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Biomedical subjects

B Olson

Publications and source records attributed to B Olson.

At least 37 records · Page 2Linked to original sources
PubMed1985

Occult aminoglycoside resistance in Pseudomonas aeruginosa: epidemiology and implications for therapy and control.

The epidemiology of aminoglycoside-resistant Pseudomonas aeruginosa was evaluated in an intensive care unit (ICU) with serial surveillance cultures of throat and rectum. Bacterial population analysis performed by replica plating of primary isolation plates onto gentamicin-containing agar revealed the presence of resistant subpopulations in the initial isolates from 41 (71%) of 58 consecutive assessable patients; these isolates were stably resistant and proportionately less susceptible to other aminoglycosides. An increase in resistant subpopulations occurred during the ICU stay in 34% of 38 colonized patients cultured serially as opposed to none of 23 followed after ICU discharge (P = .0008). Isolates of P. aeruginosa from patients who received aminoglycosides in the ICU were more likely to show an increase in resistance than were isolates from other patients (55% vs. 11%; P = .005); decreasing resistance after ICU discharge followed discontinuation of antibiotic administration. ICU mortality was higher in patients with increasingly resistant subpopulations (69% vs. 16%; P = .0004). The difficulty in treating infections with P. aeruginosa and in controlling drug resistance likely relates to the common carriage of clinically undetected resistant subpopulations that emerge during therapy.

Aminoglycosides↗
PubMed1984

Epidemiology of endemic Pseudomonas aeruginosa: why infection control efforts have failed.

The epidemiology of Pseudomonas aeruginosa was evaluated in an intensive care unit for a period of six months by means of serial surveillance and environmental cultures. One hundred (37%) of 270 patients were noted to be colonized: 63 at the time of their admission and 37 during their stay on the unit. Colonization at the time of admission was associated with length of hospitalization before admission to the intensive care unit, age, gastrointestinal disease, and prior use of antibiotics. The strains acquired on the intensive care unit represented several different serotypes, with little clustering; the source of most strains was not found. In only 12 cases did the acquisition of P. aeruginosa appear to represent cross-infection; the use of barrier isolation could have prevented at most five of these cases. Undetected endogenous gastrointestinal carriage may have been responsible for many other apparent acquisitions. Clinical infection in association with preceding gastrointestinal colonization developed in 20 patients. The data indicate that traditional control measures aimed at the prevention of exogenous acquisition of P. aeruginosa are unlikely to have an impact on the overall incidence of infection and that efforts to prevent infection in patients who are already colonized are necessary.

Communicable Disease Control↗
PubMed1984

Pseudomonas in the sinks in an intensive care unit: relation to patients.

Sink drains in a medical-surgical intensive care unit (ICU) were cultured during six consecutive weeks as part of a seven month prospective study of acquisition of Pseudomonas aeruginosa by ICU patients. Isolates were typed serologically and by aminoglycoside and chlorhexidine susceptibility patterns. All 11 sinks contained multiple strains of P aeruginosa; some strains persisted for weeks while others were isolated once. Of the sink isolates 56% had high level resistance to gentamicin and tobramycin whereas none of the strains found in patients. In sink isolates chlorhexidine resistance correlated with aminoglycoside resistance and with the presence of a chlorhexidine dispenser at a sink. The sequence of recovery of phenotypically similar isolates suggested that sinks were the source of at most two acquisitions of P aeruginosa by patients during the six weeks. Our study confirms that sinks may be reservoirs for large numbers of highly resistant P aeruginosa but are rarely the source of organisms colonising patients in our ICU.

Aminoglycosides↗
PubMed1983

Employee rubella screening programs in Arizona hospitals.

One year after voluntary guidelines on rubella screening of hospital employees were issued by the Arizona Department of Health, a survey of 68 members of the Arizona Hospital Association was conducted, with an 81% response. Some form of employee rubella screening was present in only 49% of responding hospitals. Of the screening hospitals, 70% of programs had a mandatory aspect for selected employees. Administrative logistics, cost, problems encountered, and the quality and coverage of the program varied substantially among the different hospitals. Fewer than half of the screening hospitals had programs for physicians, students, or volunteers. Verbal histories of immunization or serological tests, although notoriously unreliable, were accepted by 14% of the screening hospitals. Half of the nonscreening hospitals plan to implement programs in the future. Reasons given for not establishing rubella screening programs include cost, no pediatric or obstetric service, liability issues, high turnover, and no previous case of rubella in an employee. Three hospitals (all screening) reported they had had a case of rubella in an employee. The data suggest slow partial compliance with recommendations for rubella screening in hospitals.

Adolescent↗
PubMed1983

Broad-spectrum beta-lactam resistance in Enterobacter: emergence during treatment and mechanisms of resistance.

Of three patients with Enterobacter mediastinitis treated with cefamandole, two failed initial treatment due to emergence of strains resistant to cefamandole and third generation cephalosporins. Extracts of the sensitive strains showed inducible hydrolysis of cephalothin; resistant strains (wild and laboratory derived) showed constitutive hydrolysis of cephalothin and cefamandole and bound but did not hydrolyze cefotaxime and latamoxef (moxalactam). In one mutant, increased latamoxef resistance appeared due to non-enzymatic mechanism(s). The Enterobacter strain from the patient who was treated successfully with cefamandole yielded only low level resistant mutants with lower cephalosporin binding than obtained with the other strains.

Anti-Bacterial Agents↗
PubMed1981

Non-cardiogenic pulmonary oedema. A serious complication of transurethral prostatectomy. A case report.

A patient undergoing prostatectomy under epidural analgesia developed clinical signs of a severe TURP syndrome. During resuscitation, it was revealed that serum sodium was only moderately decreased. Plasma oncotic pressure was, however, markedly decreased and the pressure gradient between plasma oncotic pressure and pulmonary capillary wedge pressure (approximately hydrostatic pressure) was 1 mmHg (0.13 kPa) only, allowing almost free filtration of fluid through the pulmonary capillary wall, resulting in a non-cardiogenic pulmonary edema. The patient was successfully resuscitated with albumin and inotropic stimulation with prenalterol.

Aged↗
PubMed1978

A survey of drug use among probationers in the Los Angeles area in 1976.

The results are presented from the analysis of 10,000 urine specimens from Los Angeles County probationers in early 1976 for the following drugs: amphetamine, methamphetamine, allylbarbital, amobarbital, butabarbital, pentobarbital, phenobarbital, secobarbital, morphine, codeine, methadone, primary metabolite of methadone, cocaine, benzoylecgonine, propoxyphene, norpropoxyphene, methaqualone, and phencyclidine. Over 27% of the urine samples analyzed were positive for at least one drug. Opiates were found to be the most widely used drugs, but multiple drug use was also quite common.

California↗
PubMed1978

Dieldrin, DDT, PCBs, and mercury levels in freshwater mullet from the upper Great Lakes, 1975-76.

Freshwater mullet harvested commercially during various seasons of 1975-76 from the upper Great Lakes were analyzed for organochlorine pesticides, PCBs, and mercury. Species analyzed were Catostomus commersoni, C. catostomus, and Moxostoma erythruran. Whole ground fish, mechanically deboned flesh, head, middle, and tail steaks, and various muscles were analyzed for pesticides and PCBs; only edible flesh was analyzed for mercury. Dieldrin ranged from none detected to 0.23 ppm in deboned and whole ground samples, the DDT range was a trace to 0.30 ppm, and PCBs ranged from 0.06 ppm to 0.79 ppm. Levels were also higher in head sections and in high fat-containing medial muscle and belly flap. Mercury levels ranged from 0.03 ppm to 0.28 ppm in the flesh of mullet from Lake Michigan.

Animals↗
PubMedDate not supplied

Pressure ulcer prevalence and incidence in a rehabilitation hospital.

Pressure ulcers remain a serious health problem, especially in terms of personal suffering and economics. The study described here, conducted in a rehabilitation setting, investigated the prevalence (number of persons with pressure ulcers at a given time) and the incidence (number of persons developing pressure ulcers over a given time) of pressure ulcers. Skin assessments and risk assessments of the subjects were completed using the Braden Scale for Predicting Pressure Sore Risk. Demographic data were obtained. The prevalence rate was 25%, although there was no incidence during the time of this study. Factors associated with the prevalence of pressure ulcers are discussed.

Adult↗
PubMedDate not supplied

The effectiveness of skin care protocols for pressure ulcers.

Pressure ulcers (PU) remain a serious healthcare problem in the United States. This study investigated the effectiveness of a prevention and early intervention program in reducing the prevalence of pressure ulcers (i.e., the number or the percentage of persons with pressure ulcers at a given time) in a rehabilitation hospital. The Braden Scale for Predicting Pressure Sore Risk was used to assess subjects' PU risk. Protocols were established for PU stages consistent with the National Pressure Ulcer Advisory Panel consensus statement on pressure ulcers. Staff were educated about PUs and the specific protocols for prevention and treatment. Concurrent quarterly prevalence audits on a total of 116 patients were conducted for 1 year. An audit also was done 16 months after protocols had been established. There was a 60% decrease in pressure ulcer prevalence from the 25% baseline to the 10% found at the audit following implementation of the protocols.

Aged↗
PubMedDate not supplied

The patient in a halo brace: striving for normalcy in body image and self-concept.

This retroactive descriptive study identified specific psychologic concerns and needs of halo patients related to the halo experience. Thirty-eight subjects who had a halo brace applied in the previous 8 years completed the questionnaire. Responses were categorized and analyzed using nursing diagnoses. Results showed that distortion of body image, distortion of self-concept, grieving for losses, and striving for normalcy are among the phenomena experienced by halo patients.

Adaptation, Psychological↗
PubMedDate not supplied

Variables associated with hypotension in postoperative total knee arthroplasty patients receiving epidural analgesia.

The purpose of the study was to identify variables that may place the total knee arthroplasty patient receiving epidural analgesia at risk for hypotension postoperatively. A review of medical records of this convenience sample of 99 subjects was conducted in this retrospective, descriptive, correlational study. Variables predictive of postoperative hypotension using stepwise multiple regression included low postoperative systolic BP on the nursing unit the day of surgery (R2 = .26, p less than .001), low diastolic BP in postanesthesia room (R2 = .31, p less than or equal to .01), low hemoglobin the third postoperative day (R2 = .37, p less than or equal to .01), use of diuretics preoperatively (R2 = .40, p less than or equal to .05), and total fluid intake first day postoperatively (R2 = .43, p less than or equal to .05). These variables accounted for 43% of the variability in the occurrence of hypotension. Identification of variables predictive of hypotension should provide direction for future care givers and researchers.

Adult↗
PubMedDate not supplied

The prevalence and incidence of pressure ulcers in the hospice setting: analysis of two methodologies.

Hospice patients may be at greater risk of pressure ulcer development than most patients. This descriptive study explored the prevalence and incidence of pressure ulcers in the hospice setting, utilizing both a prospective and retrospective methodological approach. Levine's theory of the four principles of conservation formed the theoretical basis for the study, and the Braden Scale for Predicting Pressure Ulcer Risk was used for data collection. Prevalence of pressure ulcers was noted to be 13 percent in the study. Incidence of pressure ulcers was found to be zero percent using prospective methodology and 13 percent using retrospective methodology. Five of eight ulcers (62 percent) occurred within two weeks of patient death. Factors related to pressure ulcer development are presented, as well as a discussion of using research methodologies in the hospice setting. The article suggests the need for preventive protocols for skin care for patients who are at risk for pressure ulcer development.

Female↗
PubMedDate not supplied

Evaluation of pressure ulcer prevalence rates for hospice patients post-implementation of pressure ulcer protocols.

Hospice patients may be particularly at risk for pressure ulcer development due to several factors. Identifying populations at risk for pressure ulcer development, such as hospice patients, and providing prevention and risk protocols for these populations can substantially reduce the prevalence and incidence of pressure ulcers. However, are hospice patients prone for skin breakdown despite prevention and treatment efforts? This study examines the prevalence of pressure ulcers in hospice patients following the implementation of pressure ulcer prevention and treatment protocols. Levine's theory of conservation of structural integrity formed the theoretical framework for this descriptive study. A midwestern hospital-based hospice agency was the site for this study. All patients 18 years of age and older were included in the study. Pressure ulcer prevalence audits were done at four, eight, 12, and 18 months after protocols were outlined by the hospice staff. Results of the audits revealed prevalence rates of 14.8 percent, 8.5 percent, 13.6 percent, and 23.8 percent, at each of the aforementioned audits. 10 of 15 patients who were pressure ulcer positive were males; the sacral location was most common (seven of 19 ulcers occurred sacrally) with the ischial location being the next common (six of 19 ulcers were ischially located). No ulcers occurred above the waist or in patients below 51 years of age. Recommendations from this study urge that particular prevention attention be given to protocols which address "sitting," due to the predominance of ulcers located in the sacral and ischial regions. In addition, the author concludes that perhaps, pressure ulcers may occur in this population despite the best of efforts to prevent them.

Aged↗
PubMedDate not supplied

Self-care needs of patients in the halo brace.

This retrospective, descriptive study examined the wishes, concerns, and experiences of patients who had been placed in a halo brace to treat a cervical fracture. Thirty-eight subjects who had a halo brace applied during the past 8 years completed the questionnaire. Data obtained reflected physiologic as well as psychosocial needs of these patients. Responses were categorized based on nursing diagnoses. Results demonstrated the need for more specific information given to patients before discharge from the hospital to facilitate adjustment to the halo brace and activities of daily living.

Activities of Daily Living↗