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Biomedical subjects

J Grasso

Publications and source records attributed to J Grasso.

9 recordsLinked to original sources

Patient falls from bed and the role of bedrails in the acute care setting.

The use of bedrails in preventing patient falls from bed remains highly controversial and has received only limited research attention throughout the last decade. The present study questioned the relationship between bedrail use and patient falls from bed particularly in terms of age-gender characteristics, mental status and the severity of injuries sustained. A retrospective, cross-sectional analysis was conducted of 419 patient falls occurring in an urban, acute care hospital from 1993-2000. This audit identified 136 falls from bed. It was found that for all age-gender groups the incidence of falls from bed with bedrails elevated was equal to or higher than when bedrails were not elevated. Patients in a 'non rational' state at the time of falling were significantly more likely to have fallen with the bedrails elevated (chi 2 = 19.463, p < 0.001). Whilst there was no statistically significant relationship between the position of bedrails and the severity of injuries sustained (chi 2 = 1.088, p = 0.780) the fact that there was a patient death resulting from a fall from bed over elevated bedrails was considered to be of particular clinical significance. Thus the role of bedrails as protective or safety devices was challenged and an urgent re-evaluation of current practices recommended.

Accidental Falls↗

Effect of denture adhesive on retention of the mandibular and maxillary dentures during function.

The purpose of this study was to determine the effect of denture adhesive on retention of mandibular and maxillary dentures over a four-hour period. Denture movements were measured using an alternating magnetic field tracking device that determines the position of magnetic receiver coils relative to a transmitter coil positioned over the head. Ten adults with complete maxillary dentures and complete mandibular implant overdentures were enrolled in the study. Specially fabricated mandibular dentures contained a relief area that exposed the implant post which no longer anchored the denture, but now served as an attachment point for a receiver coil that measured mandibular movement. The denture coil was attached lateral to the post coil on a shelf cut into the denture. Mandibular denture movements were recorded as the difference between the mandible movement signal and the mandible + mandibular denture signals. Measurements of denture movements were made at baseline (no adhesive) and at 0, 2, 4 hours post-adhesive application with Fixodent cream for standardized chewing and biting. The MoveTrack signals were recorded on a digital data cassette recorder for subsequent computer analysis. The results of the measurements were analyzed using paired sample t-tests. Specifically, the following comparisons of movement means were made: mandibular vs. maxillary, baseline vs. post-baseline and successive changes (e.g., baseline vs. hour 0, hour 0 vs. hour 2, etc.). Results of these analyses showed that: 1) mandibular denture movements under both adhesive and non-adhesive conditions were significantly greater than maxillary denture movements; 2) the adhesive significantly reduced movement of the maxillary and mandibular dentures during both chewing and biting; and 3) the improvement occurred immediately post-application of the adhesive and was maintained for the four hours of follow-up.

Adhesives↗

Hyaluronic acid substantially increases the retention of motility in cryopreserved/thawed human spermatozoa.

We have demonstrated previously that hyaluronic acid (HA) improves the velocity and the retention of motility in freshly ejaculated human spermatozoa. In the present work, we examined the effect of HA on cryopreserved/ thawed spermatozoa in four paradigms: (i) effect of HA on sperm motility and velocity in semen; (ii) stabilizing effect of HA after 4 h of incubation when the decline of sperm motility is already detectable; (iii) the duration of improved motility after the separation of spermatozoa from HA by Percoll gradient centrifugation; and (iv) motility of sperm cryopreserved in the presence of HA. HA improved the retention of sperm motility in thawed spermatozoa. Indeed, the motility values after 30 h were approximately 100% higher in the HA compared with the control samples. This effect of HA was also evident in the stabilization of spermatozoa with already declining motility. After removal of the HA from the incubation medium, significantly increased motility in the HA-exposed spermatozoa was still detectable for at least 4 h. Cryopreservation of spermatozoa in the presence of HA did not improve the recovery of motility. The data indicate that HA improves the retention of motility of cryopreserved/thawed spermatozoa, even after the removal of HA from the incubation medium. The utilization of HA will probably prove beneficial in assisted reproduction: in intrauterine insemination and in in-vitro fertilization (IVF), the extended sperm motility and velocity will enhance the fertilizing efficiency; in intracytoplasmic sperm injection (ICSI), the improved motility will facilitate the identification of viable spermatozoa. Because HA is a physiological component of the cumulus and of the female and male reproductive tracts, administration of HA should not cause ethical concerns.

Cryopreservation↗

Pathogenesis of hepatic fibrosis in experimental iron overload.

Significant increases in prolyl hydroxylase activity, a key enzyme in the collagen biosynthetic pathway, were noted in the hepatic homogenates of iron-loaded animals as compared to controls. The increase in prolyl hydroxylase activity was seen without any light microscopic histologic evidence of cell necrosis or accumulation of collagen in the livers from the iron-loaded animals. However, utilizing electron microscopy, collagen fibrils were demonstrated immediately adjacent to the hepatocytes in the iron-loaded animals but not the controls. No fibroblasts or inflammatory cells were noted in this area. There was no evidence of damage to the subcellular organelles of the iron-loaded hepatocytes. The hydroxyproline content of the iron-loaded livers was also shown to be increased. These experimental studies in conjunction with clinical observations described below suggest that in vivo iron overload may have a primary effect on stimulating collagen synthesis by hepatocytes.

Animals↗

A new intermediate dental outcome measure: amalgam replacement rate.

The length of time amalgam restorations last before replacement was investigated for use as an intermediate outcome measure in utilization review and quality assurance studies. Based on record data from 37 general dental practices, a determination was made of the average percentage of two- or three-surface amalgams receiving another service at 6, 12, and 24 months from the date of insertion. After 2 years, approximately 13 per cent of the amalgams were replaced, and the estimated median life time for amalgams was between 10 and 14 years. The variation in replacement rates among practices was substantial but was not explained by the technical quality of restorations or several practice characteristics.

Dental Amalgam↗

Sperm function and choice of preparation media: comparison of Percoll and Accudenz discontinuous density gradients.

We compared the sperm populations prepared by Accudenz (35-65%) and Percoll (40-80%) density gradients in 21 normospermic specimens (concentration, 53.6 +/- 3.8 x 10(6) sperm/ml; motility, 44.5 +/- 3.5%). Accudenz facilitated a higher recovery of sperm and motile sperm (68.4 +/- 6.6% vs. 49.3 +/- 4.9%, P < 0.001, and 87.8 +/- 4.1% vs. 77.8 +/- 3.7%, P < 0.01, respectively). Sperm motility was lower in the Accudenz compared to the Percoll pellets; thus the values of total motile sperm recovered were not different (17.1 +/- 2.4 vs. 15 + /- 1 2.2 x 10(6) sperm/ml). The long term retention of sperm motility was substantially improved in Accudenz (at 24 hours, 34.9 +/- 2.8% vs. 26.3 +/- 1.5%; 60% vs. 40% of the initial motility, P < 0.001), and the Accudenz vs. Percoll samples also exhibited a higher retention of total motile sperm (at 24 hours, 9.8 +/-.2 vs. 6.1 = 0.5 x 10(6) motile sperm/ml, P < 0.05). The sperm motility index, a multiple of velocity and motility in the sample that reflects the efficiency of the sperm population in sperm-oocyte interaction, was 75% higher in the Accudenz samples at 24 hours (3.6 +/- 0.4 vs. 2.1 +/- 0.2, mu m/second, P < 0.01). Sperm cellular maturity by the creatine phosphokinase (CK) activity and CK-M to CK-B isoform ratio parameters (in the original samples 0.14 +/- 0.02 lU CK/100 x 10(6) sperm and 57.9 +/- 3.7%, respectively) were improved in both the Accudenz and Percoll pellets (P < 0.001), with no difference between the two sperm fractions. Sperm activation status monitored by chlortetracycline fluorescence indicated that after 4 hours of incubation the incidence of fully acrosome-reacted spermatozoa in the Accudenz versus Percoll pellets was 6.2 +/- 0.3% versus 13.1 +/- 1.0% (P < 0.001), a 100% increase in Percoll. We can conclude that Accudenz yields a higher concentration of motile spermatozoa, with improved retention of motility, velocity, and acrosomal integrity and without an increase of sperm with diminished cellular maturity. Thus, in sperm preparation for intrauterine insemination, in which the timing of ovulation and insemination frequently do not correspond, Accudenz-prepared sperm, with a better retention of motility/velocity and acrosomal integrity and with a consequential higher resistance to activation by the female reproductive tract, are expected to be more effective.

Anti-Bacterial Agents↗