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M Patrick

Publications and source records attributed to M Patrick.

At least 37 records · Page 2Linked to original sources
PubMed1995

Survival of Campylobacter jejuni in foods and comparison with a predictive model.

Campylobacter jejuni was inoculated into a range of raw and cooked foods and survival determined during storage at 2 degrees, 10 degrees and 20 degrees C for up to 56 d. To facilitate easy enumeration, two antibiotic-resistant strains of Camp. jejuni, which had similar survival characteristics to the parent strain, were used. Campylobacter jejuni survived for longer at lower temperatures in all foods and inactivation was most rapid in pâté. There was generally good agreement between the survival data and predictions from a Camp. jejuni survival model (Food MicroModel).

Anti-Bacterial Agents↗
PubMed1994

Health care benchmarking: a team approach.

The management tool of benchmarking, widely used in industry for more than a decade, is today being adapted for health care organizations. Hospitals and other health care providers are developing ways to compare their practices, processes, and resulting outcomes with other organizations in order to discover "best practices." This article describes a team approach to health care benchmarking and details several projects being conducted by hospitals in The SunHealth Alliance. The examples include benchmarking for both operational and clinical processes.

Cardiology Service, Hospital↗
PubMed1993

Osmolality electrolyte and carbohydrate type and oral rehydration solutions: a controlled study to compare the efficacy of two commercially available solutions (osmolalities 240 mmol/L and 340 mmol/L).

An open-label, inpatient study was undertaken to compare the efficacy of two oral rehydration solutions (ORS) given randomly to children aged 1-10 years who had acute gastroenteritis with mild or moderate dehydration (n = 45). One solution contained 60 mmol/l sodium and 1.8% glucose, total osmolality 240 mosm/l (Gastrolyte, Rhone-poulenc, Rorer) and the other contained 26 mmol/l sodium, 2.7% glucose and 3.6% sucrose, total osmolality 340 mOsm/l (Glucolyte, Gilseal). Analysis of data indicated that Gastrolyte therapy resulted in significantly fewer episodes and volume of vomiting over all time periods in comparison to Glucolyte and significantly less stool volume during the first 8 h and in the 0-24 h period. The differences between treatments in degree of dehydration at each follow-up period, duration of diarrhoea, and duration of hospital stay were not significant. No adverse drug reactions occurred. Six patients received intravenous rehydration treatment and were considered treatment failures. We conclude that oral rehydration therapy is safe and efficacious in the management of dehydration in acute diarrhoea and that the lower osmolar rehydration solution has clinically marginal advantages.

Acute Disease↗
PubMed1991

Malnutrition in children with chronic liver disease accepted for liver transplantation: clinical profile and effect on outcome.

The nutritional profiles of 37 children (aged 0.5-14.0 years) with chronic liver disease at the time of acceptance for orthotopic liver transplantation (OLTP) have been evaluated using clinical, biochemical and body composition methods. Nutritional progress while waiting for a donor has been related to outcome, whether transplanted or not. At the time of acceptance, most children were underweight (mean standard deviation (s.d.) weight = -1.4 +/- 0.2) and stunted (mean s.d. height = -2.2 +/- 0.4), had low serum albumin (27/35) and had reduced body fat and depleted body cell mass (measured by total body potassium--mean % expected for age = 58 +/- 5%, n = 15). Mean ad libitum nutrient intake was 63 +/- 5% of recommended daily intake (RDI). Those who died while waiting (n = 8) had significantly lower mean initial s.d. weight compared with those transplanted. The overall actuarial 1 year survival of those who were transplanted (mean waiting time = 75 days) was 81% but those who were initially well nourished (s.d. weight greater than -1.0) had an actuarial 1 year survival of 100%. There were no significant differences in actuarial survival in relationship to age, type of transplant (whole liver or segmental), liver biochemistry or the presence or absence of ascites. Of the total group accepted for OLTP, whether transplanted or not, the overall 1 year survival for those who were relatively well nourished was 88% and for those undernourished (initial s.d. weight less than -1.0) was 38% (P less than 0.003). Declining nutritional status during the waiting period also adversely affected outcome.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Cyclosporin-responsive enteropathy and protracted diarrhea.

We describe a child born to unrelated parents who developed severe protracted secretory type diarrhea associated with subtotal villus atrophy and intestinal inflammation at the age of 19 months. No infectious, metabolic, or anatomical basis for this condition was identified and the child required total parenteral nutrition for a period of 18 months despite trials of special enteral formulas, steroids, and anti-inflammatory agents. This refractory "enteropathy" responded dramatically to the introduction of cyclosporin, with cessation of the secretory diarrhea, recovery from the enteropathy, and cessation of parenteral nutrition. The symptoms relapsed when cyclosporin was briefly discontinued and improved following reintroduction of this drug. This experience suggests a role for immune factors in the pathogenesis of the enteropathy in this case and that a trial of cyclosporin is worthy of consideration in similar cases.

Cyclosporins↗
PubMed1990

A two year follow up of new long-stay patients in an inner city district general hospital.

In 1967 Magnus described 'the new chronics', patients admitted to a psychiatric hospital who then stayed for more than one year. Since that time many studies have examined this patient group but the majority have focussed on psychiatric hospital populations. There is some doubt, however, as to whether the characteristics of new-long stay patients in District General Hospital (DGH) psychiatric in-patient units are comparable. The current paper describes a two year follow-up study of Medium and New-Long Stay patients identified within an inner-city DGH unit in 1986. Elderly patients with affective disorders and patients with organic brain syndromes were particularly highly represented. Length of stay at the time of the original survey, male sex, associated physical disability, and the presence of a secondary diagnosis were particularly associated with poor outcome. The results are discussed in relation to service provision.

Adult↗
PubMed1990

The gerontological nurse practitioner in the nursing home: 12 years later.

Comparing graduates of a GNP program 12 years ago with those graduating from a recent program revealed that GNPs are now staying in their roles. This is in spite of a number of barriers to practice over the years. GNPs also are continuing to work in nursing homes. At the University of Washington, we believed that training and hiring GNPs was one way to improve the care of patients in nursing homes. Our program was designed to meet that goal. That it has been achieved is evidenced by the low turnover and the GNPs' satisfaction in their roles. States should therefore encourage nursing homes to hire GNPs, as in Washington. As the clinical arm for the director of nursing service, and working together with the physician, the GNP can improve patient care as never before.

Geriatric Nursing↗
PubMed1989

Nursing assistant turnover in nursing homes and need satisfaction.

1. Level of Maslow's Hierarchy of Needs is basic physiological needs measured by salary, adequate housing, and food. Attainment of these needs increased the length of stay of nursing assistants in nursing homes. 2. Safety and security (level 2) influenced length of stay of nursing assistants. Those with benefits of retirement, vacation, and holiday pay tended to have less turnover. 3. Praise by the patient and family was most important to nursing assistants. Belonging to a peer group and praise by charge nurse also decreased turnover of nursing assistants (level 3). 4. Level 4, self-esteem measured by input into decisions and being able to criticize, increased length of stay of nursing assistants.

Adolescent↗
PubMed1988

Intestinal anaphylaxis: in vivo and in vitro studies of the rat proximal colon.

The response of the rat proximal colon to an immunoglobulin E (IgE)-mediated hypersensitivity reaction was examined. Rats were sensitized to egg albumin (EA) by intraperitoneal injection, and serum titers of specific anti-EA IgE were measured at 14 days. Sensitized animals had titers of greater than or equal to 1:64, whereas no anti-EA IgE antibodies were detected in controls. Water and electrolyte absorption in the proximal colon, before and during antigen challenge, was measured by in vivo marker perfusion. Antigen challenge resulted in significant inhibition of water, Na+, Cl-, and K+ absorption in vivo. Proximal colonic tissue from sensitized and control animals was studied in Ussing chambers under short-circuited conditions. Antigen challenge of sensitized tissue resulted in significant increases in short-circuit current due to the induction of active Cl- secretion. No such changes were seen in control tissue. The abnormalities induced by antigen challenge in tissue from sensitized animals was blocked by doxantrazole (10(-3) M), a mast cell stabilizer. The findings indicate that IgE-mediated reactions in rat proximal colon to a food protein cause pertubations in water and electrolyte transport secondary to active Cl- secretion and these abnormalities appear to be due to mast cell degranulation.

Anaphylaxis↗
PubMed1987

Comparison of conventional intermittent positive pressure ventilation with high frequency jet ventilation. Studies following aortocoronary bypass graft surgery.

This study was designed to compare the cardiorespiratory effects of high frequency jet ventilation at 150 breaths/minute with and without added positive and expiratory pressure, with conventional intermittent positive pressure ventilation in 20 patients following aortocoronary bypass graft surgery. On comparison with intermittent positive pressure ventilation, there was a decrease in peak airway pressure during high frequency jet ventilation when positive and expiratory pressure of 0 or 0.5 kPa was applied, but not with 1 kPa, and an increase in mean airway pressure with positive end expiratory pressures of 0.5 and 1 kPa. On changing from intermittent positive pressure to high frequency jet ventilation with no added end expiratory pressure, there was an acute decrease in arterial oxygen tension and increases in cardiac output and total tissue oxygen delivery. On changing from intermittent positive pressure ventilation to high frequency jet ventilation with 1 kPa of positive end expiratory pressure, there was an acute decrease in arterial oxygen tension, cardiac output and oxygen delivery, and increases in pulmonary arterial, right atrial and pulmonary capillary wedge pressures. The addition of positive end expiratory pressure did not prevent the acute decrease in arterial oxygen tension which occurred on transfer to high frequency jet ventilation.

Adult↗
PubMed1984

Alfentanil-supplemented anaesthesia for short procedures. A double-blind comparison with fentanyl.

Eighty unpremedicated female patients undergoing short gynaecological procedures were randomly allocated to four groups and received either alfentanil or fentanyl (double-blind), together with Althesin-oxygen or methohexitone-nitrous oxide'-oxygen. Recovery from anaesthesia was assessed using the post-box test and the deletion of p. There was a significantly greater frequency of vomiting after operation (P less than 0.05) with methohexitone compared with Althesin and with fentanyl compared with alfentanil, and a significantly greater frequency of pain on injection (P less than 0.001) with methohexitone compared with Althesin. The alfentanil groups completed the post-box test significantly earlier after operation than the fentanyl groups (P less than 0.05). We conclude that alfentanil may offer a significant advantage over fentanyl as an analgesic supplement to i.v. anaesthesia for short procedures.

Adjuvants, Anesthesia↗