Clearly clean. Show off those buffed-up pumps!
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Central Supply, Hospital↗
Biomedical subjects
J Campbell
Publications and source records attributed to J Campbell.
Comparison of 3 methods of selenium assessment in cattle.
Three tests are routinely done to assess blood status of selenium in cattle: serum selenium, whole blood selenium, and glutathione peroxidase. The objective of this study was to compare the various analytical methods for determining blood selenium status in groups of mature cows and beef calves. Twenty to 30 blood samples per herd were collected from 8 beef herds in central Alberta and 1 dairy in Alberta herd twice a year from the spring of 1992 through the fall of 1995, and once from 185 spring calves in 2 beef herds in Saskatchewan. Serum and whole blood samples were submitted to 1 laboratory and whole blood samples were submitted to a 2nd laboratory. Samples for glutathione peroxidase determinations were submitted to a 3rd laboratory. Pearson's correlation coefficients and Cohen's kappa were calculated for each possible comparison among the different measures. The best agreement was observed between serum and whole blood analysis within Laboratory A. The remaining comparisons reflected poor agreement. Comparison of herd-level assessment resulted in better agreement than comparison of individual sample results among laboratories and procedures for all combinations tested. Serum selenium analysis was the only laboratory procedure for which external reference material was utilized. Serum selenium, whole blood selenium, and glutathione peroxidase measure different compartments of the blood selenium pool. The time frame of interest, supplementation practices, and the stability of recent dietary intake determine the optimum assessment method for individual animals or herds. Determination of the serum status or of blood selenium is more consistently measured at the herd-level than for individual samples.
Animals↗
Quantitative rheumatology: a survey of outcome measurement procedures in routine rheumatology outpatient practice in Canada.
OBJECTIVE: To assess the extent to which quantitative clinical measurement is performed by rheumatologists in the longitudinal followup of patients with rheumatoid arthritis (RA), osteoarthritis (OA), ankylosing spondylitis (AS), and fibromyalgia (FM) in routine outpatient practice in Canada. METHODS: A cross sectional postal survey was conducted using an 18 item self-administered questionnaire sent to Canadian Rheumatology Association members. RESULTS: Rheumatologists (response rate 85%) were more likely to longitudinally follow patients with RA and AS than those with OA or FM. There was a high degree of variability in the methods used to monitor patients longitudinally. Many measures used in clinical research were used infrequently in routine clinical practice. In general, the major health status measures surveyed were not used in clinical monitoring. There was a high level of agreement (>80%) that the characteristics required of an outcome measure for use in clinical practice should include simplicity, brevity, ease of scoring, reliability, validity, and sensitivity to change. CONCLUSION: The majority of Canadian rheumatologists perform outcome measurement during the longitudinal followup of their outpatients with RA, AS, OA, and FM. However, the process lacks standardization. High performance health status measures, developed for clinical research, have not been widely adopted in rheumatology practices. There is agreement on the characteristics required by Canadian rheumatologists for measurement procedures used in routine clinical care. Quantitative measurement in clinical practice using standardized procedures is an attainable, but as yet, unrealized opportunity.
Ambulatory Care↗
An information strategy for radiotherapy patients.
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Humans↗
Bacterial contamination of scrub jackets during dental hygiene procedures.
PURPOSE: The purpose of this study was to assess bacterial contamination of uniforms by aerosols produced during dental hygiene procedures, including examination, hand and ultrasonic scaling, and polishing. METHODS: Sterile milipore filters were taped to long-sleeved scrub jackets of 26 senior dental hygiene students and worn during patient appointments. Filters were removed at the end of the appointment and cultured to determine bacterial contamination on the dominant arm, non-dominant arm, and chest. RESULTS: Analysis of filter position by procedure with SPSS MANOVA showed a statistically significant difference (1.95, df = 9,299, p = .045). Univariate statistics showed that filters on the dominant arm (p = .013) and non-dominant arm (p = .030) had significantly higher colony forming unit/filter for ultrasonic scaling than for examination, while chest did not (p = .154). CONCLUSION: Aerosol contamination is produced during dental hygiene procedures, even examination and hand scaling. The number of micro-organisms is higher on the sleeves than the chest of scrub jackets, and is higher when ultrasonic or sonic scalers or air polishers are used.
Adult↗
Integrating the family into routine patient care: a qualitative study.
BACKGROUND: The field of family medicine has been enriched by a family-oriented approach and the inclusion of family systems concepts. Keeping the family as a central focus of care has been a fundamental commitment of family medicine. This research examines how exemplary physicians ("exemplars") integrate a family-oriented approach into the routine care of individual patients. METHODS: Four family physician exemplars were observed. A total of 16 days was spent observing the physicians; 137 physician-patient encounters were audiotaped, transcribed, and analyzed. Grounded theory was used for analysis, and a model of a family-oriented approach was developed. RESULTS: Visits were classified by the reason for visit and the intensity of family-oriented talk and actions. There was modest variation among the physicians in terms of intensity and time spent with patients. Overall, 19% of patient encounters had a high intensity of family-orientedness; 34% were of low intensity. The average time spent with patients was 13 minutes, with visits ranging from 3 to 39 minutes in length. CONCLUSIONS: Our study demonstrated that physicians integrate family systems concepts into routine individual patient care. The findings identify characteristics of the family-oriented approach and those circumstances that promote and hinder it. Family physicians can adapt specific components of the family-oriented approach into their routine individual patient care.
Communication↗
A 150-base pair 5' region of the MHC class I HLA-B7 gene is sufficient to direct tissue-specific expression and locus control region activity: the alpha site determines efficient expression and in vivo occupancy at multiple cis-active sites throughout this region.
To characterize cis- and trans-acting mechanisms that regulate MHC class I transcription during development and in adult tissues, we have used transgenic mice to study a series of human MHC (HLA)-B7 class I gene constructs. Previous studies identified the 5' -0.66-kb to -0.075-kb region as sufficient to direct appropriate and efficient tissue-specific levels of HLA-B7 RNA relative to H-2 class I. Results here show that DNA 5' of -0.26 kb is not required for any aspect of expression. As the expression level correlated with the transgene copy number, was comparable to H-2 or a per-gene copy basis and was independent of integration site, the -0.075 to -0.26-kb segment also functions as a locus control region. With this region, sequences 3' of -0.075 kb, possibly at the promoter, appear to direct the appropriate tissue distribution. Of conserved sequences in the -0.075 to -0.26-kb region, enhancer B box is nonessential. In contrast, in vivo "footprinting" implicated region I/ enhancer A/NF-kappaB, IFN consensus/response sequence, and alpha in class I regulation as they are "occupied" in a tissue-specific pattern that correlates with expression. Mutation of alpha leads to decreased expression and loss of occupancy not only at alpha but also at region I/enhancer A/NF-kappaB and IFN consensus/response sequence. Thus, site alpha is an essential class I regulatory element, the dominant function of which is to mediate tissue-specific occupancy at multiple adjacent cis-active sites, possibly by facilitating stable synergistic interactions between factors at these distinct elements.
Animals↗
New guidelines on managing back pain are similar to previous ones.
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Back Pain↗
Inhibition of Neurospora crassa growth by a glucan synthase-1 antisense construct.
We have used the filamentous fungus, Neurospora crassa, as a model system to test the concept that antisense targeting of the cell-wall assembly enzyme, (1,3)beta-glucan synthase [E.C. 2.4.1.34; UDPglucose: 1,3-beta-D-glucan 3-beta-D-glucosyltransferase], leads to a corresponding decrease in growth of the organism. Previously, our laboratory isolated a gene (glucan synthase-1, gs-1) that is required for (1,3)beta-glucan synthase activity. Wild-type cells were transformed with DNA vectors encoding various RNAs complementary to the gs-1 messenger RNA (antisense RNA) cloned downstream from an inducible promoter (quinic acid-2[qa-2p]). Stable transformants, expressing a partially inverted antisense message of gs-1 (pMYX107), exhibited dramatic reduction ingrowth compared with empty vector controls. Hyphal measurements of these transformants grown on race tubes indicated that all of the transformants showed various degrees of inhibition. Microscopic observations of transformants revealed shorter hyphal lengths when grown under conditions expressing antisense. Further characterization revealed that the specific activities of (1,3)beta-glucan synthase were decreased by as much as 63% relative to empty vector controls. Together, these observations suggest that antisense against (1,3)beta-glucan synthase led to a reduction in enzyme levels that resulted in altered cell-wall morphology and inhibition of growth. It is possible that antisense oligonucleotides against gs-1 may be useful antifungal agents.
Antifungal Agents↗
Cytotoxicity and mitogenicity of adenosine triphosphate in the cochlea.
Evidence is accumulating to indicate that extracellular adenosine 5'-triphosphate (ATP) may function as a neurotransmitter, neuromodulator, cytotoxin and mitogen. Many of the cells in the cochlea have ATP receptors, however, their function is unknown. The purpose of the present study was to test whether ATP may act as a cytotoxin in the cochlea. ATP was applied to acutely isolated outer hair cells (OHCs) and their shape changes monitored. In addition, ATP was applied into the cochlea by perfusion of the perilymph compartment for 2 h and the animals allowed to survive 3-4 weeks post drug application. At this time, sound-evoked cochlear potentials and distortion product otoacoustic emissions (DPOAEs) were monitored and the cochleas evaluated histologically. Results indicate that when applied to isolated OHCs, ATP (3-30 mM) induced a bleb formation in the infracuticular region of the cell that burst within a few minutes. Short OHCs were more sensitive to this effect of ATP than long OHCs. 3-4 weeks after the perilymph perfusion of ATP (60 mM; 2 h) cochlear potentials and DPOAEs were abolished, and histologically, cells in the organ of Corti and the stria vascularis were found to have been destroyed. In addition, there was loss of spiral ganglion cells and proliferating connective tissue filled varying proportions of the scala tympani and vestibuli. Application of sodium gluconate, a control, at the same concentrations had no effect either on the isolated OHCs or when applied in vivo. Results suggest that extracellular ATP or a metabolic product may act as a cytotoxin to some epithelial and neural elements in the cochlea and possibly as a mitogen to mesenchymal cells or fibrocytes.
Adenosine Triphosphate↗
Quantitative determination of theophylline by an automated chemiluminescent immunoassay in serum and plasma: comparison to other methods of analysis.
A chemiluminescent immunoassay for theophylline in serum or plasma was developed for the Ciba Corning ACS: 180 automated analyzer. The assay has a limit of quantitation of 0.2 microgram/ml, with a range up to 40 micrograms/ml. The cross-reactivity to metabolites 1,3-dimethyluric acid 3-methylxanthine was 3.4% and 2.5%, respectively. Overall means of 101.0% and 97.8% were determined from dilution linearity and addition studies, respectively. When compared to a high-performance liquid chromatography (HPLC) method, a linear regression of ACS Theophylline = 0.996 (HPLC) + 0.35, r = 0.991, n = 93, was obtained. Similar results were obtained when the ACS assay was compared to other immunoassays. Precision (within-run and total coefficient of variation or CV) was < 6% in the therapeutic range (10-20 micrograms/ml). The performance data demonstrate that the ACS Theophylline assay provides an additional choice for the clinical measurement of the drug.
Chromatography, High Pressure Liquid↗
The effect of cisapride on oral and intravenous glucose tolerance in normal subjects.
Cisapride is used widely for the treatment of diabetic gastroparesis. There is some evidence that cisapride may influence insulin secretion. The aim of this study was to evaluate the effect of cisapride on plasma concentrations of glucose, insulin and C-peptide in response to oral and intravenous glucose loads. Twelve normal subjects took cisapride and placebo, each for 10 days using a randomized, double-blind, crossover design. In each treatment phase, the plasma glucose, insulin and C-peptide response to intravenous (0.5 g/kg) and oral (75 g) glucose loads was evaluated on separate days. Gastric emptying of the oral glucose load was also measured. After the intravenous glucose load, plasma concentrations of C-peptide were higher (P< 0.01) on cisapride when compared with placebo (e.g. peak C-peptide 2.08+/-0.25 nmol/L vs 1.78+/-0.22 nmol/L, P< 0.01) while there was no significant difference in plasma glucose or insulin. Cisapride had no effect on the rate of gastric emptying of the oral glucose load. Mean plasma concentrations of insulin and C-peptide were higher after oral glucose on cisapride than placebo, but these differences were not significantly different. These observations indicate that cisapride may increase glucose-stimulated insulin secretion.
Administration, Oral↗
How consumers/survivors are evaluating the quality of psychiatric care.
In the past decade, mental health consumers have increasingly become involved in evaluating the quality of psychiatric care and applying sophisticated data strategies to affect system reform. Through multistakeholder partnerships, they have identified outcome indicators, collaborated in the development of a mental health report card, and designed and conducted consumer self report surveys on satisfaction and needs and preferences for housing and supports. The formation of multistakeholder assessment teams; the definition of the consumer perspective through focus groups and concept-mapping pilots; and research on coercion, personhood, recovery, and empowerment are key activities of consumers/survivors in the field of evaluation.
Community Participation↗
Efficacy of outpatient intensive treatment for drug abuse.
OBJECTIVE: Outpatient intensive treatment for drug and alcohol abuse has become an alternative approach to management of substance abuse. We evaluated the efficacy of an outpatient intensive treatment program for crack cocaine; and the impact of psychiatric diagnosis on outcome variables. METHOD: Subjects participating in an outpatient intensive treatment program underwent descriptive testing at entry and at six-month followup. Outcome variables included Addiction Severity Index composite scores and retention in treatment. RESULTS: Subjects demonstrated significant improvement in ASI scales, over time, with an interaction effect of time and scale. Minimal interaction of psychiatric diagnosis and outcome was found. CONCLUSION: Outpatient intensive treatment demonstrated efficacy in reduction of ASI composite scores. Comparison with standard outpatient treatment and inpatient treatment is needed.
Adult↗
Idarubicin and intermediate dose ARA-C followed by consolidation chemotherapy or bone marrow transplantation in relapsed or refractory acute myeloid leukemia.
Sixty-one adult patients with relapsed or refractory acute myelogenous leukemia (AML) were treated in a cooperative study with Idarubicin 12 mg/m2/day on days 1 to 3 and AraC 1 g/m2/12h on days 1 to 4. Responding patients were scheduled for consolidation with Ida-IDAraC and bone marrow transplantation (BMT) when feasible. Twelve of 23 refractory patients (52%) and 21 of 38 relapsed patients (55%) achieved complete remission (CR). Refractory patients treated very early with Ida-IDAraC (CR 63%) and relapsed patients with initial CR > 6 months (CR 68%) were the subgroups with better CR rate. The only factor influencing the disease free survival (DFS) was the intensity of postremission therapy: Nine patients had severe toxicity with the salvage regimen and were excluded for consolidation, fourteen patients received Ida-IDAraC and ten patients proceeded to myelo-ablative therapy supported with autologous or allogeneic BMT. The three groups had different median DFS of 6 months, 9 months and 15 months respectively (P = 0.017). In summary, Ida-AraC is an efficient salvage regimen for AML. The CR rate seems to be improved in refractory patients if used promptly, but the long term outcome appears to depend on the intensity of treatment given once remission is achieved and on the ability to perform BMT.
Acute Disease↗
Anaphylaxis.
Some people's response to different drugs, foods or insect stings can be severe. This article examines the normal physiology of the body's antigen-antibody reaction and considers the abnormal life-threatening allergic reaction of anaphylaxis.
Anaphylaxis↗
Measurement of individual vs total antioxidants.
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Antioxidants↗
Intravenous cannulation: potential complications.
The procedure of establishing peripheral venous access carries the risk of potential complications to both the patient and the practitioner. Complications include infection, phlebitis and thrombophlebitis, emboli, pain, haematoma or haemorrhage, extravasation, arterial cannulation and needlestick injuries. Careful adherence to guidelines and procedures can minimise these risks.
Catheterization, Peripheral↗