Biomedical subjects

R Acuff

Publications and source records attributed to R Acuff.

4 recordsLinked to original sources

PubMed1996

Optimizing physician access to surgical intensive care unit laboratory information through mobile computing.

Approximately 30 minutes of computer access time are required by surgical residents at Stanford University Medical Center (SUMC) to examine the lab values of all patients on a surgical intensive care unit (ICU) service, a task that must be performed several times a day. To reduce the time accessing this information and simultaneously increase the readability and currency of the data, we have created a mobile, pen-based user interface and software system that delivers lab results to surgeons in the ICU. The ScroungeMaster system, loaded on a portable tablet computer, retrieves lab results for a subset of patients from the central laboratory computer and stores them in a local database cache. The cache can be updated on command; this update takes approximately 2.7 minutes for all ICU patients being followed by the surgeon, and can be performed as a background task while the user continues to access selected lab results. The user interface presents lab results according to physiologic system. Which labs are displayed first is governed by a layout selection algorithm based on previous accesses to the patient's lab information, physician preferences, and the nature of the patient's medical condition. Initial evaluation of the system has shown that physicians prefer the ScroungeMaster interface to that of existing systems at SUMC and are satisfied with the system's performance. We discuss the evolution of ScroungeMaster and make observations on changes to physician work flow with the presence of mobile, pen-based computing in the ICU.

Algorithms↗

PubMed1994

Lipid content of microparticulate (1-->3)-beta-D-glucan isolated from Saccharomyces cerevisiae.

The preparation of pharmaceutical grade (1-->3)-beta-D-glucans from Saccharomyces cerevisiae requires that the microparticulate glucans which are employed as the starting material for drug production be of the highest purity. Potential contaminants of the (1-->3)-beta-D-glucan isolation process are yeast cell wall lipids, which are frequently found in association with glucans. The lipid content of yeast-derived (1-->3)-beta-D-glucan during various stages of the isolation process by methyl esterification and total ion gas chromatography and mass spectrometry (GC-MS) was examined. Following sequential alkaline and acid hydrolyses, the total lipid content of (1-->3)-beta-D-glucan was 100.4 nmol/mg with 9-cis-C 18:1 fatty acid accounting for 45.3 nmol/mg glucan (45%). Following ethanol extraction of the (1-->3)-beta-D-glucan, lipid was not detected. Indeed, fatty acid methyl esters were not detectable by total ion GC-MS in all twelve samples investigated. These data demonstrate that the isolation process for yeast-derived (1-->3)-beta-D-glucan effectively reduces contamination by yeast cell wall lipids.

Cell Wall↗

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↗

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↗