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J Spisso

Publications and source records attributed to J Spisso.

5 recordsLinked to original sources

A refined complement-enhanced neutralization test for detecting antibodies to Junin virus.

A refined, complement-enhanced, plaque-reduction neutralization test was developed for measuring neutralizing antibodies against Junin (Argentine hemorrhagic fever) virus. The assay measured neutralizing antibodies after natural as well as vaccine-induced Junin virus infections. Among vaccinated individuals, titers were 2-4-fold higher than those obtained with conventional assays, without loss of specificity. Enhanced sensitivity was achieved by using a standardized complement source (vs human or animal serum) for virus dilution, incubation of virus-serum mixtures at 36 degrees C for 2 h (vs overnight at 4 degrees C) prior to plaque assay, control of age and density of cell monolayers, and variation in overlay conditions.

Analysis of Variance↗

Improved quality of care and reduction of housestaff workload using trauma nurse practitioners.

The University of California, Davis, Medical Center introduced the use of nurse practitioners (NPs) to the trauma service in fiscal year 1986-87 to alleviate the increasing burdens placed on the surgical housestaff in their attempt to accommodate the rising patient volume and acuity. The use of NPs was associated with a decrease in average length of stay for the seriously injured patients from 8.10 to 7.05 days while the length of stay for other patients in the hospital remained unchanged. Documentation of quality of care in the medical record increased substantially. For example, discharge summaries that were dictated by the NPs were judged complete in all aspects in at least 95% of sampled records compared with approximately 75% of records that were dictated by the residents. With introduction of the NPs, outpatient clinic waiting times decreased from 41 to 19 minutes. Patient complaints regarding the trauma team decreased from 16 to seven/year. Time saved for the housestaff averaged 352 minutes/day while the NPs were on duty. The NPs were well received by the hospital nurses, hospital quality assurance personnel, and ancillary services. They have proved to be of great value to the patients, the patients' families, the hospital, and the trauma team.

California↗

Early fluid requirements in trauma patients. A predictor of pulmonary failure and mortality.

The fluid required for initial resuscitation of trauma patients should reflect, at least in part, the severity of the original injuries and shock. We examined the hypothesis that the initial fluid requirements might also predict development of subsequent pulmonary failure and death. Fluid balances were calculated for the first 24 hours in the intensive care unit for 100 high-risk trauma patients. The mean (+/- 1 SD) fluid balance for 63 patients who developed pulmonary failure was 4.6 +/- 5.5 L; the mean balances for the 37 patients who did not develop pulmonary failure were 1.0 +/- 3.1 L. The balances in 23 patients who died and in 77 who survived were 6.8 +/- 5.4 and 2.2 +/- 4.5 L, respectively. A cutoff value of 3 L determined prospectively before beginning the study predicted pulmonary failure with a sensitivity of 52% and a specificity of 89%. For mortality, the 3-L cutoff point gave a sensitivity of 74% and a specificity of 74%. The predictive value of the fluid balance was independent of other prognostic indicators, such as revised trauma scores, injury Severity Scores, and modified APACHE II scores. This simple measurement should help in allocating intensive care unit resources, as patients in positive fluid balance are likely to require Swan-Ganz catheterization and are likely to require long-term mechanical ventilation. The fluid balance should also be useful in stratifying patients for entry into clinical trials.

Adolescent↗