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Biomedical subjects

R Talley

Publications and source records attributed to R Talley.

17 recordsLinked to original sources
PubMed1994

The use of failure mode effect and criticality analysis in a medication error subcommittee.

Failure Mode Effect and Criticality Analysis (FMECA) is the systematic assessment of a process or product that enables one to determine the location and mechanism of potential failures. It has been used by engineers, particularly in the aerospace industry, to identify and prioritize potential failures during product development when there is a lack of data but an abundance of expertise. The Institute for Safe Medication Practices has recommended its use in analyzing the medication administration process in hospitals and in drug product development in the pharamceutical industry. A medication error subcommittee adopted and modified FMECA to identify and prioritize significant failure modes in its specific medication administration process. Based on this analysis, the subcommittee implemented solutions to four of the five highest ranked failure modes. FMECA provided a method for a multidisciplinary group to address the most important medication error concerns based upon the expertise of the group members. It also facilitated consensus building in a group with varied perceptions.

Accident Prevention↗
PubMed1993

Amniotic fluid interleukin-6 levels correlate with histologic chorioamnionitis and amniotic fluid cultures in patients in premature labor with intact membranes.

OBJECTIVES: Our purpose was (1) to determine the frequency of intraamniotic and extraamniotic intrauterine infection in patients with premature labor and intact membranes and (2) to determine if intrauterine infection is associated with elevated amniotic fluid interleukin-6 levels. STUDY DESIGN: Amniocentesis was performed on 57 patients in preterm labor and 201 controls at various gestational ages without labor and at term with labor. The amniotic fluid was evaluated with gram stain, cultures, and an enzyme-linked immunosorbent assay specific for interleukin-6. Placentas from study patients (n = 52) and term controls (n = 120) were analyzed. RESULTS: The frequency of positive amniotic fluid cultures (intraamniotic intrauterine infection) was 10 of 57 (18%) in the preterm labor group and zero of 201 for controls. Histologic chorioamnionitis (extraamniotic intrauterine infection) was present in 21 of 24 (88%) of patients in preterm labor that failed tocolysis and 28 of 120 (23%) of term laboring controls. An amniotic fluid interleukin-6 level of > or = 600 pg/ml was 100% sensitive and 89% specific (positive predictive value 85%, negative predictive value 100%) for the identification of intrauterine infection. CONCLUSION: Interleukin-6 is a sensitive and specific marker for the identification of both intraamniotic and extraamniotic intrauterine infection in patients in preterm labor with intact membranes.

Adult↗
PubMed1988

Fludarabine monophosphate: a potentially useful agent in chronic lymphocytic leukemia.

Recent developments in experimental chemotherapy may benefit patients with chronic lymphocytic leukemia (CLL). Fludarabine monophosphate has shown promise in heavily pretreated patients with advanced CLL. The Southwest Oncology Group has recently completed a phase II investigation of fludarabine in 32 patients. The patient population had a median age of 63 years, median performance status of 1, and included patients with the following stages of the disease: stage 0-3 patients; stage I-5 patients; stage II-6 patients; stage III-4 patients; stage IV-14 patients. A total of 176 courses were administered. Myelosuppression was the most frequent toxicity observed with 13 patients having a decline in platelets, and 11 patients having some decline in granulocytes. Fludarabine monophosphate has had unequivocal antileukemic activity in a group of patients with advanced CLL.

Adult↗
PubMed1988

Systemic talc granulomatosis associated with disseminated histoplasmosis in a drug abuser.

A 32-year-old intravenous drug abuser was found to have systemic talc granulomatosis and disseminated histoplasmosis. The clinicopathologic findings of this case support the hypothesis that the patient was predisposed to disseminated histoplasmosis by repeated intravenous talc administration. The effects of silica, a close relative of talc, on macrophages and the role of macrophages in recovery from Histoplasma capsulatum infection are described.

Adult↗
PubMed1987

Platelet satellitism: a possible mechanism.

Markedly increased platelet surface-bound IgG was found on platelets collected in citrate and heparin in a patient with platelet satellitism. The level on platelets collected in EDTA was mildly increased. However, neutrophils from this patient collected in EDTA had markedly increased surface IgG due to attached platelets, while no surface IgG was seen in citrate or heparin neutrophils, indicating that the anticoagulant EDTA in some way modified the surface IgG or neutrophil membrane resulting in platelet attachment. This is the first case in which a possible mechanism for platelet satellitism has been identified.

Blood Platelets↗
PubMed1983

Improved complete remission rates and survival for patients with large cell lymphoma treated with chemoimmunotherapy. A Southwest Oncology Group Study.

Between 1974 and 1977, 652 patients with non-Hodgkin's lymphoma without prior chemotherapy were randomized to 1 of 3 combination chemotherapy programs designed to induce complete remission (CR): COP-bleomycin (180 patients), CHOP-bleomycin (232 patients) or CHOP plus immunotherapy with Bacillus Calmette Guerin (BCG) (240 patients). With mature follow-up, the major effect of BCG immunotherapy was observed in patients with large cell lymphomas (diffuse or nodular "histiocytic") and not in other common lymphoma subtypes. CR rate for 65 patients with large cell lymphoma treated with CHOP-BCG was 68% compared to 48% in 61 patients treated with CHOP-bleomycin (P = 0.02) (two-tailed test) or 44% for 45 patients treated with COP-bleomycin (P = 0.02). CR duration for both CHOP-based regimens was similar and superior to that produced by COP-bleomycin (P = 0.03). Survival of patients with large cell lymphoma treated with CHOP-BCG was better than that observed with CHOP-bleomycin (P = 0.02) or COP-Bleomycin (P = 0.002). Although the explanation for the favorable effect of BCG remains unclear, further clinical trials to evaluate the combination of chemotherapy and other "biologic response modifiers" is warranted for patients with lymphoma.

Antineoplastic Agents↗
PubMed1983

Cis-platinum plus high-dose methotrexate. Toxicity and efficacy in ovarian carcinoma.

Cis-platinum plus high-dose methotrexate with citrovorum factor rescue underwent an initial evaluation of toxicity in patients with pelvic or abdominal adenocarcinoma and a subsequent efficacy trial in proven ovarian cancers. Forty-five patients with advanced abdominal adenocarcinoma were evaluable for toxicity. Toxicity was minimal and was not exacerbated by the presence of effusions or by modestly compromised renal function. Twenty-six patients had definite ovarian primaries and were evaluable for efficacy. All but four were refractory to standard therapy. Seven achieved either complete response (four) or partial response (three). Four additional patients showed lesser, but clinically important, objective responses. Patients who had not received prior therapy all responded with three of the four attaining complete response lasting from 7-22+ months. This regimen is well tolerated and has definite tumoricidal activity even in heavily pretreated patients.

Adenocarcinoma↗
PubMed1982

Autologous and allogeneic suppressor lymphocyte inhibition of human erythroid colony forming unit proliferation.

Certain in vitro and in vivo animal studies have supported the concept that lymphocyte-derived microenvironmental factors are important in erythroid proliferation. Considerable controversy has developed regarding the applicability of these concepts to human erythroid proliferation. We, therefore, evaluated the role of lymphocytes on human erythroid colony forming unit (CFUE) proliferation in the plasma clot system. Bone marrow (BM) was obtained from normal donors and cocultured with the following cell populations: a) cultured (6 day) lymphocytes autologous or allogeneic to BM; b) cultured lymphocytes stimulated with conconavalin A (Con A), allogeneic lymphocytes or streptokinase streptodornase (SKSD). In general, unstimulated cultured lymphocytes enhanced CFUE proliferation. In contrast, lymphocytes stimulated with Con A. SKSD, or allogeneic lymphocytes suppressed lymphocyte proliferation. The suppressor cell was concentrated in the T-cell fraction obtained by sheep red blood cell rosetting followed by ficoll-Hypaque centrifugation. Both allogeneic and autologous stimulated T-cells suppressed CFUE. Moreover, supernatants from stimulated lymphocyte cultures suppressed CFUE proliferation although the cell of origin and characteristics of the suppressive factors have not been defined. These data support the concept that lymphocytes may play an important role in modulating the human BM erythroid microenvironment.

Bone Marrow Cells↗