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Biomedical subjects

J R Nelson

Publications and source records attributed to J R Nelson.

At least 19 recordsLinked to original sources
PubMed2005

[Central catheters and pericardial effusion: results of a multicentric retrospective study].

OBJECTIVE: To evaluate the use of neonatal central venous catheters (CVC) in 38 french neonatal units and occurrence of pericardial effusion (PCE) over the past 5 years. MATERIALS AND METHODS: We surveyed 38 units with a questionnaire and studied the cases of PCE in five units. RESULTS: Response rate was 89% (34/38). Accepted CVC tip positions were: junction of right atrium (RA) and vena cava (VC) 76%, VC 58%, RA 11%. Fifty percent of the centers had been exposed to PCE. 16 cases of PCE were studied. Median gestational age was 31 weeks (range: 26.1 to 40 weeks). Median time from insertion: 3.2 days (range: 0.4-13.5). In all cases CVC tip was intracardiac at insertion with inadequate withdrawing in 13 cases. Sudden cardiac collapse was reported in eight cases, and unexplained cardiorespiratory instability in six cases. Echography showed PCE in 14 cases. One diagnosis was post-mortem. CVC was withdrawn in 12 patients and 13 underwent pericardiocentesis. Four patients died and two had neurological sequelae. CONCLUSION: PCE was associated with intracardiac CVC tip. The CVC tip should be controlled with radiography or echography outside the cardiac silhouette. PCE diagnosis must be considered in face of unexplained cardiovascular decompensation of neonate with CVC.

Catheterization, Central Venous↗
PubMed2001

The importance of postdischarge telephone follow-up for hospitalists: a view from the trenches.

Hospitalist practice highlights the need for effective communication between doctors that share the care of a patient, and between doctors and patients. Telephone contact with patients after hospital discharge can enhance adherence, inform the hospitalist about the results of treatment or of adverse outcomes, and allow the hospitalist to receive feedback from the patient and family.

Aftercare↗
PubMed2001

Characteristics and work experiences of hospitalists in the United States.

BACKGROUND: Little is known about the personal characteristics, work-related attitudes, or professional experiences of hospitalists. In considering the future of hospital medicine as a viable career choice for physicians (primarily, internists), these issues should be examined in a systematic fashion. Learning more about hospitalists and their work can enhance dialogue about the advantages and shortcomings of such a career from the perspective of the individual physician. METHODS: A self-administered mail survey was sent to 820 hospitalists who are dues-paying members of the National Association of Inpatient Physicians and who spend 50% or more of their time doing clinical work, teaching, or research related to hospital medicine. Attitudes about topics such as job-related burnout and job satisfaction were tapped, as well as information about different professional and social experiences. The analyses were performed using descriptive statistics and analysis of variance techniques. RESULTS: Analysis was based on 393 responses (48% response rate). Results show hospitalists to be a group of younger, mostly male, early-career individuals with high levels of job satisfaction and autonomy, low levels of burnout, and a long-term commitment to remaining in the role. Hospital medicine is a source of positive social and professional work experiences related to interactions with physician peers, patients and their families, and nonphysician hospital coworkers. Key components of hospitalists' jobs, practices, and workload are coalescing. However, certain developments, such as changing patterns of compensation and the enlisting of more general internists and women as hospitalists, merit further examination. CONCLUSIONS: The results offer insight into the physicians who are becoming hospitalists, the jobs and settings in which they work, and how hospitalists experience their everyday work lives. Valuable baseline data are provided for assessment of attitudes, such as burnout, that should be examined regularly in this fledgling group. This study complements research looking at the performance-related outcomes of hospitalists, and it can be used by various stakeholders to better understand and assess the long-term potential of what is being proposed as a new career path.

Adult↗
PubMed2001

Rapid amplification of plasmid and phage DNA using Phi 29 DNA polymerase and multiply-primed rolling circle amplification.

We describe a simple method of using rolling circle amplification to amplify vector DNA such as M13 or plasmid DNA from single colonies or plaques. Using random primers and phi29 DNA polymerase, circular DNA templates can be amplified 10,000-fold in a few hours. This procedure removes the need for lengthy growth periods and traditional DNA isolation methods. Reaction products can be used directly for DNA sequencing after phosphatase treatment to inactivate unincorporated nucleotides. Amplified products can also be used for in vitro cloning, library construction, and other molecular biology applications.

Bacillus Phages↗
PubMed2000

Evidence for a second function for Saccharomyces cerevisiae Rev1p.

The function of the Saccharomyces cerevisiae REV1 gene is required for translesion replication and mutagenesis induced by a wide variety of DNA-damaging agents. We showed previously that Rev1p possesses a deoxycytidyl transferase activity, which incorporates dCMP opposite abasic sites in the DNA template, and that dCMP insertion is the major event during bypass of an abasic site in vivo. However, we now find that Rev1p function is needed for the bypass of a T-T (6-4) UV photoproduct, a process in which dCMP incorporation occurs only very rarely, indicating that Rev1p possesses a second function. In addition, we find that Rev1p function is, as expected, required for bypass of an abasic site. However, replication past this lesion was also much reduced in the G-193R rev1-1 mutant, which we find retains substantial levels of deoxycytidyl transferase activity. This mutant is, therefore, presumably deficient principally in the second, at present poorly defined, function. The bypass of an abasic site and T-T (6-4) lesion also depended on REV3 function, but neither it nor REV1 was required for replication past the T-T dimer; bypass of this lesion presumably depends on another enzyme.

DNA Repair↗
PubMed2000

Intractable benign paroxysmal positional vertigo in patients with Meniere's disease.

OBJECTIVE: To provide a detailed description of the coexistence of benign paroxysmal positional vertigo (BPPV) and Meniere's disease in individuals and to offer a possible mechanism that explains the findings in these patients. STUDY DESIGN: Retrospective. METHODS: Chart review. RESULTS: Of 162 patients diagnosed with Meniere's disease between January 1998 and January 1999, 9 were found to have both "definite" Meniere's disease and "certain" BPPV. Meniere's symptoms preceded the onset of BPPV in all of our patients. Seven of the 9 patients were female. Except for one patient who experienced BPPV bilaterally, BPPV was limited to the same ear as the Meniere's disease. All patients presented with intractable BPPV that did not respond completely to otolith repositioning procedures. A detailed description of five patients is presented. CONCLUSION: Our data, in conjunction with that of others, suggest that Meniere's disease may predispose patients to intractable BPPV. Hydropically induced damage to the maculae of the utricle and saccule or partial obstruction of the membranous labyrinth may be possible mechanisms that explain the coexistence of Meniere's disease and BPPV.

Acoustic Maculae↗
PubMed1999

A whole-glove method for the evaluation of surgical gloves as barriers to viruses.

BACKGROUND: Today, because of the wide variety of infectious agents encountered in the health care environment, clinicians must be particularly concerned about the potential for small-sized virus penetration through glove defects. OBJECTIVE: To describe a method for testing gloves that evaluates the entire glove and allows for detection of low levels of virus penetration. Ten sets of 10 different gloves from 4 manufacturers were evaluated using this method. METHODS: Barrier properties were evaluated using the bacteriophage, phiX174. Gloves were filled with surfactant solution placed in flasks containing 10(6) viruses per mL. Flasks were agitated at 37 degrees C +/- 2 degrees C and assayed for 180 minutes. RESULTS: Virus penetration was detected in 8% of the 100 gloves tested using the quantitative assay. The qualitative assay determined that 14% of the gloves tested allowed penetration.

Evaluation Studies as Topic↗
PubMed1999

Financial implications of implementing a hospitalist program.

The use of hospitalists, who are physicians specializing in providing hospital inpatient care, has become increasingly popular. Preliminary data suggest that hospitalists can shorten inpatient lengths of stay and lower costs without compromising clinical outcomes or patient satisfaction. The role of hospitalists, their position in the organizational framework, and their contractual and financial relationships are influenced by the structure of the healthcare organization in which they work. Although hospitalist programs can benefit hospitals and medical groups financially, they rarely become self-supporting through professional fees alone. The long-term viability of hospitalist programs frequently will depend on the support the programs receive from whichever entity benefits from hospitalist-generated efficiencies.

California↗
PubMed1997

Immunohistochemical and genetic evidence of myeloperoxidase involvement in multiple sclerosis.

The myeloperoxidase enzyme (MPO) is expressed specifically in myeloid cells and catalyzes the formation of hypochlorous acid and other cytotoxic oxidants. We previously reported that two alleles of MPO exist which differ in promoter strength due to a base difference in an Alu-encoded hormone response element. The present study shows that the higher expressing MPO genotype is overrepresented in early onset multiple sclerosis in females, implicating MPO in this demyelinating disease. Contrary to the general conception that macrophages lack MPO, immunohistochemical analysis shows that MPO is present in microglia/macrophages in and around MS lesions as shown by colocalization with major histocompatibility antigens HLA-DR and phagocytized myelin. Also, MPO mRNA sequences are detected in cDNA derived from isolated human adult microglia. This is the first evidence that MPO is present in microglia/macrophages at MS lesions, that MPO gene expression occurs in microglia and that MPO plays a role in MS pathogenesis as shown by the allelic disequilibrium in early onset disease.

Adult↗
PubMed1997

Remote medical consultation for vestibular disorders: technological solutions and case report.

Complaints of vertigo and imbalance are common presentations to primary care physicians, yet there are few specialists who diagnose and treat these problems as a significant part of their practices. We demonstrated the feasibility of remote consultation for a patient presenting with vertigo using a two-way digital video and audio network. It was possible to take an appropriate history, examine the patient, and provide a diagnosis and treatment. The patient had a common problem that causes dizziness: benign positional vertigo (BPV). An essential component of the examination was the use of a head-mounted display with embedded cameras. The cameras allowed viewing of the patient's eye movements, which were diagnostic.

Dizziness↗
PubMed1996

Deoxycytidyl transferase activity of yeast REV1 protein.

Mutagenesis induced by DNA damage in Saccharomyces cerevisiae requires the products of the REV1, REV3 and REV7 genes. The Rev3 and Rev7 proteins are subunits of DNA polymerase-zeta (Pol-zeta), an enzyme whose sole function appears to be translesion synthesis. Rev1 protein has weak homology with UmuC protein which facilitates translesion synthesis in Escherichia coli by an unknown mechanism. We show here that Rev1 protein has a deoxycytidyl transferase activity which transfers a dCMP residue from dCTP to the 3' end of a DNA primer in a template-dependent reaction. Efficient transfer occurred opposite a template abasic site, but approximately 20% transfer also occurred opposite a template guanine and approximately 10% opposite adenine or uracil; < or = 1% was seen opposite thymine or cytosine. Insertion of cytosine opposite an abasic site produced a terminus that was extended efficiently by Pol-zeta, but not by yeast Pol-alpha.

Base Sequence↗
PubMed1996

Thymine-thymine dimer bypass by yeast DNA polymerase zeta.

The REV3 and REV7 genes of the yeast Saccharomyces cerevisiae are required for DNA damage-induced mutagenesis. The Rev3 and Rev7 proteins were shown to form a complex with DNA polymerase activity. This polymerase replicated past a thymine-thymine cis-syn cyclobutane dimer, a lesion that normally severely inhibits replication, with an efficiency of approximately 10 percent. In contrast, bypass replication efficiency with yeast DNA polymerase alpha was no more than 1 percent. The Rev3-Rev7 complex is the sixth eukaryotic DNA polymerase to be described, and is therefore called DNA polymerase zeta.

Base Sequence↗
PubMed1996

Systemic concentrations of salbutamol and HFA-134a after inhalation of salbutamol sulfate in a chlorofluorocarbon-free system.

The objective of this study was to determine if salbutamol was absorbed from a new salbutamol sulfate chlorofluorocarbon (CFC)-free metered-dose inhaler (MDI). Measurement of HFA-134a, the CFC-free propellant, was included to provide proof of delivery of this MDI. Eight healthy men received two inhalations (90 micrograms salbutamol base equivalents per inhalation ex adapter) from the CFC-free inhaler (MDI A) in period 1 and from a reference CFC inhaler (MDI V) in period 2. Eight postdose samples were collected for the determination of salbutamol serum levels over a 4-h period. Salbutamol levels were not quantifiable in most samples. Four subjects given MDI A and two given MDI V had a few transient salbutamol levels, which occurred in the first hour after dosing, within a narrow range of 1-2 ng/ml and close to the lower limit of detection (1 ng/ml). No pharmacokinetic analyses were possible. Blood samples were also collected after MDI A for propellant quantitation. HFA-134a levels were seen in all subjects, verifying absorption. We conclude that the transient salbutamol serum levels can be attributed to the two-inhalation dose and not to either propellant system.

Administration, Inhalation↗
PubMed1996

Cornerstone: Illinois' approach to service integration.

Cornerstone is a management information system developed and implemented by the Illinois Department of Public Health as a mechanism to facilitate maternal and child health service integration. Its design features combined program registration, standardized risk assessment, automated care plan development, and consolidated referral and scheduling. Cornerstone is a flexible, PC- and local area network-based system, allowing portability across program applications and geographic areas. A wide-area network enables local agencies to share data about clients. Development of Cornerstone was a collaborative effort by potential Cornerstone users and statewide administrative staff. The standard for equipment is set at a one-to-one ratio of workstations to case managers.

Computer Systems↗
PubMed1994

The effects of learning strategy instruction on the completion of job applications by students with learning disabilities.

The purpose of this study was to assess the effects of learning strategy instruction on the completion of job applications by students identified as learning disabled. Thirty-three students (average age 15 years 6 months) were randomly assigned by grade and gender to one of two experimental conditions: learning strategy instruction or traditional instruction. The result was 16 students (10 boys and 6 girls) being placed under the learning strategy instruction condition and 17 students (10 boys and 7 girls) being placed under the traditional instruction condition. Results indicated that in addition to statistically significant lower numbers of information omissions and information location errors, holistic ratings of the overall neatness of the job applications were significantly higher for those students under the learning strategy instruction condition. In addition to these positive changes in the performance measures, social validity data suggest that students under the learning strategy condition would be more likely to receive an invitation for a job interview. The findings and future research needs are discussed.

Adolescent↗