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Biomedical subjects

J Toole

Publications and source records attributed to J Toole.

33 records · Page 2Linked to original sources
PubMed1992

Information industry leaders share visions of future. Interview by Carolyn Dunbar and Michael L. Laughlin.

Computers in Healthcare editors Carolyn Dunbar and Michael L. Laughlin spoke to nearly a hundred exhibitors during the 1992 Healthcare Information and Management Systems Society last February in Tampa, Fla. The themes of these conversations invariably turned to patient-focused systems, standards, integration and, of course, controlling healthcare costs. Many HIMSS participants offered valuable insights, and unfortunately space does not permit us to run every interview. In the following interviews, however, three industry leaders share visions of where their companies--and the industry--are headed.

Attitude of Health Personnel↗
PubMed1992

Pentafraction reduces the lung lymph response after endotoxin administration in the ovine model.

For the past half-century, several high molecular weight compounds have been used for volume expansion during cardiopulmonary resuscitation. However, the effectiveness and side effects of these different expanders are varied. We have compared plasma, pentastarch, and a new product, pentafraction, for effective plasma volume expansion before and after tissue injury with endotoxin administration. In each group, eight range ewes instrumented with a Swan-Ganz, arterial, and venous catheters, and lung and flank lymphatic cannulas were compared. Each group received 15 ml/kg of either 6% pentafraction, 6% pentastarch, or plasma followed two hours later by 1.5 micrograms/kg/0.5 hr E. Coli endotoxin over 30 min. Data were collected for an additional 24 hr after endotoxin administration. Our results indicated a plasma volume expansion in all three groups. However, the prior administration of pentafraction significantly attenuated the increase in the lung lymph flow and early evaluation of systemic vascular resistance noted with endotoxin in comparison to the other two groups.

6-Ketoprostaglandin F1 alpha↗
PubMed1989

Blood cell rheology in acute cerebral infarction.

Recently it has been hypothesized that leukocyte rheology could be a relevant variable of the microcirculation during cerebral ischemia. However, relatively few studies have been carried out on the rheologic behavior of leukocytes in vascular diseases. This study aimed at quantifying the filterability through Nuclepore filters (mean pore diameter 5 microns) of both leukocyte subpopulations and red blood cells in patients with acute stroke compared with age-matched healthy controls. Leukocytes were separated by density into polymorphonuclear and mononuclear cells. Filterability of the red blood cells and polymorphonuclear and mononuclear subpopulations in buffer was measured using a constant-flow and low-positive pressure system. We used one-way analysis of variance, signed rank sum, and simple and multiple regression tests for statistical analysis. Twenty consecutive male patients with acute ischemic infarction were compared with 20 age-matched healthy subjects. Mononuclear cell filterability was impaired in acute stroke (7.26 +/- 2.00) compared with the controls (5.55 +/- 1.23) (p less than 0.01). Polymorphonuclear cell filterability was less, but still significantly (p less than 0.05), impaired in acute infarction (5.75 +/- 0.87 vs. 4.19 +/- 0.43). The results show that leukocyte and, especially, mononuclear cell filterability is impaired in acute infarction, while no differences exist in red blood cell filterability.

Acute Disease↗
PubMed1985

Role of a systems consultant during the implementation of a patient care system.

These are just a few examples of areas where systems consultants and nurses can work closely together in designing and implementing a patient care system. Implementation of a patient care system will require careful examination of most nursing policies and procedures. The consultant's depth and range of experience is greatly enhanced by the nurse's understanding of the patient care environment and of day-to-day activities. By adhering to a carefully planned and controlled implementation process, they can combine their skills and strengths to ensure the successful implementation of a new patient care system.

Computers↗
PubMed1984

Coagulation factors V and VIII and ceruloplasmin constitute a family of structurally related proteins.

Computer searches of the National Biomedical Research Foundation protein and nucleic acid sequence data bases using the NH2 terminus of the bovine factor Va 94-kilodalton heavy chain, the NH2 terminus of the 74-kilodalton factor Va light chain, and an internal 98-residue segment of porcine factor VIII revealed that both bovine factor V and porcine factor VIII are statistically homologous to human ceruloplasmin. The NH2-terminal segment of bovine factor Va heavy chain is homologous to three segments of ceruloplasmin sequence starting at residues 1, 351, and 713; the NH2-terminal sequence of bovine factor Va light chain is homologous to the same human ceruloplasmin sequence segments beginning at residues 1, 349, and 711. The longer porcine factor VIII sequence is homologous to three segments of human ceruloplasmin, residues 1-77, 400-433, and 683-791. These data indicate that factor V, factor VIII, and ceruloplasmin comprise a group of evolutionarily linked protein structures that possibly resulted from multiplication of ancestral precursor genes.

Amino Acid Sequence↗
PubMed1983

Surgical treatment of mitral valve disease: pathologic findings and atrial dysrhythmia.

One hundred fifty patients underwent surgery for mitral valve disease between January 1974 and May 1981. There were 98 female and 52 male patients with a mean age of 57 years (+/- 18.6). One hundred forty-six patients were in New York Heart Association functional class III or IV. Pathologic diagnoses included 67% rheumatic (55 calcified), 27% degenerative and fibrotic, 3.3% prosthetic valve malfunctions, and 2.6% acute papillary muscle dysfunction. Atrial biopsy material was normal in 72% (37/51) and Aschoff's bodies were present in 2% (1/51). Preoperative cardiac rhythm was regular sinus in 40%, atrial fibrillation in 59%, and pacemaker-induced in 1%. Valve replacement was performed in 119 patients, commissurotomy in 26, and annuloplasty in five. Left atrial thrombus was removed from 21 patients. Hospital mortality was 10%. The 135 survivors have been followed up for an average of 30.4 months. Of patients who were in regular sinus rhythm preoperatively, 90.7% maintained it postoperatively, and 9.3% converted to atrial fibrillation. Of patients in atrial fibrillation preoperatively, 33.8% converted to regular sinus rhythm postoperatively and 66.2% remained in atrial fibrillation. These data indicate that rheumatic mitral valve disease is still the most common finding in patients coming to surgery, followed by degenerative and fibrotic mitral valve disease. Acute papillary muscle dysfunction is uncommon. The chance of preserving preoperative regular sinus rhythm postoperatively is excellent (90.7%), and a 33% conversion rate of preoperative atrial fibrillation to postoperative regular sinus rhythm is encouraging.

Adult↗
PubMed1982

Endocrine complications of topical and intralesional corticosteroid therapy.

Four previously healthy children acquired skin problems that were treated with topical or intralesional fluorinated corticosteroids. Three developed signs that suggested Cushing's syndrome 1-4 months after initial treatment. Investigation showed low plasma cortisol levels and inadequate response to corticotrophin stimulation. After 7 months of treatment with topical steroids the fourth child presented with failure to thrive; during a febrile illness he had a convulsion followed by acute hypotension which responded to parenteral corticosteroid administration. Adrenal function was not studied in this patient. Although fluorinated corticosteroids seldom lead to overt adrenal suppression in children, they may impair pituitary-adrenal responses in some. Such patients should be given oral or parenteral steroid cover in the event of illness or trauma.

Administration, Topical↗