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Biomedical subjects

P Lewis

Publications and source records attributed to P Lewis.

At least 19 recordsLinked to original sources
PubMed1992

Human immunodeficiency virus infection of cells arrested in the cell cycle.

Cell proliferation is necessary for proviral integration and productive infection of most retroviruses. Nevertheless, the human immunodeficiency virus (HIV) can infect non-dividing macrophages. This ability to grow in non-dividing cells is not specific to macrophages because, as we show here, CD4+ HeLa cells arrested at stage G2 of the cell cycle can be infected by HIV-1. Proliferation is necessary for these same cells to be infected by a murine retrovirus, MuLV. HIV-1 integrates into the arrested cell DNA and produces viral RNA and protein in a pattern similar to that in normal cells. In addition, our data suggest that the ability to infect non-dividing cells is due to one of the HIV-1 core virion proteins. HIV infection of non-dividing cells distinguishes lentiviruses from other retroviruses and is likely to be important in the natural history of HIV infection.

Base Sequence↗
PubMed1992

Comparison of plain with pH-adjusted bupivacaine with hyaluronidase for peribulbar block.

Fifty patients scheduled for cataract surgery under peribulbar block were randomised to receive either plain (pH 5.4) or pH-adjusted (pH 6.8 range 6.7-6.9) 0.75% bupivacaine. Hyaluronidase was added to both solutions prior to peribulbar block. The time of onset of akinesia of the globe and the need for supplementary injections were recorded by an independent observer. Patients who returned for surgery to the second eye received the alternative local anaesthetic solution for the second peribulbar block. The relative efficacy of the different anaesthetic solutions was compared in patients who underwent unilateral surgery (Group A, n = 50). In 12 patients (Group B) who underwent bilateral surgery, direct comparisons between eyes in the same patient were possible. In both groups of patients, eyes receiving peribulbar block with the pH-adjusted solution showed a shorter time to partial akinesia of the globe (P less than 0.05). However, there was no difference between the solutions in the time to complete akinesia of the globe, but the number of supplementary injections required for an effective block with the pH-adjusted solution was increased. Onset time to akinesia of the lateral and superior rectus muscles was shortened in patients receiving the pH-adjusted solution but there were minimal effects on the medial and inferior recti.

Anesthesia, Local↗
PubMed1992

Infection control practices in cardiac transplant recipients. The Research Committee, Houston-Gulf Coast Chapter of the American Association of Critical-Care Nurses.

Infection is a common cause of morbidity and mortality among transplant recipients. Infection control measures lie within the realm of nursing interventions and involve large expenditures of resources. Because transplantation is such a new specialty, few standards exist. The research question for this study was What nursing interventions are being used to prevent infection in cardiac transplant recipients? A 156-item questionnaire was developed that included isolation procedures, dressings, invasive lines, medications, staffing, staff education, dress codes, unit design, visitation, infections, length of stay, survival, and other demographic data. Content validity was established by a panel of transplant experts. After local piloting, the tool was mailed to 120 cardiac transplant centers, and 68 were returned completed. Data were analyzed using descriptive and correlational statistics. Findings revealed wide diversity in practice. Older and larger transplant programs tended to use fewer precautions. Survival rates appeared unrelated to the number of precautions used.

Heart Transplantation↗
PubMed1991

Gastric fluid volume and pH in elective patients following unrestricted oral fluid until three hours before surgery.

This clinical study was designed to assess the results of new preoperative fasting guidelines in which patients are instructed that they must not eat any solid food after midnight, but that they may drink unrestricted amounts of clear fluid until three hours before their scheduled time of surgery. We studied 199 healthy, elective surgical inpatients aged 18-70 yr to determine whether there was any correlation between the ingestion interval or the volume of fluid ingested, with the volume and pH of residual gastric fluid at induction of anaesthesia. Pregnant patients, and those with gastric disorders or who were taking medications that affect gastric motility or secretion, were excluded. Either no premedication was given, or oral diazepam 5-15 mg was given 90 min preoperatively. Of the 199 patients, 105 ingested 50-1200 ml on the morning of surgery. The ingestion-induction interval was less than three hours in 12 patients whose actual surgery time was ahead of schedule. The remaining 94 patients did not drink because they were scheduled for surgery before 11:00 (n = 51), they did not want to drink (n = 24), or they were advised not to drink by their nurse or surgeon (n = 16). Following induction of anaesthesia, gastric fluid was aspirated through a #18 Salem sump orogastric tube, the volume was recorded and pH was measured with a calibrated pH meter. Patients were divided retrospectively into four groups (in three of which patients ingested fluid) according to the ingestion-induction interval (1.3-3.0 hr, 3.1-5.0 hr, 5.1-8.0 hr, and nothing by mouth after midnight).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Urodynamic morbidity and dysuria prophylaxis.

A group of 324 patients received prophylactic treatment with either sodium bicarbonate, potassium citrate or a glucose placebo following urodynamic studies. Urine was screened for infection both before and after testing and the incidence of dysuria assessed by postal questionnaire; 63% of patients experienced some degree of dysuria and this was severe and prolonged in 6.3%, the majority of whom were male. Neither sodium bicarbonate nor potassium citrate was any more effective in preventing dysuria than placebo. The presence of severe prolonged dysuria was not associated with a urinary tract infection or with any particular urodynamic diagnosis.

Bacteriuria↗
PubMed1991

Effects of dextromethorphan on rat brain during ischemia and reperfusion assessed by magnetic resonance spectroscopy.

Using proton and phosphorus magnetic resonance spectroscopy, we evaluated the metabolic effects of preischemic administration of the N-methyl-D-aspartate antagonist dextromethorphan (50 mg/kg i.p.) during global forebrain ischemia and subsequent reperfusion in rats. Dextromethorphan-treated animals (n = 10) showed less lactate formation during ischemia than untreated animals (n = 11, p less than 0.001). During reperfusion, the lactate level in the treated group was reduced (p less than 0.05). Tissue pH declined less in the treated group during ischemia (p less than 0.01). There was no difference in the phosphocreatine/inorganic phosphate peak height ratio between groups. During ischemia, the N-acetylaspartate resonance peaks decreased in both groups. Histologic damage assessed in the hippocampal CA1 region 7 days after the ischemic insult was more severe in the untreated group (p less than 0.05). There was a significant correlation between end-ischemic tissue pH and hippocampal damage (r = -0.73, p less than 0.05). In the dextromethorphan-treated animals, 90% of the rats survived compared with 47% of the untreated animals (p less than 0.05). These results support findings in previous studies that dextromethorphan attenuates ischemic damage.

Animals↗
PubMed1991

Elicited responding in chain schedules.

An omission procedure was employed to study elicited pecking in the first component of a two-component chain schedule. Both components were fixed-interval schedules correlated with colored keylights. The first response following the initial-link schedule produced a second fixed-interval schedule. We studied several fixed-interval lengths in two conditions: a standard response-dependent condition and an omission-contingent condition. The omission-contingent condition differed from the response-dependent condition in that responses during the initial fixed interval terminated the trial (omitting the terminal component and grain). If the terminal component was not omitted, a response following the terminal link's requirement produced 4-s access to grain. Pigeons responded during more than 70% of the initial links in the omission-contingent condition and responded during more than 90% of the initial links in the response-dependent condition. In general, rates of responding were consistent with the percentage data. The responding in the omission condition suggests that there may be elicited pecking, in chain schedules using pigeons, that is not the result of contingent conditioned reinforcement.

Animals↗
PubMed1991

Stimulus generalization, discrimination learning, and peak shift in horses.

Using horses, we investigated three aspects of the stimulus control of lever-pressing behavior: stimulus generalization, discrimination learning, and peak shift. Nine solid black circles, ranging in size from 0.5 in. to 4.5 in. (1.3 cm to 11.4 cm) served as stimuli. Each horse was shaped, using successive approximations, to press a rat lever with its lip in the presence of a positive stimulus, the 2.5-in. (6.4-cm) circle. Shaping proceeded quickly and was comparable to that of other laboratory organisms. After responding was maintained on a variable-interval 30-s schedule, stimulus generalization gradients were collected from 2 horses prior to discrimination training. During discrimination training, grain followed lever presses in the presence of a positive stimulus (a 2.5-in circle) and never followed lever presses in the presence of a negative stimulus (a 1.5-in. [3.8-cm] circle). Three horses met a criterion of zero responses to the negative stimulus in fewer than 15 sessions. Horses given stimulus generalization testing prior to discrimination training produced symmetrical gradients; horses given discrimination training prior to generalization testing produced asymmetrical gradients. The peak of these gradients shifted away from the negative stimulus. These results are consistent with discrimination, stimulus generalization, and peak-shift phenomena observed in other organisms.

Animals↗
PubMed1990

Metabolic causes of myoglobinuria.

To evaluate the proportion of cases of myoglobinuria that can be ascribed to specific metabolic defects, we have studied eight enzymes--phosphorylase, phosphorylase kinase, phosphofructokinase (PFK), phosphoglycerate kinase (PGK), phosphoglycerate mutase (PGAM), lactate dehydrogenase (LDH), carnitine palmitoyltransferase (CPT), and myoadenylate deaminase (MAD)--in muscle biopsy specimens from 77 consecutive patients with myoglobinuria (documented in 44, suspected in 33). Enzyme defects were found in 36 patients: CPT deficiency in 17, phosphorylase deficiency in 10, phosphorylase kinase deficiency in 4, MAD deficiency in 3, PGK deficiency in 1, and a combined defect of CPT and MAD in 1. Exercise was the main precipitating factor, both in patients with and in those without detectable enzymopathies. Thirty patients had specific enzymopathies without myoglobinuria: 14 had phosphorylase deficiency, 9 had MAD deficiency, 3 had phosphorylase kinase deficiency, 3 had PFK deficiency, and 1 had PGAM deficiency. Systematic biochemical evaluation of muscle biopsy specimens revealed specific enzymopathies in about half of the patients with idiopathic myoglobinuria. The rest may have blocks of metabolic pathways not yet studied routinely, such as beta oxidation, or genetic defects of the sarcolemma, such as Becker's muscular dystrophy.

AMP Deaminase↗
PubMed1990

Common femoral artery volume flow in peripheral vascular disease.

Common femoral artery volume flow was measured at rest and during postocclusive reactive hyperaemia in 80 normal subjects and 67 patients with radiological evidence of occlusive peripheral vascular disease. At rest, means(s.d.) common femoral artery volume flow in normal subjects (344(135) ml/min) and all patients with peripheral vascular disease (401(168) ml/min) was not significantly different. During postocclusive reactive hyperaemia, mean(s.d.) peak flow was significantly higher in normal subjects (1951(438) ml/min) than in patients with peripheral vascular disease (996(457) ml/min) (P less than 0.01). Common femoral artery volume flow in patients with critical ischaemia and intermittent claudication did not differ at rest but mean(s.d.) peak flow in patients with critical ischaemia (697(276) ml/min) was significantly lower than in claudicants (1131(447) ml/min) (P less than 0.01). Mean(s.d.) resting common femoral artery volume flow in limbs with femoropopliteal disease (457(185) ml/min) was significantly greater than that in limbs with occlusion of the aortoiliac segment (308(130) ml/min) (P less than 0.01). However, this difference did not persist during postocclusive reactive hyperaemia. A hyperaemic index, calculated from the hyperaemic responses to below knee and whole limb ischaemia, was used to quantify segmental perfusion during postocclusive reactive hyperaemia. The mean(s.d.) value in normal subjects, 46(9) per cent, and in those with aortoiliac disease, 52(12) per cent, indicated approximately equal perfusion of the above and below knee limb segments. In those with femoropopliteal disease the mean(s.d.) hyperaemic index was 17(13) per cent, revealing relative hypoperfusion of the below knee segment.

Adult↗