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Biomedical subjects

E Cross

Publications and source records attributed to E Cross.

14 recordsLinked to original sources
PubMed2005

Rationing in the emergency department: the good, the bad, and the unacceptable.

OBJECTIVES: Waiting times in emergency departments (EDs) are an important government priority. Although substantial efforts are currently being made to reduce waiting times, little attention has been paid to the patients' view. We used qualitative methods to explore patients' perspectives on waiting times and other approaches to rationing and prioritisation. METHODS: Face to face, in depth, qualitative interviews (n = 11) explored how patients valued waiting times for non-urgent ED care. The framework approach (identifying a thematic framework through repeated re-reading) was used to analyse transcripts. RESULTS: Interviewees found some forms of rationing and prioritisation acceptable. They expected rationing by delay, but required explanations or information on the reason for their wait. They valued prioritisation by triage (rationing by selection) and thought that this role could be expanded for the re-direction of non-urgent patients elsewhere (rationing by deflection). Interviewees were mainly unwilling or unable to engage in prioritisation of different types of patients, openly prioritising only those with obvious clinical need, and children. However, some interviewees were willing to ration implicitly, labelling some attenders as inappropriate, such as those causing a nuisance. Others felt it was unacceptable to blame "inappropriate" attenders, as their attendance may relate to lack of information or awareness of service use. Explicit rationing between services was not acceptable, although some believed there were more important priorities for NHS resources than ED waiting times. Interviewees disagreed with the hypothetical notion of paying to be seen more quickly in the ED (rationing by charging). CONCLUSIONS: Interviewees expected to wait and accepted the need for prioritisation, although they were reluctant to engage in judgements regarding prioritisation. They supported the re-direction of patients with certain non-urgent complaints. However, they perceived a need for more explanation and information about their wait, the system, and alternative services.

Adult↗
PubMed2003

Role of aromatization in anticipatory and consummatory aspects of sexual behavior in male rats.

The present study was designed to test the hypothesis that aromatization is involved in the maintenance by testosterone of the appetitive component of male sexual behavior. We measured appetitive sexual behavior by administering behavioral tests in bilevel chambers and quantifying anticipatory level changes during a 5-min period prior to introduction of a stimulus female. In addition, we recorded standard measures of consummatory male sexual behavior after the female was introduced. Following 3 weekly tests, level-changing behavior reached a plateau and remained stable for up to 10 weeks. After 10 bilevel tests, rats were given subcutaneous testosterone capsules to clamp circulating androgen at physiological levels. Rats were tested and divided into two groups that were matched for measures of sexual behavior. One group was then treated with the nonsteroidal aromatase inhibitor, Fadrozole (2.5 mg/kg/day), given subcutaneously in beta-cyclodextrin and the other group was treated with vehicle. Within 1 week of Fadrozole treatment, the number of anticipatory levels changes was significantly reduced, but not the latency to begin searching. Fadrozole treatment also significantly reduced all measures of copulatory behavior over the period of treatment and increased latencies to first mount, intromission, and ejaculation. After 8 weeks, both treatment groups were given an additional Silastic capsule filled with estradiol and tested for 4 additional weeks. Estrogen treatment partially restored level-changing behavior, mounts, and intromissions but had little effect on ejaculations. These results support the view that aromatization is important for maintaining both the appetitive and the consummatory aspects of sexual behavior in male rats.

Animals↗
PubMed2001

Prevalence of vaginal colonization by drug-resistant Candida species in college-age women with previous exposure to over-the-counter azole antifungals.

We enrolled 382 college-age women in a cross-sectional survey to investigate the relationship between use of over-the-counter (OTC) azole-based antifungal drugs and vaginal colonization by drug-resistant Candida. This study showed no correlation (P=.506) between previous OTC exposure and colonization of drug-resistant Candida in vaginal flora. However, a small number of resistant Candida species isolates were obtained from women with a history of multiple exposures to OTC antifungals; given the widespread use of these products, this may be an emerging concern.

Adult↗
PubMed2000

Backbone dipoles generate positive potentials in all proteins: origins and implications of the effect.

Asymmetry in packing the peptide amide dipole results in larger positive than negative regions in proteins of all folding motifs. The average side chain potential in 305 proteins is 109 +/- 30 mV (2. 5 +/- 0.7 kcal/mol/e). Because the backbone has zero net charge, the non-zero potential is unexpected. The larger oxygen at the negative and smaller proton at the positive end of the amide dipole yield positive potentials because: 1) at allowed phi and psi angles residues come off the backbone into the positive end of their own amide dipole, avoiding the large oxygen; and 2) amide dipoles with their carbonyl oxygen surface exposed and amine proton buried make the protein interior more positive. Twice as many amides have their oxygens exposed than their amine protons. The distribution of acidic and basic residues shows the importance of the bias toward positive backbone potentials. Thirty percent of the Asp, Glu, Lys, and Arg are buried. Sixty percent of buried residues are acids, only 40% bases. The positive backbone potential stabilizes ionization of 20% of the acids by >3 pH units (-4.1 kcal/mol). Only 6.5% of the bases are equivalently stabilized by negative regions. The backbone stabilizes bound anions such as phosphates and rarely stabilizes bound cations.

Amides↗
PubMed1999

17beta-estradiol rapidly facilitates chemoinvestigation and mounting in castrated male rats.

Testosterone and estradiol act synergistically to stimulate male sexual behavior. Previous studies demonstrated that testosterone's actions are mediated genomically. Attempts to show that estradiol acts in a similar fashion have been inconclusive. However, estrogens have been shown to exert short-latency effects by acting directly on neuronal membranes. The present experiment examined whether testosterone or estradiol rapidly facilitates copulatory behaviors in castrated sexually experienced rats. Within 35 min of administration, estradiol stimulated chemoinvestigation and frequency of mounting and reduced mount latency in a dose-dependent manner. In contrast, acute administration of testosterone did not alter sexual activity. These data demonstrate for the first time that estradiol exerts short-latency effects on copulatory behavior, providing indirect evidence that this action is mediated through a nontranscriptional mechanism.

Animals↗
PubMed1994

Short-course norfloxacin and trimethoprim-sulfamethoxazole treatment of shigellosis and salmonellosis in Egypt.

In a double-blind clinical study, 109 adult Egyptian patients infected with Shigella spp. and 45 infected with Salmonella spp. were randomly assigned to three treatment groups: 1) norfloxacin in a single 800-mg dose, 2) norfloxacin, 400 mg twice a day for three days, and 3) trimethoprim (160 mg)-sulfamethoxazole (800 mg) (TMP-SMX), twice a day for three days. Among Shigella-infected patients, diarrheal symptoms had resolved in 86-97% and bacteriologic failure (repeat positive stool culture) occurred in only two patients five days after the start of the three treatment regimens. Among Salmonella-infected patients, diarrheal symptoms had resolved in 76-82% of patients and bacteriologic failure was common (18-36%) five days after the start of therapy. These data indicate that short-course therapy with either norfloxacin or TMP-SMX can be effectively used to treat shigellosis in adults in developing countries. However, for uncomplicated Salmonella spp. infection, short-course therapy with norfloxacin and TMP-SMX may not lead to a rapid resolution of symptoms or consistently eliminate this enteropathogen.

Adult↗
PubMed1993

Meningitis and encephalitis at the Abbassia Fever Hospital, Cairo, Egypt, from 1966 to 1989.

A total of 7,809 patients with meningitis or encephalitis were admitted to the Abbassia Fever Hospital in Cairo, Egypt from November 1, 1966 to April 30, 1989. The etiology was Neisseria meningitidis (mostly group A) in 27.3% of the patients, Mycobacterium tuberculosis in 19.7%, Streptococcus pneumoniae in 7.3%, and Haemophilus influenzae in 4.1%. Almost 27% of the cases had purulent meningitis but without detectable etiology; however, the epidemiologic data suggest that most of these had meningococcal meningitis. Encephalitis was suspected in 12.5% of the patients. Most of the meningococcal, pneumococcal, and Haemophilus cases occurred during the winter months. The number of meningococcal and culture-negative purulent cases per year reached a maximum three times during the 22.5 years of this study. There were more males than females in all etiologic groups, with the ratio for the total patient population being 1.6:1. The average age ranged between 11.7 and 16.5 years for all groups except for Haemophilus patients, who had a mean age of 2.5 years. The mortality rate was almost 55% for tuberculous patients and was approximately 40% for both pneumococcal and Haemophilus patients; it was 8.5% in patients with meningococcal disease.

Adolescent↗
PubMed1992

Risk of viral hepatitis among military personnel assigned to US Navy ships.

A prevalence study of 2072 male US shipboard military personnel scheduled for deployment to South America/West Africa and the Mediterranean was conducted to determine whether serologic evidence of prior hepatitis A, B, or C infection is associated with exposure in foreign countries. There were 210 subjects (10.1%) who had antibodies to hepatitis A virus (anti-HAV), 76 (3.7%) to hepatitis B core antigen (anti-HBc), and 9 (0.4%) to hepatitis C virus (anti-HCV). By multivariate analysis, anti-HAV seropositivity was independently associated with age, non-white racial/ethnic groups, birth outside of the United States, and prior Caribbean deployment for less than 1 year. Anti-HBc seropositivity was independently associated with black and Filipino race/ethnicity, foreign birth, a history of a sexually transmitted disease, South Pacific/Indian Ocean deployment (less than 12 months), and South Pacific or Mediterranean duty for (greater than 1 year). No geographic risk factors were associated with anti-HCV positivity. These data indicate that military personnel deployed outside the United States are at increased risk of viral hepatitis infection and should be considered for vaccination.

Adult↗
PubMed1971

Rounds and rounds.

Explore the source record for details and available documents.

Nursing, Team↗
PubMed1966

Abnormalities of lipid metabolism in the vitamin E-deficient monkey.

A soybean protein diet was used to induce vitamin E deficiency in rhesus monkeys. The deficient monkeys had reduced triglyceride concentrations in liver and skeletal muscle, but the cholesterol concentration in their skeletal muscle was increased. A constant amount of radioactively labeled (3)H-cholesterol-7alpha-(3)H was fed daily for 48-114 days to control and vitamin E-deficient monkeys to study the relationship between plasma, liver, and skeletal muscle cholesterol. Plasma cholesterol reached constant, maximum specific activity by the 42nd day both in control and in vitamin E-deficient monkeys. In control and previously deficient vitamin E-treated monkeys the specific activity of cholesterol in liver and skeletal muscle was approximately equal to that of plasma. In vitamin E-deficient monkeys the liver cholesterol specific activity was equal to that of plasma cholesterol, but the ratio of skeletal muscle cholesterol specific activity to plasma cholesterol specific activity was reduced. It is concluded from these studies that there is a specific defect(s) in cholesterol metabolism in the skeletal muscle of vitamin E-deficient monkeys.

Animals↗
PubMedDate not supplied

Heterosexual transmission of viral hepatitis and cytomegalovirus infection among United States military personnel stationed in the western Pacific.

A serosurvey of United States military personnel presenting to a sexually transmitted diseases (STD) clinic or reporting for routine physical examination in the Philippines was conducted to determine the risk factors for hepatitis B (anti-HBc), hepatitis C (anti-HCV), and cytomegalovirus (anti-CMV) infection. Among 470 male study subjects, 74 (15.7%) were positive for anti-HBc, five (1.1%) were positive for anti-HCV, and 232 (49.4%) were positive for anti-CMV. A history of a STD (odds ratio [OR] = 7.7) and contact with a female prostitute (OR = 2.3) were significantly associated with anti-HBc seropositivity after adjusting for age, race/ethnicity, foreign birth, and classification as either a STD or routine examination patient. Anti-CMV seropositivity was significantly associated with a history of a STD (adjusted OR = 2.0). These data suggest that in this military population, heterosexual activity was a risk factor for acquiring hepatitis B and CMV infection. United States military personnel stationed in high-risk areas of the western Pacific, particularly patients presenting to STD clinics, may need to be targeted for hepatitis B vaccination.

Adolescent↗