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Biomedical subjects

R Dworkin

Publications and source records attributed to R Dworkin.

11 recordsLinked to original sources
PubMed1994

Reality of glove use and handwashing in a community hospital.

BACKGROUND: Since the advent of universal precautions and body substance isolation, few studies have examined the relationship between glove use and handwashing. METHODS: During a 5-month period in 1991, 477 structured observations were conducted on 19 patients care units at a community teaching hospital during each of three shifts. Patient care contacts were defined as either high level or low level according to potential for blood or body fluid contact. RESULTS: Health care workers were potentially exposed to body fluids (high-level contact) on 152 occasions. Eighty-eight percent of all high-level contacts were limited to the hands; 47% of these contacts occurred during the night shift. Handwashing occurred after 32% of high-level contacts. Health-care workers wore gloves in 57% of high-level contacts. Rates of handwashing and glove use varied markedly among patient care units. Correct handwashing (> or = 9 seconds) occurred after 20% of contacts when health care workers wore gloves but after only 3% of high-level contacts when gloves were not used (p = 0.004). CONCLUSIONS: Despite universal precautions or body substance isolation, educational efforts, and written policies, rates of handwashing and glove use are inadequate in cases of potential blood and body fluid contact. The perceived need for gloves may encourage handwashing.

Blood↗
PubMed1993

Correlation of tobramycin-induced inhibition of protein synthesis with postantibiotic effect in Escherichia coli.

Scant data exist on intracellular events during aminoglycoside-induced postantibiotic effect (PAE). We examined DNA, RNA, and protein syntheses after tobramycin exposure using [3H]thymidine, [14C]uracil, and [14C]alanine incorporation in a clinical Escherichia coli strain. Late-log-phase bacteria in oxygenated minimal salts medium at 37 degrees C were exposed to tobramycin (7.5 micrograms/ml) (twice the MIC) for 30 min. Tobramycin caused a kill of 2 log10 CFU/ml prior to drug removal by filtration and a 5-h PAE, measured by viable counts. Excess amounts of labelled precursors were added to tobramycin-exposed organisms during, immediately after, and at various intervals following exposure. In the presence of tobramycin, DNA, RNA, and protein syntheses were sequentially inhibited within 1 generation time. Following drug removal, both DNA and RNA syntheses promptly resumed, suggesting readily dissociable nonspecific binding to DNA and RNA. However, total protein synthesis did not resume until 4 h later. beta-Galactosidase activity, a measure of functional enzymatic protein synthesis, was also inhibited for 4 h after drug removal. Bacterium length, measured by confocal microscopy, increased during PAE. Two distinct populations eventually emerged: one that returned to control dimensions and one that remained excessively elongated by the end of PAE (2.5 microns versus 4.0 microns; P < 0.05). We hypothesize that only viable cells return to the control morphology. Flow cytometry showed enhanced DNA complexity during PAE, consistent with either impaired cellular protein synthesis in viable cells or perturbations in dying cells. In summary, duration of PAE correlated with inhibition of total and functional protein synthesis but not DNA or RNA synthesis.

Bacterial Proteins↗
PubMed1990

The effective tracheal diameter that causes air trapping during jet ventilation.

Jet ventilation consists of injection of gas at high flow rates through a small-diameter tracheal catheter. Air trapping (increase in end-expiratory lung volume) can occur during jet ventilation if the diameter of the trachea proximal to the tracheal catheter tip is too small (at least at one point in the trachea) to permit complete exhalation of the tidal volume around the tracheal catheter (ie, through the effective tracheal diameter). A mechanical lung model was used to determine the critical effective tracheal diameter at which air trapping starts to occur during jet ventilation. The experiment allowed derivation of a multivariable equation, namely: [formula: see text] to express the tidal volume produced by jet ventilation (y) as a function of gas flow rate (C), jet injection time (D), lung compliance (B), upper airway resistance (A), and effective tracheal diameter (E). As A to D increased and E decreased, y increased. More importantly, exhalation time was measured over the full range of values for A to E, and it was found that for every possible combination of values for A to D, there was always a unique critical effective tracheal diameter, 4.0 to 4.5 mm, that began to cause a very large increase in expiratory time (and with a sufficiently rapid respiratory rate [greater than 12 beats/min in this experiment], air trapping). Thus, when lung/jet ventilation factors tend to promote entry of jetted gas into the lungs (increased A to D, decreased E), even a small tidal volume has difficulty exiting the lung, if E is smaller than 4.5 mm.(ABSTRACT TRUNCATED AT 250 WORDS)

Airway Resistance↗
PubMed1990

Comparative efficacies of ciprofloxacin, pefloxacin, and vancomycin in combination with rifampin in a rat model of methicillin-resistant Staphylococcus aureus chronic osteomyelitis.

The efficacies of the quinolones ciprofloxacin and pefloxacin alone and in combination with rifampin were compared with those of vancomycin alone and in combination with rifampin in a rat model of chronic osteomyelitis caused by methicillin-resistant Staphylococcus aureus. Neither the quinolones nor vancomycin alone was effective in reducing titers of organisms in bone after therapy, while rifampin alone was effective. All combination regimens with rifampin were more effective than the regimen with rifampin alone was, although these differences did not achieve statistical significance. Rifampin-resistant isolates were detected rarely. Quinolone-rifampin combination regimens may offer a nonparenteral option for the treatment of chronic osteomyelitis caused by methicillin-resistant S. aureus.

Animals↗
PubMed1986

The accuracy of children's self-reports of diet: Family Health Project.

This study was designed to test the accuracy of four different methods for enabling children in the third to sixth grades to record their frequency of consumption of foods high in any of four targeted nutrients. The forms varied in two ways: recording the whole day or a segment of the day (morning, afternoon, or evening) or use or non-use of pictures of the food items. The accuracy of the children's recording of food consumption was validated by observation of their behavior for 2 continuous 12-hour days. Twenty-four children in the third to sixth grades were observed for each of the 2 days. An 82.9% agreement was obtained between the child's self-reported food frequency and the observer's record of the child's consumption. Ethnicity slightly affected the accuracy of form completion, while gender and grade level of the children did not. The results of this study validate the accuracy with which children record diet using a food frequency of consumption method.

Child↗
PubMed1983

Theory-based health education activities for third to sixth grade children.

Eight educational activities based on social learning and social support theories were used as part of a comprehensive cardiovascular risk reduction program for families with children in the third to sixth grades. These activities focused on providing the children with skills in recognizing high-salt and high-saturated fat foods, preparing such foods, resisting pressures to each such foods, increasing aerobic activity and providing support to peers and family in attempting such changes. Data analyses revealed significantly greater decreases in high-salt and high-saturated, fat food consumption and perceived increases in aerobic activity, in the experimental than the control group. The participative, enjoyment and inexpensive aspects of these activities are emphasized to encourage their use in school health programs.

Cardiovascular Diseases↗
PubMed1983

The family health project: cardiovascular risk reduction education for children and parents.

The principles of family support and of social learning theories were applied to a feasibility study of working directly with family units in a health education program. Twenty-four Anglo, Black, and Mexican-American families of young elementary school children participated in a 3-month cardiovascular risk reduction education project which included eight weekly evening sessions designed to assist families to decrease the frequency of consumption of foods high in sodium and in saturated fats, and to increase the frequency of aerobic exercise. Statistically significant differences between randomly assigned treatment and control groups were noted for reported consumption of high sodium foods and of foods high in saturated fats. Experimental subjects gained more knowledge of factors influencing cardiovascular risk, even though the intervention was behaviorally, rather than cognitively, based. This method of health promotion is deserving of further study.

Adolescent↗