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Biomedical subjects

J Bracken

Publications and source records attributed to J Bracken.

14 recordsLinked to original sources

Deletion of the alpha(1,3)galactosyl transferase (GGTA1) gene and the prion protein (PrP) gene in sheep.

Nuclear transfer offers a cell-based route for producing precise genetic modifications in a range of animal species. Using sheep, we report reproducible targeted gene deletion at two independent loci in fetal fibro-blasts. Vital regions were deleted from the alpha(1,3)galactosyl transferase (GGTA1) gene, which may account for the hyperacute rejection of xenografted organs, and from the prion protein (PrP) gene, which is directly associated with spongiform encephalopathies in humans and animals. Reconstructed embryos were prepared using cultures of targeted or nontargeted donor cells. Eight pregnancies were maintained to term and four PrP-/+ lambs were born. Although three of these perished soon after birth, one survived for 12 days. These data show that lambs carrying targeted gene deletions can be generated by nuclear transfer.

Animals↗

When time is muscle.

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Emergency Medical Services↗

Initial experience with laparoscopic ultrasound-guided radiofrequency thermal ablation of hepatic tumours.

BACKGROUND AND STUDY AIMS: Radiofrequency (RF) thermal ablation has been applied almost exclusively through the percutaneous approach under radiological/external ultrasound guidance. We have embarked on a programme of laparoscopic ultrasound-guided RF ablation of hepatic tumours in view of the potential advantages of this approach, i. e. reduced heat sink effect, greater precision and improved assessment of the thermal ablative zone. PATIENTS AND METHODS: RF thermal ablation using the Zomed International generator and multielectrode probes in two patients with hepatoma arising on a background of cirrhosis and in eight patients with multiple deposits from primary colorectal cancer. RESULTS: Total ablation was performed in two patients with hepatoma and 7/8 patients with secondary deposits. Total ablation with a minimum of 0.5-cm margin was achieved in 32 lesions. No complications were encountered postoperatively and all patients were discharged within 2 days of the intervention. One patient in whom thermal ablation was not completed has since died of progressive disease, eight appear to be free of tumour (follow-up 6-20 months) but one patient has developed further secondary hepatic deposits. CONCLUSIONS: The initial experience with laparoscopic ultrasound-guided RF ablation of hepatic tumours indicates its safety and therapeutic potential in patients with inoperable hepatic tumours.

Adult↗

Effect of muscle injection site and drug temperature on pre-anaesthetic sedation in pigs.

The responses of 83 Meishan gilts given azaperone (1.0 mg/kg) and ketamine (5 mg/kg) intramuscularly at one of four sites: the cervical muscles (20); the triceps muscle (m triceps brachii) (20); the middle gluteal muscle (m gluteus medius) (22); and the fascia lata muscle (m fascia lata) (21) were recorded. There were more reactions to the injection into the fascia lata muscle than to injections into the middle gluteal muscle and the triceps muscle (P = 0.024) and fewest after injections into the cervical muscles (P = 0.013). The injection site did not influence the time from injection to recumbency but there was least variability with the fascia lata muscle. The degree of sedation achieved, and the response to venous cannulation were similar in all four groups. There were no long-term complications (lameness or abscess formation) associated with the injections at any of the sites. In a second study with 68 pigs the same drug mixture was injected into the triceps muscle at either 6 to 8 degrees C (23), 19 to 22 degrees C (23) or 38.5 to 40.5 degrees C (22). There was no significant difference (P = 0.078) between the numbers of responses to the injections at each temperature. Mean time to recumbency was shortest with the injections at the highest temperature although the differences were not statistically significant (P = 0.498). The degree of sedation achieved, the response to venous cannulation and the incidence of complications were similar in all three groups.

Absorption↗

Reducing door-to-needle time: treatment delay versus presentation delay.

One of the primary goals of the current American College of Cardiology/American Heart Association guidelines for treating patients with AMI is reduction of treatment delay. Delays consist of three phases: time from onset of symptoms to call for help, prehospital care and transportation, and door-to-treatment time. In turn, door-to-treatment time, the delay probably most amenable to change, consists of three distinct intervals: door-to-data, or diagnosis; data-to-decision (which therapy); and decision-to-drug administration. Care should be initiated in the emergency department (ED). Along with ready accessibility of electrocardiograms, interdepartmental protocols that facilitate diagnosis in the ED have been shown to reduce the door-to-data delay. Systems that expedite the exceptional cardiologist consult help speed the time to decision. Along with standing orders for standard care, orally obtained informed consent and availability of the drug in the ED can substantially decrease delay in drug delivery. By reducing unnecessary delays, standardization of protocols for diagnosing and treating patients with AMI in the ED may substantially decrease mortality and morbidity.

Electrocardiography↗

Effects of North Carolina's mandatory safety belt law on children.

OBJECTIVES: To assess the effect of the North Carolina law mandating that all front seat passengers use a safety belt on children 4 through 15 years of age. METHODS: North Carolina collision reports, completed by local police or the state highway patrol for crashes with greater than $500 worth of damage, were analyzed using time series analysis on the monthly percentage of deaths and serious injuries between January of 1980 and February of 1994. RESULTS: Following the 1985 implementation of the law, children 4 to 15 years of age experienced a 42% decline in deaths and serious injuries. CONCLUSIONS: The mandatory safety belt law in North Carolina has been associated with a decline in deaths and serious injuries. Additional research in needed to assess the seat belt behaviors of this age group as well as the specific effects of seat belt use using outcome measures more precise than those available in police crash reports.

Accidents, Traffic↗

An epidemiologic study of prn/stat medication use in a state psychiatric hospital.

The prevalence of prn/stat psychotropic medication administration and the characteristics and concomitants of high use of these medications were examined via a retrospective medical record review in a 973-bed state hospital. While 22.9% of the total hospital population received at least 1 prn/stat dose during the study month, 27 patients (2.8% of the total population) received 44.4% of the prn/stat doses, averaging 9.7 doses per patient. Examination of high-prn/stat use patients whose disruptive behavior and prn/stat use was "intermittent" throughout the month (N = 16) vs those who exhibited these characteristic for only a "discrete period" with resolution (N = 11) suggested that the prescription of antipsychotic drugs as prn/stat doses as well as increases in or institution of these medications was significantly associated with the latter group's resolution of disruptive behavior. The findings suggest the need for clinical protocols as guides for clinicians in the establishment of effective pharmacotherapy for patients with agitated, threatening behavior, including the use of plasma levels to ensure adequate dosage of psychotropic medication.

Dose-Response Relationship, Drug↗

A case-control study of rapid readmission in a state hospital population.

A case-control comparison of clinical and service system characteristics among chronic psychiatric patients with rapid readmission (within 90 days of discharge), patients with readmission after more than 90 days of community tenure, and nonreadmitted patients revealed several clinical variables (e.g., medication noncompliance, substance abuse, and disruptive behavior) to be associated with readmission regardless of community tenure. In contrast, two service system variables (discharge to a structured outpatient treatment program and adequacy of discharge planning) were more highly associated with rapid readmission than the other conditions, while availability of case management had no association with readmission, rapid or otherwise.

Adult↗

Blame the victim?

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Acquired Immunodeficiency Syndrome↗

Pneumonia and psychotropic drug use in elderly psychiatric patients.

A study of the use of psychotropic drugs among 30 elderly psychiatric patients with pneumonia (15 of whom died), in comparison to the general elderly population of the hospital, revealed a negative association between the use of psychotropic agents and the development of pneumonia. The factors of age, sex, pre-existing illness, and organism virulence/patient resistance were all associated with death from pneumonia. However, the present findings do not support the hypothesis that psychotropic drugs are implicated in pneumonia deaths among elderly psychiatric patients.

Age Factors↗

Application of glass capillary columns to monitor petroleum-type hydrocarbons in marine sediments.

High resolution glass capillary columns coated with SE 52 liquid phase were used to resolve the indigenous hydrocarbons extracted from sediment samples collected from three outer continental shelf areas. The extracts were than spiked with small amounts of aliphatic or aromatic components isolated from a Louisiana crude oil and rechromatographed. The resolution was sufficient to separate almost all the isoprenoid, branched and cyclic alkanes associated with petroleum. Additionally, many of the key petroleum aromatics could also be resolved from naturally occurring organics. Such chromatographic procedures will aid in distinguishing between indigenous hydrocarbons of contemporary origin and those known to be associated with fossil hydrocarbon pollution of marine sediments.

Chromatography, Gas↗