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11.
12.
D Wallace 《The Canadian journal of psychiatric nursing》1988,29(1):9-11, 16
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The kinetics of insulin-mediated glucose uptake (IMGU) and non-insulin-mediated glucose uptake (NIMGU) in humans have not been well defined. We used the glucose-clamp technique to measure rates of whole-body and leg muscle glucose uptake in six healthy lean men during hyperinsulinemia (approximately 460 pM) to study IMGU and during somatostatin-induced insulinopenia to study NIMGU at four glucose levels (4.5, 9, 12, and 21 mM). To measure leg glucose uptake, the femoral artery and vein were catheterized, and blood flow was measured by thermodilution (leg glucose uptake = arteriovenous glucose difference [A-VG] x blood flow). With this approach, we found that, during hyperinsulinemia, both whole-body and leg glucose uptake increased in a curvilinear fashion at every glucose level, the highest glucose uptake values obtained being 139 +/- 17 mumol.kg-1.min-1 and 3656 +/- 931 mumol.min-1.leg-1, respectively. Leg blood flow increased twofold from 6.0 +/- 1.7 to 11.7 +/- 3.1 dl/min (P less than 0.01) over the range of glucose and was correlated with whole-body glucose uptake (r = 0.55, P less than 0.005). Leg muscle glucose extraction, independent of changes in blood flow, which is reflected by the A-VG, saturated over the range of glucose (1.28 +/- 0.12, 2.22 +/- 0.30, 2.92 +/- 0.42, 3.02 +/- 0.41 mM, NS between last 2 values) with a half-maximal effective glucose concentration (EG50) of 5.3 +/- 0.4 mM.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
16.
Kathryn E Arnold Jody L Schweitzer Barbara Wallace Monique Salter Ruth Neeman W Gary Hlady Bernard Beall 《Infection control and hospital epidemiology》2006,27(12):1377-1384
OBJECTIVE: To describe investigation of a tightly clustered outbreak of invasive group A streptococcal (GAS) disease associated with a high mortality rate in a long-term care facility (LTCF). DESIGN: Cross-sectional carriage survey and epidemiologic investigation of LTCF resident and employee cohorts. SETTING: A 104-bed community LTCF between March 1 and April 7, 2004. PATIENTS: A cohort of LTCF residents with assigned beds at the time of the outbreak. INTERVENTIONS: Reinforcement of standard infection control measures and receipt of chemoprophylaxis by GAS carriers. RESULTS: Four confirmed and 2 probable GAS cases occurred between March 16 and April 1, 2004. Four case patients died. The final case occurred during the investigation, before the patient was determined to be a GAS carrier. No case occurred during the 6 months after the intervention. Disease was caused by type emm3 GAS; 16.5% of residents and 2.4% of employees carried the outbreak strain. Disease was clustered in 1 quadrant of the LTCF and associated with nonintact skin. GAS disease or carriage was associated with having frequent personal visitors. CONCLUSIONS: Widespread carriage of a virulent GAS strain likely resulted from inadequate infection control measures. Enhanced infection control and targeted prophylaxis for GAS carriers appeared to end the outbreak. In addition to employees, regular visitors to LTCFs should be trained in hand hygiene and infection control because of the potential for extended relationships over time, leading to interaction with multiple residents, and disease transmission in such residential settings. Specific attention to prevention of skin breaks and proper wound care may prevent disease. The occurrence of a sixth case during the investigation suggests urgency in addressing severe, large, or tightly clustered outbreaks of GAS infection in LTCFs. 相似文献
17.
A. Ian Smith Catherine A. Wallace Lain J. Clarke John W. Funder 《Journal of neuroendocrinology》1989,1(5):357-362
In the sheep, unlike many other species, a significant proportion (>25%) of immunoreactive β-endorphin in the anterior pituitary is post-translationally modified to opioid-inactive, α-N-acetylated forms. In a study to determine the precise molecular nature of α-N-acetylated β-endorphin immunoreactivity, we noted a striking difference in high-performance liquid chromatography profiles of anterior pituitary extracts between sheep killed on the farm, and age-, sex- and strain-matched slaughterhouse animals. These altered patterns of a-N-acetylated β-endorphin processing were reproduced in farm animals by chronic (≤ 4 days) treatment with the synthetic glucocorticoid dexamethasone; in contrast dexamethasone had no effect on a-N-acetylated β-endorphin processing in hypothalamo-pituitary disconnected sheep. These data suggest that (1) the change in processing is a stress response, mediated by prolonged glucocorticoid exposure, (2) this effect is central, rather than a direct effect on the pituitary, and (3) the relative abundance of various peptide sequences in slaughterhouse-derived material may not reflect their abundance under more physiological conditions. 相似文献
18.
M J Wallace K Ogawa K Wright C H Carrasco W Richli C Charnsangavej 《AJR. American journal of roentgenology》1986,147(6):1247-1250
New inferior vena caval filters for percutaneous placement were made by attaching filter wires similar to those in the bird's nest inferior vena caval filter onto expandable metallic stents. These stents formed a base on which to anchor the filter to the wall of the inferior vena cava. The stent filter can be introduced through a 12- to 13-French catheter sheath system. The system was successfully tested in 13 dogs. 相似文献
19.
L. Ostrosky-Zeichner C. Sable J. Sobel B. D. Alexander G. Donowitz V. Kan C. A. Kauffman D. Kett R. A. Larsen V. Morrison M. Nucci P. G. Pappas M. E. Bradley S. Major L. Zimmer D. Wallace W. E. Dismukes J. H. Rex 《European journal of clinical microbiology & infectious diseases》2007,26(4):271-276
The study presented here was performed in order to create a rule that identifies subjects at high risk for invasive candidiasis
in the intensive care setting. Retrospective review and statistical modelling were carried out on 2,890 patients who stayed
at least 4 days in nine hospitals in the USA and Brazil; the overall incidence of invasive candidiasis in this group was 3%
(88 cases). The best performing rule was as follows: Any systemic antibiotic (days 1–3) OR presence of a central venous catheter
(days 1–3) AND at least TWO of the following—total parenteral nutrition (days 1–3), any dialysis (days 1–3), any major surgery
(days −7–0), pancreatitis (days −7–0), any use of steroids (days −7–3), or use of other immunosuppressive agents (days −7–0).
The rate of invasive candidiasis among patients meeting the rule was 9.9%, capturing 34% of cases in the units, with the following
performance: relative risk 4.36, sensitivity 0.34, specificity 0.90, positive predictive value 0.01, and negative predictive
value 0.97. The rule may identify patients at high risk of invasive candidiasis.
Results of this project were partially presented at Focus on Fungal Infections 14, New Orleans, LA, USA, 2004. Abstract no.
51. 相似文献
20.
Rachel M Massey Oliver J Warren Michal Szczeklik Sophie Wallace Daniel R Leff John Kokotsakis Ara Darzi Thanos Athanasiou 《Journal of cardiothoracic surgery》2007,2(1):26-9
The use of a skeletonized internal thoracic artery in coronary artery bypass graft surgery has been shown to confer certain
advantages over a traditional pedicled technique, particularly in certain patient groups. Recent reports indicate that radial
and gastroepiploic arteries can also be harvested using a skeletonized technique. The aim of this study is to systematically
review the available evidence regarding the use of skeletonized radial and gastroepiploic arteries within coronary artery
bypass surgery, focusing specifically on it's effect on conduit length and flow, levels of endothelial damage, graft patency
and clinical outcome. Four electronic databases were systematically searched for studies reporting the utilisation of the
skeletonization technique within coronary revascularisation surgery in humans. Reference lists of all identified studies were
checked for any missing publications. There appears to be some evidence that skeletonization may improve angiographic patency,
when compared with pedicled vessels in the short to mid-term. We have found no suggestion of increased complication rates
or increased operating time. Skeletonization may increase the length of the conduit, and the number of sequential graft sites,
but no clear clinical benefits are apparent. Our study suggests that there is not enough high quality or consistent evidence
to currently advocate the application of this technique to radial or gastroepiploic conduits ahead of a traditional pedicled
technique. 相似文献