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Biomedical subjects

S M Olson

Publications and source records attributed to S M Olson.

At least 19 recordsLinked to original sources
PubMed2001

An invasive cleavage assay for direct quantitation of specific RNAs.

RNA quantitation is becoming increasingly important in basic, pharmaceutical, and clinical research. For example, quantitation of viral RNAs can predict disease progression and therapeutic efficacy. Likewise, gene expression analysis of diseased versus normal, or untreated versus treated, tissue can identify relevant biological responses or assess the effects of pharmacological agents. As the focus of the Human Genome Project moves toward gene expression analysis, the field will require a flexible RNA analysis technology that can quantitatively monitor multiple forms of alternatively transcribed and/or processed RNAs (refs 3,4). We have applied the principles of invasive cleavage and engineered an improved 5'-nuclease to develop an isothermal, fluorescence resonance energy transfer (FRET)-based signal amplification method for detecting RNA in both total RNA and cell lysate samples. This detection format, termed the RNA invasive cleavage assay, obviates the need for target amplification or additional enzymatic signal enhancement. In this report, we describe the assay and present data demonstrating its capabilities for sensitive (<100 copies per reaction), specific (discrimination of 95% homologous sequences, 1 in > or =20,000), and quantitative (1.2-fold changes in RNA levels) detection of unamplified RNA in both single- and biplex-reaction formats.

Base Sequence↗
PubMed1999

Evaluation of a community-based program to improve infant immunization rates in rural Minnesota.

OBJECTIVE: The purpose of this study was to evaluate the effects of enrollment in a community-based public health nursing program, Communities Caring for Children (CCC), on infant immunization rates in rural Minnesota. The program involved health education, a registry, and a reminder system. DESIGN: The evaluation was a collaborative effort of university, public health agency, and private managed-care personnel. Two data sources were used to assess the association of program enrollment and immunization compliance; public birth certificates and a telephone survey of 421 CCC enrollees and non-enrollees. RESULTS: Birth certificate and survey data showed that CCC enrollees were significantly younger, less educated, more likely to be white, and of lower parity than non-enrollees. The average age of subjects' infants was eight months. The survey data showed that, overall, CCC enrollees perceived less danger in infant immunizations than did non-enrollees and were more likely than non-enrollees to have access to infant immunization reminder cards. CCC enrollees reported significantly higher immunization compliance for their infants than did non-enrollees. CONCLUSIONS: The area served by this program is relatively low-income and rural. Infant immunization status was among the lowest in Minnesota prior to the implementation of CCC. The evaluation suggested that enrollment in CCC was one of the most powerful predictors of infant immunization compliance.

Age Factors↗
PubMed1995

Abdominal stab wound protocol: prospective study documents applicability for widespread use.

Traditionally, stab wounds violating the abdominal wall fascia led to exploratory celiotomy that was often nontherapeutic. In an attempt to limit the number of nontherapeutic celiotomies (NTC), we devised a protocol to prospectively study stab wounds violating the anterior abdominal wall fascia. Through protocol, abdominal stab wounds were explored in stable adults. If the anterior fascia was violated, paracentesis and, if necessary, peritoneal lavage was undertaken in the absence of previous abdominal surgery. If evisceration was noted, it was reduced and the patient lavaged. Fascial penetration was noted in 72 patients. 46 patients underwent celiotomy: because of shock/peritonitis in 8 (2 NTC), fascial penetration with a history of previous celiotomy in 7 (5 NTC), positive paracentesis in 20 (5 NTC), or positive lavage in 10 (4 NTC). One patient underwent late celiotomy without ill-effect after a negative lavage because she subsequently developed fever and localized peritonitis (ice pick injury to cecum). Eleven patients had evisceration; nine underwent celiotomy. Patients with abdominal stab wounds can be selectively managed safely. More than one-third with fascial penetration, some with evisceration, avoided exploration. Only one patient underwent delayed celiotomy and did so without detriment. Nontherapeutic celiotomy rates were highest in patients with previous abdominal surgery who, thereby, could not undergo paracentesis/lavage; excluding these patients, the nontherapeutic celiotomy rate was 17% (11/65) for those with fascial penetration.

Abdomen↗
PubMed1994

Comparison of cardiovascular risk factors in obese blacks and whites.

Blacks are known to have higher blood pressure levels, a higher prevalence of hypertension, and higher body weights than whites. However, the interrelationships of these and other cardiac risk factors have not been analyzed in an obese population. We compared blood pressure (BP) and lipid levels in 174 obese blacks and 939 obese white patients who were entering a weight loss program; we also assessed the effects of weight loss on these factors. Prevalence of treated hypertension was similar in blacks and whites (28% vs. 25%, respectively). In patients not taking BP medication, black women weighed more (108 kg) than white women (102 kg) and black and white males' weights were similar (135 kg vs. 131 kg). Systolic and diastolic BP were similar in black and white women; black males had similar SBP but a significantly lower DBP than white males (83 mmHg vs. 89 mmHg, respectively). Lipid levels were similar in black and white women except black women had lower triglycerides (1.30 mmol/L) than white women (1.58 mmol/L, p < 0.05); and black males compared to white males had significantly lower total cholesterol (4.76 mmol/L vs. 5.56 mmol/L), LDL-cholesterol (3.15 mmol/L vs. 3.52 mmol/L) and triglycerides (1.31 mmol/L vs. 2.17 mmol/L, p < 0.05). Adult-onset obesity adversely affected a number of cardiovascular risk factors in whites, but not in blacks. Blacks lost significantly less weight (-13 kg) than whites (-19 kg). However, controlling for the difference in weight loss, blacks sustained comparable improvement in lipids and blood pressure, except for TC/HDL-C (whites improved significantly more, -0.36 kg/m2, than blacks, 0.03 kg/m2). Thus, the impact of obesity on cardiovascular risk factors seems ameliorated in blacks compared to whites.

Adult↗
PubMed1993

Prehospital traumatic cardiac arrest: the cost of futility.

UNLABELLED: Of 12,462 trauma patients cared for by prehospital services from October 1, 1989 to March 31, 1991, 138 patients underwent CPR at the scene or during transport because of the absence of blood pressure, pulse, and respiration. Ninety-six (70%) suffered blunt trauma, 42 (30%) suffered penetrating trauma. Sixty (43%) were transported by air utilizing county-wide transport protocols. None of the patients survived. Aggregate care cost $871,186.00. In 11 cases (8%), tissue for transplantation was procured (only corneas). CONCLUSION: Trauma patients who require CPR at the scene or in transport die. Infrequent organ procurement does not seem to justify the cost (primarily borne by hospitals), consumption of resources, and exposure of health care providers to occupational health hazards. The wisdom of transporting trauma victims suffering cardiopulmonary arrest at the scene or during transport must be questioned. Allocation of resources to these patients is not an insular medical issue, but a broad concern for our society, and society should decide if the "cost of futility" is excessive.

Cardiopulmonary Resuscitation↗
PubMed1992

Long-term follow-up of patients attending a combination very-low calorie diet and behaviour therapy weight loss programme.

We examined the effects of treatment with a very-low calorie diet (VLCD) combined with behaviour modification on weight loss and long-term maintenance of weight loss in 118 of 199 patients who completed eight weeks of VLCD. Those who began therapy in 1984 were surveyed by telephone an average of 3.3 years after ending the VLCD. Questionnaire data included reported weight, exercise, eating, work and sleep habits, emotional factors, and current use of behavioural techniques taught in the programme. Results showed that mean maximum weight loss during the time they attended the programme (average 51.6 weeks) was 31.3 kg, corresponding to a decrease in body mass index of 10.7 kg/m2. At follow-up a regain of 60.9% was reported yielding a net overall weight loss of 13.6 kg and decrease in body mass index of 4.4 kg/m2. Seventy-five per cent of subjects showed only a 37.5% regain of the weight they had lost. Those whose weight loss was better maintained at the time of follow-up reported exercising more, eating fewer high fat foods, and using more of the behavioural techniques taught in the programme. This study provides support for the conclusion that some patients treated with VLCD and behaviour modification can maintain significant weight losses over a relatively long period of time and that specific behaviours relate to this success.

Adult↗
PubMed1987

The equilibrium position of the mitral valve: an accurate model of mitral valve motion in humans.

A "semiopen" diastolic equilibrium position of the mitral valve that is assumed in the absence of transmitral flow has been demonstrated in instrumented dogs. It has been suggested that the papillary muscles and chordae tendineae play an integral role in returning the valve to this position after initial diastolic opening. To determine whether such a model of mitral valve motion is valid in noninstrumented humans without underlying valvular disease, M-mode and Doppler ultrasound studies were performed in 6 subjects who underwent prolonged periods of ventricular diastole and atrial inactivity. After maximal opening, the mitral valve assumed a stable open position in which mean separation of the anterior and posterior mitral leaflets was 52% of maximal separation. This position was maintained for a mean duration of 585 ms, during which time transmitral flow fell to 0 m/s. Peak mitral valve opening preceded the early transmitral flow peak by an average of 42 ms, suggesting an active closure of the mitral valve as flow continued to accelerate. It is concluded that a semiopen equilibrium position of the mitral valve is assumed during prolonged diastolic periods in the absence of transmitral flow and is an accurate model describing diastolic mitral valve motion in noninstrumented humans. The chordae tendineae and papillary muscles may actively participate in the genesis and maintenance of the equilibrium position.

Adult↗
PubMed1987

Cost analysis of mixing clindamycin and aminoglycosides.

Data were collected to determine if cost savings could be achieved by mixing clindamycin and aminoglycosides (gentamicin or tobramycin) in the same minibag for intravenous administration. The following issues were investigated: drug and supply costs associated with combination admixtures, pharmacy labor costs, and waste. Over a 17-month period, 1961 combination admixtures were prepared; 62 of these doses were wasted. Drug cost savings of $128.15, supply cost savings of [4719.48, and labor cost savings of [1878.40 were achieved, with an overall cost savings (minus waste) of $5658.01. Overall waste was similar with the combined admixture service and the preparation of separate doses, and the aminoglycoside pharmacokinetic dosing service did not substantially affect use of the combination admixtures. The clindamycin and aminoglycoside admixture system was effective in reducing supply and labor costs.

Aminoglycosides↗
PubMed1985

Effect of acute standing and prolonged upright activity on left ventricular hemodynamics, systolic and diastolic intervals, and QT-QS2 relationship.

It is generally accepted that upright posture decreases preload and afterload, which could alter left ventricular (LV) performance. It is not known if changes occurring with acute standing persist after prolonged ambulatory activity (amb-act). In seven normal subjects echocardiographic end-diastolic and end-systolic diameters, percent shortening of the internal diameter (% delta D) and end-systolic wall stress (ES-WS), radionuclide diastolic volume and ejection fraction, preejection period over left ventricular ejection time (PEP/LVET), and diastolic time and QT-QS2 were measured supine, within 1 to 2 minutes after standing and after prolonged (60 minutes) amb-act. In addition, serial measurements were performed in PEP/LVET for 105 minutes at 15-minute intervals. With acute standing, end-diastolic diameter, diastolic volume, and ES-WS decreased (p less than 0.01); heart rate and PEP/LVET increased (p less than 0.01); while % delta D and ejection fraction remained unchanged. There was an inverse correlation between change in PEP/LVET and diastolic diameter (r = -0.59), but no correlation between PEP/LVET and ES-WS. The diastolic time per beat and per minute decreased (375 +/- 115 msec from 519 +/- 176 msec [p less than 0.01] and 31.3 +/- 4.2 sec/min from 33.7 +/- 4.5 sec/min [p less than 0.01]). The QT-QS2 increased when compared to supine (-7 +/- 7.6 msec from -22 +/- 7.7 msec [p less than 0.005]), but the QT-QS2 relationship remained normal (QT less than or equal to QS2). All the dynamic changes that occurred with acute standing tended to persist during prolonged amb-act.

Adult↗
PubMed1985

Feasibility of prime vendor purchasing for a state university hospital.

The economic feasibility of implementing a prime vendor purchasing system for pharmaceuticals was evaluated in a midwestern university hospital. Inventory costs, personnel costs, and check processing costs under the current purchasing system were compared with costs estimated for a proposed prime vendor purchasing system. For each step in the purchasing process that would be changed under the proposed system, work measurement techniques were used to determine personnel costs. The total savings from reductions in inventory holding costs, personnel costs, and check processing costs under the proposed prime vendor system was +98,396.37, or 2.4% of the value of pharmaceuticals purchased. Since the pharmacy department could not negotiate a contract in which the prime vendor's service fee was 2.4% or less, implementing a prime vendor purchasing system would not have been cost effective. Therefore, the hospital retained its existing purchasing system. Through detailed analysis of the major costs involved in pharmaceutical purchasing, the hospital was able to determine that it was not cost effective for it to use prime vendor purchasing.

Costs and Cost Analysis↗