Biomedical subjects

D Leland

Publications and source records attributed to D Leland.

7 recordsLinked to original sources

PubMed2000

Contaminated drinking water in one town manifesting as an outbreak of cryptosporidiosis in another.

In early 1992 we identified an outbreak of cryptosporidiosis in Oregon and sought to identify and control its source. We used a series of studies to identify risk factors for illness: (i) a case-control study among employees of a long-term-care facility (LTCF); (ii) a matched case-control study of the general community; (iii) a cohort study of wedding attendees; and (iv) a cross-sectional survey of the general community. Drinking Talent water was associated with illness in the LTCF (OR = 22.7, 95 % CI = 2.7-1009.0), and in the community (matched OR = 9.5, 95% CI 2.3-84.1). Drinking Talent water was associated with illness only among non-Talent residents who attended the wedding (P < 0.001) and in the community (RR = 6.5, 95 % CI 3.3-12.9). The outbreak was caused by contaminated municipal water from Talent in the absence of a discernible outbreak among Talent residents, suggesting persons exposed to contaminated water may develop immunity to cryptosporidiosis.

Adolescent↗

PubMed1996

Logical observation identifier names and codes (LOINC) database: a public use set of codes and names for electronic reporting of clinical laboratory test results.

Many laboratories use electronic message standards to transmit results to their clients. If all laboratories used the same "universal" set of test identifiers, electronic transmission of results would be greatly simplified. The Logical Observation Identifier Names and Codes (LOINC) database aims to be such a code system, covering at least 98% of the average laboratory's tests. The LOINC database should be of interest to hospitals, clinical laboratories, doctors' offices, state health departments, governmental healthcare providers, third-party payors, organizations involved in clinical trials, and quality assurance and utilization reviewers. The fifth release of the LOINC database, containing codes, names, and synonyms for approximately 6300 test observations, is now available on the Internet for public use. Here we describe the LOINC database, the methods used to produce it, and how it may be obtained.

Clinical Laboratory Information Systems↗

PubMed1992

Partial thoracic aortic occlusion in blunt trauma.

This case raises some interesting points. First, it allows a review of Poiseuille's Law and its application to vascular disease. It raises the question of whether or not some CT and MRI findings are of clinical significance. Finally, one must question whether or not intervention is indicated based on these "high tech" findings. Only the passage of time and accumulation of further data will give us the correct answers.

Accidents, Traffic↗

PubMed1991

Glucose infusion improves endogenous protein synthesis efficiency in multiple trauma victims.

Metabolic costs of excessive nutritional support in stressed patients have been increasingly recognized. The decreased endogenous protein synthesis efficiency (PSE) following major injury has been attributed to the predominant need of amino acid precursors for gluconeogenesis. The present study tested the hypothesis that provision of glucose alone, not to exceed the resting energy expenditure (REE), for the first 4 to 5 days after trauma would be enough to restore PSE and stimulate the injured body to accept full nutrition. Eight severely injured, adult, hypermetabolic, and highly catabolic patients admitted to the Trauma Intensive Care Unit (TICU) served as our subjects. Integrated measurements of whole body fuel-substrate kinetics were obtained for energy metabolism (indirect calorimetry), protein kinetics (primed constant infusion of 15N-glycine), and glucose kinetics (labeled glucose infusions). Two studies were conducted on each same subject, one in the early flow phase of injury (48 to 60 hours after trauma) and a second after 4 to 5 days of hypertonic glucose (4.1 +/- 0.5 mg/kg/min; 80% REE calories) infusion with electrolytes, trace elements, and minerals. Significant (P less than .05) increases in PSE (14%, 65% +/- 2% to 74% +/- 2%), plasma growth hormone and insulin levels, and respiratory quotient (RQ) (31%, 0.74 +/- 0.03 to 0.97 +/- 0.04), and decreases in endogenous glucose appearance rate (55%, 3.1 +/- 0.5 to 1.4 +/- 0.1 mg/kg/min), and negative N balance (48%, 219 +/- 26 to 114 +/- 15 mgN/kg/d) were observed. The results suggest that hypertonic glucose infusion alone may be sufficient for physiological adaptation in the immediate posttrauma days. This therapy restores normal PSE, which should protect the labile protein pool.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1983

The use of TORCH titers.

Of 603 patients undergoing serologic tests for Toxoplasma, syphilis, rubella, cytomegalovirus, and herpes simplex (TORCH tests) during a 4-year period, 381 (63%) were infants younger than 6 months and 110 (18%) were either the mothers of those infants or pregnant women. The remaining 112 (19%) were older infants and children, male adults, or nonpregnant female adults. Of 381 infants less than 6 months of age who were tested, 323 (85%) had only a single TORCH test. Of 35 (9%) infants who had follow-up titers, 16 (46%) had a specific titer requested whereas in 19 (54%) the entire TORCH battery was repeated. Follow-up titers were infrequently (25%) requested when initial titers were elevated. Infection with a TORCH agent was not confirmed serologically in any of the 603 patients. The pattern of TORCH test use has a poor diagnostic return.

Adult↗

PubMedDate not supplied

Incidence of positive serologic tests for treponemal infection in healthy rabbits.

Sera from 167 apparently normal rabbits were screened by the Venereal Disease Research Laboratory (VDRL) slide test and by the fluorescent treponemal antibody-absorption (FTA-Abs) and microhemagglutination assay for Treponema pallidum antibodies (MHA-TP) test. Three sera (1.8%) were reactive in all three tests, a fact suggesting possible inapparent infection with Treponema paraluis-cuniculi. One hundred forty-four sera (86.2%) were nonreactive in all tests. The VDRL slide test was reactive with 22 sera (13.2%). In 19 of these, treponemal tests were nonreactive; thus the rabbits probably were not infected with pathogenic treponemes. One hundred sixty-three sera (97.6%) were nonreactive in both treponemal tests, and three sera (1.8%) were reactive in both. One serum was reactive in the FTA-Abs test and nonreactive in the MHA-TP test. The lower incidence of reactivity with treponemal tests suggests that the FTA-Abs and MHA-TP tests are more useful than the VDRL slide test for screening rabbits intended for experimental studies of syphilis.

Animals↗

PubMedDate not supplied

Development of the Logical Observation Identifier Names and Codes (LOINC) vocabulary.

The LOINC (Logical Observation Identifier Names and Codes) vocabulary is a set of more than 10,000 names and codes developed for use as observation identifiers in standardized messages exchanged between clinical computer systems. The goal of the study was to create universal names and codes for clinical observations that could be used by all clinical information systems. The LOINC names are structured to facilitate rapid matching, either automated or manual, between local vocabularies and the universal LOINC codes. If LOINC codes are used in clinical messages, each system participating in data exchange needs to match its local vocabulary to the standard vocabulary only once. This will reduce both the time and cost of implementing standardized interfaces. The history of the development of the LOINC vocabulary and the methodology used in its creation are described.

Classification↗