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Biomedical subjects

M Goodwin

Publications and source records attributed to M Goodwin.

At least 19 recordsLinked to original sources
PubMed1992

The effect of gamma-irradiation on the toxicity of malathion in V79 Chinese hamster cells and Molt-4 human lymphocytes.

There is growing interest in the irradiation of food and agricultural products for insect disinfestation, sprout inhibition, delayed ripening and the reduction of microbiological loads. Extensive research has been done on this process, and irradiation to a maximum dose of 10 kGy is recognized as safe by national and international regulatory agencies. The question has been raised, however, whether irradiation of pesticide residues might produce radiation products that were more toxic or less toxic than the original pesticide. To address this question, we observed the effects of 10 kGy of gamma-radiation on malathion as measured by sister-chromatid exchange (SCE), micronuclei formation, cell survival, growth rate and polyploid formation. We found no significant differences between the effects of irradiated and unirradiated malathion on any of these end-points. Polyploid formation was the most dramatic effect of both irradiated and control malathion on V79 Chinese hamster cells. Cell survival, polyploid formation and growth rate were slightly better in cells treated with irradiated malathion. In Molt-4 human lymphocyte cells, micronuclei formation was not affected by irradiated or unirradiated malathion. Compared to malathion alone, the lack of such biological effects indicates that none of the presumed radiation-induced breakdown products increased or decreased the endpoints studied. The number of SCE was consistently, but not significantly, higher in the cells treated with irradiated malathion. There were no significant differences in cell survival or micronucleus formation in the human lymphocyte cell line Molt-4 treated with irradiated or control malathion. Thus, the irradiation of the pesticide malathion to 10 kGy, a recommended upper dose for most food irradiations, does not significantly alter its toxicity in these in vitro systems.

Animals↗
PubMed1991

Working group recommendations: targeting criteria for geriatric evaluation and management research.

To maximize the cost effectiveness of geriatric evaluation and management (GEM) programs, criteria need to be established for selecting patients most likely to benefit. A working group was convened to define appropriate patient selection (targeting) criteria for each type of GEM program and to consider research questions for future targeting studies. The group outlined targeting criteria for the spectrum of GEM program types and locations. GEM program types included: inpatient GEM units; hospital geriatric consultation service; GEM programs in nursing homes; outpatient GEM programs for functionally impaired persons; and geriatric community outreach/screening programs for functionally independent elders. For each program type, the group outlined targeting criteria based on current literature and experience. Because research has not yet established the effectiveness of many of these patient targeting strategies, the group drafted a set of research questions, pertinent to targeting, that require attention: (1) For each identifiable population of elderly people, who are most likely to benefit from GEM? (2) How should these people best be identified/targeted? (3) What criteria should be used for targeting? (4) How and how often should population screening be performed to identify persons in need of GEM?

Aged↗
PubMed1991

Heart-lung transplantation for cystic fibrosis. 1: Assessment.

Forty five patients with cystic fibrosis (age 5-15 years) were assessed for heart-lung transplantation between September 1987 and March 1990. The two main conditions for acceptance were (i) life expectancy less than 2 years and (ii) a severely impaired quality of life. Patients were accepted onto an active waiting list (n = 26), a provisional waiting list (n = 15), or not accepted (n = 4). Selection was made on clinical grounds with objective measurements used as an aid in assessment. As expected, the mean values for objective measures were significantly different between patients on the active waiting list compared with the provisional waiting list/not accepted group for resting heart rate (118/minute v 101/minute), percentage of ideal weight (83.2% v 93.1%), forced expiratory volume at one second as percent of predicted normal (27.3% v 47.6%), Shwachman-Kulczycki score (33.6 v 52.5), Chrispin-Norman x ray score (25.8 v 22.1), 12 minute walk (540 m v 854 m), and minimal oxygen saturation (81.5% v 92%). Psychological evaluation demonstrated a 55% incidence of individual and a 50% incidence of family morbidity. Of the 26 patients accepted onto the active waiting list, 11 have been transplanted (mean waiting time 3.3 months), 10 have died within a mean of 3.7 months of acceptance, and five remain on the active list (mean 5.6 months).

Adolescent↗
PubMed1991

Heart-lung transplantation for cystic fibrosis. 2: Outcome.

From March 1988 to March 1990, 11 children with cystic fibrosis (age 5-15 years) underwent combined heart-lung transplantation at our institutes. Maintenance immunosuppression consisted of cyclosporin and azathioprine with corticosteroids and antithymocyte globulin used perioperatively and during rejection episodes. Six patients (55%) survive from 1.5-23 months all of whom have improved life quality. Actuarial survival to 1 year was 55%. At six months after transplant, mean forced expiratory volume at one second was 73.5% of predicted normal, compared with 25% before transplant. There was one perioperative death, three later deaths associated with obliterative bronchiolitis at two, eight, and nine months, and one from mediastinitis at four months. Of the 15 children accepted for transplantation but not receiving grafts, 10 have died (eight within four months of being placed onto the transplant list). Early postoperative problems included acute reversible rejection (n = 10), meconium ileus equivalent (n = 3), and pancreatitis (n = 1). There was a high incidence of later pulmonary rejection with a mean of 5.7 episodes per patient in the first six months. Pulmonary infection occurred relatively infrequently, with Pseudomonas aeruginosa being the most common pathogen. Persistent diabetes mellitus requiring insulin occurred in four and systemic hypertension developed in one.

Adolescent↗
PubMed1991

Comparison of four methods for free thyroxin.

We performed a limited evaluation of four free thyroxin (FT4) reagent kits: the Amerlex-M (AFT4), the Amerlite (LFT4), the MagicLite (MFT4), and the GammaCoat two-step RIA (GFT4). FT4 was measured in specimens from 201 subjects: 19 healthy controls, 14 patients who were thyrotoxic, 13 who were hypothyroid, 59 who had a past history of thyroid disease, seven with thyroxin autoantibodies, seven who were taking amiodarone, and 82 who had no clinical indication of thyroid hormone abnormality. Of these 201 subjects, 78 had a low serum albumin (less than 35 g/L) and 27 had severe nonthyroidal illness. We also investigated 60 pregnant subjects. We found no correlation between thyroxin-binding globulin (TBG) and FT4 in any of the assays, and only the AFT4 method showed a significant correlation with albumin concentrations. The presence of autoantibodies to thyroxin affected the results of all methods except the GFT4 method. All methods showed a decrease in mean FT4 values in late pregnancy. Correlation of patients' clinical state and FT4 results suggested that the reference ranges published by the manufacturers need to be modified for our laboratory.

Adolescent↗
PubMed1991

Characterization of LY233569 on 5-lipoxygenase and reperfusion injury of ischemic myocardium.

LY233569 produced concentration-dependent inhibition of isolated guinea pig 5-lipoxygenase (5-LPO) and 5-LPO activity of human polymorphonuclear leukocytes in vitro; IC50 values were 0.4 and 0.1 microM, respectively. LY233569 also inhibited (IC50 approximately 1.8 microM) zymosan-stimulated production of leukotriene B4 in canine whole blood but had little or no concomitant effect on the production of thromboxane B2. Concentrations of LY233569 as high as 10 microM did not inhibit production or scavenge superoxide from activated human neutrophils. In normal anesthetized dogs, infusion of LY233569 (0.11 mg/kg/min, i.v.) for 6 hr produced persistent inhibition (approximately 80%) of leukotriene B4 production in blood challenged ex vivo with zymosan; the plasma concentration (approximately 4 microM) of LY233569 was consistent with in vitro data illustrating selective and maximal inhibition of 5-LPO. In subsequent experiments, myocardial infarct size was measured after 1 hr of occlusion of the circumflex coronary artery and 5 hr of reperfusion. Continuous infusion of LY233569 (0.11 mg/kg/min, i.v.) had little or no effect on base-line systolic arterial pressure, cardiac rate and the pressure rate product when compared with time-related changes observed in control dogs. LY233569 infusion also did not alter the degree of ST-segment deviation or the intensity and duration of cardiac arrhythmias associated with coronary artery occlusion and reperfusion. Resultant myocardial infarct sizes were 45 +/- 5% of the left ventricle placed at risk in control dogs and 43 +/- 4% in dogs given LY233569. Myeloperoxidase activity of infarcted myocardium did not differ between groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

Diagnosis of coronary sinus diverticulum in Wolff-Parkinson-White syndrome using coronary angiography.

The entity of Wolff-Parkinson-White Syndrome and coronary sinus diverticula when the bypass tract is posteroseptal in location has been described recently. The presence of this diverticulum may complicate arrhythmia surgery and could potentially add to the risk of catheter ablation. We describe a case of Wolff-Parkinson-White Syndrome in which the diagnosis of a coronary sinus diverticulum was made preoperatively using late-phase coronary angiography and suggest angiography be considered in patients with posteroseptal bypass tracts prior to surgery or catheter ablation.

Adult↗
PubMed1989

Cardiac amyloidosis causing ventricular tachycardia. Diagnosis made by endomyocardial biopsy.

In patients with malignant ventricular arrhythmias, endomyocardial biopsy may be helpful when all other findings from the workup are negative. A case of nonsustained polymorphic ventricular tachycardia is presented. The findings from an echocardiogram, coronary angiogram, and cardiac catheterization were negative. An electrophysiologic study showed inducible nonsustained ventricular tachycardia. A right ventricular endomyocardial biopsy was diagnostic of cardiac amyloid. The findings from a workup for systemic amyloidosis were negative. Primary cardiac amyloidosis should be considered in patients with malignant arrhythmias and no documented heart disease, and endomyocardial biopsy is helpful in making this diagnosis.

Amyloidosis↗
PubMed1988

A system approach to intravenous thrombolysis in acute myocardial infarction in community hospitals: the influence of paramedics.

UNLABELLED: During a 3-year period, intravenous streptokinase (IV STK) was given to 110 consecutive patients ages 34-78 in the course of acute myocardial infarction (AMI) in three community hospitals served by the same paramedic system. 1.5 million units of IV STK was given over 30 minutes. Half of the patients were brought to the hospital by paramedics. The average time from onset of pain to administration of IV STK was 107 minutes in the paramedic group and 182 minutes for the others. Of 110 patients, 98 (89%) showed clinical evidence of reperfusion and 94 of 106 patients (89%) showed angiographic reperfusion. Angiography was performed from 1 to 10 days post-AMI. Mean time to angiography was 6 days for the first 58 patients and 2 days for the last 52 patients. In-hospital mortality was 2 of 110 patients and there was 1 late death at 8 months for an overall 3-year mortality 2.7%. Of 86 patients, 83 (96%) working before their infarct are working now. Of 107 survivors, 96 (90%) are Functional Class I. CONCLUSIONS: (1) IV STK is safely administered in a high percentage of AMI patients. (2) IV STK is safely administered in community hospitals. (3) Paramedics act as an early warning system and allow for earlier treatment than patients presenting without paramedic involvement. (4) Successful coronary reperfusion with IV STK results in low mortality rates and minimizes functional disability. (5) A system-wide approach to reducing time to treatment in AMI may be the most influential factor in affecting morbidity and mortality.

Adult↗
PubMed1987

Assessment of the Albuscreen microalbuminuria kit in diabetic outpatients.

Diabetic patients who have albumin excretion rates of greater than 30 micrograms/min (30 mg/L at normal urine volumes) are at increased risk of the development of diabetic nephropathy. The Albuscreen microalbuminuria kit detects albuminuria at concentrations of 30 mg/L and above by an agglutination-inhibition reaction. One hundred and ninety-five random urine samples from diabetic outpatients were assessed by Albuscreen and Albustix testing for albuminuria and the results were correlated with those of a sensitive radioimmunoassay technique. Albuscreen testing was simple, easy to use and had a sensitivity of 96%, with a specificity of 88%. Albustix testing at a detection level of 50 mg/L revealed a sensitivity of 100% and a specificity of 68% (43 samples, false-positive "trace" readings), while, at 30 mg/L, the sensitivity and specificity were 90% and 71%, respectively. Therefore, Albuscreen testing is well suited as a screening test for the presence of microalbuminuria in a diabetic outpatient setting. However, the role of Albustix in screening for microalbuminuria is less well defined, especially at the 30 mg/L level of detection, and requires further investigation.

Albuminuria↗
PubMed1987

Anomalous thyrotropin values.

We studied problems associated with use of an "ultrasensitive" thyrotropin (TSH, thyroid-stimulating hormone) assay for diagnosis of hyperthyroidism. Of 955 TSH assays performed in our laboratory during four months, 135 gave TSH values less than 0.1 milli-int. unit/L. We noted low TSH values at all concentrations of free thyroxin (FT4) in plasma. Nine of 13 patients with a normal or low FT4 and no obvious endocrine explanation for a low TSH were elderly and ill. This raises questions about the pituitary function in such patients. Twenty-seven patients who had high FT4 and non-suppressed TSH were clinically euthyroid, 20 of them being on treatment with thyroxin or amiodarone. Low TSH values in a hospital environment do not always indicate hyperthyroidism, although a normal value for TSH probably indicates euthyroidism.

Acute Disease↗
PubMed1986

Wheelchair use by ambulatory nursing home residents.

In a survey of wheelchair use in two nursing homes, the authors found a substantial number of cognitively intact nursing home residents who walked, but who also used a wheelchair. Using chart review and interviews with the residents, it was found that multiple physical factors, including pain, strength, endurance, vision and balance, and multiple social and environmental factors, including the fear of falling, were related to the resident's decision to use a wheelchair as an alternative means of mobility. A physical examination focused on aspects of mobility was completed on each resident and was intended to characterize the physical limitations in groups studied. In the nursing home environment, use of the wheelchair is viewed by the residents as a self-initiated choice which the residents believed significantly enhanced their sense of well-being. Finally, there was minimal recognition of mobility as a problem on the part of the medical and nursing staff. The study raises a number of important issues concerning walking versus wheelchair use in the nursing home.

Aged↗