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Biomedical subjects

T Clark

Publications and source records attributed to T Clark.

At least 37 records · Page 2Linked to original sources
PubMed1998

Ichthyophthirius multifiliis: a model of cutaneous infection and immunity in fishes.

The parasitic ciliate Ichthyophthirius multifiliis offers a useful system for the study of cutaneous immunity against an infectious microorganism. Naive fish usually die following infection, but animals surviving sublethal parasite exposure become resistant to subsequent challenge. This resistance correlates with the presence of humoral antibodies in the sera and cutaneous mucus of immune fish. A mechanism of immunity has recently been elucidated that involves antibody binding to surface proteins (referred to as immobilization antigens or i-antigens) located on the parasite cell and ciliary membranes. Antibody-mediated cross-linking of i-antigens triggers a response by the parasite resulting in its exit from the host. These effects can be observed directly on the surface of live fish. In addition to allowing the observation of effector responses in vivo, Ichthyophthirius also provides a means to study the ontogeny of the mucosal immune response. The sites of antigen capture and presentation, and the sites of antibody production, are unknown with regard to cutaneous immunity. Because the external epithelial surfaces of fish are often the points of pathogen entry, a basic understanding of the inductive immune mechanisms and immune cell interactions in the skin and gills is extremely important with regard to vaccine development. The development of Ichthyophthirius as an experimental system and how it might be used to address these issues are discussed in this review.

Animals↗
PubMed1998

A novel Asp380Ala mutation in the GLC1A/myocilin gene in a family with juvenile onset primary open angle glaucoma.

Glaucoma describes a clinically and genetically heterogeneous group of diseases that result in optic neuropathy and progressive loss of visual fields. A gene for juvenile onset primary open angle glaucoma JOAG) has recently been mapped to 1q21-31. Mutations in the trabecular meshwork induced glucocorticoid response gene (TIGR, also known as myocilin or the GLC1A locus) have been found to cause both juvenile and later onset primary open angle glaucoma. Family TCD-POAG1 is a Spanish kindred, which segregates JOAG in an autosomal dominant fashion. This family was found to be linked to the previously identified GLC1A locus on chromosome 1q. Direct sequencing of the TIGR/myocilin gene showed a heterozygous A to C transition in codon 380, resulting in the substitution of alanine for aspartic acid (Asp380Ala). This substitution created a StyI restriction site, which segregated with the JOAG phenotype and permitted rapid screening of all members of the family. This restriction site was not present in 60 controls.

Adolescent↗
PubMed1997

Self-directed work teams: application to a drug information center.

OBJECTIVE: To describe the transition of a drug information center from a traditionally managed center to a self-directed work team responsible for service, education, research, and drug use policy development. SUMMARY: To adapt to economic, educational, and technologic changes, traditional management structures in healthcare organizations are being reassessed. In some instances, a team approach (using self-directed work teams [SDWTs]) is being implemented. SDWTs have the potential to provide a number of benefits to an organization, including reduced costs and greater employee motivation. The University of Illinois at Chicago Drug Information Center had functioned under a traditional management structure. For economic and professional reasons, the management structure of the center was changed to an SDWT, prompting a reevaluation of the mission and activities of the center. DISCUSSION: Although still in transition, the center's change to a team structure has proven to be positive. The nature of the SDWT requires greater involvement by team members in all aspects of the center's operation, adding to the experience of team members. The team structure also allows for greater freedom to pursue projects of personal interest to individual team members. A number of issues still need to be resolved, such as performance-based compensation and peer- and self-evaluations. CONCLUSIONS: SDWTs can provide many benefits. The successful implementation of an SDWT, however, has a number of requirements, the most important of which are a commitment from management and effective communication among team members and with management.

Drug Information Services↗
PubMed1997

Infant feeding practices of low-income African American women in a central city community.

It is a well-established fact that nutrition is central to the growth and development of all infants. Yet it has been observed that health care professionals are frequently unfamiliar with the most typical infant feeding practices of the clients within the communities they attempt to serve. This observation was apparent during the development of a program in an inner-city community of Wisconsin to support the feeding practices of low-income African American women with low-birth-weight infants. As a result of initial encounters with prospective clients and health care and social service professionals from the targeted community, it was apparent that professionals and staff involved in this project needed to gain an understanding of common infant feeding practices of low-income African American women; a greater awareness of the values, beliefs, and health care practices of the population; and a greater understanding of the impact of poverty on the families within the targeted community. To assist the staff in gaining a better understanding of the influence of culture and economics on infant feeding practices, a study of the infant feeding practices of a select group of low-income African American women was undertaken. The study aimed to (a) gather information that could be used to describe common infant feeding practices of low-income African American women in an inner-city community of Wisconsin and (b) determine the influence of cultural and economic variables on the decisions made by low-income African American women regarding infant feeding. This article presents an analysis and summary of the data collected during the course of the study.

Adult↗
PubMed1997

An overview of types of relationships between hospitals and colleges/schools of pharmacy.

Three vignettes describe the details of each of the three types of practice-education relationships in academic hospitals identified in a survey by the University HealthSystem Consortium. The educational affiliation at Penn State's Hershey Medical Center, the affiliated relationship of the Medical College of Virginia, and a fully integrated relationship at the University of Illinois at Chicago are described by the Director of Pharmacy at each institution. The advantages, disadvantages, and future goals are described.

Education, Pharmacy↗
PubMed1997

Effect of hemoglobin- and Perflubron-based oxygen carriers on common clinical laboratory tests.

Polymerized hemoglobin solutions (Hb-based oxygen carriers; HBOCs) and a second-generation perfluorocarbon (PFC) emulsion (Perflubron) are in clinical trials as temporary oxygen carriers ("blood substitutes"). Plasma and serum samples from patients receiving HBOCs look markedly red, whereas those from patients receiving PFC appear to be lipemic. Because hemolysis and lipemia are well-known interferents in many assays, we examined the effects of these substances on clinical chemistry, immunoassay, therapeutic drug, and coagulation tests. HBOC concentrations up to 50 g/L caused essentially no interference for Na, K, Cl, urea, total CO2, P, uric acid, Mg, creatinine, and glucose values determined by the Hitachi 747 or Vitros 750 analyzers (or both) or for immunoassays of lidocaine, N-acetylprocainamide, procainamide, digoxin, phenytoin, quinidine, or theophylline performed on the Abbott AxSym or TDx. Gentamycin and vancomycin assays on the AxSym exhibited a significant positive and negative interference, respectively. Immunoassays for TSH on the Abbott IMx and for troponin I on the Dade Stratus were unaffected by HBOC at this concentration. Tests for total protein, albumin, LDH, AST, ALT, GGT, amylase, lipase, and cholesterol were significantly affected to various extents at different HBOC concentrations on the Hitachi 747 and Vitros 750. The CK-MB assay on the Stratus exhibited a negative interference at 5 g/L HBOC. HBOC interference in coagulation tests was method-dependent-fibrometer-based methods on the BBL Fibro System were free from interference, but optical-based methods on the MLA 1000C exhibited interferences at 20 g/L HBOC. A 1:20 dilution of the PFC-based oxygen carrier (600 g/L) caused no interference on any of these chemistry or immunoassay tests except for amylase and ammonia on the Vitros 750 and plasma iron on the Hitachi 747.

Animals↗
PubMed1996

The inhibition of alpha-chymotrypsin predicted using theoretically derived molecular properties.

The structures and molecular properties of 95 aromatic and heteroaromatic ligands previously tested as reversible inhibitors of chymotrypsin catalysis have been calculated using AMl. The properties obtained have been used as input for multiple linear regression analysis and as descriptors for a back-propagation neural network to predict the binding affinity of alpha-chymotrypsin inhibitors. Using polarizability, molecular shape, electrostatic similarity, dipole moment, ClogP, and the diagonalized quadrupole moments of the ligands, correlation coefficients between calculated and experimental affinities of 0.96 for the training set and 0.89 for the test set were obtained using a neural network. The performance of the multiple linear regression was significantly worse, although useful QSARs were also obtained.

Binding Sites↗
PubMed1996

Primary small-cell carcinoma of the oesophagus with spontaneous oesophageal perforation following chemotherapy.

The authors describe a 66 year old woman with small-cell carcinoma of the oesophagus who developed a perforation following chemotherapy. Small-cell carcinoma of the oesophagus is a rare neoplasm, varying in appearance from a small mucosal lesion to a larger fungating mass, which in our patient presented as a bulky soft-tissue mass causing stricture. Pleural fluid collections which developed via a spontaneous oesophageal-pleural fistula were subsequently drained using percutaneously placed catheters. Radiologic management of this condition provided a successful and cost-effective means of patient care.

Aged↗
PubMed1996

Estimation of fetal lung volume using enhanced 3-dimensional ultrasound: a new method and first result.

OBJECTIVE: To measure fetal lung volume using a computer based, enhanced, 3-dimensional ultrasound imaging system. DESIGN: An observational study. SETTING: The Fetal Medicine Unit at Guys Hospital, London. PARTICIPANTS: Twenty healthy women with a singleton pregnancy between 24 and 36 weeks of gestation were scanned on one occasion during pregnancy using an ultrasound based 3-dimensional imaging system. All delivered at term with weights above the 10th centile for gestation. RESULTS: Total lung volume increased exponentially with gestational age. Right lung volume measured consistently greater than left lung volume. CONCLUSIONS: The use of this new enhanced 3-dimensional imaging system allows for estimations of fetal lung volume. Preliminary data confirm that fetal lung volume, measured by a computerised 3-dimensional ultrasound imaging system increased exponentially with gestational age. The use of this system has obvious application in the further study of lung growth in utero and possible clinical application in disease states where fetal lung growth may be impaired.

Female↗
PubMed1994

The effectiveness of an intervener model of services for young deaf-blind children.

Project Validation of the Intervener Program (VIP) studied and documented the effectiveness of the Intervener Service Model which provides the services of a paraprofessional (called an intervener) to families of young children who are deaf-blind. The intervener provides auditory, visual, and tactile stimulation for the child and helps the child develop interactive behaviors instead of isolated, defensive, or self-stimulatory behaviors. The intervener also enables the parents to obtain much needed respite. Project VIP obtained abundant quantitative and qualitative data on the effectiveness of the Intervener Service Model. The data strongly support the need for Intervener Services for young children who are deaf-blind and their families.

Blindness↗
PubMed1994

Right hemispace presentation and left cueing on Raven's Coloured Progressive Matrices among right brain-damaged neglect patients.

Despite the substantial experimental literature that has accrued on factors associated with a reduction in neglect, few empirical studies have attempted to extrapolate these findings to clinical assessment and evaluate the efficacy of neglect-reducing strategies on patient performance. The current study developed a modified version of the Raven's Coloured Progressive Matrices (RCPM) by aligning the response alternatives in a column, in the right hemispace. Three groups of patients (right brain-damaged (RBD) with neglect, RBD without neglect, and orthopaedic controls) were administered abbreviated versions of the revised format, and performance was compared to the standard presentation format. The efficacy of left cues with the revised format was also investigated. Presence of neglect was assessed via the Schenkenberg Line Bisection Task and the Bells Test. Results showed a significant performance decrement among RBD neglect patients under all conditions. However, contrary to predictions, RBD neglect patients did not reveal significantly better performance on the revised version as compared to the standard presentation format. No significant effects associated with left side cueing were observed. The finding that no significant performance changes emerged as a function of stimulus modification and verbal prompts suggests that, although these manipulations may be employed by clinicians to maximize patient performance, empirical support for the efficacy of these procedures is lacking.

Adult↗
PubMed1994

Automated order-entry mechanisms to influence prescribing.

On-line prescribing is available in many hospitals in the United States and has distinct advantages. On-line drug prescribing can be influenced by the use of automated prompts that guide and direct the prescriber to the preferred agent, dosage, or regimen. The authors have adapted screen prompts to facilitate appropriate prescribing as defined by pharmacy and therapeutic (P&T) committee decisions, restricted drug or target drug initiatives, drug-usage evaluation (DUE) actions, departmental guidelines and order-sets, and other institutional directives. Objective evidence for the effectiveness of on-line prompts is provided for H2-antagonists and antibiotics. As computer technology advances even further and is increasingly utilized in the health care setting, on-line interventions to facilitate appropriate prescribing may become increasingly useful.

Anti-Bacterial Agents↗
PubMed1994

The RN and LPN skill mix.

Until a few years ago, patient care in most acute care areas at our tertiary care hospital in Alberta was delivered almost exclusively by registered nurses (RNs). Many believed their workload included tasks that did not require an RN's knowledge and skill levels. Around the same time, the hospital was faced with budget constraints. The staffing mix changed in 1991 with the introduction of another level of caregiver in the active treatment areas--licensed practical nurses (LPNs). The new mix caused problems: many RNs were unaccustomed to supervising and delegating to other workers and the primary nursing method for delivering patient care no longer worked.

Clinical Nursing Research↗