PubMed HealthSearch

Biomedical subjects

R Gates

Publications and source records attributed to R Gates.

At least 19 recordsLinked to original sources

Out of plan. Certain HMO characteristics affect physicians' satisfaction and influence their decision to reenroll.

The authors examine the issue of continuity, which is directly associated with patient satisfaction, from the perspective of the physician. They attempt to determine which factors are most important in determining physician satisfaction with an HMO and the link between satisfaction with an HMO and intent to remain affiliated with that HMO. Their study reveals that 11 factors explain 71% of the variation in overall physician satisfaction and that a physician's satisfaction with a plan is closely linked to intentions to reenroll. Implications for HMOs, physicians, employers, and public policy makers are explored.

Attitude of Health Personnel

Australian registered nurses and sex-based harassment in the health care industry.

This paper discusses sex-based harassment in the nursing profession in Australia. The paper generates industry-specific hypotheses which may provide insights into sex-based harassment in the Australian context. A good understanding of sex-based harassment in health care is essential for reducing and eliminating the problem and its toxic sequelae.

Australia

Contrasting in vivo effects on T helper cell functions induced by mitogenic (intact) versus nonmitogenic (F(ab')2) anti-CD3 monoclonal antibody.

Anti-CD3 mAbs are potent inhibitors of T cell function; however, administration of mitogenic mAb can cause significant morbidity secondary to T cell activation and cytokine release. Nonmitogenic anti-CD3 mAb is immunosuppressive in mice without inducing detectable morbidity, and may thus be preferable for in vivo T cell immunosuppression. The precise mechanisms of action of these two forms of mAb have not been fully defined. To further characterize and compare the in vivo functional effects of mitogenic and nonmitogenic anti-CD3 mAbs, mice were treated with the intact (mitogenic) form of the anti-murine CD3 mAb, 2C11, or with F(ab')2 fragments (nonmitogenic). Effects on T cell phenotypes and the secretion of Th1-derived cytokines were compared. Nonmitogenic mAb induced a prolonged downregulation of secretion of interleukin (IL)-2 and interferon (IFN)-gamma from CD4+ T cells, and of IL-2 secretion from CD8+ T cells, and preferential depletion of CD4+ T cells. In marked contrast, mitogenic mAb induced a prolonged upregulation of IL-2 and IFN-gamma secretion from both CD4+ and CD8+ cells, and preferential depletion of CD8+ T cells. Both forms of mAb induced a shift in the T cell populations from a naive to a memory phenotype; however, this shift was not responsible for the observed changes in cytokine secretion. These results demonstrate that mitogenic and nonmitogenic forms of 2C11, while binding to the identical epitope, differentially affect T cell functions, and have implications for the use of anti-CD3 mAbs in the clinical setting.

Animals

Use of bi-level biotinylation for concurrent measurement of in vivo recovery and survival in two rabbit platelet populations.

BACKGROUND: The objectives of this research were 1) to determine whether two populations of platelets may be labeled with different levels of biotin and followed concurrently in vivo by flow cytometry and 2) to determine whether the level of biotinylation affects the in vivo platelet recovery and survival. STUDY DESIGN AND METHODS: Two platelet aliquots were biotinylated under conditions that resulted in either a lower or a higher number of biotin molecules per platelet. After transfusion, the two populations were distinguished and quantitated by flow cytometry. RESULTS: In five animals, recoveries were 69.8 +/- 27.0 percent for low-biotin platelets and 72.6 +/- 26.7 percent for high-biotin platelets. For each animal, the recoveries agreed closely. Life span, determined by the multiple-hit method, was 2.68 +/- 0.63 days for low-biotin platelets and 2.58 +/- 0.69 days for high-biotin platelets. These values for recovery and life span are consistent with those measured in rabbits by using radioisotope labels. CONCLUSION: Platelet biotinylation offers a nonisotopic method for direct comparison of alternative harvest and storage conditions. It also offers the potential for simultaneous evaluation of the in vivo characteristics of platelets from at least two donors.

Animals

Studies with biotinylated RBC: (1) use of flow cytometry to determine posttransfusion survival and (2) isolation using streptavidin conjugated magnetic beads.

Methods are reported for the quantitation and isolation of biotinylated red blood cells (B- RBC). The first method is for determination of posttransfusional survival of rabbit RBC by flow cytometry. The survival of B-RBC was measured using both fresh and paraformaldehyde-fixed cells with similar results. The posttransfusion survival of rabbit RBC measured in this way was normal. There was no indication of increased cell destruction due to antibodies directed against B-RBC and no evidence for loss of biotin from circulating cells. The second methodology is for the isolation of B-RBC from blood with streptavidin-coated magnetic beads. At least eighty percent of positive cells were recovered with very few false positives. Both methods may be helpful in the study of resealed erythrocytes.

Animals

Complications from intra-aortic balloon counterpulsation: a review of 303 cardiac surgical patients.

From January 1980 to January 1990 all patients undergoing cardiac surgery at the Royal North Shore Hospital, Sydney, and requiring intra-aortic balloon counterpulsation (IABCP) were retrospectively reviewed. A total of 99 patients (32.6%) developed complications. Vascular/haemorrhagic complications occurred in 46 patients (15.2%); 79 patients (26%) required platelet transfusions. We have found that only a history of hypertension was predictive of an increased incidence of developing vascular complications. Surgical intervention was required in 17 patients (5.6%), or 47% of the patients who developed a vascular complication. The mortality among patients requiring IABCP was 36.6%. Intra-aortic balloon pump-related deaths occurred in 6 patients (2%). Use of the intra-aortic balloon pump can be a life-saving procedure, but it carries a significant morbidity and mortality rate. This makes it imperative to temper our indications to those patients who demonstrate a need for it.

Adult

Who leaves the service area? Profiling the hospital outshopper.

Rural hospitals are facing a crisis of major proportions. Declining patient loads, revenues, and profits are the norm. The authors find that in rural communities, the likelihood of going to the local hospital increases with age and may decrease with income.

Adolescent

Disseminated cutaneous and synovial Mycobacterium marinum infection in a patient with systemic lupus erythematosus.

A patient with systemic lupus erythematosus had a protracted skin infection with Mycobacterium marinum after a puffer fish sting. Disseminated cutaneous and synovial disease was associated with clinically active systemic lupus erythematosus two years after the initial infection. The infection was poorly responsive to multiple antituberculous regimens. Hematogenous spread of infection was the likely route of dissemination.

Adult

Comparison of chromosome analysis to DNA content by flow cytometry for pediatric tumors.

Chromosome analyses in a series of 50 pediatric tumor samples showed abnormal chromosome number, ranging from hypodiploid to tetraploid. Aliquots of the same solid tumor samples were analyzed by flow cytometry (FCM). Material from spontaneous abortions and 12 tumor samples with normal chromosomes were also compared in a control series of 83 samples. Tumors or abortuses with 44-48 chromosomes could not be differentiated from material with normal diploid complement by FCM. However, greater than or equal to 3-4 extra chromosomes produced detectable differences in mean DNA index. Triploidy and tetraploidy were readily identified by FCM. It is concluded that FCM could identify an important group of hyperdiploid pediatric tumors, as well as 3N and 4N tumor complements.

Child

Documenting safe treatment of the medical-risk patient.

An easily mastered safe treatment documentation system is presented. The routine consists of two parts, a comprehensive yet manageable medical history and a treatment modification record. Millions of medically compromised patients may now receive comprehensive care in safety.

Anesthesia, Dental

Folacin status in adolescent females.

The folacin status of 103 adolescent females aged 12, 14, and 16 y was evaluated. In the third year, longitudinal data regarding folacin status was obtained from 50 girls aged 14 and 16 y who had participated in the first year. In the first year, 11.7% and 47.6% of the girls had serum and erythrocyte folacin levels less than 3 ng/mL (6.8 nmol/L) and 140 ng/mL (317 nmol/L), respectively. Serum folacin levels and dietary folacin intake decreased with increasing age but not significantly. During the first year, 75% and 66% of the subjects that were folacin deficient based upon serum and erythrocyte folacin values, respectively, were the same subjects considered to be deficient during the third year. Folacin status, as indicated by serum and erythrocyte folacin values, was not related to per capita income. These findings demonstrate that folacin status is less than adequate in females during the adolescent years.

Adolescent

Effects of premilking stimulation on complete lactation milk yield and milking performance.

Effects of premilking preparation on complete lactation performance were measured with two groups of multiparous Holstein cows; 1) 17 cows received full stimulation, a 60-s routine, and 2) 16 cows received minimum stimulation, a 15-s routine, before machine attachment. Actual unadjusted average lactation milk yield for cows receiving full stimulation was 5.4% less than that for cows receiving minimum stimulation. When postpeak persistencies were compared by linear regression of either 1) daily milk weights or 2) 3.5% FCM from DHI records of milk yield and milk fat percent and fitted to lactation curves using an incomplete gamma function, cows receiving full stimulation produced 1) 2.8 or 2) 2.5% more milk per lactation than did cows receiving minimal stimulation. However, none of the treatment differences in mean milk yield was significant statistically. Milk flow rates, strip yields, and machine on-times were measured at 8-wk intervals throughout lactation. Cows receiving full stimulation had significantly higher average milk flow rates and shorter machine on-times starting at wk 32. There were no significant differences in strip yields or percent residual milk between cows receiving full and minimum stimulation.

Animals

Comparison of cognitive ability, personality profile, and school success in epileptic children with pure right versus left temporal lobe EEG foci.

By reviewing electroencephalographic reports compiled over five years and checking clinical details, we identified and studied 27 children with apparently pure left or pure right temporal lobe epilepsy. The children underwent neurological examination and neuropsychological testing (Halstead-Reitan Battery, Wechsler Intelligence Scale for Children [WISC] and Wide Range Achievement Test), and parents completed the Personality Inventory for Children (PIC). Of 15 boys and 12 girls with a mean age of 12.7 years, 14 had right and 13 left temporal lobe epilepsy. Seizure control was excellent in 17. Five (2 with left, 3 with right temporal lobe epilepsy) had received professional emotional help, 6 (3 with left, 3 with right focus) received special help at school, and 5 (3 with left, 2 with right focus) had failed a grade in school. No significant left-right differences were seen in WISC full scale, verbal, or performance IQ scores, neuropsychological test battery findings, or clinical scale scores on the PIC. Most of the children with unilateral temporal lobe epilepsy had no measurable cognitive or emotional difficulties. Cognitive, personality, and school problems were equally distributed between left and right temporal lobe epilepsy groups. When the two groups were combined, however, 10 patients (5 with left, 5 with right focus) were identified by the PIC as maladjusted, and as a group showed significantly lower neuropsychological test functioning than did the normally adjusted children.

Achievement

Memory impairment in multiple sclerosis.

The memory performance of 22 Multiple Sclerosis (MS) subjects and their matched controls was compared on three tasks: a perceptual memory test, a picture recognition test and a verbal recognition test. Results showed that perceptual memory does not suffer as a consequence of MS. Moreover, MS subjects are as sensitive as controls to deep semantic encoding of individual items in a picture recognition task. However, for a verbal recognition task, where a semantic encoding strategy was optional, MS subjects were less likely to report use of a strategy. Those MS subjects who did use a strategy, did more poorly on memory for verbal information than controls. The results suggest a specific inter-item semantic encoding problem in MS.

Adult