==================================CMR03==================================
3.   Laminar airflow treatment for cancer patients.
     Children and laminar air flow.
     Psychological concerns regarding laminar air flow.
     Psychological well-being in laminar air flow.
1
UI  - 87058111
AU  - Ravussin E ; Lillioja S ; Anderson TE ; Christin L ; Bogardus C
TI  - Determinants of 24-hour energy expenditure in man. Methods and
      results using a respiratory chamber.
AB  - Daily human energy requirements calculated from separate
      components of energy expenditure are inaccurate and usually in
      poor agreement with measured energy intakes. Measurement of
      energy expenditure over periods of 24 h or longer is needed to
      determine more accurately rates of daily energy expenditure in
      humans. We provide a detailed description of a human respiratory
      chamber and methods used to determine rates of energy expenditure
      over 24-h periods in 177 subjects. The results show that:
      fat-free mass (FFM) as estimated by densitometry is the best
      available determinant of 24-h energy expenditures (24EE) and
      explains 81% of the variance observed between individuals (24EE
      [kcal/d] = 597 + 26.5 FFM); 24EE in an individual is very
      reproducible (coefficient of variation = 2.4%); and even when
      adjusted for differences in FFM, there is still considerable
      interperson variability of the daily energy expenditure. A large
      portion of the variability of 24EE among individuals, independent
      of differences in body size, was due to variability in the degree
      of spontaneous physical activity, i.e., "fidgeting,: which
      accounted for 100-800 kcal/d in these subjects.
MH  - Activities of Daily Living ; Basal Metabolism ; Body Weight ;
      Calorimetry ; *Energy Metabolism ; *Environment, Controlled ;
      Food ; Human ; Obesity/METABOLISM ; Oxygen Consumption ;
      Regression Analysis ; Sleep/PHYSIOLOGY ; Time Factors
SO  - J Clin Invest 1986 Dec;78(6):1568-78
2
UI  - 87022832
AU  - Geissler CA ; Dzumbira TM ; Noor MI
TI  - Validation of a field technique for the measurement of energy
      expenditure: factorial method versus continuous respirometry.
AB  - The field technique for measuring daily energy expenditure, using
      activity diary plus short-term indirect calorimetry, was
      validated with a room respirometer. Eleven male and 14 female
      subjects spent 24-h periods in the respirometer and kept an
      activity diary to the nearest minute. Subsequently, the energy
      cost of the recorded activities was measured in duplicate, and
      24-h expenditure was calculated. Over the 42 24-h measurements
      the mean value by the factorial field method was within 1% of
      that from continuous indirect calorimetry. However, the error in
      individual daily expenditure ranged from -17% to +25%. Correction
      of the error involved in using calculated BMR for the cost of
      sleeping resulted in a 5% mean underestimation of the daily
      value. The factorial method is, therefore, too inaccurate for the
      estimation of individual daily expenditures but provides a close
      estimate of the true energy expenditure for population groups.
MH  - Adult ; Calorimetry/*INSTRUMENTATION ; Calorimetry, Indirect/
      *INSTRUMENTATION ; Comparative Study ; *Energy Metabolism ;
      *Environment, Controlled ; Exertion ; Female ; Human ; Male ;
      Respiration ; Sleep/PHYSIOLOGY ; Support, U.S. Gov't, Non-P.H.S.
SO  - Am J Clin Nutr 1986 Nov;44(5):596-602
3
UI  - 86321869
AU  - Daga SR ; Chandrashekhar L ; Pol PP ; Patole S
TI  - Appropriate technology in keeping babies warm in India.
AB  - Provision of a thermoneutral environment to the newborns has made
      an important contribution to improved neonatal survivals. Modern
      systems which only warm one baby are expensive and their
      maintenance not very easy. Warming a room with three to four
      babies by means of simple devices is cost-effective and should be
      preferred by those to whom cost matters very much.
MH  - Body Temperature Regulation ; *Environment, Controlled ; Heating
      ; *Hospital Units ; Human ; India ; *Infant Care ; *Infant,
      Newborn ; Technology, Medical ; Transportation of Patients
SO  - Ann Trop Paediatr 1986 Mar;6(1):23-5
4
UI  - 86276943
AU  - Petersen FB ; Buckner CD ; Clift RA ; Lee S ; Nelson N ; Counts
      GW ; Meyers JD ; Sanders JE ; Stewart PS ; Bensinger WI ; et al
TI  - Laminar air flow isolation and decontamination: a prospective
      randomized study of the effects of prophylactic systemic
      antibiotics in bone marrow transplant patients.
AB  - 122 patients with hematologic malignancies underwent allogeneic
      marrow transplantation from HLA-matched sibling donors and
      received one of two forms of infection prophylaxis while
      granulocytopenic: 1) decontamination and laminar air flow
      isolation (LAF, 68 patients), and 2) LAF plus prophylactic
      systemic antibiotics (LAF + PSA, 54 patients). Patients were
      evaluated for infection acquisition while in isolation.
      Septicemia occurred in 11 (16%) of the patients in the LAF group
      and in three (6%) patients in the LAF + PSA group. Fourteen (21%)
      of the patients in the LAF group and four (7%) patients in the
      LAF + PSA group had a major local infection. There was no
      difference in the incidence and severity of graft-versus-host
      disease or incidence and duration of fever. The addition of
      prophylactic intravenous broad-spectrum antibiotics for patients
      isolated in LAF rooms significantly decreased infection
      acquisition.
MH  - Adolescence ; Adult ; Antibiotics/*THERAPEUTIC USE ; Bone Marrow/
      *TRANSPLANTATION ; Child ; Child, Preschool ; Environment,
      Controlled ; Graft vs Host Disease/OCCURRENCE ; Granulocytes ;
      Human ; Infection/OCCURRENCE/*PREVENTION & CONTROL ; Leukocyte
      Count ; Middle Age ; *Patient Isolation ; *Premedication ;
      Prospective Studies ; Pulmonary Fibrosis/OCCURRENCE ; Random
      Allocation ; Septicemia/OCCURRENCE/PREVENTION & CONTROL ;
      Sterilization ; Support, Non-U.S. Gov't ; Support, U.S. Gov't,
      P.H.S.
SO  - Infection 1986 May-Jun;14(3):115-21
5
UI  - 86245745
AU  - Guerra IC ; Shearer WT
TI  - Environmental control in management of immunodeficient patients:
      experience with "David:.
AB  - Environmental control in managing patients with immunodeficiency
      ranges from the exceedingly complex to the relatively simple. At
      one end of the spectrum is the total isolation technology applied
      to David, the "Bubble Boy: who lived his entire life behind
      sterile plastic barriers. At the other end of the spectrum is the
      simpler technology applied to patients receiving bone marrow
      transplants who are maintained in ordinary private hospital rooms
      and attended by personnel who merely observe handwashing
      precautions. Most properly performed and controlled studies of
      the use of special isolation procedures to reduce infections
      derive from patients receiving bone marrow transplants for
      conditions of aplastic anemia and leukemia or patients receiving
      chemotherapy for malignancy. The design of isolation procedures
      for immunodeficient patients borrows from these studies because
      of the relatively small number of immunodeficient patients. These
      studies have shown that laminar airflow rooms produce a
      significantly lower incidence of infections but may not change
      the mortality of all patients. Also, protective isolation has
      clearly reduced the incidence and severity of graft-versus-host
      disease in transplanted patients with aplastic anemia. Recently
      there has been a trend away from strict isolation procedures
      because careful studies have indicated that host rather than
      acquired pathogens are responsible for at least 85% of infections
      in these special patients. Also, the human stress of prolonged
      isolation is becoming increasingly recognized. The complex and
      expensive isolation techniques that were used in David's case are
      no longer being utilized in immunodeficient subjects, partly
      because new transplantation technology has made it possible to
      cross histocompatibility barriers, obviating the need for
      permanent isolation.
MH  - Bacterial Infections/ETIOLOGY/*PREVENTION & CONTROL ; Child ;
      *Environment, Controlled ; Human ; Immunologic Deficiency
      Syndromes/COMPLICATIONS/ECONOMICS/*THERAPY ; Male ; Patient
      Isolation/ECONOMICS/*METHODS/PSYCHOLOGY ; Review ; Support,
      Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S.
SO  - Clin Immunol Immunopathol 1986 Jul;40(1):128-35