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Biomedical subjects

L Goodwin

Publications and source records attributed to L Goodwin.

At least 19 recordsLinked to original sources
PubMed2001

Evaluation of two current generation enzyme immunoassays and an improved isolation-based assay for the rapid detection and isolation of rotavirus from stool.

BACKGROUND: Rapid and accurate rotavirus testing is important in decisions involving patient care and management. Quality assurance testing needs to be periodically performed, especially among widely used assays having a direct impact on patient care. OBJECTIVES: To evaluate the current generation Kallestad Pathfinder Direct antigen Detection system (PTH), and the widely used Rotaclone(R) Rotavirus EIA Diagnostic Kit (RTC), in comparison with an improved cell culture amplification-antigen detection (CCA-Ag) isolation-based assay. STUDY DESIGN: Two hundred stool specimens (specimen stored at > or =-75 degrees C), which had been previously tested by PTH, were tested by RTC and CCA-Ag. Discordant specimens were retested by PTH, blocking assay, polyacrylamide gel electrophoresis (PAGE), and/or electron microscopy (EM). RESULTS: Among 200 stool specimens, 197 were in accord by PTH, RTC and CCA-Ag. The sensitivity, specificity, positive and negative predictive values for RTC, PTH and CCA-Ag were, 100, 99, 99, 100, 100, 99, 99, 100; and 98, 100, 100, 98%, respectively. Among five initially discordant specimens, two required a period of 10 days to affect isolation. A non-cultivatable (CCA-Ag negative) but true positive specimen, was identified as rotavirus group A serotype G2 by RT-PCR. Four true positive but discordant specimens were blocking assay negative using one or both EIA kits. CONCLUSIONS: PTH and RTC are excellent rotavirus detection system. However, PTH is more expensive (ca. $3.50 vs. $2.00 per test), mandates a slightly longer turn-around time (ca. 1 vs. 1.5 h), and necessitates slightly more hands-on manipulative/preparative steps. Blocking assay was not a reliable confirmatory test for the resolution of specimen discordancy. A combination of CCA-Ag, PAGE, EM, and/or perhaps RT-PCR, is recommended as an appropriate test panel for the resolution of discordant results during assay evaluation. The newly modified and simplified 48-h rotavirus isolation-based assay may serve as a base line methodology in laboratory evalaution studies, as a laboratory support methodology during drug/vaccine efficacy trials, or for the testing of sources (e.g., biopsy/autopsy tissues) not approved for assay by commercial rotavirus kits.

Antigens, Viral↗
PubMed2000

Building knowledge in a complex preterm birth problem domain.

Data mining methods used a racially diverse sample (n = 19,970) of pregnant women and 1,622 variables that were collected in Duke's TMR electronic patient record over a 10-year period. Different statistical and data mining methods were similar when compared using receiver operating characteristic (ROC) curves. Best results found that seven demographic variables yielded .72 and addition of hundreds of other clinical variables added only .03 to the area under the curve (AUC). Similar results across methods suggest that results were data-driven and not method-dependent, and that demographic variables may offer a small set of parsimonious variables with predictive accuracy in a racially diverse population. Work to determine relevant variables for improved predictive accuracy is ongoing.

Area Under Curve↗
PubMed1999

Coinfection with influenza B virus does not affect association of Neisseria meningitidis with human nasopharyngeal mucosa in organ culture.

There is an epidemiological association between influenza virus infection and meningococcal disease. Proposed mechanisms are the destruction of the normal epithelial barrier function of the upper respiratory tract by influenza virus or the expression of human or viral surface-exposed proteins that enhance bacterial adherence and/or invasion. To test these hypotheses, human nasopharyngeal mucosa specimens from a total of 19 individual donors were successfully infected with influenza B virus and then inoculated with serogroup B Neisseria meningitidis. Subsequent bacterial association with the epithelial surface was measured in three separate series of experiments by using transmission electron microscopy (n = 6), scanning electron microscopy (n = 6), and counting of viable bacteria within homogenates of explants (n = 7). Penetration of the mucosa was estimated by measuring the count of viable bacteria recovered from explants after exposure to sodium taurocholate. Bacterial association with the surface of explants was time dependent over 24 h of superinfection. Influenza virus did not positively or negatively influence bacterial attachment to or penetration of explant mucosa compared to those of uninfected controls, even when the period of preincubation with virus was extended to 7 days. When proteins were purified from mucosal epithelium and immobilized on nitrocellulose membranes, N. meningitidis attached predominantly to bands corresponding to proteins of 210 and 130 kDa. In the presence of influenza virus infection, these proteins were gradually lost over the course of 72 h. In conclusion, influenza B virus did not increase association of serogroup B N. meningitidis with human nasopharyngeal mucosa.

Antigens, Viral↗
PubMed1997

What is normal vaginal flora?

OBJECTIVE: To observe the composition of the vaginal flora of healthy women over time, and in relation to hormonal changes, sexual activity, and hygiene habits. DESIGN: A longitudinal surveillance of the vaginal flora over an eight week period. SUBJECTS: 26 female health care workers in local genitourinary medicine clinics. METHODS: The participants were anonymised. They filled in diary cards daily. Blind vaginal swabs were self-taken two-seven times weekly. A smear was air-dried for later Gram staining. The swabs were also cultured for Candida spp, Gardnerella vaginalis, anaerobes, Mycoplasma hominis and Ureaplasma urealyticum. RESULTS: Of 26 subjects, only four had normal vaginal microbiology throughout. One woman, who was not sexually active, had bacterial vaginosis (BV) throughout and nine (35%) had intermittent BV. Candidiasis was found intermittently in eight women (31%), and eight had normal microscopy. U urealyticum was isolated intermittently in 40% of women with BV, 25% with candida, and 50% with normal microscopy. Many women were symptomatic, but symptoms correlated poorly with microbiological findings. All but two women were sexually active; however, more women with BV were exposed to semen. BV seemed to be related to frequent use of scented soap, and there appeared to be an additive effect of clothing and hygiene factors. CONCLUSIONS: Our study raises doubts about what should be regarded as normal vaginal flora. It calls into question the significance of finding BV or U urealyticum on a single occasion in asymptomatic women, or of finding normal flora in symptomatic women. The effect of external factors on the vaginal flora deserve further study.

Adult↗
PubMed1997

A collaborative international nursing informatics research project: predicting ARDS risk in critically ill patients.

An international nursing informatics research collaboration between Duke University Medical Center in Durham, North Carolina, USA and Allgemeine Krankenhaus Hospital in Vienna, Austria used data mining techniques called Knowledge Discovery in Databases (KDD) to explore the relationship between clinical data variables and adult respiratory distress syndrome (ARDS) in critically ill patients. Results of the study and logistics of international research collaboration will be presented at NI '97. The conceptual model, data mining methodology, and objectives for the collaboration are described here.

Austria↗
PubMed1997

Data extraction and archiving for nursing research using a bedside clinical information system.

Institution wide use of an intensive care bedside information system creates the opportunity to make available vast amounts of clinical data to support research and quality improvement activities. Acting on this opportunity has required the development of several innovative approaches to transform this raw data into usable information. The process described herein uses commercially available software and hardware tools to extract on a daily basis, process and archive data for 7 intensive care units. Once this procedure is complete, attention is turned to using individual and combinations of data elements to build a higher level of information that more directly relates to the kinds of inquiries that help to address questions of outcome, and care quality.

Archives↗
PubMed1997

Performance support concepts for Web-based informatics instruction.

Duke University first offered World Wide Web (WWW) based courses in Nursing Informatics in January of 1997. The first class enrolled 18 nurses who were completing either a Post-Master's Certificate Program or were near completion of their Master's degree. Courses were designed around principles of advanced nursing practice, performance support, mastery learning, and virtual learning communities. Extensive learning assessment included traditional papers, real-world application projects, and a variety of pre and post-test measurements.

Computer Communication Networks↗
PubMed1997

Data mining issues for improved birth outcomes.

Issues obstructing progress in data mining for improved health outcomes include data quality problems, data redundancy, data inconsistency, repeated measures, temporal (time-contextual) measures, and data volume. Related issues involve theoretical and technical problems involving uncertainty management, missing data and missing values, and matching appropriate data mining techniques to patient data sets. Results of data mining research in progress are reported for Duke University's perinatal database that contains nearly a decade of clinical patient data, 71,753 database (patient) records and 4-5000 variables per patient.

Artificial Intelligence↗
PubMed1995

Effects of surgical treatment on the microbial flora in residual periodontal pockets.

The aim of this study was to investigate the effects of modified Widman flap surgery on the microbial flora in deep residual periodontal pockets remaining after non-surgical treatment. Micro-organisms from samples of subgingival plaque obtained from adult periodontitis sites in six patients were cultured aerobically and anaerobically, on a variety of media and identified. Non-surgical treatment produced little clinical improvement and had little effect on the total microbial count. Subsequent modified Widman flap surgery resulted in significant clinical improvements which were accompanied by an overall reduction in microbial counts. Regular reviews for scaling and oral hygiene maintained the clinical improvements and balance in favour of beneficial microbial species during the 1 year of the study.

Adult↗
PubMed1994

Interactions of the cytoplasmic domain of the desmosomal cadherin Dsg1 with plakoglobin.

Dsg1 is a 165-kDa glycoprotein component of suprabasal epidermal desmosomes and the prototype of a subset of the cadherin superfamily of cell-cell adhesion proteins known as desmogleins. The adhesive function of classical cadherins is known to be dependent upon their association with cytoplasmic components called catenins. In the case of desmogleins, a single interaction has been described with a protein called plakoglobin that is found in desmosomal plaques, adherens junctions, and the cytosol. Several proteins with homology to plakoglobin have been described that regulate junction assembly and implement morphoregulatory signals. To address the functional significance of plakoglobin-desmoglein interaction, we have mapped the sequences of Dsg1 that are crucial for this association by using blot overlay techniques. By examining the binding of plakoglobin to a deletion series of the Dsg1 cytoplasmic domain expressed as fusion proteins, we have defined a 19-amino acid sequence that is important for association. This region of Dsg1 sequence shows significant similarity to the catenin-binding domain of classical cadherins, suggesting a common mechanism for the association of plakoglobin with desmosomes and adherens junctions.

Amino Acid Sequence↗
PubMed1994

Essential program components for perinatal home care.

Home care will continue to be a rapidly expanding area of health care. This growth will be evident in the perinatal nursing specialty. There are multiple models for delivery of perinatal home services. In each case, consideration needs to be given to licensing and other standards; to operational areas such as staffing, supplies, equipment, and reimbursement; and to quality issues, such as staff development, internal and external customer service, and a continuous quality improvement program. Successful marketing of the services requires recognition that the product is nursing care.

Community Health Nursing↗
PubMed1993

New findings on the microbial flora associated with adult periodontitis.

The predominant microbial flora associated with adult periodontitis was investigated in 21 patients aged 20-40 years. Microorganisms from samples of subgingival plaque were cultured on selective and non-selective media under aerobic and anaerobic conditions. Ten species or groups out of a total of 31 were found to comprise the predominant cultivable flora: diphtheroids, Porphyromonas asaccharolytica, coagulase-negative staphylococci, 'Streptococcus milleri'-group, Bacteroides ureolyticus, Capnocytophaga ochracea, the Prevotella veroralis/buccalis complex, P. intermedia, P. oralis and unidentified Prevotella spp. Two species previously reported at periodontitis sites, namely P. gingivalis and Fusobacterium nucleatum, were not isolated, whereas Prevotella species accounted for the majority of isolates in this investigation. The large proportion of non-pigmented Prevotella species, P. asaccharolytica and B. ureolyticus that were found have not generally been reported previously. The role of these microorganisms and also coagulase-negative staphylococci, diphtheroids and the 'Streptococcus milleri'-group requires further investigation in adult periodontitis.

Adult↗
PubMed1993

Levobunolol compared to dipivefrin in African American patients with open angle glaucoma.

The prevalence of open angle glaucoma is disproportionately high in the African American population. Information about the effectiveness of anti-glaucoma medications in an exclusively African American population is lacking. We treated both eyes of 38 African American patients who have stable open angle glaucoma with either levobunolol b.i.d. or dipivefrin b.i.d. to evaluate the effectiveness of each drug in lowering intraocular pressure. Patients were treated for six weeks following a two week washout period. We measured intraocular pressure levels after one, three, and six weeks. Each medication produced a statistically significant decrease in intraocular pressure by week one. The mean pre-treatment pressure of 24.4 mmHg in the levobunolol was reduced to 17.0 mmHg by week six. The mean pre-treatment pressure of 25.4 mmHg in the dipivefrin treated group was reduced to 18.2 mmHg by week six. There was not a statistically significant difference in the pre-treatment or the final pressure between the two groups. Both levobunolol and dipivefrin produce a statistically significant decrease in intraocular pressure in African American patients with open angle glaucoma.

Adult↗