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Biomedical subjects

M Lam

Publications and source records attributed to M Lam.

89 records · Page 5Linked to original sources
PubMed1981

Massive pulmonary hemorrhage and fulminant renal failure associated with immune complex glomerulonephritis.

A 54-year-old man had massive pulmonary hemorrhage and fulminant renal failure. Although his clinical presentation was similar to that of Goodpasture's syndrome, his renal disease was associated with deposition of immune complex rather than with production of antiglomerular basement membrane antibody. Serum cryoglobulins were present, presumptive evidence of circulating immune complexes; serum antiglomeral basement membrane antibodies were absent. Renal biopsy revealed a crescentic, exudative glomerulonephritis with a granular immunofluorescence pattern; subepithelial deposits were demonstrated by electron microscopy. This immune complex glomerulonephritis was thought possibly to be postinfectious in origin, with characteristics distinguishing it from Goodpasture's syndrome. Pulmonary hemorrhage and crescentic immune-complex-mediated glomerulonephritis are reviewed.

Acute Kidney Injury↗
PubMed1981

Pharmacokinetics of moxalactam in patients with renal insufficiency.

Moxalactam pharmacokinetics were determined in 18 patients with renal insufficiency (creatinine clearance, 0 to 99 ml/min). Each patient was given 0.5 g of moxalactam intramuscularly. Drug half-life ranged from 4.1 to 49.1 h and correlated inversely with creatinine clearance (r = -0.97). Total body drug clearance ranged from 0 to 88 ml/min, and renal clearance ranged from 0 to 57 ml/min. In four patients studied during hemodialysis, drug half-life was 21.7 +/- 7.5 h (mean +/- standard error) between dialyses and 4.4 +/- 0.5 h during dialysis. Moxalactam dialysance averaged 44 +/- 2 ml/min per m2 of dialyzer surface area, and approximately 50% of the drug was removed during a single hemodialysis. We confirmed that moxalactam is eliminated from the body primarily by renal excretion. Recommendations are given for dosage adjustment in patients with renal insufficiency.

Cephalosporins↗
PubMed1978

Binding of hippurate in normal plasma and in uremic plasma pre- and postdialysis.

The protein binding of 14C-hippurate has been measured by conventional ultrafiltration techniques in the plasma of normal subjects and in uremic subjects pre- and postdialysis. In addition, the clearance of 14C-hippurate was determined in vitro in both isotonic saline and plasma to assess binding limitations on hippurate removal during dialysis. Binding levels of hippurate in normal subjects of 68+/-1.8% (n = 5) were significantly higher than either postdialysis (48.3+/-15.4%; n = 7) or predialysis (36.6+/-11.7%; n = 7) levels in the same uremic subjects. Actual levels of plasma hippurate were, however, considerably greater in uremics (24.7+/-11.2 mg/dl' n = 7) than in normal subjects (congruent to 0.5 mg%). The difference in hippurate binding between pre- and postdialysis samples in uremics was significantly different from zero (p less than 0.01, t = 5.36), indicating depletion of competitive site-binding species during dialysis. The saline clearance of hippuric acid (99.1 +/-0.5 ml/min; n = 6) under standard conditions in a capillary dialyzer (CDAK-4) was consistent with the expected clearance of a solute of its molecular weight. Hippurate clearance in citrated plasma, where binding was determined as 50+/-3%, was 65+/-0.7 ml/min (n = 6), in good agreement with a theoretically predicted clearance of 60 ml/min for this level of binding. High serum levels of hippurate and its derivatives, may depress effective function of various organs. In addition to the normal dietary intake of hippurate and its precursors, patients on dialysis receive a further burden of hippurate precursor in the form of benzyl alcohol, the common preservative in heparin solutions. The large body burdens of hippurate in dialysis patients, coupled with its impaired removal on dialysis due to binding, point to the necessity for a through investigation of the potential toxicity of this compound.

Carbon Radioisotopes↗
PubMedDate not supplied

In vitro antibacterial activity of trospectomycin (U-63,366F) against anaerobic bacteria and aerobic gram-positive cocci in Chile.

The in vitro activity of trospectomycin sulfate was compared with those of several antimicrobials, against 301 anaerobic bacteria and 613 aerobic Gram-positive cocci. Trospectomycin was about 4- to 32-fold more active than was spectinomycin. Trospectomycin exhibited consistently good activity against all Bacteroides fragilis group isolates, except Bacteroides vulgatus, and against all other anaerobes comparable or higher to that of clindamycin. The trospectomycin's activity was most similar to that of vancomycin, even against methicillin-resistant Staphylococcus aureus and methicillin-resistant Staphylococcus epidermidis.

Anti-Bacterial Agents↗
PubMedDate not supplied

The effect of staff nurse participation in a clinical nursing research project on attitude towards, access to, support of and use of research in the acute care setting.

The purpose of this study was to determine the effect of participation in research on staff nurses' attitude towards, access to, perceived support of and reported use of research in practice. Six medical surgical units in a southeastern Ontario teaching hospital were randomly assigned to receive 3 different levels of exposure to research: high, low and usual. On the high participation units, a clinical research group consisting of the investigator and interested nurses (n = 18) critiqued research literature related to an important clinical issue (i.e., patterns of sleep) and designed and implemented a clinical research study. On the low participation units, a similar clinical research group (n = 10) met once and were involved, solely, in the design and implementation of the clinical research protocol. On the control units, there were no formalized research groups or activities. All registered nurses (n = 235), including the research group participants, on the 6 units were surveyed with a research utilization questionnaire (RUQ) pre and post participant intervention. The RUQ scores were higher on the high participation units at baseline and post intervention in comparison to the low and control units. Nurses who participated directly in the clinical research groups (high and low) reported similar RUQ scores post intervention and higher scores in comparison to all nurses. All RUQ scores were higher post intervention. Nurses with clinical expertise but minimal research expertise participated meaningfully in clinical research. While participation had an individual effect there was no unit effect, suggesting other factors, such as organizational support and culture, are important determinants of research use.

Adult↗
PubMedDate not supplied

Changes among retailers selling cigarettes to minors.

This study analyzes changes over a three-year period among Ontario retailers selling cigarettes to minors. Under supervision, 13 and 14-year-old minors were sent into stores to attempt to buy cigarettes. These minor-purchase-events (MPEs) were carried out in a local health unit that had implemented a community-based intervention and in an adjoining comparison health unit. After the local program we observed a large reduction (from 46% to 6%) in merchants willing to sell tobacco to minors. In the neighbouring health unit, a high rate of selling continued until a federal program using a similar intervention was implemented, after which a large reduction (from 47% to 2%) was observed. This magnitude of change has been unprecedented, except when active enforcement was implemented by police officers. Thus, from a public health perspective, it is important to understand what is influencing the store operators.

Adolescent↗
PubMedDate not supplied

Tobacco access to youth: beliefs and attitudes of retailers.

Results of a telephone survey provide insights into the knowledge, attitudes and beliefs of tobacco merchants from two local health units. More than 90% of the retailers said they should not be able to sell cigarettes to minors. They are aware of laws prohibiting such sales but are sceptical about the impact on young people. The majority report being motivated to help protect the health of youth, however, they advise that legislation provides the main reason for not selling cigarettes to minors. Other responses and behaviours of the merchants help provide a profile of an important group that is being asked to stop selling tobacco to young people. The authors classify the retailers into three groups according to the potential influence on their behaviour of messages about health and threats of enforcement. One of the health units had implemented a local intervention, therefore we also compare responses between the two health units. This type of information can be used when selecting strategies to strengthen health policies. Such policies and strategies should include input and feedback from retailers of tobacco.

Adolescent↗