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Biomedical subjects

M L Fitzpatrick

Publications and source records attributed to M L Fitzpatrick.

At least 19 recordsLinked to original sources
PubMed1998

Cellular immune responses to four doses of percutaneous bacille Calmette-Guérin in healthy adults.

To explore the hypothesis that low-dose immunization might induce preferential Th1 cell immunity, 76 adults were vaccinated with one of four doses of bacille Calmette-Guérin (BCG): The doses contained very low (1.6 x 10(5) cfu), low (3.2 x 10(6) cfu), standard (1.6 x 10(8) cfu), or high (3.2 x 10(8) cfu) levels of BCG. Delayed-type hypersensitivity responses occurred 8 weeks after vaccination in 10% of persons given very low or low doses of BCG, compared with 95% and 100% of persons given standard or high doses, respectively. Lymphoproliferative responses, which were increased only for high-dose vaccinees, peaked 2 weeks after vaccination and were directed chiefly against Mycobacterium tuberculosis-secreted proteins, particularly the antigen 85 complex. Significant increases in mycobacteria-specific interferon-gamma expression were present 16 weeks after vaccination only for persons given standard or high doses of BCG. Percutaneous BCG appears capable of inducing a temporary Th1-like immune response, but standard or higher dosages are required.

Administration, Cutaneous↗
PubMed1993

Qualitative approaches in nursing research. Historical research: the method.

The use of the historical research process in nursing is a valuable approach to expanding nursing's understanding of itself, and for interpreting the field and its contributions to others. It provides a scholarly means of connecting the field to the whole of human experience. Its liberating and liberalizing quality assists the profession further to define its identity through understanding of its heritage and to provide direction for its future. As a research method, it links nurse scholars with their colleagues in the humanities. As a scholarly pursuit within the professional field, historical inquiry, properly executed, has become essential to the refinement of nursing's understanding of itself.

Historiography↗
PubMed1991

Curricula of doctoral programs in nursing.

Each doctoral program possesses unique features that reflect the special characteristics of the faculty, the environment, and the students of its respective institution. This study focused more narrowly on the formalized structure of programs of study available in printed literature which does not fully capture the richness of doctoral education. While most doctoral programs in this country appear to possess curricular elements of quality previously identified by AACN with respect to curricular issues in the areas of research, theory construction, and philosophy, there was much more variation in the curricular content focusing on areas of substantive nursing knowledge, and data management, tools, and technology.

Curriculum↗
PubMed1986

Oedema of the neck after ablation of the thyroid with radioactive iodine.

Six out of 30 patients who underwent thyroid ablation with 131I during the period 1975-85 developed acute oedema of the neck within 48 h of the therapeutic dose. The condition was painless and responded well to treatment with corticosteroids. The early onset and absence of pain distinguish this complication from radiation thyroiditis. Dosage calculations and thermoluminescent-dosimeter measurements of the dose at various points on the anterior surface of the neck of a patient with a toxic adenoma of the thyroid treated with 131I were in fairly good agreement with one another and confirmed that the oedema of the neck could not be a direct effect of irradiation on the extrathyroidal tissues. It is suggested that this phenomenon may be a hypersensitivity reaction associated with massive destruction of thyroid tissue.

Adult↗
PubMed1985

Defective gallbladder emptying and cholecystokinin release in celiac disease. Reversal by gluten-free diet.

Normal volunteers (n = 6), patients with untreated celiac disease and subtotal villous atrophy (n = 6), patients with nonresponsive celiac disease (n = 2), and patients with celiac disease on a gluten-free diet with a virtually normal biopsy specimen (n = 6) drank a liquid fat meal after an overnight fast. Gallbladder emptying was monitored by using 99mTc-eHIDA, and blood samples were taken for cholecystokinin estimation by radioimmunoassay after high-performance liquid chromatography. The half-times of gallbladder emptying were 20.4 +/- 2.9 min (mean +/- SEM) for normals and 22.1 +/- 2.8 min in treated patients with celiac disease (NS). In patients with untreated celiac disease half-times were 154.3 +/- 10.3 min (p less than 0.02 vs. normals and treated patients with celiac disease), and in 2 nonresponsive patients, half-times were 40.7 and 37.3 min. Integrated plasma cholecystokinin responses were 473 +/- 87 and 436 +/- 137 pmol X L-1 X 30 min-1 in normals and treated patients with celiac disease (NS). In untreated patients with celiac disease values were 16 +/- 9 pmol X L-1 X 30 min-1 (p less than 0.001 vs. normals and treated patients with celiac disease), and in nonresponsive patients values were 442 and 322 pmol X L-1 X 30 min-1. In 2 patients studied before and during gluten-free diet half-times for gallbladder emptying changed from 168.9 and 302.4 min to 20.1 and 23.4 min, and cholecystokinin responses changed from 0 and 45 to 623 and 298 pmol X L-1 X 30 min-1. Cholecystokinin immunoreactivity cochromatographing with cholecystokinin-octapeptide was responsible for 50%-60% of circulating cholecystokinin in normals and in treated patients but the small amount of cholecystokinin that was released in untreated patients with celiac disease cochromatographed with cholecystokinin-33/39. We conclude that there is a reversible defect of gallbladder emptying and cholecystokinin release in celiac disease.

Adult↗
PubMed1985

Oral water causes emptying of the human gallbladder through actions of vagal stimuli rather than motilin.

A drink of water was found to cause partial emptying of the human gallbladder in parallel with the release of motilin. The water-induced effect on the gallbladder was abolished by atropine, whereas the release of motilin remained unchanged. Exogenous infusions of porcine motilin aimed at achieving either a physiological or a pharmacological plasma motilin increment were both without effect on gallbladder dynamics as compared with saline infusions. It is concluded that the water-induced gallbladder emptying is vagally dependent. Furthermore, the results suggest that motilin does not cause gallbladder emptying in man.

Adult↗
PubMed1984

Effects of peptide YY and neuropeptide Y on gastric emptying in man.

Neuropeptide Y (NPY) and peptide YY (PYY) are two structurally related peptides. PYY has been identified within endocrine cells and NPY within nerves of the gastrointestinal tract. Infusion of PYY at a low dose at a nominal rate of 2 pmol/kg/min resulted in an increment of 59.2 +/- 7.1 pmol/1 in plasma concentration and a significant delay in gastric emptying of glucose. Infusion of NPY at the same rate produced similar plasma concentrations (52.5 +/- 1.1 pmol/1) and had no significant effect on the rate of gastric emptying.

Adolescent↗
PubMed1982

Effects of intravenous somatostatin and motilin on the blood glucose and hormonal response to oral glucose.

Exogenous intravenous infusions of control saline, somatostatin, motilin and somatostatin and motilin together were compared in normal volunteers for their effects on the rise of blood glucose following 50 g oral glucose and for their effects on gastric emptying and plasma hormone concentrations. All regulatory peptide infusions increased the rate of gastric emptying by between 182% and 198% at 60 min post-ingestion. The glucose response during the oral glucose tolerance test was suppressed when somatostatin with or without motilin was infused but was increased during motilin. The somatostatin infusion reduced concentrations of motilin, insulin, gastric inhibitory polypeptide, gastrin and neurotensin whilst the motilin infusion was associated with an increased initial rise in insulin and gastric inhibitory polypeptide. The metabolic effects of the motilin infusion were overriden by the effects of somatostatin when both peptides were infused together; this suggests that somatostatin inhibits both the effects and secretion of motilin.

Adult↗
PubMed1982

Interdigestive biliary output in man: relationship to fluctuations in plasma motilin and effect of atropine.

The fasting output of bile into the bowel was investigated in nine healthy volunteers by hepatobiliary scanning. Subjects were studied twice, on each occasion for 2.5 hours. A significant flow of radioactivity from the gall bladder to the duodenum was observed on one or two occasions during each experiment. A 32 +/- 4% mean decrease in counts over the gall bladder was recorded, indicating partial emptying of this organ in the interdigestive state. The output of bile into the bowel was found to be related to fluctuations in fasting plasma motilin levels in that a significant motilin increment (18 +/- 4 pmol/l, p less than 0.005) paralleled the appearance of radioactivity in the duodenum. The onset of gall-bladder emptying regularly preceded the peak in plasma motilin (mean: 25 +/- 2 minutes). Atropine, intravenously, 0.6 mg followed by 0.3 mg, nearly abolished both fasting biliary output and plasma motilin fluctuations. Thus, bile output appears to occur frequently in fasting humans, but our data do not allow any conclusions as to the possible causal relationship between fasting gall-bladder emptying and release of motilin. Cholinergic influences appear to be of importance in the regulation of interdigestive biliary output in man.

Adult↗
PubMed1981

Regional lung function in children: the accuracy of nitrogen-13 inhalation and infusion studies.

The assumptions made in 13N lung function tests in children with pulmonary or cardiac disorders have been examined. The index of lung function employed was the height/area (H/A) of the lung curves obtained following either bolus inhalation or infusion of 13N. Three aspects were considered: (1) the accuracy of H/A values with count rates obtained in typical patients; (2) the effect on perfusion H/A values of prolonged arrival of isotope in the lungs; and (3) the effect on perfusion H/A values of recirculation of isotope through the lungs due to a right-to-left intracardiac shunt. It was found that, for inhalation studies, the index H/A was sufficiently accurate to distinguish localised from generalised disease. For perfusion studies, prolonged arrival of isotope in the lungs caused a reduction in measured H/A values of up to 15%. In the presence of a right-to-left shunt recirculation of isotope could prevent the detection of a small, poorly-ventilated lung component. It is concluded that the use of 13N for measurement of ventilation/perfusion balance is not a sensitive method for monitoring the progress of generalised pulmonary disease.

Child↗
PubMed1981

Measurement of red cell volume and splenic red cell pool using 113m indium.

Using the lipophilic chelating agent, acetylacetone, red cells have been radiolabelled with the short-lived, generator-produced isotope, 113mIn. Following re-injection of these labelled cells, red cell volume has been measured and compared with corresponding values using 99mTc labelled red cells in 18 patients, and with 51Cr labelled red cells in five patients. 99mTc slightly overestimated red cell volume in relation to 113mIn, but 51Cr values were identical to 113mIn values. There was a close correlation between splenic red cell pool measured with 99mTc and with 113In. It was concluded that the intracellular stability and gamma emission of 113mIn make this isotope a superior alternative to 99mTc and 51Cr in measurements of red cell volume and splenic red cell pool.

Chromium Radioisotopes↗
PubMed1981

Spleen function and platelet kinetics.

In patients suffering from various platelet abnormalities, quantitative scanning after injection of indium-111 (111In) labelled platelets showed three different patterns of platelet destruction and distribution. In patients with a normal platelet life span but with evidence of increased splenic pooling, the spleen tended to be the main site of destruction. In patients with a moderately reduced platelet life span, the distribution of destruction in the system and variable destruction in the marrow. However, because of its rapidity this destruction was difficult to quantify, and it was difficult in these cases to distinguish reliably between spleen pool, sequestration, and destruction. Destruction of platelets on the liver appeared to be unimportant in all three groups. 111In, because of its physical characteristics, is preferable to chromium-51 as a platelet label in the assessment of abnormal platelet kinetics.

Adolescent↗