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Biomedical subjects

R W Andrews

Publications and source records attributed to R W Andrews.

10 recordsLinked to original sources
PubMed1999

Use of antibiotic resistance analysis to identify nonpoint sources of fecal pollution.

A study was conducted to determine the reliability and repeatability of antibiotic resistance analysis as a method of identifying the sources of fecal pollution in surface water and groundwater. Four large sets of isolates of fecal streptococci (from 2,635 to 5,990 isolates per set) were obtained from 236 samples of human sewage and septage, cattle and poultry feces, and pristine waters. The patterns of resistance of the isolates to each of four concentrations of up to nine antibiotics were analyzed by discriminant analysis. When isolates were classified individually, the average rate of correct classification (ARCC) into four possible types (human, cattle, poultry, and wild) ranged from 64 to 78%. When the resistance patterns of all isolates from each sample were averaged and the resulting sample-level resistance patterns were classified, the ARCCs were much higher (96 to 100%). These data confirm that there are measurable and consistent differences in the antibiotic resistance patterns of fecal streptococci isolated from various sources of fecal pollution and that antibiotic resistance analysis can be used to classify and identify these sources.

Animals↗
PubMed1993

Using claims data to monitor hospital utilization.

Controlling provider use is a continuing problem for health care insurers. This paper describes a Blue Cross and Blue Shield of Michigan system that places primary responsibility for inpatient admissions on participating hospitals and uses a dual monitoring approach. Expensive annual samples that review medical records against published criteria constitute the basic test of compliance. An inexpensive indicator is developed quarterly using automated universal claims review. Statistical methodology, costs, and savings for both monitors are described. The claims monitor uses diagnosis related group (DRG) characteristics to estimate the percentage of inappropriate utilization from historical values for the patient group.

Blue Cross Blue Shield Insurance Plans↗
PubMed1989

High-tech task tracking.

The authors discuss the benefits of instituting a computerized dispatch card system to make the hospital security department more efficient and effective.

Data Interpretation, Statistical↗
PubMed1986

Molecular analysis of membrane immunoglobulin-negative variants.

The mouse B-cell lymphoma WEHI 279.1 is a tumor which synthesizes both membrane and secreted immunoglobulin M (IgM). We have immunoselected variants which fail to express the membrane form (mIgM-); the most frequently isolated phenotype is a complete loss of both membrane expression and synthesis of the mu heavy chain within the cells. We have chosen four of these mIgM- mutants for detailed molecular investigation. One of these has suffered a large deletion which covers the region of chromosome 12 containing the expressed mu gene, but three have no detectable changes in the DNA arrangement of the mu gene. All of the mutants, including the deletion mutant, synthesize 10-30% of the wild-type level of cytoplasmic mu RNA; however, none is the appropriate size for membrane mu (mu m) or secreted mu (mu s) message. Based on our studies of the deletion mutant, which retains its nonproductively arranged allele, at least some of these RNAs may be 'sterile' transcripts from the nonproductively arranged allele. However, if all of these mRNAs derive from the other allele, they represent a substantial elevation of these sterile messages relative to the wild-type level. Furthermore, the three nondeletion mutants transcribe mu RNA at a level indistinguishable from the wild type. It is likely that their defects lie in the stability, processing, or transport of the mu RNA within the nucleus. Somatic cell hybrids between P3X and the IgM- variants produced mostly mIgM- hybrids. However, a few mIgM+ hybrids were produced, suggesting that the mu- defects may be partly complemented by the P3X fusion partner.

Animals↗
PubMed1982

Lactoperoxidase-catalyzed oxidation of thiocyanate: polarographic study of the oxidation products.

The lactoperoxidase-catalyzed oxidation of thiocyanate (SCN-) was studied by two different polarographic techniques: direct current polarography and linear sweep voltammetry. The main oxidation product at pH 6.5, with a half-wave potential (E1/2) of -0.39 to -0.44 V, was identified as hypothiocyanite (OSCN-) ion. The E1/2 for OSCN- was not available in the literature. The identification of OSCN- was based on a close correlation between the current of the OSCN- peak and the concentration of chemically assayed OSCN-. Also the specific rates of decay of the current and that of chemically detectable OSCN- were similar, and both curves followed apparent first-order kinetics. Subsequently, the addition of a reducing agent (2-mercaptoethanol) resulted in immediate disappearance of both chemically detectable OSCN- and the OSCN- wave in the polarograms. All three components of the lactoperoxidase (LPO) system (SCN-, H2O2, and LPO) were needed to produce the OSCN- peak. Addition of excess H2O2 or H2O2-LPO to an OSCN--SCN- mixture resulted in a formation of a new peak with a characteristic peak potential (Ep) of -0.20 to -0.25 V. The generation of this new peak was associated with a simultaneous, markedly enhanced decrease of OSCN- concentration, indicating a possible reaction between H2O2 (or H2O2-LPO) and OSCN-. No equivalent reaction was obtained by the addition of buffer alone. This new peak may represent higher oxy acids of SCN- (O2SCN-, O3SCN-), formed in the oxidation of OSCN- by H2O2 or by H2O2-LPO. This type of reaction can explain why, in solutions which already contain OSCN- (e.g., in saliva), the addition of H2O2 results in the formation of highly reactive, short-lived antimicrobial products in addition to OSCN-.

Animals↗
PubMed1981

Cardiovascular effects of protamine sulfate in man.

The effect of protamine sulfate on several cardiovascular and biochemical variables was studied in man under clinical conditions. This study was performed to quantitate these effects in 15 adult patients who had undergone cardiopulmonary bypass for coronary artery bypass grafting. Protamine was administered in typical clinical doses (3 mg/kg) at typical clinical rates (total dose infused over 5 minutes). This infusion rate is greatly in excess of the 50 mg/10 min suggested in the protamine package insert. No statistically significant changes in mean arterial blood pressure, cardiac output, central venous pressure, total or ionized calcium, PaO2, PaCO2, pH, Na+, or K+ were found during or after administration of protamine sulfate. Hypotension was observed after administration of protamine to one patient, but no etiologic mechanism was apparent. Previous reports suggest cardiovascular depression by protamine in the dog, a species highly susceptible to these effects. Data obtained in man in this study do not corroborate the canine studies.

Adult↗
PubMed1980

Peripheral vascular response to potassium administration during cardiopulmonary bypass.

Potassium (K+) is often administered to patients during cardiopulmonary bypass (CPB). The effects of rapid K+ administration during CPB were studied in 30 adult patients. Each patient received one bolus dose (2, 4, 8, 12, or 16 mEq) of potassium chloride (KCl) (2 mEq/ml) during CPB. Serum K+ was significantly increased from baseline values at KCl doses of 8 mEq and larger (p less than 0.05). All increases in serum K+ returned to clinically acceptable levels within 5 minutes after the bolus. Mean arterial pressure (MAP) (torr) and total peripheral resistance (TPR) (dynes sec cm-5) changes were biphasic; after an initial transient decrease, maximal with the 16 mEq K+ bolus (MAP -21 +/- 6, TPR - 315 +/- 135), these parameters increased (8 mEq K+ bolus, MAP + 15 +/- 16, TPR + 301 +/- 90; 12 mEq K+ bolus, MAP + 43 +/- 9, TPR + 998 +/- 250; 16 mEq bolus, MAP + 51 +/- 9, TPR + 1,216 +/- 120) with a peak at 3 minutes after the bolus. Hypertension, in nine of 18 patients receiving a KCl bolus of 8 mEq or larger, was of such magnitude (range 132 to 196 torr) as to require rapid therapeutic intervention to lower blood pressure. When KCl supplementation is required on CPB and slow infusion rates seem unreasonable, bolus doses of less than 8 mEq may be administered without vascular effect.

Adult↗