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Biomedical subjects

B Warren

Publications and source records attributed to B Warren.

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

Ceftriaxone (Rocephin) in abdominal trauma.

A prospective study was undertaken to evaluate the use of ceftriaxone in patients with abdominal trauma admitted to our hospital over a period of 6 months. Because of the large trauma load and an unacceptable waiting period before surgery combined with the fact that many patients on 6-hourly antibiotic regimes often did not receive their second and third doses, it was decided to use ceftriaxone because of its long half-life with maintenance of fluid and tissue concentrations for 24-48 hours. Because ceftriaxone is not reliably effective against anaerobic organisms such as Bacteroides fragilis, it was decided to add metronidazole as a combined initial dose. Two hundred ninety patients were entered in this trial, of which there were 259 stab wounds (89.3%), 20 missile injuries (6.9%), and 11 blunt injuries (3.8%). It was found that the mean delay between injury and initial dosage of ceftriaxone was 9.1 hours, with a range of 1-126 hours, and the mean delay between antibiotic therapy and operation 6.3 hours, with a range of 0-39 hours. The organs most frequently injured were the small bowel, the large bowel, the stomach, and the liver. Wound infection developed in only 4 patients (1.4%); intra-abdominal sepsis did not occur; and 35 patients (12%) developed respiratory infections. There were no deaths. We conclude that ceftriaxone, because of its 24-hour dosage was not only convenient but also adequate to prevent intra-abdominal sepsis and there was no difference in cost between this product and our previous protocol of 6-hourly antibiotic regime.

Abdominal Injuries↗
PubMed1991

Static pre-load effect on knee extensor isokinetic concentric and eccentric performance.

The effect of two static pre-load levels on isokinetic concentric (CON) and eccentric (ECC) performance of the knee extensors at 90 degrees.s-1 was evaluated in 35 healthy subjects. The low pre-load level was 50 N, and the high level was 75% of a maximal voluntary isometric contraction, performed at the start angles of 100 degrees (CON) and 30 degrees (ECC) of knee flexion. A two-way ANOVA with two repeated measures (load and angle) and a Newman-Keuls post hoc analysis were performed to compare the interaction of pre-load and angle at every 5 degrees in the ROM. The differences in average torque, peak torque, and peak torque angle between the pre-load levels were also analyzed with repeated-measures t-tests. The high pre-load condition had a significant increase in torque at 99, 95, 90, and 85 degrees concentrically and 31, 35, 40, 45, and 50 degrees eccentrically. In comparing the two pre-load conditions over the whole torque curve, there was a significant difference in average torque values of both CON and ECC, no significant difference in peak torque in either contraction, and a significant shift in peak torque angle with CON contractions only.

Adult↗
PubMed1990

Cancer screening practices of nurse practitioners.

The Nurse Practitioner's (NP) role in providing quality primary care with emphasis on health promotion is well established. Yet the NP's actual cancer detection activities are unknown. To determine the cancer screening and detection activities of NPs in adult primary care settings, a questionnaire survey was developed from the American Cancer Society's "Guidelines for the Cancer-Related Checkup" and current cancer detection literature. The survey was distributed to primary care NPs throughout the state of Michigan (n = 97). Pearson correlation coefficients were applied to the data to establish the relationship of cancer screening practices by NPs to specific age groups and by gender. Practitioners reported significantly higher frequencies of recommended screening for adult women than for adult men. Although at a lower risk for developing cancer, younger and early middle-aged adults (19-39 years) received significantly higher frequencies of recommended screening than middle-aged and older adults. NPs believe that cancer screening and counseling are consistent with their role except in the areas of male physical exam (testes, prostate) and invasive procedures such as sigmoids for men and women. The broader implications for further research, organization of primary care services, and strategies to increase nurses' involvement in cancer screening practices are presented.

Adult↗
PubMed1989

Activation of human neutrophil NADPH-oxidase in vitro by the catalytic fragment of protein kinase-C.

Phorbol ester treatment of intact neutrophils both stimulates protein kinase C (PK-C) and causes the rapid proteolytic conversion to a cytosolic, co-factor independent fragment, protein kinase M (PK-M). In intact neutrophils, phorbol ester treatment activates the NADPH-oxidase, the enzyme responsible for the oxidative burst. Addition of purified PK-M to resting neutrophil light density membranes activated the NADPH-oxidase in the presence of PS, ATP and Mg2+. A 3.5-fold greater stimulation of oxidase (ca. 25 nmoles O2-/min/mg membrane protein) was obtained with comparable PK-M concentrations to that observed with the reconstituted PK-C system, and approximately 1/3 that obtained with arachidonic acid (AA) or SDS. In contrast to the reconstituted system using PK-C, PMA and Ca++ were neither required nor affected activity. The effect of PS was unexpected, since PK-M does not require phospholipids for enzymatic activity, and likely represents the action of PS on the oxidase itself or on another component in the plasma membrane fraction. Our studies demonstrate for the first time that purified PK-M permits reconstitution of a physiologic phorbol ester response.

Adenosine Triphosphate↗
PubMed1987

Expression of enzymatically active poliovirus RNA-dependent RNA polymerase in Escherichia coli.

The poliovirus genome is replicated by a virus-encoded RNA-dependent RNA polymerase (RNA polymerase). The RNA polymerase is first synthesized as a larger precursor polypeptide, which is subsequently processed by a viral proteinase, 3Cpro, to give the mature polymerase molecule, 3Dpol. To further characterize the poliovirus RNA polymerase, we have constructed plasmids that expressed this protein in Escherichia coli. The plasmids consisted of fusions between the E. coli DNA encoding the first 13 amino acids of the trp operon leader protein and viral genes encoding the 3Cpro and 3Dpol polypeptides. E. coli harboring such plasmids gave significant, inducible levels of enzymatically active RNA polymerase as determined by the poly(A).oligo(U) poly(U) polymerase assay. The purified RNA polymerase activity from E. coli corresponded to a protein with the approximate molecular weight of the mature 3Dpol protein. The availability of a recombinant, enzymatically active poliovirus RNA polymerase provides a system in which we can precisely delineate the role this enzyme plays in the regulation of poliovirus replication.

Escherichia coli↗
PubMed1987

Cardiovascular health knowledge of children and school personnel in Louisiana public schools.

Questionnaires describing educational and administrative practices and cardiovascular health knowledge tests for fourth, sixth, and 12th grade students, teachers, and principals were used to evaluate cardiovascular health knowledge in a carefully matched, representative sample in Louisiana public schools. Data indicated cardiovascular health knowledge of both professionals and students was low, with several correlations between knowledge and educational or administrative practices. Recommendations for improvements in school health education programs are offered.

Adolescent↗
PubMed1986

Budd-Chiari syndrome. A report of 3 cases.

Three patients with the Budd-Chiari syndrome are presented. This is a rare condition characterized by hepatomegaly, progressive and refractory ascites, distension of the abdominal wall veins, abdominal pain and leg oedema. These features are attributed to congestion of the liver and portal hypertension. The condition has been notoriously difficult to treat medically. Surgical measures are directed towards relieving the liver congestion and lowering pressure in the portal system by portal-systemic shunting operations. In some cases refractory ascites may be treated by peritoneovenous shunting with a Le Veen shunt. In a select group of patients orthotopic liver transplantation has proved to be worth while.

Adolescent↗
PubMed1985

Takayasu's disease. A report of 3 cases.

Three patients with Takayasu's disease are described. In 2 cases aortography demonstrated an occlusion of the great vessels at the origin of the arch of the aorta. In 1 patient there was concomitant aneurysmal dilatation of the brachiocephalic trunk. Common and internal carotid artery stenosis occurred in 1 patient and was associated with hemiplegia and blindness. All 3 patients had constitutional symptoms and signs of the disease as well as markedly elevated erythrocyte sedimentation rates; 2 patients had moderate clinical responses to steroid administration in the short term and 1 developed bilateral calf vein thrombosis, which responded satisfactorily to conservative management.

Adult↗
PubMed1985

Intrahepatic gallstones. A case report.

A Coloured woman was admitted to hospital with a 3-day history of acute right upper abdominal pain, nausea and vomiting. Acute cholecystitis was confirmed by biliary imaging using technetium-99m. An acutely inflamed gallbladder and two pigment stones in the common bile duct were removed. There were numerous retained gallstones in biliary radicles of the right hepatic duct; attempts to dislodge these by saline flushing failed. An extended choledochotomy with further exploration of the intrahepatic radicles also failed to remove the incarcerated stones. Biliary enteric drainage was achieved by choledochoduodenostomy and short-term postoperative progress was uneventful.

Acute Disease↗
PubMed1984

An unusual presentation of carcinoma of the colon in a child. A case report.

A patient with carcinoma of the large bowel who presented with a subphrenic abscess is reported. This case emphasizes two important facts relating to colonic cancer in childhood: (i) premalignant disease of the large bowel is no prerequisite for the development of colonic cancer; and (ii) in childhood this disease is characterized by a fulminating course and high mortality. In about 50% of cases the tumour is of the signet ring or mucin-producing type, which explains the grave prognosis.

Adenocarcinoma↗
PubMed1984

Acute pancreatitis and Cushing's syndrome.

A case of acute necrotizing pancreatitis in a 53-year-old man with an ectopic adrenocorticotrophin (ACTH) producing bronchial carcinoma is described. The aetiology of acute pancreatitis in relation to steroid therapy and malignancy is discussed and it is suggested that excess endogenous steroid production may also cause acute pancreatitis.

ACTH Syndrome, Ectopic↗
PubMed1979

Forum sparks creative energy.

Human support committee provides a forum where staff, patients, and administration can become involved in the planning, implementation, and evaluation of patient services.

British Columbia↗