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Biomedical subjects

V Bell

Publications and source records attributed to V Bell.

At least 19 recordsLinked to original sources
PubMed2006

Two separate outbreaks of Salmonella enteritidis phage type 14b food poisoning linked to the consumption of the same type of frozen food.

OBJECTIVES: To ascertain, using a combination of epidemiological, environmental and microbiological methods of investigation, a possible link between two outbreaks of salmonella food poisoning. METHODS: Case-control studies were carried out on the known at-risk populations. Environmental investigations took place in the food preparation areas used for the social functions and microbiological examinations were carried out on faecal specimens obtained from cases, environmental swabs, and food specimens when these were available. RESULTS: In both outbreaks, illness was associated with the consumption of sesame prawn toast (outbreak one P<0.004; outbreak two P<0.0001). Salmonella enteritidis phage type 14b was cultured from the faecal specimens of cases in both outbreaks and from a packet of sesame prawn toast used for the second outbreak function. Molecular typing methods indicated that the salmonella cultures obtained in both outbreaks were indistinguishable from each other and from cultures obtained from imported Spanish eggs in a previous survey. Imported Spanish eggs were used in the manufacture of the sesame prawn toast. CONCLUSIONS: Adequate cooking must take place of raw food products, which should be clearly labelled as such. Manufacturers should consider, when possible, the use of pasteurized egg in the preparation of food products.

Adult↗
PubMed1997

Comparison of ThinPrep and conventional preparations: nongynecologic cytology evaluation.

ThinPrep processing, an automated cytopreparatory method, has been reported to show good correlation with conventional preparations and to reduce the rate of false-negative diagnoses. In a retrospective review of 230 consecutive nongynecologic cytology cases, we compare the ThinPrep (TP) method with conventional preparations (CP). There were 129 fine-needle aspiration (FNA) specimens from various sites, including 51 breasts, 40 thyroids, 14 lungs, 8 livers, and 16 miscellaneous sites. The sources of 101 body cavity fluids included 68 pleural/peritoneal effusions, 25 peritoneal/pelvic washings, and 8 miscellaneous sites. Each case was evaluated for cellularity, morphologic, details, and obscuring background material. Diagnoses of the TP slides were classified as insufficient, normal, benign, suspicious, or malignant. Each case was then correlated with the tissue diagnosis when available. In TP slides, cellular arrangements, nuclear details, and nuclear cytoplasmic ratio were preserved, while blood and diathesis were eliminated. There was no statistically significant difference between TP and CP in the diagnostic categories. However, in six cases of "insufficient for diagnosis" on FNA by CP, TP yielded sufficient cells and tissue fragments for diagnosis. One case each of FNA and body fluid with a diagnosis of "suspicious for malignancy" by CP was considered "positive" on TP slides. The overall sensitivity of TP was 97.6%, and the specificity was 92.9%. The positive predictive value was 93.0%. We conclude that the ThinPrep method shows good correlation with conventional preparations in both FNA and body fluids.

Biopsy, Needle↗
PubMed1997

The "knack" of Alzheimer's care.

Some caregivers just seem to have a "knack" when it comes to dealing with people with Alzheimer's disease. But you don't have to be born with it--many coping techniques can be learned.

Adaptation, Psychological↗
PubMed1993

Antimicrobial treatment of occult bacteremia: a multicenter cooperative study.

This prospective multicenter study was conducted to define more clearly clinical and laboratory criteria that predict a strong probability of occult bacteremia and to evaluate the effect of empiric broad spectrum antimicrobial treatment of these children. Children 3 to 36 months old with fever > or = 40 degrees C (104 degrees F) or, > or = 39.5 degrees C (103 degrees F) with white blood cells (WBC) > or = 15 x 10(9)/liter, and no focus of infection had blood cultures obtained and were randomized to treatment with oral amoxicillin/potassium clavulanate or intramuscular ceftriaxone. Sixty of 519 (11.6%) study patients had positive blood cultures: Streptococcus pneumoniae, 51; Haemophilus influenzae b, 6; Neisseria meningitidis, 2; and Group B Streptococcus, 1. Subgroups of high risk were identified as fever > or = 39.5 degrees C and WBC > or = 15 x 10(9)/liter, 55 of 331 or 16.6% positive with increasing incidence of positive culture with increasing increments of degrees of leukocytosis to WBC > or = 30 x 10(9)/liter where 9 of 21 or 42.9% were positive. Subgroups of significantly lower risk were identified as fever > or = 39.5 degrees C and WBC < 15 x 10(9)/liter, 5 of 182 or 2.7% positive and those with WBC < 10 x 10(9)/liter, 0 of 99 or 0.0% positive. Children with positive cultures who received ceftriaxone were nearly all afebrile after 24 hours whereas a significant number who received amoxicillin/potassium clavulanate remained febrile. In the 459 culture-negative children more amoxicillin/potassium clavulanate-treated children developed diarrhea and had less improvement in clinical scores after 24 hours than ceftriaxone-treated children.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1993

Detection of false DNA aneuploidy and false DNA multiploidy in flow cytometric DNA analysis.

Although false DNA aneuploid peaks have previously been described in normal tissue, criteria for distinguishing them from 'true' near-diploid peaks have not been established. Normal thyroid (n = 4) and kidney (n = 1) tissue were allowed to autolyze over a fixed period of time and DNA content was analyzed by flow cytometry (FCM). Autolysis was associated with the development of distinct separate G0/G1 peaks which had low DNA indices (1.09-1.18) and showed decreased forward light scatter (FSC) when compared to fresh tissue. Using DNA content and FSC measurements similar false DNA aneuploid peaks were identified in 29/94 surgical specimens. These cases included both benign and malignant lesions from thyroid (n = 63) with the remaining 31 neoplastic cases being from breast (16), lymphoma (8), sarcoma (4), lung (2) and uterine (1) tissue. In addition, false DNA multiploidy was identified. None of these cases showed histological evidence of necrosis. In a parallel comparison study using image cytometry (ICM) on the thyroid nodules, the presence of false DNA aneuploidy was supported. Investigators should routinely employ quality control criteria to identify possible cases of false DNA aneuploidy when measuring DNA content using FCM.

Adolescent↗
PubMed1991

Improved endocervical sampling with the Cytobrush.

OBJECTIVE: To evaluate the effectiveness of the Ayre wooden spatula, the cotton-tipped swab and the Zelsmyr Cytobrush in obtaining endocervical cells. DESIGN: Cross-sectional comparison study. SETTING: Family practice unit. PATIENTS: All postpubertal, nonpregnant women who underwent a routine Papanicolaou smear during a 7-month period. INTERVENTIONS: The three devices were used in each patient in a randomized sequence. An experienced cytotechnologist blinded to the device used evaluated the slides for overall epithelial cellularity (graded from 0 [acellular specimen] to 12 [overloaded sample]), density (the number of groups of five or more endocervical cells) and size of cell clusters (5 to 10 cells per cluster [score of 1], 11 to 100 [2] or more than 100 [3]). MAIN RESULTS: Samples from 2 of the 136 women were rejected because of improper labelling of the slides or failure to use all three devices. Seventy-six (57%) of the smears obtained with the spatula and 71 (53%) with the swab had no endocervical cells, as compared with only 14 (10%) obtained with the Cytobrush (p = 0.001). The overall cellularity (and standard deviation [SD]) of the smears obtained with the Cytobrush (5.69 [SD 1.17], p = 0.001) and the spatula (5.70 [SD 1.46], p = 0.001) was significantly greater than the cellularity of those obtained with the swab (4.31 [SD 1.17]). The Cytobrush yielded significantly more groups of endocervical cells (109.84 per slide) than either the spatula (4.17) or the swab (6.25) (p = 0.001). The Cytobrush also produced larger cell clusters (1.56 [SD 0.67], p = 0.001) than either the swab (0.83 [SD 1.70]) or the spatula (0.64 [SD 0.67]). CONCLUSIONS: The Cytobrush and the spatula should be used instead of the spatula alone or the spatula and the swab for collecting endocervical cells.

Adolescent↗
PubMed1990

Dopaminergic involvement in the cocaine-induced up-regulation of benzodiazepine receptors in the rat caudate nucleus.

One group of 12 rats received discrete 6-hydroxydopamine (6-OHDA) injections into the caudate nucleus on one side of the brain and sham infusions on the other. Following chronic daily injections of cocaine (20 mg/kg, i.p.) or saline (1 ml/kg, i.p.) for 15 days, the caudate nuclei were separately dissected, and the number of benzodiazepine receptors labeled with [3H]Ro 15-1788 were assessed using individual homogenate receptor binding assays. A second group of 24 rats received bilateral infusions of 6-hydroxydopamine or sham infusions into the lateral ventricles followed by chronic cocaine or saline administration as described above. The animals were sacrificed by cardiac perfusion, and the brains were sectioned and prepared for light microscopic quantitative autoradiography. The extent of the lesion was assessed by measuring dopaminergic and noradrenergic uptake sites visualized with [3H]mazindol, while [3H]Ro 15-1788 was used to estimate the number of benzodiazepine receptors. Chronic cocaine administration resulted in significant increases in benzodiazepine receptors in the caudate nucleus, and these effects were attenuated following dopamine depletion. These data suggest that the effects of cocaine on benzodiazepine receptors may be mediated, in part, through the effects of the drug on dopaminergic neuronal activity.

Animals↗
PubMed1990

[Integration and reintegration of first admission psychiatric patients].

In the framework of a prospective follow-up study, development and outcome of the occupational and social status in 258 first-admission psychiatric patients was investigated. Interviews were made at the time of discharge, 1 year and 5 years later. For that reason prospective data exist on the prehospital and hospital time as well as on short-term and long-term course. Social adjustment, occupational rehabilitation, early retirement, social status and pre- and post-hospital occupational integration were investigated. It must be placed on record, that psychiatric patients are subjected to severe negative changes in their occupational and social life even after the first hospital treatment. Type and quantity of disintegration depended on the diagnostic group. Schizophrenic patients differed from the other patients in every intergration area.

Alcoholism↗
PubMed1989

Work and psychiatric illness: the significance of the posthospitalization occupational environment for the course of psychiatric illnesses.

The value of the reintegration and rehabilitation of inpatients vocationally was studied. Certain of the vocational experiences (unemployment and stressful working conditions) of former psychiatric inpatients were examined, with attention being paid to their stabilizing or destabilizing effect on symptomatic behaviour. A cohort of 230 first-time admissions for treatment of various disorders were interviewed while hospitalized and 1 year later. A 20-item list prepared by INFAS was used for indexing stressful working conditions. Psychopathological states were assessed with the help of the Present State Examination of Wing et al. (1973). The results indicate that mentally ill persons (especially those with organic or affective disorders), when confronted with unemployment after discharge from hospital, will usually respond by developing new or worse syndromes. Stressful working conditions appear to have very different effects in schizophrenia and affective disorders, viz. deterioration and amelioration of psychopathological syndromes respectively.

Humans↗
PubMed1989

Mortality and rate of suicide of first admission psychiatric patients. A 5-year follow-up of a prospective longitudinal study.

Patients who commit suicide in a psychiatric hospital are, in general, patients who have had previous admission or who have already made at least one suicide attempt. The following study focuses upon an earlier time within the course of a psychiatric illness, that is the time of first admission, and examines the rate of suicide of 258 patients after 5 years. Two control groups were selected: first admitted psychiatric patients who did not commit suicide, and patients who died a 'natural death'. We analyzed how the suicides were integrated into the vocational, social and medical areas of life before they were admitted to the hospital. Further it was possible to identify predictors of future suicide.

Female↗
PubMed1988

Hemodynamic effects of flestolol, a titratable short-acting intravenous beta-adrenergic receptor blocker.

The hemodynamic effects of flestolol were evaluated in 30 patients undergoing routine cardiac catheterization. Hemodynamic measurements were obtained during baseline (prior to flestolol), at steady state during IV flestolol infusion (1, 5, and 10 micrograms/kg/min) and at 20 to 30 minutes after discontinuation (postinfusion). Flestolol-induced hemodynamic changes were similar to those induced by other beta blockers without intrinsic sympathomimetic activity. Significant dose-dependent reduction in heart rate, rate pressure product, and increase in peripheral vascular resistance were seen. Flestolol produced clinically insignificant decrease in myocardial contractility as shown by slight decrease in LVdp/dt, CI, and LVEF. Hemodynamic data from patients with paced heart rate, further confirms a direct mild cardiac depressant effect of flestolol, a finding common to other beta blockers. Consistent with the short elimination half-life of flestolol (t1/2 = 6.5 minutes), most of the hemodynamic changes rapidly returned to preinfusion level within 20 to 30 minutes following its discontinuation. Thus flestolol, with its unique pharmacokinetic profile and titrability, may be beneficial in the treatment of critically ill patients.

Adrenergic beta-Antagonists↗
PubMed1988

The problem of readmission with respect to occupational factors. Course and predictive influences after 5 years.

In this study the course of Readmission after one, 2.5 and 5 years was examinated at a sample of 258 first admitted psychiatric patients of different diagnostic groups. In the analysis occupational, soziodemographic and clinical parameters of these patients were related to the readmission after 5 years and studied if these parameters allow a predictive statement. It was shown that 40%-60% (dependent of diagnoses) of the patients were readmitted in a period of 5 years. The course of the readmission also varied in the different diagnostic groups. The most striking result was the rate of readmission of the schizophrenic psychoses which was at the time of the 1 year catamnesis below average after the 2.5 year analysis however above average. Beside these findings occupational and clinical predictors were identified in all diagnostic groups with exception of the schizophrenic psychoses group. The results are discussed and attention is put on possible consequences to prevent rehospitalization.

Follow-Up Studies↗
PubMed1988

[Outcome, course and prognosis of the vocational status of psychiatric patients hospitalized for the 1st time--results of a multiple factor study].

In the framework of a prospective longitudinal investigation, the occupational course of first-admission psychiatric patients was analyzed for the first year (1980) and the fifth (1984) post-discharge from the clinic. Findings indicate that, to quite an important degree, tendencies towards occupational disintegration had existed already immediately after the first in-patient treatment episode. This applied almost totally independent of the clinical diagnosis given at the time of the first hospitalization. Only persons with substance abuse illness had been affected clearly less often, the situation four years later being however comparable. Except for the groups of neurotic and personality disorders, the occupational situation had by then however tightened drastically for all of the diagnostic groups, a structural analysis making it clear that this development had initiated already in the course of the first year. Thus, all patients who had been without work over the entire first year of the five-year period, had already reached the "terminal point" in their employment history. As far as diagnoses are concerned, our study confirms the experience that a schizophrenic illness will by no means always entail a straight course toward an unfavourable outcome. The investigation at the same time however also indicated that non-schizophrenic illnesses take a more unfavourable course than had been expected. In relation to earlier longitudinal catamnestic studies of persons with schizophrenia, the findings for our schizophrenic patients moreover were markedly worse, this discrepancy being presumed to be accounted for by the different methods applied, different selection criteria, as well as differences in economic activity at the time.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[Readmission of psychiatric patients hospitalized for the first time--course and predictive factors after 5 years].

In this study the course of rehospitalisation after one, 2 1/2 and 5 years was examined in a sample of 113 readmitted patients of different diagnostic groups. In a second step of analysis occupational, sociodemographic and clinical parameters of these patients were related to the readmission after 5 years and studied if these parameters allow a predictive statement. It was shown that 40%-60% (dependent of diagnoses) of the patients were readmitted in a period of 5 years. The course of the rehospitalization also varied in the different diagnostic groups. The most striking result was the rate of readmission of the schizophrenic psychoses which was at the time of the 1 year catamnesis below average after the 2 1/2 years analysis however above average. Besides these findings occupational and clinical predictors were identified in all diagnostic groups with exception of the schizophrenic psychoses group. The results are discussed and attention is put on possible consequences to prevent rehospitalization.

Follow-Up Studies↗