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D Wells

Publications and source records attributed to D Wells.

138 records · Page 8Linked to original sources

Ricin antitoxins based on lyotropic mesophases containing galactose amphiphiles.

Lyotropic mesophases of the inverse hexagonal or cubic type are nanostructured materials that result from the self-assembly of amphiphilic surfactant molecules in water. The extremely large area of the surfactant-water interface inherent within these structures makes them attractive media for sorbent or encapsulant systems. Here, we report on the development of a new class of polyvalent materials that are based on the incorporation of bioactive ligands within lyotropic mesophases. In particular, we have studied the potential for these materials to behave as polyvalent antitoxins by incorporating synthetic galactose amphiphiles, which mimic the natural cell surface ligand for the protein toxin ricin. The study demonstrates that cubic morphology lyotropic mesophases containing galactose amphiphiles exhibit high specificity ricin uptake, with favorably high dissociation constants and high capacities. We suggest that lyotropic mesophase polyvalent ligands are thus promising materials for the incorporation of a broad range of cell surface recognition moieties and hence may have wide applicability as materials capable of partaking in biological recognition processes.

Antitoxins↗

Impact of the Caring for Aging Relatives Group program: an evaluation.

Caregiver support programs have been developed with the goal of alleviating the stress associated with the demanding role of caring for an older person. The majority of these programs, however, have not been formally evaluated. This study is a formal program evaluation which assessed the impact of a caregiver support program on its participants. Both the intervention and matched comparison groups included a convenience sample of 23 female caregivers. A quasi-experimental pretest-posttest design was used to measure morale, social support, and information. Findings showed there was a positive relationship between morale and social support. In the comparison group only, there was a positive relationship between morale and information in both the pretest and posttest. Within the intervention group, there was a significant increase (t = 2.79, p = 0.01) in the information scores between the pretest and posttest. Caregivers in the intervention group reported that the Caring for Aging Relatives Group (CARG) provided them with social support. The results of this study partially supported the usefulness of a caregiver support program; that is, information was gained, morale was maintained, and caregivers perceived the support program as helpful. Future research is needed to address what factors lead caregivers to attend a support program and what type of social support they receive from attending such a program.

Adult↗

Diethyl ether interference with infrared breath analysis.

Diethyl ether vapor may substantially interfere with breath alcohol analysis by instruments based on infrared absorption at 9.5 microns. Exposure of two volunteers simultaneously to diethyl ether vapor for one hour followed immediately by breath tests on the Draeger Alcotest 7110, Siemens Alcomat V5.2F, and Seres Ethylometre 679T produced apparent alcohol readings in one subject of 0.4, 0.1, and 0.1 g/100 mL of blood respectively. Positive readings persisted in this subject for more than 3 hours. The second subject produced much lower readings of 0.03, 0.01, and 0.00, respectively. Readings persisted with the Alcotest 7110 for one hour. Gas chromatographic analyses of blood and breath samples confirmed that these readings were caused by diethyl ether and not ethanol. The blood concentration of diethyl ether in Subject A immediately after exposure was 25 mg/L. This level produced no clinically detectable neurological changes in the subject.

Adult↗

A comparison of morning and evening instillation of a combination travoprost 0.004%/timolol 0.5% ophthalmic solution.

PURPOSE: To compare the intraocular pressure lowering efficacy and side effect profile of travoprost 0.004%/timolol 0.5% ophthalmic solution dosed in the morning and evening. METHODS: This was a multicenter, prospective, randomized, double-masked, parallel group clinical study of 92 patients with open-angle glaucoma (with or without pseudoexfoliative or pigmentary glaucoma) or ocular hypertension. After a washout of existing glaucoma medications, patients were randomly assigned to receive one drop of travoprost 0.004%/timolol 0.5% in the morning or evening for 6 weeks. The main outcome measures were mean intraocular pressure (IOP) assessed at 9 am, 11 am, and 4 pm, and safety variables. RESULTS: Travoprost 0.004%/timolol 0.5% ophthalmic solution, dosed in the morning or evening, controlled IOP consistently throughout the day. Mean IOP ranged from 16.5 to 16.7 mmHg in the morning treatment group and from 16.1 to 17.2 mmHg in the evening treatment group. Travoprost 0.004%/timolol 0.5% ophthalmic solution produced statistically significant and clinically relevant reductions in IOP from baseline; mean reductions ranged from approximately 8 to 10 mmHg (32% to 38%). Travoprost 0.004%/timolol 0.5% ophthalmic solution was safe and well tolerated with the most frequently reported adverse event being ocular hyperemia, which occurred in 12.5% of patients in the morning treatment group and 13.6% of patients in the evening treatment group. CONCLUSIONS: Travoprost 0.004%/timolol 0.5% given once daily, either in the morning or evening, is a safe and effective treatment for open-angle glaucoma and ocular hypertension. It may be beneficial for patients judged to be inadequately controlled on a prostaglandin analogue or ophthalmic beta-blocker alone.

Adult↗

Radiographic evaluation of transchondral dome fractures of the talus.

Transchondral fractures of the talar dome have been cited frequently in the literature. The number of radiographic techniques available for the evaluation of these lesions often leads to confusion for the physician. The authors discuss each of the radiographic modalities available for the assessment of this entity. Advantages and disadvantages of these modalities have been presented. This manuscript provides the clinician with the knowledge to perform an appropriate evaluation of the problem.

Arthrography↗

Daniel's allergies.

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Follow-Up Studies↗

Review of slipped capital femoral epiphysis associated with endocrine disease.

Review of type and bilaterality of 131 cases (40 bilateral) of slipped capital femoral epiphysis (SCFE) in patients with known endocrinopathies (hypothyroidism, panhypopituitarism, hypogonadism) from 1960 to 1990 showed an increased frequency of patients with endocrine disorders, primarily hypothyroidism (nine of 131 patients, 6.9%); three had bilateral slips; six developed bilateral slips in an average of 11.17 months. Delayed growth plate closure is common in SCFE. Because hypothyroidism can be easily overlooked, all patients with SCFE should be screened for hypothyroidism by measuring serum T4 and TSH (such screening is inexpensive (r = $60). Pituitary deficiency should be considered in children short for their age who have hypogonadism. Any child with a unilateral slip and one of these endocrine deficiencies has a high risk of subsequent bilateral involvement. Prophylactic pinning of the uninvolved hip is recommended because 100% of our patients eventually had bilateral slips.

Adolescent↗

The sixth level of electronic health records: a look beyond the screen.

A recent publication details five levels of electronic health records as defined by the Medical Records Institute and notes that no computer-based patient record system from any company meets the criteria set by the Institute of Medicine. The present article calls to the attention of potential purchasers of medical record software our observation that even if a package appears to meet the abstract criteria for all five levels of electronic health records, its performance may not be satisfactory. A look beyond the user interface screen is highly recommended. Examples from our recent experience are given.

Equipment Failure↗