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L Wheeler

Publications and source records attributed to L Wheeler.

63 records · Page 4Linked to original sources
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Teaching strategies for preceptors of beginning intrapartal students.

This article describes a variety of ways to help novice students learn the nurse-midwifery skills required when caring for laboring women. The influences of learning style, undergraduate nursing experience, and previous work settings are discussed. The art of nurse-midwifery is emphasized, and ways to encourage and support students are discussed.

Clinical Competence↗
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Chemotherapy response rates in recurrent/progressive pediatric glioma; results of a systematic review.

The optimum treatment strategy for recurrent childhood glioma is unknown. This report presents a systematic analysis of the currently available clinical data on chemotherapeutic management of this disease. A study protocol was prospectively developed outlining the objectives and methods of analysis including literature search strategy, eligibility criteria for published trials to be included, key data elements to be extracted and a plan for statistical analysis. Summary statistics were analyzed for the primary outcome variables. Data on recognized prognostic factors were recorded in order to adjust the outcome measures for these factors. A total of 27 non-randomized clinical trails were included in the analysis. Studies were stratified into 6 chemotherapy classes based on the frequency of drug used across studies. Average median response (complete + partial) across all drug categories was approximately 14% (range 10.4-23.5%). Adding patients with stable disease to complete and partial responders at least doubled average median response rates. Time to tumor progression ranged from 29.4 weeks to 49.7 weeks. The most frequently used drugs were the platinum analogs which demonstrated a mean TTP of 42.0 = /-23.4 weeks. Small sample sizes and the overall poor quality of the available data precluded definitive conclusions regarding the clinical impact of the various drug classes on the natural history of this disease.

Adolescent↗
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Curriculum↗
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Diatrizoate contrast agents: 2-amino-5-acetamido-, and 3,5-diamino-2,4,6-triiodobenzoates.

We have examined the metabolic behavior of several triiodobenzoic acid derivatives because of the observed mutagenicity and cytotoxicity of 3-amino-5-acetamido-2,4,6-triiodobenzoate (I) and 3,5-diamino-2,4,6-triiodobenzoate (II). Measurements were facilitated using iodine-131 (131I)-labeled compounds. Drug retention in rabbits was monitored with a gamma camera. Metabolic products were studied by column and thin-layer chromatography. 3,5-Diacetamido-2,4,6-triiodobenzoate (diatrizoate) was partially deacetylated by liver microsomes to I and II. II was transformed in part to another substance whose structure remains undetermined. About 1% of nominal doses of I, II, and diatrizoate were retained for several days following intracardiac injection in rabbits. The rabbit did not appreciably acetylate I to diatrizoate and converted some of II to a urinary metabolite which was similar to that formed by liver microsomes. I was present in human urine following excretory urography with diatrizoate, but II was not detected. Manufacturers of diatrizoate should further reduce the level of free aromatic amines in preparations of diatrizoate. A method of doing so is reported.

Animals↗