species. Pefloxacin inhibited 90% of isolates of Pseudomonas aeruginosa at 4 mg/l and 90% of isolates of the Bacteroides fragilis group at 16 mg/l. The activity of enoxacin was similar to that of pefloxacin, with enoxacin being four-fold less active against Staph. aureus, two-fold less active against the Bacteroides fragilis group and most species of the Enterobacteriaceae, and two-fold more active against Ps. aeruginosa. Pefloxacin showed good activity against gentamicin-resistant Ps. aeruginosa and Enterobacteriaceae and against methicillin-resistant Staph. aureus. Strains with decreased susceptibility to norfloxacin tended to be less susceptible to both pefloxacin and enoxacin.

Anti-Bacterial Agents↗
PubMed1985

HR 810 and BMY-28142, two new cephalosporins with broad-spectrum activity: an in-vitro comparison with other beta-lactam antibiotics.

The in-vitro activity of the new parenteral cephalosporins, HR 810 (HR) and BMY-28142 (BMY), was compared with that of other beta-lactam antibiotics, including cefotaxime, against a total of 315 recent clinical isolates and characterized beta-lactamase producers. An agar dilution procedure was used to determine MICs and two inocula (10(4) and 10(6) cfu) were used throughout. Against all species of the Enterobacteriaceae tested, both HR and BMY were as active as, or slightly more active than, cefotaxime. HR differed from cefotaxime mainly in being eight-fold more active against Pseudomonas aeruginosa and two-fold more active against Staphylococcus aureus. BMY was also eight-fold more active than cefotaxime against Ps. aeruginosa but was two-fold less active than the latter against Staph. aureus. Both new compounds had good activity against Haemophilus influenzae, including the beta-lactamase producing strains of that species, and both had poor activity against the Bacteroides fragilis group (MIC90 greater than 128 mg/l).

Anti-Bacterial Agents↗
PubMed1985

An evaluation of three crisis intervention programmes for general hospital patients.

Three crisis intervention programmes were implemented on the basis of prior research and observation with patients in a general hospital. Programme 1 had been designed to decrease their anxiety and depression, programme 2 to decrease their indirectly expressed anger and increase anger which was directly expressed, and programme 3 to decrease the feelings of helplessness and increase their levels of competence. Examination of the psychological states of the sample of ill and injured patients on admission showed that those who were judged to have a poor counselling prognosis were found, as hypothesized, to be highly anxious, depressed and helpless, and to be expressing their anger only indirectly. The goals of the programmes therefore seem to have been appropriately selected to meet the psychological needs of the patients. After crisis intervention counselling, these differences on admission were no longer apparent on discharge or on follow-up 12 months later. Programme 1 did not prove differentially effective on discharge or follow-up. Programme 2 was not found to be more effective than the other programmes on discharge but, as hypothesized, was associated with direct expression of anger and decreased anxiety and depression more at follow-up. Programme 3 increased patients' expressions of competence and decreased their anxiety more on discharge; but on follow-up it proved more liable to maintain their depression than to have beneficial effects.

Adolescent↗
PubMed1984

Clavulanic acid in combination with ticarcillin: an in-vitro comparison with other beta-lactams.

The in-vitro activity of ticarcillin in combination with clavulanic acid was compared with that of ticarcillin alone, piperacillin, cefotaxime and, where appropriate, other beta-lactams against a total of 301 recent clinical isolates and characterized beta-lactamase producers. An agar dilution procedure was used to determine MICs and two inocula (10(4) and 10(6) cfu) were used throughout. MICs of the combination of ticarcillin and clavulanic acid were expressed as MICs of ticarcillin in the presence of 5 or 10 mg/l of clavulanic acid. Against most members of the Enterobacteriaceae (Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Providencia stuartii and Serratia marcescens), ticarcillin plus clavulanic acid was as active as or more active than piperacillin. Against Staphylococcus aureus. Haemophilus influenzae and the Bacteroides fragilis group the combination was considerably more active than piperacillin. Piperacillin was more active than the ticarcillin/clavulanic acid combination against Pseudomonas aeruginosa.

Anti-Bacterial Agents↗
PubMed1984

Constancy and change in the growth of human characteristics.

Neither genetic programmes nor social influences necessarily unfold in a constant way, and their interactions are complex. The role of chance events adds a further and sometimes potent uncertainty in prediction equations. Both constancies and changes of ordinal position and/or level occur for most characteristics in normal circumstances but, following significant ecological improvement, personal changes among the disadvantaged can be much larger. Recent research emphasises the inadequacy of considering either genetic or environmental effects during one period of development outside the context of preceding and subsequent influences. It is to long-term consistent influences that importance must be ascribed.

Adolescent↗
PubMed1983

Comparative in-vitro activity of temocillin (BRL 17421), a new penicillin.

The activity in vitro of the new parenteral penicillin, temocillin, was determined by an agar dilution technique at two inocula against 201 recent clinical isolates and also against reference strains that produced characterized beta-lactamases. Ampicillin, ticarcillin, latamoxef (moxalactam) and cefoxitin were used as comparative agents. Temocillin showed no useful activity against Pseudomonas aeruginosa or the Bacteroides fragilis group but was highly active against the Enterobacteriaceae, inhibiting all isolates (Serratia marcescens excepted) at less than or equal to 8 mg/l. The MIC50 and MIC90 were usually within one dilution and results with both inoculum sizes were similar. Temocillin also had good activity against Haemophilus influenzae and beta-lactamase producing strains were as susceptible as non-beta-lactamase producers. Neither for the Enterobacteriaceae nor for H. influenzae did a 1000-fold increase in inoculum result in a greater than two-fold increase in MIC. The above results implied excellent stability to beta-lactamases and this was borne out by the activity of temocillin against strains containing chromosomal cephalosporinases, the 'broad-spectrum' Class IV enzyme and the plasmid mediated enzymes TEM-1, OXA-1 and SHV-1. The protein binding of temocillin was found to be 87%.

Bacteria↗
PubMed1983

Antibacterial activity of the cephamycin cefotetan: an in-vitro comparison with other beta-lactam antibiotics.

The cephamycin, cefotetan, was compared with other beta-lactam antibiotics including the monocyclic beta-lactam, azthreonam, against a total of 277 recent clinical isolates. Cefotetan had activity comparable to moxalactam against Staphylococcus aureus and against the Enterobacteriaceae, inhibiting all isolates except for Serratia marcescens and Enterobacter spp. at less than or equal to 0.5 mg/l. Cefotetan was active against beta-lactamase producing and non-beta-lactamase producing Haemophilus influenzae (MIC90 1 mg/l); was inactive against Pseudomonas aeruginosa (MIC90 greater than 128 mg/l); and was eightfold less active than cefoxitin against the Bacteroides fragilis group. Azthreonam was as active as moxalactam against the Enterobacteriaceae and was more active than moxalactam against Ps. aeruginosa, inhibiting 90% of isolates at less than or equal to 8 mg/l, but was inactive against the Bact. fragilis group (MIC90 greater than 128 mg/l) and against Staphylococcus aureus (MIC90 greater than 128 mg/l).

Anti-Bacterial Agents↗
PubMed1982

Melanoma.

Explore the source record for details and available documents.

Female↗
PubMed1982

Diagnosis and survival in carcinoma of the large bowel.

Diagnostic delay was measured in 455 consecutive patients who had large bowel cancer and it was found to be less pronounced than in a previous study in the same hospitals. However overall corrected five year survival remained the same. The duration of symptoms was not correlated with the stage of the disease, nor with five year survival. The pattern of disease resembled other Western series, with an overall corrected five year survival rate of 33.2%. Prognosis was significantly better in women and worse in patients with an elevated ESR on presentation. Intestinal obstruction due to carcinoma did not adversely affect prognosis.

Adult↗
PubMed1981

Urinary tract infections due to Staphylococcus saprophyticus biotype 3.

Staphylococcus saprophyticus biotype 3 (Micrococcus subgroup 3 or M3) has usually been shown to be the second commonset cause of urinary tract infections in European women who are not in hospital. It generally causes pyuria and symptoms as severe as those caused by Escherichia coli. Unlike S. epidermidis it is seldom found as a contaminant in midstream urine specimens, and almost exclusively infects women in their reproductive years. However, S. saprophyticus is seldom differentiated from S. epidermidis in Canadian clinical laboratories. Urinary isolates of S. saprophyticus were presumptively differentiated from other coagulase-negative Micrococcaceae by their resistance to novobiocin as demonstrated by a simple disc susceptibility test that misidentified the infecting organism in only 3.4% of specimens. These novobiocin-resistant, coagulase-negative organisms caused similar proportions of the urinary tract infections in young women in York, England and Vancouver -- 6.6% and 6.9% respectively. In York these organisms were associated with significantly greater pyuria than novobiocin-sensitive organisms or bile-tolerant streptococci but not S. aureus or Enterobacteriaceae. In both communities novobiocin-sensitive, coagulase-negative Micrococcaceae were appreciably more resistant to penicillin than novobiocin-resistant organisms. Thus, differentiating S. saprophyticus from novobiocin-sensitive, coagulase-negative organisms provides information that is clinically useful, particularly for primary care practitioners working in the community or in outpatient clinics.

Adult↗
PubMed1981

Long-term modified Goeckerman regimen for psoriasis using an ultraviolet B light source in the home.

An ultraviolet B (UVB) unit for the home was built for each of fifty-six people with extensive psoriasis. This light unit is constructed to deliver the most cost-effective radiation while remaining portable, height-adjustable, and free of the necessity to nail or screw the unit to the wall. Six 40-watt fluorescent sunlamps in an open configuration will deliver 150 to 170 mu watts/cm2 to one half of the body at a distance of 30.5 cm (1 minimal erythema dose [MED] = 1-2 min). Fifty-five patients completed a modified Goeckerman program starting at 1-minute exposures, with weekly increases of light by 1 minute until 6 or 8 weeks of treatment had elapsed. All patients were cleared of psoriasis (scalp not included). Fifty-one patients accomplished the clearance program totally in the home. Over 80% of them remain virtually clear as they have maintained a 6- to 8-minute tar-light program two to five times a week. Thirty-seven subjects have used this home UVB unit for over a year. Our results with the modified Goeckerman treatment of psoriasis in the home show that: (1) only six nonenclosed lamps are needed for the economical clearing and maintenance of many psoriatics, and (2) the initial clearing rate using forty-two to sixty suberythemal treatments is outstanding.

Coal Tar↗