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Biomedical subjects

L Massey

Publications and source records attributed to L Massey.

9 recordsLinked to original sources
PubMed2005

Magnesium therapy for nephrolithiasis.

PURPOSE: Critically evaluate the experimental evidence and clinical trial outcomes as the basis for use of magnesium (Mg) supplements as therapy for calcium oxalate nephrolithiasis. MATERIALS AND METHODS: Literature search of MedLine and Web of Science through January 2005; articles cited in papers found by searches. RESULTS: Magnesium inhibits calcium oxalate crystallization in human urine and model systems. Magnesium also inhibits absorption of dietary oxalate from the gut lumen. Three early trials of Mg oxide (MgO) and Mg hydroxide (Mg(OH)2) reported lower rates of recurrent stone formation. However in a double-blind, randomized, placebo-controlled trial with more carefully selected patients, there was no significant difference between recurrence rates with 650 or 1300 mg MgO daily and the placebo. Another trial reported 391 mg (21 meq) Mg daily as a mixed salt, Mg potassium citrate, reduced calcium stone recurrence by 90%, similar to potassium citrate, but with better gastrointestinal tolerance. The failure of MgO and Mg(OH)2 as sole therapy may be related to poor absorption and low rates of Mg deficiency in the patient populations tested. CONCLUSIONS: Clinical trial evidence does not justify the use of MgO or Mg(OH)2 as a sole therapy for calcium oxalate kidney stones in a general patient population. However, the addition of magnesium to potassium citrate therapy improves outcomes. Clinical trials should focus on patients who are likely to be Mg deficient.

Calcium Oxalate↗
PubMed2001

Surgical outcomes of a randomized prospective trial involving patients with a proximal femoral fracture.

BACKGROUND: An orthopaedic management/patient-focused care unit (OMPFCU) involving a dedicated orthopaedic-geriatrics liaison team was established at the Royal Brisbane Hospital in 1994 in an effort to safely accelerate rehabilitation of patients with proximal femoral fractures. METHODS: The surgical outcomes of the patients were monitored in order to determine whether accelerated rehabilitation had any significant adverse effects on the surgical outcomes, measured by mortality, readmission to hospital, deep wound infection, fracture union delay, mobility and the revision surgery rate. RESULTS: No significant difference was recorded in mortality and morbidity, deep wound infection and revision surgery rates between patients in the Royal Brisbane Hospital OMPFCU and those in standard care in the orthopaedic surgery wards. CONCLUSION: Accelerated rehabilitation for patients with a proximal femoral fracture in a major teaching hospital can be accomplished safely.

Canes↗
PubMed2001

Recertification of respiratory therapists' intubation skills one year after initial training: an analysis of skill retention and retraining.

Allied health personnel and nonanesthesiologist physicians often undergo training in tracheal intubation but then may actually use the skill relatively infrequently. This study assessed retention of skills one year after initial training and identified specific areas of knowledge critical to successful performance of intubation. Eleven respiratory therapists on the staff of a 253-bed hospital, each of whom had been trained one year previously in airway management, were evaluated. Prior to returning to the operating room for skills assessment and recertification, each respiratory therapist took a 21-question written exam. Therapists then went to the operating room and a trained observer (anesthesiologist) monitored the intubations performed to see whether critical steps were followed, while a second observer monitored a checklist of skills performed. The attending anesthesiologist recertified the therapist only when all steps were correctly performed and the intubation was successful. There was a poor correlation (r = -0.25, p > 0.1) between the number of intubations performed by the therapists for emergencies in the previous year and the number of intubations needed to be recertified. There was a negative correlation (r = -0.8, p < 0.05) between the score on the written test and the number of intubations required for recertification-a higher score meant fewer intubations were needed to achieve recertification. First-pass success occurred significantly more frequently if all skills tested were performed correctly (50/75 first-pass successes had all skills performed correctly vs 10/28 for failed first-pass, p < 0.01). The most common errors were levering the blade on the upper teeth (12/91) and tube not inserted from the right side of the mouth (28/104). When the blade was levered, 8 of 10 intubations failed. When the tube was not inserted from the right side of the face, 6 of 12 failed. The useful findings of this study are: (1) occasional performance of intubation did not ensure skill maintenance; (2) cognitive and procedural abilities correlated, suggesting benefits to study as well as to practical training; and (3) two specific mistakes were associated with a high incidence of failure.

Allied Health Personnel↗
PubMed1998

The management of elderly patients with femoral fractures. A randomised controlled trial of early intervention versus standard care.

OBJECTIVE: To determine the effect of an early intervention program in an acute care setting on the length of stay in hospital of elderly patients with proximal femoral fractures. SETTING: Acute orthopaedic ward of a large teaching hospital. DESIGN AND PARTICIPANTS: A randomised controlled trial comparing 38 Intervention patients with 33 Standard Care patients. INTERVENTION: Early surgery, minimal narcotic analgesia, intense daily therapy and close monitoring of patient needs via a multidisciplinary approach versus routine hospital management. MAIN OUTCOME MEASURES: Length of stay (LOS); deaths; level of independent functioning. RESULTS: Mean LOS was shorter in the Intervention group than in the Standard Care group (21 days v. 32.5 days; P < 0.01). After adjusting for other factors that could affect LOS (eg, age, sex, pre-trauma functional levels, pre-trauma comorbidity and postsurgical complications), the Intervention program was significantly predictive of shorter LOS (P = 0.01). The Intervention group did not experience greater numbers of deaths, deterioration in function or need for social support than the Standard Care group. CONCLUSION: This early intervention program in an acute care setting results in significantly shorter length of hospital stay for elderly patients with femoral fractures.

Aged↗
PubMed1987

A potassium thiocyanate extract vaccine prepared from Pasteurella multocida 3:A protects rabbits against homologous challenge.

Potassium thiocyanate extracts of a virulent Pasteurella multocida 3:A rabbit isolate were prepared and used as a vaccine in rabbits. The extract contained protein, carbohydrate, hyaluronic acid, lipopolysaccharide, DNA, and RNA. The protein and lipopolysaccharide profiles of the extract were similar to those of the P. multocida cell membrane. Rabbits were vaccinated intranasally (i.n.) or intramuscularly (i.m.) four times at 1- or 3-week intervals and challenged i.n. with the homologous P. multocida 2 weeks after the last vaccination. Rabbits vaccinated with the extract by the i.n. route developed persisting serum immunoglobulin G (IgG) and nasal IgA antibodies, whereas rabbits immunized by the i.m. route produced persisting serum IgG and transient nasal IgA antibodies. The extract prevents the death of rabbits which were vaccinated by either route and challenged. Vaccination by the i.n. route in rabbits reduced the numbers of virulent P. multocida in nasal cavities and lungs and the prevalence and severity of rhinitis and pneumonia. These i.n.-vaccinated rabbits were also resistant to virulent P. multocida colonization in liver, spleen, uterus, and tympanic bullae. Similarly, i.m. vaccination in rabbits resulted in a reduction in the severity of rhinitis; the numbers of virulent P. multocida in lungs; and the prevalence of colonization in liver, spleen, uterus, and tympanic bullae. Vaccination by the i.n. route was superior to that by the i.m. route in that there was a significant reduction in the severity of pneumonia and numbers of virulent P. multocida in nasal cavities and lungs. Rabbits vaccinated with the extract without challenge showed no lesions.

Administration, Intranasal↗
PubMed1987

Hyperimmune serum from rabbits immunized with potassium thiocyanate extract of Pasteurella multocida protects against homologous challenge.

Hyperimmune rabbit sera directed to the KSCN extract of 3:A Pasteurella multocida were characterized by enzyme-linked immunosorbent assay (ELISA), presolubilized cell radioimmunoprecipitation, and immunoblotting analysis. The results showed that the hyperimmune serum had a very high titer of immunoglobulin G ELISA antibody and a negligible immunoglobulin A ELISA antibody, precipitated 10 different outer membrane protein antigens by radioimmunoprecipitation, and reacted to 10 different membrane vesicle antigens of P. multocida by immunoblotting analysis. The hyperimmune rabbit sera were also evaluated for protective efficacy against experimental rabbit pasteurellosis by homologous challenge. Thirty-six rabbits were divided into four groups. Group 1, 2, and 3 rabbits were inoculated intranasally with hyperimmune rabbit serum, phosphate-buffered saline, or normal rabbit serum, respectively, at 24 h prior to and 24, 48, and 72 h after intranasal challenge with the virulent homologous P. multocida strain. Group 4 rabbits were inoculated with normal rabbit serum without challenge. Necropsies of surviving rabbits were performed 2 weeks postinfection. The mortality rates for groups 1 through 4 were 25% (3 of 12), 67% (8 of 12), 75% (6 of 8), and 0% (0 of 4), respectively. The prevalence and severity of pneumonia were significantly lower in the hyperimmune serum-treated rabbits. The prevalence of P. multocida colonization in lungs was significantly lower in group 1 rabbits, and the geometric mean CFU of P. multocida in lungs was 59,166-fold less in group 1 rabbits than in group 3 rabbits. The geometric mean CFU of P. multocida in nasal cavities of group 1 rabbits was significantly lower than that of group 3 rabbits. All challenged rabbits (groups 1,2, and 3) had elevated nasal immunoglobulin A and pulmonary (lung lavage) immunoglobulin A antibody levels at necropsy (day 14 postinfection). Similarly, all challenged rabbits had elevated levels of ELISA immunoglobulin G antibody in serum at day 14 but not at day 7 postinfection, indicating that rabbits receiving hyperimmune serum can mount a specific humoral immune response against the homologous challenge P. multocida organisms. We concluded that hyperimmune serum directed to the KSCN extract of 3:A P. multocida provides significant protection against homologous challenge in rabbits.

Animals↗
PubMed1985

Development of an assessment form: attitude toward weight gain during pregnancy.

A Likert-format questionnaire with 18 statements expressing attitudes of pregnant women toward their own pregnancy weight gain was developed and tested. Attitudinal data and actual weight gain were obtained from 29 women to determine whether attitudes toward slimness affect weight gain during pregnancy. Forty-one percent of the respondents had a negative attitude toward pregnancy weight gain. Attitude scores related significantly with actual weight gains (p less than .025) but not with age and number of previous pregnancies. Knowledge of appropriate weight gain and recommendation of the doctor also exerted significant influences on weight gains (p less than .05). This study suggests that attitudes favoring slimness may relate to lower maternal weight gains during pregnancy.

Adolescent↗
PubMedDate not supplied

Blood and urinary magnesium kinetics after oral magnesium supplements.

A study was conducted to compare the pharmacokinetic profile of three oral magnesium supplements--magnesium chloride solution, slow-release magnesium chloride tablets, and magnesium gluconate tablets--at 16 mmol/dose. Twelve healthy normomagnesemic subjects were evaluated during an initial baseline study, followed by three magnesium supplementation studies. Supplements were administered in a randomized, crossover fashion at weekly intervals. During each of the four trials, subjects followed the same routines and consumed identical diets. Magnesium concentrations were measured in urine samples collected from 0 to 4, 4 to 8, 8 to 12, and 12 to 24 hours. Intraleukocyte, total serum, and ultrafiltrable magnesium were measured in blood samples drawn at 0, 1, 2, 3, 4, 8, 12, and 24 hours. Compared with baseline, 24-hour urinary magnesium excretion significantly increased (P < 0.05) after the administration of the magnesium chloride solution and also increased after the administration of the other supplements, but the difference was not significant. The 24-hour areas under the curve (AUCs) for total serum, ultrafiltrable, and leukocyte magnesium were greater after the administration of each of the supplements when compared with baseline, although the differences were not statistically significant. Differences in delta AUCs (supplement AUC minus baseline AUC) for total magnesium, ultrafiltrable magnesium, and 24-hour urinary magnesium excretion were statistically different from zero or between supplements. Statistically significant differences (P < 0.05) in total serum, ultrafiltrable, and leukocyte magnesium concentrations were observed at various time points. These results suggest that there were no major differences in the overall effect of these supplements on total serum, ultrafiltrable, and leukocyte magnesium concentrations but do reveal differences in the time-concentration profiles in magnesium levels in blood and urine among the three supplement forms.

Administration, Oral↗