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Biomedical subjects

M Castle

Publications and source records attributed to M Castle.

11 recordsLinked to original sources

A DNA-binding factor in adult hematopoietic cells interacts with a pyrimidine-rich domain upstream from the human delta-globin gene.

To date, DNA-binding factors with a developmental pattern of expression have not been described in human erythroid cells to explain the switch from fetal (gamma-) to adult (delta- and beta-) globin gene expression. Here we describe a factor present in nuclear extracts from adult mouse and human hematopoietic cells that binds to an oligopyrimidine repeat approximately 960 base pairs upstream from the human delta-globin gene. The binding site for the factor is within an unusual 250-base-pair domain that is greater than 95% pyrimidines on one strand. This domain is preferentially sensitive to S1 nuclease in supercoiled plasmids, indicating that it can adopt an alternative non-B-DNA conformation. A number of S1-sensitive sites within the domain, including the factor-binding site, have sequence characteristics associated with the formation of a triple helix (H-DNA). The position of the binding site between the fetal and adult beta-globin-like genes, its potential for adopting an unusual secondary structure, and the restricted activity of the binding factor to adult hematopoietic tissues suggest possible roles in hematopoietic cell development and hemoglobin switching.

Adult

Antibiotic use at Duke University Medical Center.

A study of antibiotic use at Duke University Medical Center in June 1973 showed that 34.2% of all patients received antibiotics (43.6% surgical, 21.4% medical patients). Cephalothins were most frequently ordered for surgical patients, ampicillin sodium and penicillin G or penicillin V with potassium for other patients. A retrospective analysis of 50 randomly selected patients, according to the Kunin's categories of use, showed 64% of total antibiotic therapy as not indicated or inappropriately administered in terms of drug or dosage. These results are similar to previous reports of antibiotic surveillance and further establish the need for continuing education of prescribing physicians.

Anti-Bacterial Agents

Studies of inactivated influenza virus vaccines in hospital employees: reactogenicity and absenteeism.

The impact of a mass influenza vaccination program on the operation of a major medical center was evaluated in adult volunteer employees who were given either ether-split or whole-virus bivalent influenza vaccine in a double-blind manner by jet-injector gun. Each volunteer completed a reaction information form, nurses monitored temperatures, and data on absenteeism of the employees of the Nursing Service and the Building Management Service were collected. The results of this study demonstrated that the mass campaign did not adversely affect absenteeism. However, the whole-virus vaccine caused significantly more local, systemic, and febrile reactions thant the split-virus vaccine. Purified inactivated influenza virus vaccines can be given in a mass campaign to hospital personnel without adversely affecting the operation of the hospital.

Absenteeism

Outbreak of a multiply resistant Acinetobacter in a surgical intensive care unit: epidemiology and control.

During January, 1976 seven patients in an SICU became colonized or infected with Acinetobacter calcoaceticus (variation, anitratum) at an attack rate of 12.5 per cent. The organism showed a marked reduction in antimicrobial sensitivity from previous experience. Comparison with 34 uninfected control patients indicated that intubation and continuous ventilatory assistance were significantly associated with acquiring the organism (p = 0.0154). Acinetobacter was cultured from nurses' hands, AMBU adaptors, respirator apparatus, respirometers, and unlabeled bottles of saline used for tracheal irrigation. Control measures were designed to interrupt transmission. The investigation identified the nursing techniques and reservoirs that allowed this outbreak to occur, and we emphasize the need for close surveillance of patient care procedures in an intensive care unit.

Acinetobacter