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Biomedical subjects

C H Patrick

Publications and source records attributed to C H Patrick.

11 recordsLinked to original sources
PubMed1992

Relatedness of strains of methicillin-resistant coagulase-negative Staphylococcus colonizing hospital personnel and producing bacteremias in a neonatal intensive care unit.

The emergence of methicillin-resistant coagulase-negative Staphylococcus as a major bacterial pathogen in neonatal intensive care units has stimulated interest in the epidemiology of spread of the organism. During a 12-month "epidemic" of bacteremias with methicillin-resistant coagulase-negative Staphylococcus we compared the characteristics of bacteremic and personnel nasally-carried strains by traditional and biomolecular methods. Sixty-two percent of neonatal intensive care unit nurses were colonized with methicillin-resistant coagulase-negative Staphylococcus with similar speciation to bacteremic strains. Inspection of plasmid profiles revealed a moderate degree of similarity between bacteremic and colonizing strains although genomic DNA restriction patterns showed diversity. Ribotype patterns were highly conserved (90%) in personnel strains. A 2.6-kilobase plasmid DNA probe hybridized to similarly sized plasmids and larger plasmids in one-half of the strains. We hypothesize that related methicillin-resistant strains may be transferred among personnel and neonates in the neonatal intensive care unit. Epidemiologic studies of coagulase-negative staphylococci should consider multiple molecular techniques to relate strains.

Bacteremia↗
PubMed1991

Prenatal care and prematurity: is there an association in uncomplicated pregnancies?

A retrospective investigation examined patterns of use of prenatal care and pregnancy outcomes (low birthweight and preterm births) in 6176 pregnancies without antepartum medical complications. Prenatal care use patterns differed significantly by mother's age, marital status, race, education, method of payment, and gravidity. By controlling for these differences through a logistic regression procedure, results showed that prenatal care was associated with significant reductions in the number of infants who were delivered preterm or had low birthweight. Fewer very low-birthweight (less than 1500 g) infants were among the preterm infants delivered to mothers with prenatal care compared with women who received no prenatal care. These data suggest that significant improvements in pregnancy outcomes are seen among women who use prenatal care, and these benefits occur in the absence of antepartum complications.

Adolescent↗
PubMed1990

The effect of bacteremia on automated platelet measurements in neonates.

Platelet volume measurements have been used to differentiate consumptive and hypoplastic thrombocytopenia. Since thrombocytopenia is a frequent complication of neonatal sepsis, the authors explored the utility of correlating mean platelet volume (MVP) and platelet distribution width (PDW) with bacteremia. In a sample of 156 infants, there was a significantly increased presence of bacteremia in those infants with MPV greater than 10.8 fL and/or PDW greater than 19.1%. High MPV and PDW showed high specificity for detecting bacteremia (95% and 79%, respectively), and had good negative predictive value. Neonates with blood cultures positive at birth (early infection) tended to have normal platelet volumes, while those infected after three days of age (late infection) had dramatic increases in MPV and PDW. Changes in MPV and PDW should be noted when the diagnosis of late sepsis is considered.

Age Factors↗
PubMed1988

Complication of prolonged transpyloric feeding: formation of an enterocutaneous fistula.

Enteral feeding tubes have been associated with perforations of the gastrointestinal tract, usually requiring surgical repair. A neonate with centronuclear myopathy developed an enterocutaneous fistula from the duodenum following prolonged placement of a transpyloric catheter. He did not require surgery and died later of unrelated complications.

Duodenal Diseases↗
PubMed1988

Stool water loss in very-low-birth-weight neonates.

Fluid requirements in very-low-birth-weight (VLBW) infants include compensation for renal, insensible (skin and lung), and stool losses and provision for fluid retained for growth. Current estimates of stool water losses in VLBW infants are based on measurements established in term neonates. Therefore, the water content of 24-hour stool collections were determined in 11 healthy VLBW male infants on full enteral feeds and compared to the working norms. The neonates in this study were less than 2 weeks old with a mean +/- SD birth weight and gestational age of 1,311 +/- 112 g and 30.8 +/- 1.5 weeks, respectively. They were receiving only enteral formula feedings of 100 ml/kg/day or more with no parenteral fluid supplementation. The mean +/- SD number of stools and water content of the stools was 2.7 +/- 2.0/day and 7.2 +/- 4.0 ml/kg/day, respectively. There was a significant correlation (r = 0.696, p less than 0.02) between gestational age at birth and number of stools per day, but the correlation between stool water loss per day, gestational age, volume of feedings per day, and birthweight was not significant. Based on this study, 7 ml/kg/day is a reasonable estimate of daily stool water loss in VLBW babies.

Feces↗
PubMed1987

Mean platelet volume and platelet distribution width in the neonate.

Normal values for mean platelet volume (MPV) and platelet distribution width (PDW) have not been firmly established for term and preterm neonates. Cord blood samples from 143 healthy newborns (78 full term and 65 premature) were analyzed with the Coulter counter. Platelet count and MPV were significantly greater (p less than 0.05 and p less than 0.001, respectively) in term versus preterm infants, while PDW was significantly less in term infants (p less than 0.001). Platelet count and MPV correlated with gestational age, and platelet count also correlated with birth weight. There was a significant (p less than 0.001) negative correlation of PDW with gestational age and birth weight. These data represent normal reference ranges for neonates and demonstrate significant variation with gestational age.

Blood Platelets↗
PubMed1987

Health differentials between blacks and whites: recent trends in mortality and morbidity.

Black Americans continue to have large numbers of premature and excess deaths, measured against white experience, from seven major causes. Major differences in chronic disease, disability and case fatality rates persist despite similarities in the amount of health care received; the nature and quality of care is likely to be dissimilar. Epidemiological and clinical evidence suggests various strategies to reduce these differentials through well-designed public health efforts at prevention. These will have to deal with harsh realities of sociocultural, economic, and political contexts.

Black or African American↗
PubMed1982

Sex differences in declining cohort death rates from heart disease.

We examined cohort mortality from heart disease (HD) at ages 40 and over for White men and women in the United States between 1945 and 1975. For each successive birth cohort from 1886 to 1890 and 1906 to 1910, female HD mortality rates exhibit a continuous decline with parallel slopes which shows no sign of abating in recent years. Among men, cohort HD mortality rates were increasing prior to 1965; since 1965, there has been a reversal of prior trends, i.e., each successive cohort has shown a decrease in HD mortality rates. None of the various hypotheses put forward to explain the recent decline in HD mortality provides a cogent explantation for the differential effects in men and women.

Adult↗
PubMedDate not supplied

The Emory cubicle bed: an alternative to restraints for agitated traumatically brain injured clients.

As traumatically brain injured (TBI) clients emerge from coma, there may be transitory periods of agitation during which they pull at feeding tubes and intravenous catheters and thrash about, thus placing themselves at high risk of injury. During these periods, staff traditionally have resorted to restraints. But chemical restraints actually may be detrimental to cognitive recovery, and physical restraints often serve to increase agitation and foster dependence. Another approach is to modify the environment. The Emory cubicle bed, a modification of the Craig bed used at Craig Hospital in Colorado, allows for freedom of movement while blocking the client's field of vision. In reducing both tactile and visual stimulation, the bed also reduces agitation.

Beds↗