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Biomedical subjects

A Walters

Publications and source records attributed to A Walters.

10 recordsLinked to original sources

Comparison of Sentinel and Bactec blood culture systems.

AIMS: To evaluate the Sentinel automated blood culture system and to compare its performance with that of Bactec. METHODS: The Sentinel blood culture system was evaluated in three centres. The performance of the system was assessed in comparison with the routine blood culture method used in these centres, the Bactec system. RESULTS: Blood culture sets (n = 2180) consisting of Sentinel aerobic and anaerobic, and Bactec aerobic and anaerobic bottles yielded 218 (10%) clinically important isolates. One hundred and fifty five (71%) of the isolates were detected by both systems; 35 (16%) were detected by Sentinel only; and 28 (13%) by Bactec only. For the duration of the evaluation, the Sentinel system was deliberately configured so that it was impossible to detect positive results during the first 12 hours. The times to positivity after the first 12 hours were similar. Data gathered during and subsequent to the evaluation have been used by the manufacturer to refine the algorithm so that positive results can be detected at a minimum of 2.25 hours. CONCLUSIONS: After a period of familiarization the Sentinel system was considered easy to use. Sentinel is a useful addition to the methods available for the detection of bacteria in blood cultures.

Bacteriological Techniques

Propriospinal myoclonus: a neurophysiologic analysis.

We are reporting a neurophysiologic analysis of two patients presenting with thoracoabdominal spontaneous muscle jerks. Polymyographic recordings showed myoclonic bursts with onset in the upper rectus abdominis or lower intercostal muscles followed by rostral propagation to the upper intercostal and caudal propagation to the abdominal muscles by slowly conducting pathways. Jerk-locked back-averaging did not show time-locked cortical or premovement potentials. Peroneal somatosensory evoked response, C-reflex, and intercostal nerve conduction were normal. These findings suggest a generator for the myoclonus in the midthoracic region of the spinal cord with up and down propagation by slowly conducting pathways, such as propriospinal fibers. This type of spinal myoclonus may thus be termed "propriospinal myoclonus," as suggested by Brown et al.

Aged

Clinically atypical expression of pathologically typical Lewy-body parkinsonism.

Six patients autopsied by the neuropathology service at UMDNJ-Robert Wood Johnson Medical School between 1985 and 1988 had pathologically typical Lewy-body Parkinson's disease (PD). Review of their clinical records revealed that none had clinically typical PD. Atypical clinical features included juvenile onset, retrocollis, strong family history, and absence of tremor, flexed posture, or levodopa response. One patient had dementia without parkinsonism. We conclude that the clinical spectrum of Lewy-body PD is wider than is generally assumed and that the diagnosis of pathologically typical Parkinson's disease cannot be excluded on clinical grounds alone.

Adult

Opioid responsiveness in patients with neuroleptic-induced akathisia.

Five patients with either acute or tardive neuroleptic-induced akathisia (5 weeks to 1 1/2 years duration) were videotaped before, during, and after a 2-week trial of propoxyphene (Darvon), 100 mg q.i.d., or acetaminophen (Tylenol) with 30 mg codeine, two tabs, q.i.d. Three "blinded" observers, experienced in movement disorders, rated the involuntary movements shown on the videotapes and agreed that, on opioids, all patients showed substantial to complete improvement of their stereotyped restless akathitic movements. Matching placebo was not beneficial. One patient who had improved on opioids was challenged with naloxone while on the opioids. There was a brief but severe reactivation of the akathisia. Our results suggest that opioids offer a selective therapy for patients with neuroleptic-induced akathisia and further suggest that the endogenous opiate system may be involved in patients with neuroleptic-induced akathisia.

Acetaminophen

Effects of lorazepam on hyperactivity in ratarded children.

Seven mentally-retarded children, diagnosed as hyperactive, participated in a double-blind trial of the drug lorazepam (Ativan). Statistical analysis of the behavioural records showed that hyperactivity was typically greater during lorazepam than during placebo periods. The degree of hyperactivity was not systematically related to dosage level. The drug is therefore contraindicated for the control of hyperactivity in mentally retarded children.

Adolescent

Teaching or coaching?

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Communication