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Biomedical subjects

P Chase

Publications and source records attributed to P Chase.

At least 19 recordsLinked to original sources
PubMed2001

Finding the underserved: directions for HIV care in the future.

The demographic, behavior, and background characteristics of 4,804 participants in 17 national demonstration projects for HIV medical and/or psychosocial support services were coded for an index of "service need" or possible under-representation in the traditional healthcare system. Fifteen items were coded including status as a person of color, lack of private insurance, unemployment/disability, problem drinking, crack cocaine use, heroin use, other illicit drug use, less than 12 years of education, criminal justice system involvement, children requiring care while the patient receives services, sex work, being the sex partner of an injection drug user, unstable housing, primary language not English, and age less than 21 or over 55 years. Most (87.7%) of the program participants had four or more of these factors present. Through CHAID modeling, those groups with the highest levels of service need and vulnerability were identified. These data suggest that these projects, designed to attract and serve individuals potentially underrepresented in the health services system, had in fact achieved that goal. Implications of the changing demographics of the HIV epidemic for the health service delivery system are discussed.

Adult↗
PubMed2000

Structural, relative, and absolute agreement between parents' and adolescent inpatients' reports of adolescent functional impairment.

This study assessed agreement between parents' and adolescent inpatients' scores on caretaker and self-report versions of the Functional Impairment Scale for Children and Adolescents (FISCA and FISCA-SR). Self-report data describing impairment in eight domains were collected from 375 inpatients (M age = 15.0 years, 55% females), with parent data available for 233 (62%). Confirmatory factor analysis demonstrated structural congruence between a hypothesized, three-factor model, based on a prior study of the parent FISCA, and an observed model, based on responses to the FISCA-SR (GFI = .95). Correlations (measuring relative agreement) and paired comparisons of means (assessing absolute agreement) generally identified stronger agreement in "public" than "private" domains of impairment, and greater relative than absolute agreement in covert, antisocial domains.

Adolescent↗
PubMed2000

In the steps of giants: the early geriatrics texts.

This article briefly reviews some of the major early geriatric textbooks of the last two centuries. Among the more important are books by George Day, Charcot, Nascher, Worcester, and Cowdry. Lord Amulree's book Adding Life to Years has become a watchword of modern geriatrics. It is of interest that during this time period the basic plea for high touch care of older patients and the lament that physicians have little knowledge of the needs of older patients has remained remarkably constant.

Geriatrics↗
PubMed1997

Collection and recruitment of CD34+ cells during large-volume leukapheresis.

Although sufficient progenitor cells for hematopoietic rescue following high-dose therapy may be obtained in a single leukapheresis, the majority of patients require multiple procedures. In an attempt to minimize the number of leukapheresis and maximize collection efficiency, we undertook large-volume leukapheresis in 17 patients with a variety of hematologic malignancies. Twenty-four procedures were performed over a 6-h period, with a mean of 21 L of blood processed. By employing a modified collection set, three separate 2-h collection bags were analyzed for a number of variables. CD34+ cells are collected at a steady rate throughout the procedure, with no evidence of exhaustion of progenitor cells. There was evidence of progenitor cell recruitment, with 1.4-fold more CD34+ cells in the collected product than were present in the blood at the beginning of the procedure. Initiation of leukapheresis was based on the blood CD34+ count, and this value was strongly correlated with the number of CD34+ cells in the collected product. The procedure is safe and relatively simple and minimizes the number of leukaphereses required to collect adequate progenitors for autologous transplantation.

Adolescent↗
PubMed1996

Antiislet autoantibodies usually develop sequentially rather than simultaneously.

The goal of this study was to address whether antiislet autoantibodies appear sequentially or simultaneously before the onset of type I diabetes. We analyzed sequential serum samples from 155 siblings and offspring (aged < 7 yr) of patients with type I diabetes from the Denver Diabetes Autoimmunity Study in the Young study and from a separate group of first degree relatives (aged 2-40 yr) for autoantibodies reacting with three defined autoantigens: glutamic acid decarboxylase (GAD65), insulin, and ICA512/IA-2. The youngest age at which 1 of the 3 autoantibodies appeared was 1.1 yr, and the oldest was 60.9 yr. Of the total 26 autoantibody conversion events observed, in only 3 instances did more than 1 autoantibody appear simultaneously. Among individuals (n = 12) with sequential conversion to expression of multiple autoantibodies, anti-GAD65 autoantibodies or antiinsulin autoantibodies appeared first (4 expressed antiinsulin autoantibodies first, and 8 anti-GAD65 autoantibodies first). We conclude that antiislet autoantibodies usually appear sequentially and not simultaneously. This corroborates early suggestions that humoral autoimmunity to islets develops chronically in a process usually measured in months to years. As expression of multiple autoantibodies is associated with a high risk of progression to diabetes, and sequential appearance of autoantibodies can occur late in life, long term follow-up is necessary to fully delineate the relationship of diabetes risk to autoantibody expression.

Adolescent↗
PubMed1995

Rumor management in nursing systems: role of the psychiatric CNS.

RUMOR MANAGEMENT AND control is particularly important in nursing systems during times of change. In this article, a brief history of the study of rumor and the rumor process is given and applied to nursing, systems thinking and the CNS, and three types of rumor are described. Examples are given and strategies and approaches for managing rumor are prescribed. The first approach, used when a final decision about a planned change has not been made, helps avoid "trickle down" and builds trust and empowerment by soliciting and using input from those who will be affected by the proposed change. The intent of the second approach, used when a decision has been finalized or an event has occurred and rumor has preceded an official announcement, is to debrief from the occurrence or transform the decision. The last approach is used to interrupt a pattern of misinformation and to clarify or inform. The nurse leader or manager must stay in the communication loop and refrain from blaming a speculated source in order to correct information.

Communication↗
PubMed1994

Remission and relapse of substance use disorders in schizophrenia. Results from a one-year prospective study.

Recent studies of the effectiveness of specialized programs that treat substance use disorders in schizophrenia have obtained promising results but have not involved control groups. Interpretation of these apparently positive results is problematic because remission and relapse rates of substance use disorders have not been reported in this population. The present study reports 1-year rates of substance abuse and dependence remission and relapse in a sample of schizophrenics taken from the Epidemiologic Catchment Area study. Results indicated that the prevalence of substance use disorders in schizophrenia remained constant over the year primarily because rates of remission were balanced by rates of relapse. Individuals who developed abuse or dependence over the year were younger, male, and showed increases in depression and risk for hospitalization over the year. Individuals who remitted abuse or dependence were older, female, and showed decreases in depression over the year. Dual diagnosis treatment programs have recently reported higher rates of remission than were evidenced in this sample, thus providing preliminary support for the effectiveness of these treatments.

Adult↗
PubMed1993

Advanced human resources planning.

Programs developed to advance the careers of pharmacy staff members are important tools to attract and retain qualified staff members. Integration of career development with the advancement of the department's efforts to achieve pharmaceutical care are integral for the future success of the department. Design of programs for all major positions/classifications should be considered. These programs must be developed in concert with the employees affected. In the future, these programs can demonstrate enhanced outcomes for patient care by ensuring appropriately trained and credentialed employees. This will require a commitment to advanced human resources planning.

Career Mobility↗
PubMed1991

Influence of IgG1 and IgG2 antibodies to streptococcal group A carbohydrate on neutrophil chemiluminescence.

IgG antibodies to streptococcal group A carbohydrate (A-CHO) were isolated from normal human serum and from pooled Cohn fraction II using N-acetyl-D-glucosamine affinity chromatography columns. They consisted of the subclasses IgG1 and IgG2 in variable proportions depending on the pH of the elution buffer and on the subclass composition of anti-A-CHO in the starting material. Streptococcal group A particles exposing the antigen A-CHO were opsonized with various concentrations of these antibodies and incubated with normal human polymorphonuclear leukocytes (PMN). The luminol-enhanced chemiluminescence (CL) elicited with these particles was recorded over a 60-min period. With 12 of the 14 antibody preparations tested, the observed CL signal was dose-dependent. When used at comparable concentrations for opsonization, the antibodies enriched in IgG1 induced markedly stronger CL signals than those consisting predominantly of IgG2. It was concluded that the observed CL differences reflect mainly the preferential recognition of IgG1 molecules by Fc gamma receptors of PMN.

Antibodies, Anti-Idiotypic↗
PubMed1990

Different mechanisms of increased proteolysis in atrophy induced by denervation or unweighting of rat soleus muscle.

Mechanisms of accelerated proteolysis were compared in denervated and unweighted (by tail-cast suspension) soleus muscles. In vitro and in vivo proteolysis were more rapid and lysosomal latency was lower in denervated than in unweighted muscle. In vitro, lysosomotropic agents (eg, chloroquine, methylamine) did not lessen the increase in proteolysis caused by unweighting, but abolished the difference in proteolysis between denervated and unweighted muscle. Leucine methylester, an indicator of lysosome fragility, lowered latency more in denervated than in unweighted muscle. 3-Methyladenine, which inhibits phagosome formation, increased latency similarly in all muscles tested. Mersalyl, a thiol protease inhibitor, and 8-(diethylamino)octyl-3,4,5-trimethoxybenzoate hydrochloride (TMB-8), which antagonizes sarcoplasmic reticulum release of Ca2+, reduced accelerated proteolysis caused by unweighting without diminishing the faster proteolysis due to denervation. Calcium ionophore (A23187) increased proteolysis more so in unweighted than control muscles whether or not Ca2+ was present. Different mechanisms of accelerated proteolysis were studied further by treating muscles in vivo for 24 hours with chloroquine or mersalyl. Chloroquine diminished atrophy of the denervated but not the unweighted muscle, whereas mersalyl prevented atrophy of the unweighted but not of the denervated muscle, both by inhibiting in vivo proteolysis. These results suggest that (1) atrophy of denervated, but not of unweighted, soleus muscle involves increased lysosomal proteolysis, possibly caused by greater permeability of the lysosome, and (2) cytosolic proteolysis is important in unweighting atrophy, involving some role of Ca2(+)-dependent proteolysis and/or thiol proteases.

Animals↗
PubMed1989

Neutrophil chemiluminescence induced by opsonized group A streptococcal particles: an effective probe of intravenous immunoglobulin preparations.

We compared the capacity of eight different intravenous immunoglobulin (IVIG) preparations to opsonize streptococcal group A particles and to induce luminol-enhanced chemiluminescence in neutrophil granulocytes. Antibodies to the streptococcal group A carbohydrate (A-CHO) antigen exposed on the particles were present in all preparations at high concentrations. In some preparations, anti-A-CHO consisted predominantly of either immunoglobulin G1 (IgG1) or IgG2, whereas in others, both IgG subclasses were equally represented. Dilutions of the IVIGs and of a normal IgG reference preparation were adjusted for their anti-A-CHO content, incubated with streptococcal particles, and exposed to neutrophil granulocytes isolated from normal blood. The various IVIGs differed in their capacity to elicit chemiluminescence signals. Some preparations, particularly those consisting of chemically modified IgG molecules, showed little activity, whereas others were comparable to the reference preparation. We concluded that to some extent such differences could be related to the IgG subclass composition of the antibody. However, of greater importance were the manufacturing procedures by which both the antigen-binding fragment and crystallizable fragment portions, and thus the functional integrity of the IgG molecules, were more or less severely affected.

Humans↗