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Biomedical subjects

N Kelly

Publications and source records attributed to N Kelly.

35 records · Page 2Linked to original sources
PubMed1993

An analysis of ischemic stroke in an urban southern California population. The University of California, San Diego, Stroke Data Bank.

BACKGROUND: Stroke databanks may provide important information regarding regional and temporal variations in the causes of stroke. METHODS: Five hundred consecutive patients presenting to the University of California, San Diego, stroke services with acute ischemic stroke were evaluated prospectively. A specific cause of stroke was assigned in each case according to predetermined diagnostic criteria. RESULTS: Relative incidences of ischemic stroke causes were as follows: lacunar, 27%; unknown cause, 23%; cardioembolic, 22%; large-vessel atherothrombotic/embolic, 18%; and miscellaneous, 10%. CONCLUSIONS: These relatively high rates of lacunar stroke and stroke of unknown cause are similar to those from other recent surveys and may reflect an important shift in the pathophysiologic mechanisms that underlie ischemic stroke.

Adolescent↗
PubMed1993

Treatment of steroid-dependent asthma with recombinant interferon-gamma.

We have recently reported that treatment of patients with severe atopic dermatitis with recombinant interferon-gamma (rIFN-gamma) resulted in clinical improvement as well as a reduction of circulating eosinophils. Since IgE-dependent late phase allergic reactions and eosinophilic infiltration are thought to play an important role in the pathogenesis of asthma, we conducted a two centre randomized double-blind placebo-controlled trial of rIFN-gamma in the treatment of steroid-dependent asthma. Patients were treated with daily subcutaneous injections of either 0.05 mg/m2 rIFN-gamma (n = 9) or placebo (n = 11) for 90 days. All patients completed the study without significant drug toxicity noted. Oral prednisone dose, forced expiratory volume in 1 second (FEV1), peak expiratory flow rates (PEFR) and circulating eosinophil counts were monitored throughout the trial. There was no significant difference between the two treatment groups in per cent reduction from baseline of daily prednisone (P = 0.51). There was also no significant difference between the two treatment groups in per cent change from baseline in FEV1 (P = 0.54) or in PEFR (P = 0.75). Total circulating eosinophil counts decreased by 31% in the rIFN-gamma group and increased by 8.5% in the placebo group (P = 0.09). We conclude that this treatment regimen was not effective in patients with steroid-dependent asthma.

Adolescent↗
PubMed1992

Results and impacts of the Resource-Based Relative Value Scale.

On January 1, 1992, the Health Care Financing Administration implemented the 1989 legislation reforming the Medicare payment system for physicians' services. The cornerstone of the new payment reform is the Medicare Fee Schedule (MFS), which is based on the Resource-Based Relative Value Scale (RBRVS). In this article, the major findings of the RBRVS study and its impacts on physician payment are summarized. The authors report the impacts of a RBRVS-based fee schedule on Medicare fees and physicians' income if it were fully implemented, assuming budget neutrality and absence of volume changes in services. Under this scenario, fees for evaluation and management services increase by 15% to 45%, while fees for invasive services and diagnostic tests decrease by 20% to 30%. These changes increase the Medicare income of family practitioners by more than 30% while decreasing the income of most surgical specialties by 10% to 20%.

Economics, Medical↗
PubMed1989

Pretreatment with recombinant murine tumor necrosis factor alpha/cachectin and murine interleukin 1 alpha protects mice from lethal bacterial infection.

Tumor necrosis factor/cachectin (TNF/C) is the principal mediator of bacterial endotoxin-induced shock and death. We found that the C3H/HeJ mouse, which is less able to produce TNF/C in response to endotoxin, has a 1,000-fold greater susceptibility to lethal infection with Escherichia coli than the TNF-responsive congenic mouse, C3H/HeN. This surprising finding suggested that this lethal peptide may also be involved in host protection. To test this hypothesis we pretreated the C3H/HeJ mouse with a combination of recombinant murine TNF/C-alpha and IL-1 alpha. This combination protected these mice against an intraperitoneal bacterial challenge of greater than 20 LD50S (nearly 2 x 10(2) CFU) that grew to a level of greater than 10(7) CFU/ml of blood and per gram of liver in untreated mice. This suggests a significant role for these cytokines in host defenses against invasive infections that require bacterial replication within the host. These protective mechanisms may not be important for less virulent organisms. These findings may have important implications for the proposed use of anti-TNF/C agents in the treatment of septic shock.

Animals↗
PubMed1989

Intensive combination drug therapy of familial hypercholesterolemia with lovastatin, probucol, and colestipol hydrochloride.

Patients with familial hypercholesterolemia (FH) have had a life-long sustained elevation of low-density lipoprotein (LDL) cholesterol levels. Consequently, there is a need to maximally lower their elevated levels, and this usually requires lowering LDL levels more than 50%. Because no single hypolipidemic drug will consistently produce such degrees of lowering, combination drug therapy with two or even three agents is required to produce the desired degree of cholesterol lowering. A prospective trial was designed to determine if combination therapy using three hypolipidemic agents could effectively lower LDL levels in 17 severely affected FH subjects. Colestipol hydrochloride (10 g b.i.d.), probucol (500 mg b.i.d.), and lovastatin (20 or 40 mg b.i.d.) were given to each patient, in varying combinations, over a 25-month period. Lovastatin (40 mg/day) uniformly lowered LDL levels 36%. Probucol lowered LDL only 14% and in a variable manner. The combination of lovastatin and probucol lowered LDL no better than lovastatin alone. Lovastatin plus colestipol lowered LDL 52%; probucol added as a third agent produced no further lowering. Lovastatin (80 mg/day) plus colestipol lowered LDL 56%. Lovastatin increased high-density lipoprotein (HDL) cholesterol levels 6%, whereas probucol decreased HDL 29%. In all patients there was an effective lowering of LDL levels, ranging from 40% to 70%. Thus, lovastatin plus colestipol is an effective hypolipidemic regimen for producing marked decreases in LDL levels in FH subjects. The addition of probucol as a third hypolipidemic agent adds little to the therapeutic regimen as measured by lowering of LDL levels.

Cholesterol↗
PubMed1987

An immunohistological evaluation of Pseudomonas aeruginosa pulmonary infection in two patients with cystic fibrosis.

Pseudomonas aeruginosa is the principal pulmonary pathogen in patients with cystic fibrosis. All attempts to date to prevent or eradicate P. aeruginosa infections in these patients have been unsuccessful. Vaccination against P. aeruginosa has been proposed as a preventive strategy but it has not been adequately evaluated. The purpose of this study was to determine whether P. aeruginosa, present in the lungs of patients with cystic fibrosis, express surface antigens similar to those grown in vitro; this issue is of critical importance when choosing bacterial products as vaccine candidates. Lung sections from two patients who died of the pulmonary complications of cystic fibrosis were studied. Bacteria, both in lung sections and isolated from the lung sections and grown in vitro, reacted strongly with polyclonal and monoclonal antibodies against P. aeruginosa mucoid exopolysaccharide and outer membrane proteins F and H2; this suggested that these antigens are surface exposed in vivo. It was also found that bacteria in both lung sections were associated in situ with IgG, IgA, and C3 but not with IgM or C4.

Antibodies, Bacterial↗
PubMed1978

Affinity chromatography of bacterial lactate dehydrogenases.

The affinity system used was the immobilized oxamate derivative previously used to purify mammalian lactate dehydrogenases. The bacterial dehydrogenases specific for the L-stereoisomer of lactate behaved in the same way as the mammalian enzymes, binding strongly in the presence of NADH. The D-lactate-specific enzymes, however, did not show any biospecific affinity for this gel. The L-specific enzymes could be purified to homogeneity in one affinity-chromatographic step. The D-specific enzymes could be efficiently separated from the L-specific ones and could then be further purified on an immobilized NAD derivative. The mechanism of activation of the lactate dehydrogenase from Streptococcus faecalis by fructose 1,6-bisphosphate was investigated by using the immobilized oxamate gel.

Bacteria↗
PubMed1978

Teratology study in mice subjected to inhalation of diethylhydroxylamine, nitroethane, and diethylamine hydrogen sulfite.

Pregnant female mice were exposed from Days 6 to 17 of pregnancy to 8.9 +/- 2.0 ppm of diethylhydroxylamine and 14.3 +/- 2.0 ppm of nitroethane. Exposures were for 8.25 +/- 2.25 hours/day including weekends. The mice were also exposed continuously for 24 hours a day to the vapor of diethylamine hydrogen sulfite. The exposure produced no effect on the dams compared to the control group. There was no evidence of compound-induced terata, variation in sex ratio, embryotoxicity, or inhibition of fetal growth and development.

Administration, Inhalation↗
PubMed1967

Come to the fair.

Explore the source record for details and available documents.

Central Supply, Hospital↗
PubMedDate not supplied

Antibiotic irrigations. A plea for controlled clinical trials.

Although the medical literature describes the perioperative use of antibiotic irrigations in abdominal, pelvic, orthopedic and vascular surgery, the lack of well-designed and executed, controlled clinical studies often precludes a definitive assessment of the value of this technique. Future randomized, double-blind, controlled clinical trials are required to establish its merit. In this age of cost consciousness, lavages with antibiotic solutions cannot at present be regarded as conventional medical therapy.

Anti-Bacterial Agents↗