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C E Speicher

Publications and source records attributed to C E Speicher.

At least 19 recordsLinked to original sources
PubMed1991

Decision-oriented test request forms. A system for implementing practice parameters in laboratory medicine.

The implementation of practice parameters in laboratory medicine by changing physicians' behavior represents a major challenge. Education, restriction of tests, financial incentives, and concurrent chart reviews have not been effective in persuading physicians to improve their use of laboratory tests. The use of decision-oriented test request forms is suggested as an approach to this problem.

Clinical Laboratory Information Systems↗
PubMed1986

Modulation of cellular immunity in medical students.

This study assessed the psychosocial modulation of cellular immunity in 34 medical-student volunteers. The first blood sample was obtained 1 month before examinations, and the second on the day of examinations. There were significant declines in the percentage of helper/inducer T-lymphocytes, in the helper/inducer-suppressor/cytotoxic-cell ratio, and in natural killer-cell activity in the blood samples obtained on the day of examinations. Half of the subjects were randomly assigned to a relaxation group which met between sample points; the frequency of relaxation practice was a significant predictor of the percentages of helper/inducer cells in the examination sample. Three biochemical nutritional assays (albumin, transferrin, and total iron-binding protein) were within normal limits on both samples. Data from the Brief Symptom Inventory showed significantly increased global self-rated distress associated with examinations in the no-intervention group, compared to nonsignificant change in the relaxation group. Clinical and theoretical implications are discussed.

Adult↗
PubMed1986

Stress depresses interferon production by leukocytes concomitant with a decrease in natural killer cell activity.

This study addressed the effects of a commonplace stressful event on interferon production and natural killer (NK) cell activity and numbers. The quantity of interferons (IFN) produced by concanavalin A stimulated leukocytes obtained from 40 medical students during examinations was significantly lower when compared with IFN levels produced by peripheral blood leukocytes (PBLs) taken 6 weeks earlier (baseline). In addition, three different assays measuring NK cells also showed significant decrements during examinations when compared with baseline samples. These assays included lysis of MOLT-4 target cells, percentage of anti-Leu-7+ (NK) cells, and percentage of large granular lymphocytes. Self-report data documented the significantly greater distress associated with examinations in comparison with baseline samples. The data have implications for immunosuppressive disorders and stress-associated illnesses.

Adult↗
PubMed1985

Distress and DNA repair in human lymphocytes.

This research assessed differences in DNA repair in lymphocytes from high- and low-distressed individuals. A median split on Minnesota Multiphasic Personality Inventory (MMPI) Scale 2 divided 28 newly admitted nonpsychotic psychiatric inpatients into high- and low-distress subgroups. The high-distress subgroup had significantly poorer DNA repair in lymphocytes exposed to X-irradiation than low-distress subjects. We also found that lymphocytes obtained from this psychiatric sample had significantly poorer DNA repair than lymphocytes from nonpsychiatric control subjects when compared 5 hr after X-irradiation. A high level of distress therefore appears to be associated with significant dysfunctional differences at the molecular level which may have important implications for health. These data provide evidence for a direct pathway through which distress could influence the incidence of cancer.

Adult↗
PubMed1985

Stress, loneliness, and changes in herpesvirus latency.

This study used a prospective design to examine the influence of examination stress and loneliness on herpesvirus latency as measured by changes in antibody levels to three herpesviruses, Epstein-Barr virus (EBV), Herpes simplex type I (HSV-1), and cytomegalovirus (CMV). Three blood samples were obtained from 49 first-year medical students, with the first sample drawn 1 month before final examinations, the second on the first day of final examinations, and the third during the first week after their return from summer vacation. A median split on the UCLA Loneliness Scale divided subjects into high- and low-scoring loneliness groups. There were significant changes in the antibody titers to all three herpesviruses across the sample points, with the lowest levels found in the third (low stress) sample. High-loneliness subjects had significantly higher EBV antibody titers than low-loneliness subjects. These data suggest that stress-related immunosuppression can significantly modulate herpesvirus latency.

Adult↗
PubMed1985

Stress-related impairments in cellular immunity.

The percentages of total T-lymphocytes (OKT-3+), helper T-cells (OKT-4+), and suppressor T-cells (OKT-8+) were significantly lower in blood samples obtained from 40 medical students during examinations, compared to baseline values obtained 6 weeks earlier. In addition, the response of T-lymphocytes to stimulation by phytohemagglutinin and concanavilin A was also significantly lower during examinations, compared to baseline. Self-report data documented significantly greater distress associated with examinations. The data have implications for immunosuppressive disorders and stress-related illnesses.

Adult↗
PubMed1985

Helping physicians use laboratory tests.

We have described a paradigm for viewing the use of the clinical laboratory in terms of solutions to clinical problems instead of as endless lists of tests. In this regard, we have categorized many of the clinical problems that rely heavily on laboratory testing for their solutions and have suggested ways for readers to develop their own lists for their facilities. We believe that conceptualizing laboratory services in this way can help physicians to use the clinical laboratory in more effective and cost-efficient ways.

Clinical Laboratory Techniques↗
PubMed1984

Stress and the transformation of lymphocytes by Epstein-Barr virus.

Although various stressors appear to influence herpesvirus infections, the underlying mechanisms have not been studied. A prospective design was used to examine the effects of examination stress and loneliness on the transformation of B lymphocytes in mixed cultures of T and B lymphocytes by Epstein-Barr virus (EBV). Three blood samples were drawn from 42 EBV-seropositive medical students, with the baseline sample taken 1 month before their final examinations, the stress sample drawn on the first day of final examinations, and the third sample taken the first week after their return from summer vacation. A median split on the UCLA Loneliness Scale divided the subjects into high- and low-scoring loneliness groups. There were significant effects for change over trials, with the lowest transformation levels (i.e., more virus required to transform cells) found in the stress sample. There was also a significant main effect for loneliness, in which high loneliness was associated with lower transformation levels. Possible immunological pathways for the observed changes are discussed.

Antibody Formation↗
PubMed1984

Expert systems as aids for interpretive reporting.

Interpretive reporting is an established part of the function of many clinical laboratories. Of the three types of information included in these reports, expert system technology is being demonstrated as useful in producing interpretive comments. The ability of expert systems to explain their reasoning and to be easily updated make them superior to prior attempts to computerize this type of interpretation using traditional computer languages. In the future, the broader application of these systems in realistic clinical environments should be expected given recent commercial success in embedding such programs in laboratory instruments.

Information Systems↗
PubMed1984

Interpretive reporting.

Recent growth in the number and complexity of laboratory tests requires more widespread and more sophisticated interpretive reporting. The author examines the state of the art and how pathologists can effectively manage the laboratory data portion of the medical data base.

Adult↗