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Biomedical subjects

T Kennedy

Publications and source records attributed to T Kennedy.

At least 19 recordsLinked to original sources
PubMed1992

Implementing right-to-know legislation for health care workers in Manitoba: a bipartite sectoral train-the-trainer approach.

In October 1988, right-to-know legislation was introduced in Canada. This presented a technical and administrative challenge to the health care sector. With over 170 health care facilities in Manitoba to be brought into compliance, some large, some small, some rural, some urban, a cooperative approach was needed. A labor-management steering committee with representatives from a cross-section of facilities as well as the various health care unions was formed to design and implement a train-the-trainer program. A small-group, highly participatory modular program was developed with input from all parties, and delivered across the province by trainers selected jointly by labor and management. The program achieved its goal of assisting member facilities to implement the legislation. Follow-up surveys and discussions with health care workers showed improved understanding of labelling requirements, material safety data sheet interpretation, and requirements for hazard control. This first bipartite program empowered the health care workforce to use its newly acquired right-to-know, and has provided the incentive to implement other cooperative safety and health programs.

Evaluation Studies as Topic↗
PubMed1992

Medical rehabilitation for the indigent in Louisiana: a primer for physicians.

The impact of a stroke, head injury, spinal cord injury, or other disabling condition can be especially devastating for individuals without health insurance. Fortunately, a comprehensive system has evolved to address the needs of the indigent for medical rehabilitation services in Louisiana. The purpose of this paper is to familiarize readers with this complex system, and thereby to assist practicing physicians and other health care providers in better serving this large and medically needy population. First, state and federal medical assistance programs which cover rehabilitation services are reviewed; next, services available through Louisiana Rehabilitation Services are discussed; and finally, services available through the Handicapped Children's Services Program and various voluntary organizations are described.

Persons with Disabilities↗
PubMed1991

Human immunodeficiency virus antibodies in sera of Australian blood donors: 1985-1990.

OBJECTIVE: To describe the results of human immunodeficiency virus type 1 (HIV-1) antibody testing of blood donations in Australia. DESIGN: Blood transfusion services tabulated the number of HIV-1 antibody tests carried out on blood donations and the number of donations found to be positive, from 1985 to 1990. SETTING: All blood transfusion services in Australia. PARTICIPANTS: All donors of blood in Australia from 1 May 1985 to 31 December 1990. OUTCOME MEASURES: The proportion of blood donations found to have HIV-1 antibody, according to State or Territory, year of donation and, when available, age, sex and donation status (repeat or first-time) of the donor. RESULTS: To the end of December 1990, 5,367,970 donations had been tested for HIV-1 antibody, and 46 were found to have the antibody, giving an overall prevalence rate of 0.86 per 100,000 donations. The highest rate was recorded in New South Wales, followed by Western Australia, and four of eight Australian States and Territories reported no donors with HIV-1 antibody. There has been no clear trend with time, but the rate is about 20% higher for 1989-1990 than for 1985-1986. Of donors found to have HIV-1 antibody, 67% were male and 33% female, and 41% reported no known or potential exposure to HIV-1 other than heterosexual contact. Among blood donors in two major Australian cities, the overall prevalence of HIV antibody was higher in those who were male, younger, and first-time donors. There has been a recent increase in the number of blood donors with HIV-1 antibody who were women reporting heterosexual contact as their only potential exposure. CONCLUSION: The rate of HIV-1 antibody in Australian blood donations remains very low and shows no clear temporal trend, but specific donor characteristics define higher rates of antibody prevalence.

Adult↗
PubMed1989

Effect of lipopolysaccharide on C3 and C5 production by human lung cells.

Although studies to date have demonstrated the ability of the monocyte/macrophage to produce C components in vitro, very few studies on C production by nonhepatic tissue cells have been reported. Recently, using 35S-methionine incorporation and immunoprecipitation techniques our laboratory has demonstrated the ability of tissue cells, i.e., the human lung type II pneumocyte (A549) and human lung fibroblast (WI-38), to synthesize and secrete a variety of early and terminal complement components, as well as several regulatory proteins in vitro, i.e., C1r, C1s, C4, C3, C5, C6, C7, C8, C9, factor B, factor H, factor I, and C1s inactivator. In our studies, we extended these observations by demonstrating the capability of LPS to modulate C3 production by A549 pneumocytes. Specifically, using a sensitive ELISA we demonstrated that A549 pneumocytes exposed to LPS induced an 80 to 180% increase in C3 levels when compared to untreated A549 cells. Interestingly, LPS had no effect on C5 production or total protein synthesis by A549 pneumocytes. In the case of the WI-38 fibroblast, LPS had no effect on 1) C3 production, 2) C5 production, or 3) total protein synthesis in vitro. These studies demonstrate that agents such as LPS have the potential to selectively regulate C production (i.e., C3) in individual lung cells in vitro, and suggests that in vivo LPS may alter the local tissue reservoir of C components during infection and lung injury, thus impacting on pulmonary inflammation and host defense.

Animals↗
PubMed1989

Biosynthesis of the third and fifth complement components by isolated human lung cells.

Increasing research efforts have been directed at determining the contribution of locally synthesized (cell-derived) complement in host defense and inflammation. In the studies presented here, we determined the ability of a continuous cell line of type II pneumocytes (A549) and a cell line of human lung fibroblasts (WI-38) to produce complement components in vitro. Complement biosynthesis by A549 pneumocytes and WI-38 fibroblasts was demonstrated by incorporation of [35S]methionine into immunoprecipitable complement proteins. Using this technique, A549 pneumocytes were demonstrated to synthesize Clr, Cls, C4, C3, C5, C6, C7, C8, C9, Factor B, Factor H, Factor I, and C1s inactivator. In comparison, WI-38 fibroblasts were shown to synthesize Cls, C4, C3, C5, C6, C8, and C9. Because previous work has demonstrated the central role of C3, C5, and their activation products in regulating lung inflammation and tissue injury, we further investigated the production of C3 and C5 by both lung pneumocytes and fibroblasts using enzyme-linked immunospecific assays. A549 cells cultured in the presence of 15% fetal bovine serum (FBS) produced antigenic C3 (135 ng C3/ml/24 h) at a greater rate than did identical cells maintained in serum-free culture conditions (70 ng C3/ml/24 h). Similarly, antigenic C5 production by A549 pneumocytes was greatest in the presence of FBS when compared with cells maintained in serum-free culture conditions (245 ng C5/ml/24 h versus 155 ng C5/ml/24 h).(ABSTRACT TRUNCATED AT 250 WORDS)

Cell Line↗
PubMed1988

Obstructive sleep apnea syndrome: preoperative radiologic evaluation.

The purpose of this study was to determine whether lateral radiographs of the pharynx and fluoroscopy of the lateral pharynx in the sleeping patient could be used as predictors of surgical success in patients undergoing soft-palate surgery for obstructive sleep apnea. A total of 12 patients had surgery after radiologic evaluation. There were six surgical successes and six failures. No successes occurred in patients with a soft-palate length of less than 46 mm, nor were there any successes among patients whose initial point of obstruction on fluoroscopy was inferior to the level of the soft palate. There was one surgical failure among patients in whom fluoroscopy showed upper airway obstruction beginning at the level of the soft palate during sleep. Results suggest that a patient is most likely to benefit from soft-palate resection if the soft palate is long--we conservatively suggest greater than 40 mm--and if sleep fluoroscopy of the lateral pharynx shows airway obstruction beginning at the level of the soft palate.

Fluoroscopy↗
PubMed1986

Cystic fibrosis in adults: delayed diagnosis in three siblings.

Cystic fibrosis (CF), which is transmitted as an autosomal recessive trait, is the most common lethal genetic disease in the United States. Median survival age for patients followed up at CF centers in the US is now 21 years. While the disease is diagnosed in most patients before the age of 5 years, in 10% of cases the diagnosis is not confirmed until after age 12. We report an unusual family in which the diagnosis of CF was first established in three siblings at the ages of 36, 40, and 44 years. We describe the clinical features of the patients, as well as issues relating to the diagnosis of CF in adults. This unusual pedigree supports the concept of genetic heterogeneity in CF.

Adult↗
PubMed1986

Anticoccidial efficacy of halofuginone in turkeys reared to market weight.

Floor-pen studies were conducted in three geographic locations to study the efficacy of halofuginone (3.0 ppm in feed) against important species of coccidia in turkeys. Severe coccidiosis exposure was obtained in studies in Georgia and Colorado and mild coccidiosis in Wisconsin. Coccidiosis caused by contamination of the feed with oocysts of Eimeria adenoeides, E. meleagrimitis, and E. gallopavonis was almost completely controlled by halofuginone at 3 ppm, even though intestinal lesion scores and weight loss were high in two studies. Halofuginone was also highly effective in preventing buildup of infection in pens contaminated by indirect means (movement by caretakers through the pens, etc.). Weight gains and feed conversion were best in poults receiving halofuginone, whether directly or indirectly exposed. There was no evidence that halofuginone caused any untoward reactions in the poults, even though the drug was fed until turkeys reached market weight.

Animals↗
PubMed1985

A structurally novel stimulator of guanylate cyclase with long-lasting hypotensive activity in the dog.

Studies were undertaken to characterize the activity of diphenyliodonium hexafluorophosphate (DIFP) as a structurally novel stimulator of soluble guanylate cyclase from rat lung and make comparisons to the activity of sodium nitroprusside (SNP). In addition, the effects of these two compounds on several cardiovascular parameters in anesthetized dogs were determined. DIFP stimulated guanylate cyclase activity within the same concentration range (10-300 microM) as SNP, causing a maximal 2-3-fold activation. The activities of both SNP and DIFP were dependent on the presence of dithiothreitol and inhibited by methylene blue. In anesthetized dogs, DIFP (i.v.) elicited a dose-related, long-lasting fall (greater than 3 h) in mean arterial pressure (MAP) which was accompanied by a reduction in total peripheral resistance and a transient rise in cardiac output. These effects on MAP were similar to those of SNP except they were of a much longer duration. In addition, both SNP and DIFP produced slight bradycardia and reduced negative dP/dt. These results suggest that DIFP and SNP, while structurally dissimilar, activate guanylate cyclase by a related mechanism which may be involved in vascular relaxation leading to reduced blood pressure.

Animals↗
PubMed1985

Methodological considerations of epidemiological diagnoses in respiratory diseases.

Since epidemiological research depends extensively on questionnaire responses, a comparison of such responses with a standardized medical evaluation was conducted. It was found that standardized questionnaires do well in comparison for certain kinds of information on chronic conditions. However, clinical evaluations will elicit more information, specifically of a milder nature. It was concluded that standardized epidemiological questionnaires are satisfactory for survey of chronic conditions.

Adolescent↗
PubMed1979

Proximal gastric vagotomy, fundoplication, and lesser-curve necrosis.

Out of 400 patients who underwent proximal gastric vagotomy (PGV), three developed lesser-curve necrosis (LCN) leading to perforation within the first seven days. In each case diagnosis was delayed but the patient survived after a second operation. In each an associated Nissen fundoplication had been carried out; we used the combined operation in only 33 patients. Delayed LCN occurred in a patient who had undergone splenectomy at the time of the PGV and in a fifth patient treated elsewhere who had also undergone fundoplication. These findings indicate that early postoperative gastric distension with gas, not readily voided after fundoplication, may aggravate local vascular factors and predispose to LCN. We suggest that PGV combined with fundoplication may be dangerous.

Adult↗
PubMed1979

A computer program for testing average partial association in three-way contingency tables (PARCAT).

PARCAT is a computer program which implements alternative tests for average partial association in three-way contingency tables within the framework of the product multiple hypergeometric probability model. Primary attention is directed at the relationship between two of the variables, controlling for the effects of a covariable. This approach is essentially a multivariate extension of the Cochran/Mantel-Haenszel test to sets of (s x r) tables. A set of scores such as uniform, ridits, or probits can be assigned to categories which are ordinally scaled. In particular, if ridit scores with midranks assigned for ties are utilized, this procedure is equivalent to a partial Kruskal-Wallis test when one variable is ordinally scaled, and is equivalent to a partial Spearman rank correlation test when both variables are ordinally scaled.

Age Factors↗
PubMed1978

Cimetidine for recurrent ulcer after vagotomy or gastrectomy: a randomised controlled trial.

In a randomised controlled trial cimetidine 1 g daily for six weeks was compared with placebo in the treatment of recurrent ulcers after gastrectomy or vagotomy for duodenal ulcer. Healing, assessed endoscopically, was seen in seven out of 12 patients given cimetidine and in five out of 12 controls. Four of the controls whose ulcers did not heal were subsequently treated with cimetidine, and in two the ulcers healed after six weeks. Pain recorded by the patient and consumption of alkalis were each slightly but not significantly less in the cimetidine-treated patients. When cimetidine is to be used for recurrent ulceration probably the dosage and duration of treatment should be increased.

Cimetidine↗
PubMed1978

Closure of gastrojejunostomy for the relief of post-vagotomy symptoms.

When dumping, diarrhoea or bile vomiting follows vagotomy and gastrojejunostomy, simple closure of the stoma, without alternative drainage, has been performed in 19 patients. Thirteen patients, 5 with truncal, 7 with selective and 1 with proximal gastric vagotomy, have been followed up for 1-6 years. Five were completely relieved of symptoms, 7 improved and there was only 1 complete failure. Bile vomiting was more often relieved than dumping or diarrhoea. The procedure is safe and significant gastric retention does not occur provided that at least one year is allowed to elaspse after the primary operation.

Adult↗
PubMed1978

Roux diversion for bile reflux following gastric surgery.

Regurgitation of bile into the stomach after gastric surgery often causes severe and distressing symptoms, though the onset may be delayed for some years. We have used a Roux loop diversion as a secondary procedure for bile reflux in 36 patients, making the anastomosis from 18 to 40 cm below the stomach. There were no deaths and the clinical results were good in 20 of 27 patients followed up from 1 to 10 years. Vagotomy was omitted in 13 patients, 2 of whom subsequently developed jejunal ulceration. One patient developed an unexplained gastric ulcer and 2 operations failed because the loop was too short. The optimum length may well be 40 cm and vagotomy should be added in all cases. In 3 patients with associated dumping the upper 10 cm of the Roux loop was reversed.

Adult↗