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Biomedical subjects

L Britton

Publications and source records attributed to L Britton.

13 recordsLinked to original sources
PubMed1999

Riding the waves of change in health system material management: team building in times of uncertainty.

Within the health care industry, reorganization brings new challenges and opportunities for improving work-related processes. This article examines one Midwestern health system's response to the systemic change that may occur after restructuring. The consolidation of diverse and separate material management departments within one integrated material management division prompted a concerted team development and training effort. In this model, management and non-management staff worked collaboratively to achieve a unified work group that will continue to evolve and grow with the needs of the organization.

Group Processes↗
PubMed1998

Specialised service to children with specific language impairment in mainstream schools.

The following report describes a three year project to develop, implement and evaluate a specialised speech and language therapy (SLT) service to children with specific language impairment (SLI) who attend mainstream schools and nurseries. The report describes how the service was set up and the package of care offered. A range of evaluation measures was designed and implemented and the results of these are discussed. The service aimed to enable key-workers to support children with SLI effectively within the context of the school environment. The results suggest that the package of care offered provided an effective and high quality service as judged by the parents, schools and therapists.

Child↗
PubMed1991

Myocardial preservation in neonatal lambs. Comparison of hypothermia with crystalloid and blood cardioplegia.

Low cardiac output after surgically induced myocardial ischemia is a major contributor to mortality and morbidity after operations for congenital heart defects, despite myocardial "protection" with the techniques of hypothermia and cardioplegia that have been effective in protecting mature myocardium. The purpose of this study was to investigate the effectiveness of topical cooling to 15 degrees C, crystalloid cardioplegia, and blood cardioplegia in protecting 28 isolated neonatal lamb hearts subjected to 2 hours of ischemia. Seven hearts were isolated and perfused in a similar manner with cooling to 15 degrees C but were then rewarmed without any ischemia to serve as a control group. All three groups (topical cooling, crystalloid cardioplegia, and blood cardioplegia) had recovery of systolic function (as measured by maximum developed pressure, maximum rate of pressure rise, peak developed pressure at a fixed volume, and peak rate of pressure rise at a fixed volume) equal to the control group; the exception was peak rate of pressure rise at a fixed volume in the blood cardioplegia group, in which recovery was worse than in the control group. No differences among three ischemia groups or in comparison with the control group were found for measures of diastolic function (ventricular diastolic pressure at a fixed volume or stiffness constant kA). Systolic function declined in all groups (including control) from baseline to the end of the experiment. These findings suggest that hypothermia exerted the dominant protective effect in these normal neonatal lamb hearts and there was no added protection from either crystalloid or blood cardioplegia.

Animals↗
PubMed1988

A new sealant for knitted Dacron prostheses: minimally cross-linked gelatin.

There has been a resurgence of interest in the concept of presealing high-porosity knitted Dacron prostheses with an absorbable biologic material. Such a material should provide reliable porosity control, preferably reducing water porosity from 2000 ml/cm2/min to less than 50 ml/cm2/min. It should not interfere with the fibrous and vascular ingrowth that securely anchors the developing pseudointima. In previous studies, we have examined fibrin glue and two forms of aldehyde cross-linked insoluble collagen used as Dacron sealants. We concluded that delayed resorption of the sealant as seen with glutaraldehyde cross-linked insoluble collagen results in undesirable healing characteristics, particularly lack of adhesion between pseudointima and the luminal surface of a prosthesis. This study examines a new sealant. Soluble collagen (gelatin) is treated to reduce the number of free amino groups available for aldehyde cross-linking. It is then weakly cross-linked with an aldehyde mixture and applied to a knitted Dacron prosthesis. Water porosity studies have confirmed satisfactory porosity control. Both rat subcutaneous and canine circulatory implants for 6 months reveal relatively rapid and complete sealant resorption without undesirable modification of the normal healing process of knitted Dacron.

Animals↗
PubMed1988

Cryopreserved and fresh antibiotic-sterilized valved aortic homograft conduits in a long-term sheep model. Hemodynamic, angiographic, and histologic comparisons.

There is a paucity of clinical and experimental data regarding the fate of cryopreserved valve aortic homografts. Fifteen lambs (mean age 4 months) underwent insertion of a valved aortic homograft between the right ventricle and pulmonary artery. In eight animals, the homografts were treated with antibiotics for 48 hours followed by up to 4 days of 4 degrees C storage (group A). In the other seven animals, the homografts were treated with antibiotics and cryopreserved at -196 degrees C (group B). The 12 long-term survivors were catheterized at 6 weeks and 4 months after implantation, at which time three animals from each group were killed. The remaining six animals were catheterized and killed at 9 months. There was no significant difference in transconduit gradient (p = 0.67) or resistance indexed to weight (p = 0.81) between groups A and B. The mean increase in transconduit gradient for both groups between catheterization at 6 weeks and 4 months was 73%, and weight increased by 51%. Histologic analysis focusing particularly on valve leaflet architecture and changes in the aortic wall revealed greater differences between individual animals and according to duration of implantation than differences between groups A and B. However, focal intracuspal thrombus of unknown significance was seen only in animals from group B. Although conduit valve leaflets generally remained free of calcification, calcification was prominent within the conduit wall of all animals. In conclusion, cryopreservation does not appear to adversely affect leaflet integrity and conduit function in this accelerated animal model relative to fresh homografts. This is in contrast to past clinical experience with homografts treated by freeze-drying and irradiation.

Animals↗
PubMed1987

Biological sealants and knitted Dacron conduits: comparison of collagen and fibrin glue pretreatments in circulatory models.

To assess the healing characteristics of knitted Dacron conduits sealed with fibrin glue, collagen cross-linked with glutaraldehyde, and collagen cross-linked with formaldehyde, composite conduits, each constructed from two of the three test materials, were implanted in the pulmonary and systemic circulations of sheep and dogs for 3 and 6 months. Relative rates and morphologies of sealant resorption and other histological findings were predicted by a previous study involving subcutaneous implantation of the same graft materials in the rat. In particular, both studies revealed that delayed resorption of collagen cross-linked with glutaraldehyde and collagen cross-linked with formaldehyde resulted in lack of adhesion between inner capsule and conduit, thereby causing focal hemorrhagic dissection in the circulatory implants. There were no important qualitative or quantitative differences in healing between sheep and dogs or in pulmonary versus systemic location of the conduit. Rendering an animal cyanotic by placing a pulmonary arterial-left atrial shunt or by increasing or decreasing the intraconduit systolic pressure did not obviously affect healing. The results emphasize that the biological consequences of sealed grafts are strongly dependent on the sealant material. Porosity control of knitted Dacron with biological sealants that undergo minimal or delayed resorption may lead to poor tissue adhesion and resultant complications.

Animals↗
PubMed1984

Use of behavioral science concepts and processes to facilitate change: a team building program for nursing supervisors.

This paper describes a team development program conducted for Nursing Supervisors and Nursing Executives in a Melbourne teaching hospital. It provides a detailed account of (i) the concepts which guided the formulation and conduct of the program and (ii) the processes which were used to maximise the possibilities for change and foster a joint commitment to dealing with problems in the Nursing Department. The program achieved greater understanding and clarity regarding work roles, improved cohesion and teamwork at the supervisory and executive level and a shift towards a more participative style of management within the department.

Australia↗
PubMed1983

Inappropriate use of cimetidine in hospitalized patients.

We reviewed the records of 100 medical and surgical patients who received cimetidine while hospitalized. Cimetidine use was categorized by FDA criteria as justified (23%), acceptable (40%), or unjustified (37%); prescribing patterns were similar in medical and surgical patients. Furthermore, intravenous cimetidine was often given when patients were receiving oral feedings, which resulted in unnecessary increases in hospital costs.

Administration, Oral↗
PubMed1979

The MLPNA position.

Explore the source record for details and available documents.

American Nurses' Association↗
PubMed1978

Superoxide dismutase and oxygen metabolism in Streptococcus faecalis and comparisons with other organisms.

Streptococcus faecalis contains a single superoxide dismutase that has been purified to homogeneity with a 55% yield. This enzyme has a molecular weight of 45,000 and is composed of two subunits of equal size. It contains 1.3 atoms of manganese per molecule. Its amino acid composition was determined and is compared with that for the superoxide dismutases from Escherichia coli, Streptococcus mutans, and Mycobacterium lepraemurium. When used as an antigen in rabbits, the S. faecalis enzyme elicited the formation of a precipitating and inhibiting antibody. This antibody cross-reacted with the superoxide dismutase present in another strain of S. faecalis, but neither inhibited nor precipitated the superoxide dismutases in a wide range of other bacteria, including several other streptococci, such as S. pyogenes, S. pneumoniae, and S. lactis. The inhibiting antibody was used to suppress the superoxide dismutase activity present in cell extracts of S. faecalis and thus allow the demonstration that 17% of the total oxygen consumption by such extracts, in the presence of reduced nicotinamide adenine dinucleotide, was associated with the production of O(2) (-). A variety of bacterial species were surveyed for their content of superoxide dismutases. The iron-containing enzyme was distinguished from the manganese-containing enzyme through the use of H(2)O(2), which inactivates the former more readily than the latter. Some of the bacteria appeared to contain only the iron enzyme, others only the manganese enzyme, and still others both. Indeed, some had multiple, electrophoretically distinct superoxide dismutases in both categories. There was no discernible absolute relationship between the types of superoxide dismutases in a particular organism and their Gram-stain reaction.

Amino Acids↗
PubMed1977

Intracellular localization of the superoxide dismutases of Escherichia coli: a reevaluation.

All of the superoxide dismutase isozymes of Escherichia coli have been shown to occur in the cell matrix, and none have been found in the periplasm. This was the case with both E. coli B and E. coli K-12, whether grown on a low phosphate medium or on a Trypticase soy-yeast extract medium. Alkaline phosphatase was used as a marker of the periplasm; adenosine deaminase and glucose 6-phosphate dehydrogenase were used as matrix markers, and consistent results were obtained by osmotic shock, spheroplast formation, and use of a diazonium salt that penetrates the periplasm but cannot cross the plasma membrane. A previous report that the iron-containing superoxide dismutase of E. coli is a periplasmic enzyme is now seen to have been in error.

Adenosine Deaminase↗