Biomedical subjects

M Waycaster

Publications and source records attributed to M Waycaster.

4 recordsLinked to original sources

PubMed1988

Delayed hypersensitivity on a surgical service.

Two hundred patients assessed for nutritional deficiencies were analyzed for reaction to skin testing with common antigens and the incidence of sepsis and death. Only 39% of all skin tests were positive, though 50% of the patients had at least one positive test. Associated diagnoses revealed a high incidence of malnutrition, cancer, radiation therapy, and chemotherapy. Analysis using Chi-square and Gamma shows good statistical correlation between skin tests and sepsis and death. Those with negative tests (anergic) using PPD, Candida, and mumps had a threefold higher mortality. Major sepsis also increased in the skin negative group (+80%), but here the incidence varied directly with the number of positive skin tests. Mortality, unlike sepsis, was influenced only by the presence of delayed hypersensitivity and was not related to the number of positive reactions. The basic rate of infection or mortality was not influenced by major surgery.

Bacterial Infections↗

PubMed1988

Triple lumen catheters for parenteral nutrition.

We retrospectively reviewed the charts of 61 patients in whom a total of 101 triple lumen catheters (TLCs) were used for parenteral nutrition for a total of 1,512 days (mean 15 +/- 11 days). Patients were categorized as those having culture-negative TLC tips either with or without infection elsewhere (groups 1 and 2, respectively) and those with culture-positive TLC tips (group 3). Temperature, WBC, alkaline phosphatase value, and SGOT level were recorded one or two days before TLC removal (period 1) and one or two days or three to five days after TLC removal (periods 2 and 3, respectively). The incidence of catheter sepsis was 4%. Fourteen other tips were contaminated. Patients in group 1 remained afebrile during all three periods, and all tips removed were culture-negative. Removal of the TLC in groups 2 and 3 caused neither defervescence nor decreased WBC. We conclude that TLCs can be used for total parenteral nutrition with a low incidence of infection, that TLC tips need not be cultured in afebrile patients without other sources of infection, and that a TLC can be safely left in place so long as the patient is afebrile. However, the risk of infection or contamination is high for catheters left in place for more than two weeks.

Bacteria↗

PubMed1987

Effects of postoperative carbohydrate overfeeding.

Forty-three indirect calorimetric studies were performed on 24 patients who received postoperative supplemental nutrition for a total of 1088 days. Patients were retrospectively grouped into Group 1 (G1) (respiratory quotient greater than 0.95) and Group 2 (G2) (respiratory quotient less than 0.95). The two groups had similar preoperative biochemical values, prognostic nutritional index, nitrogen intake and excretion, predicted resting energy expenditure and caloric intake. Minimal postoperative biochemical changes were noted between the two groups. Postoperative length of stay was longer for GI than GII patients (P = NS). However, septic episodes and mortality were higher (100% vs 40% and 28% vs 10%, P greater than 0.05), respectively, in G1 than in G2 patients. It is concluded that carbohydrate overfeeding may be associated with a high morbidity and mortality.

Adult↗

PubMed1983

Prognostic Nutritional Index: its usefulness as a predictor of clinical course.

Despite mounting evidence, a question still exists as to the true clinical relevance of varying degrees of malnutrition, the role of currently measured nutritional parameters in identifying malnutrition and predicting clinical risk in individual patients, and the efficacy of nutritional therapy. This study was designed to document the usefulness of the Prognostic Nutritional Index (PNI) as a predictor of clinical course. The nutritional assessments and clinical records of 328 subjects in a Veterans Administration Hospital were reviewed, PNI and complication rates were determined for each of the subjects, and the data statistically analyzed. The PNI was found to be a useful indicator of malnutrition and predictor of clinical course. The PNI appeared to be a more sensitive index of clinical outcome than did comparison of individual nutritional parameters to accepted norms, although it accounted for only 17% of the information needed to predict clinical course perfectly.

Adult↗