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Biomedical subjects

E Lusk

Publications and source records attributed to E Lusk.

6 recordsLinked to original sources
PubMed1990

Survey of exposure to genotoxic agents in primary myelodysplastic syndrome: correlation with chromosome patterns and data on patients without hematological disease.

Exposure to genotoxic agents such as insecticides, pesticides, and solvents correlated with abnormal karyotypes and development of acute nonlymphocytic leukemia (ANLL) similar to, but to a lesser degree compared to, patients exposed to irradiation and alkylating drugs in several reports. Because of the natural progression of myelodysplastic syndrome (MDS) to ANLL, we investigated the relationship of exposure to these carcinogens in patients with primary MDS by having 52 such patients diagnosed and referred to our center answer an occupational/environmental questionnaire. We excluded all secondary MDS patients with exposure to previous chemotherapy and radiation for a previous malignancy. In addition, we prospectively gave the same questionnaire to a similar number of age- and sex-matched comparable control patients from the same socioeconomic group based on their residence, health insurance coverage, and occupation. We found a 46% exposure rate to implicated genotoxic agents in our patients with MDS. Patients with MDS who were exposed had 75% incidence of a poor prognosis French-American-British classification compared to 57% in the nonexposed group but the difference was not significant (P = 0.089). However, the karyotypic abnormalities that were associated with exposure in ANLL were found equally in both exposed (55%) and nonexposed groups (50%) of our MDS patients and our control group had a similarly high exposure rate at 40% to genotoxins. Implicating a relationship between exposure to pesticides and solvents in ANLL and MDS is difficult. All the previous studies indicating such a relationship did not use a control group of patients. Our findings indicate the pitfalls of historical data without investigating the bias of obtaining an exposure history. However, our findings that the majority of our MDS patients came from the middle socioeconomic group which has a high exposure rate as shown by our control group indicate a relationship and that prospective follow-up of the exposed cohort of control patients should be done to determine if ANLL and MDS will increase after a latent period compared to the nonexposed controls.

Adult↗
PubMed1985

Interval nitrogen excretion and maintenance nitrogen requirements for parenteral nutrition in primates.

This paper discusses a regression technique for determining maintenance nitrogen requirements in well-nourished primates (M fascicularis) on total parenteral nutrition. Animals were administered a continuous glucose infusion, and parenteral nitrogen intake was varied at constant time intervals in a random order (from 0 to 1 g nitrogen/kg/day). Interval nitrogen balance (intake minus urinary nitrogen output) was plotted against interval nitrogen intake. The x-intercept was defined as the maintenance nitrogen requirement. First, 24-h intervals were used at a nonprotein caloric intake of 85 kcal/kg/day (approximately 175% of primate resting energy expenditure) and the nutritional adequacy of the estimated requirement evaluated prospectively. Next, 8-h balance intervals were used and the maintenance nitrogen requirements predicted by this abbreviated technique were compared to those obtained using the longer method. Finally, the short-interval technique was repeated at two other levels of continuous glucose infusion (60 kcal/kg/day and 8 kcal/kg/day) and the effect on predicted nitrogen requirement examined. Maintenance parenteral nitrogen requirements for primates may be determined in 48 h using the abbreviated techniques.

Animals↗
PubMed1985

Evaluating handwashing technique.

Though standards for handwashing have been defined, little effort has been made to assess the quality of handwashing in clinical settings. This paper describes tests of reliability and validity of tools to evaluate two aspects of handwashing--appropriateness and technique. Based on these tests, methods to evaluate handwashing are recommended.

Attitude of Health Personnel↗
PubMed1985

Invasive pulmonary aspergillosis in adult acute leukemia: clinical clues to its diagnosis.

Invasive pulmonary aspergillosis, a leading cause of morbidity and mortality in patients with acute leukemia, is difficult to diagnose antemortem because its signs and symptoms are ill-defined. To refine the clinical description of this infection, we reviewed our experience with 15 pathologically documented cases of invasive pulmonary aspergillosis in a population of 60 patients treated for acute leukemia. Findings occurring significantly more often (P less than or equal to .001) among cases than controls included pleuritic chest pain; acute sinus tenderness, and nasal discharge, epistaxis and eschar; rales; development of multilobar infiltrates after the 14th hospital day; and presence of nodular or cavitary infiltrates. In addition, patients with invasive pulmonary aspergillosis had a significantly prolonged duration of granulocytopenia, more febrile days and febrile episodes without a fever diagnosis and more febrile days on antibiotics (P less than or equal to .001 in all). This complex of findings should improve the clinician's ability to diagnose invasive pulmonary aspergillosis in patients with acute leukemia.

Acute Disease↗
PubMedDate not supplied

Urea nitrogen excretion in chair-adapted primates.

To evaluate the temporal pattern of urea excretion in chair-adapted primates (Macaque fascicularis) on continuous total parenteral nutrition (TPN), two groups of five animals were studied. Group I received continuous TPN (75 glucose kcal; 0.56 g nitrogen; and 100 ml fluid per kg per day) while Group II received a single morning isonitrogenous oral meal along with a continuous isovolemic intravenous infusion of 0.45% saline. Urine was collected hourly in group I for 2 days and every 4 hr in group II for 5 days and analyzed for urea content. Time series analysis revealed no periodicity of urea excretion in either group. Six animals were then studied for a total of 46 TPN days to define the relationship between the urea content of a single 3-hr morning urine aliquot and its respective content in a 24-hr collection. A significant linear relationship was found (r = +0.76, p less than 0.01). However, using this relationship, a reasonable estimate (+20%) of measured 24-hr urea output was achieved only 50% of the time using a single 3-hr urea output. Chair-adapted primates maintained on continuous TPN or a single oral meal with continuous saline infusion do not exhibit a periodic pattern of urea excretion. The variability in 3-hr urinary urea output in the chaired primate on continuous TPN does not consistently permit accurate estimation of the coincident 24-hr urinary urea output.

Adaptation, Physiological↗