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Biomedical subjects

T D Moore

Publications and source records attributed to T D Moore.

At least 55 records · Page 3Linked to original sources
PubMed1991

Achieving an effective committee through reorganization: the Ohio State University Hospital's experience.

The P & T Committee at Ohio State University (OSU) Hospitals, Columbus, is unique in that it accomplishes the bulk of its tasks through subcommittees. Four subcommittees are currently in place: a formulary subcommittee, a policy and surveillance subcommittee, an antibiotic subcommittee, and a therapeutic drug monitoring subcommittee. An advantage to this method of organization is that it allows for much more medical staff involvement in P & T Committee activities. Other unique aspects of this P & T Committee are that it is responsible for maintaining both an inpatient and outpatient formulary, and it provides decision-making services for a specialty cancer hospital. Expansion of their drug usage evaluation program, further development of their therapeutic monitoring program, and improved communication with the medical staff are future goals of this P & T Committee.

Drug Industry↗
PubMed1988

Cecocolitis in immunodeficient mice associated with an enteroinvasive lactose negative E. coli.

Infection with an atypical (lactose-negative) E. coli was associated with increased mortality rates in a colony of triple immune deficient N:NIH(S) III mice. Affected mice were lethargic and exhibited perianal fecal staining. Slight-to-moderate thickening of the wall of the cecum and colon was found on necropsy examination. Microscopic examination revealed segmental hyperplasia of the cecal and colonic mucosa with clusters of gram negative bacteria on the surface and within the cytoplasm of mucosal epithelial cells. Scattered foci of epithelial invasion and hyperplasia were observed in the colons of C57B1/6N-nunu mice after per os inoculation with the atypical E. coli. Immunocompetant mice housed in the same room as the N:NIH(S) III's remained healthy and exhibited no gross or microscopic lesions in spite of infection.

Animals↗
PubMed1985

Isolation, propagation, and characterization of a newly recognized pathogen, cilia-associated respiratory bacillus of rats, an etiological agent of chronic respiratory disease.

A Gram-negative, filamentous, rod-shaped bacillus which failed to grow in cell-free media was isolated in apparently pure culture from the bronchial scraping and washing of a laboratory rat suffering from chronic respiratory disease by inoculating embryonated chicken eggs via the allantoic route. None of the embryos died during 20 serial passages at weekly intervals. The bacillus was reisolated in embryonated eggs from cesarean-derived barrier-maintained N:SD(SD) rats 8 and 12 weeks after intranasal inoculation with 10th-passage allantoic fluid. The inoculated rats were housed in Horsfall-type units and remained free from other known respiratory pathogens, including mycoplasmas and murine viruses, throughout the study. The bacillus colonized the ciliated epithelial cells of the respiratory tract and caused a marked peribronchial infiltration and hyperplasia of mononuclear cells which progressed with time. The bacillus, ca. 0.2 micron wide by 4 to 6 micron long, stained very poorly with basic aniline dyes but was readily demonstrated with the Warthin-Starry silver technique. It was heat labile (56 degrees C for 30 min); spore forms were not observed. It withstood freeze-thawing and was successfully stored at -70 degrees C. Although no visible means of locomotion was observed with the electron microscope, a slow gliding motility, sometimes with bending and flexing of bacilli apparently adherent to the glass surface, was observed with phase microscopy. As an etiological agent of chronic respiratory disease of rats, this cilia-associated respiratory bacillus (tentatively designated the CAR bacillus) may be the first recognized gliding bacterium known to cause disease in a warm-blooded vertebrate.

Animals↗
PubMed1985

Managing employee apprehension toward handling cytotoxic drugs.

A strategy for dealing with employee apprehension about handling cytotoxic agents without a biological safety cabinet is described. Available evidence in the literature concerning the health risks of handling cytotoxic drugs was reviewed with employees. A committee was appointed to evaluate the institution's needs and current practices for handling cytotoxic agents. Airflow studies were conducted in the pharmacy department's sterile preparation areas, and policies and procedures were developed for use until biological safety cabinets could be installed. Plans were developed for dealing with special situations, such as exemption of certain employees from preparation of cytotoxic drugs or refusal of an employee to prepare these drugs. Managers can substantially reduce employees' apprehension about handling cytotoxic drugs by keeping employees informed about departmental plans, listening to their concerns, and developing procedures for safe handling of these agents.

Antineoplastic Agents↗
PubMed1984

The pharmacy computer system at The Ohio State University hospitals.

The pharmacy computer system designed, developed, and implemented at The Ohio State University Hospitals is described. The computer system was developed to make more efficient use of hospital facilities and professional staff time. The pharmacy system operates on the mainframe hospital system using computer terminals with light-pen and keyboard access. Current online applications include order entry, patient profiles, pharmacokinetic calculations, and preparation of unit dose cart fill lists. Batch processing functions include drug-use review, drug-drug interactions, and financial management reports. Approximately 95% of unit dose orders and 20% of i.v. orders are conditionally entered by pharmacy technicians for subsequent verification by pharmacists. The system saves considerable staff time in the i.v. admixture and billing areas and has relieved pharmacists from performing many clerical and repetitive tasks. Disadvantages of the system include (1) its dependence on another department for patient admission, transfer, and discharge information and (2) delays in obtaining approval for program modifications and new applications. The advantages of the pharmacy computer system lie in its ability to access information from other computerized databases in the hospital. Future modifications and enhancements to the system are discussed.

Computers↗
PubMed1984

Innovative scheduling to maintain clinical pharmacy services despite budget retrenchment.

A process is described in which staff scheduling was adjusted to maintain pharmaceutical services while achieving a 7% cutback in personnel costs. The pharmacy department in a 1000-bed university hospital was unable to achieve the necessary cost savings through reductions in sick leave and overtime hours. The pharmacy administration developed a plan that required pharmacists to work four 10-hour shifts per week and resulted in reduced hours of service. The pharmacists objected and proposed an alternative plan in which clinical service was maintained for 16 hours on weekdays and 12 hours on weekends. Pharmacist teams worked one flexible shift per week. Pharmacists developed an innovative staffing plan that allowed them to maintain a high level of practice and acceptable working hours.

Budgets↗
PubMed1982

System maintenance, problems, and enhancements.

The procedures required for software and hardware maintenance of a pharmacy computer system, and methods of dealing with operational and administrative problems of such systems, are described. Maintenance of software and hardware purchased from a vendor is usually provided by the vendor under contract. Repair maintenance is required for programs that do not run, produce incorrect results, or run too slowly. Update and revision maintenance is required when user requirements exceed the limits and design of the original program. Typical problems encountered with computer systems include slow computer response time, performance of maintenance personnel, turnover in user personnel, legal liabilities and restrictions, reliability of hardware and software, downtime, security, and changing configuration of equipment. Successful management of predictable and unpredictable problems with computer systems is accomplished through systematic review of the potential problem area and prospective planning.

Computers↗
PubMed1981

Effect of laminar air flow and clean-room dress on contamination rates of intravenous admixtures.

The effect of laminar air flow conditions and clean-room dress on the microbial contamination rates of intravenous admixtures was investigated. Intravenous admixtures were prepared by one investigator using aseptic technique under four environmental conditions: laminar air flow conditions with clean-room dress; laminar air flow without clean-room dress; clean table top with clean-room dress; and clean table top without clean-room dress. In each environmental condition, 350 admixtures were compounded. Negative-control samples (n = 150) were also tested, as were 10 positive-control samples. Samples were tested in each of two growth media and incubated at 35 degrees C for 14 days or until growth occurred. The incidence of contamination of admixtures compounded in laminar air flow conditions was significantly less than the contamination of those compounded on a clean table top (p less than 0.05) regardless of the operator's dress. The incidence of contamination of admixtures compounded while wearing clean-room dress was not significantly different from those prepared while not wearing clean-room dress regardless of the environment in which the admixture was prepared. The overall low level of contamination [0.79% (11/1400)] was inconclusive regarding the effect of dress on the incidence of contamination when admixtures were prepared under LAF conditions. It is concluded that, when one adheres to aseptic technique, the environment in which admixtures are compounded is the most important variable affecting the microbial contamination rate.

Drug Compounding↗
PubMed1981

Effect of multidose therapy on cerebrospinal fluid penetration of cefazolin.

The relationship between serum concentrations and cerebrospinal fluid (CSF) concentrations of cefazolin, and the association between these concentrations and neurotoxic reactions, were investigated. Samples of serum and spinal fluid were drawn simultaneously from six patients at the steady state on various dosages of cefazolin sodium for different conditions. The dose, dosing interval, number of doses, results of renal function tests, and signs of neurotoxicity, such as muscle twitches, confusion, and seizures, were recorded. The concentrations of cefazolin in the serum and CSF, total serum protein, and percent albumin were determined. Five of the six patients given multiple doses of cefazolin sodium had notable CSF accumulation of the drug (11.3 +/- 2.7% of the serum concentration). Three patients experienced generalized focal-motor seizures during their therapy. Neurotoxicity was found to be associated with renal dysfunction and multiple-dose therapy leading to serum concentrations greater than 360 micrograms/ml and CFS concentrations greater than 34 micrograms/ml. Cefazolin will penetrate into the CSF in patients receiving multiple-dose therapy of the drug. To avoid neurotoxicity, careful attention should be paid to the recommended dosage regimens, the impact of renal dysfunction on drug clearance should be recognized, and serum assays should be performed when necessary.

Adult↗
PubMed1980

Quality control of agar diffusion susceptibility tests. Data from the Quality Assurance Service Microbiology Program of the College of American Pathologists.

From 1974 through December 1978, over 180 laboratories participated in the Microbiology Program of the College of American Pathologists Quality Assurance Service (QAS), submitting a total of 2,372,000 individual antibiotic determinations on three quality control reference strains. Of these determinations, 89.5% were obtained by the standard Bauer-Kirby method; 8.4% by the agar overlay modification of Barry and associates. Standard statistical analysis of data obtained using the agar overlay modification has been reported for each antimicrobic/reference strain combination. Comparisons have been made between the QAS data and those data obtained in earlier collaborative studies, which currently serve as precision and accuracy control limits. In many cases QAS data exceed the existing control limits.

Anti-Bacterial Agents↗
PubMed1980

Seizures associated with high cerebrospinal fluid concentrations of cefazolin.

Three cases of generalized seizures in patients with high cerebrospinal fluid (CSF) concentrations of cefazolin are reported. Patient 1, a 60-year-old woman with impaired renal function and a Klebsiella pneumoniae infection, was treated with 70 mg every eight hours of i.v. gentamicin sulfate and 1.5 g every four hours of i.v. cefazolin sodium. Gentamicin was discontinued on day 11. On day 12, the patient had a generalized tonic-clonic seizure. Serum and CSF concentrations of cefazolin one day later were 470 and 64 micrograms/ml, respectively. Patient 2, a 70-year-old man with impaired renal function, was given i.v. cefazolin, 1 g every 12 hours; the dosage interval was shortened later to every six hours. Two days later, the patient had two tonic-clonic seizures. Serum and CSF concentrations eight hours after the last dose of cefazolin were 360 and 34 micrograms/ml, respectively. Patient 3, a 67-year-old woman with renal vein thrombosis, received 55 mg every eight hours of i.v. gentamicin and 2 g every six hours of i.v. cefazolin. The antibiotics were discontinued after eight days when the patient had two tonic-clonic seizures. Serum and CSF concentrations of cefazolin measured 28 hours later were 1000 and 106 micrograms/ml, respectively. Previous reports of cefazolin-associated seizures are reviewed. In patients with renal failure, cefazolin may obtain high CSF concentrations. To avoid seizures, cefazolin doses should be adjusted in these patients.

Aged↗
PubMed1980

Analytic clinical laboratory precision--state of the art for thirty-one analysis.

Relationships of concentration and coefficients of variation for 31 clinical laboratory analytes are described. Estimated mean regression curves and standard deviations of individual laboratory coefficients of variation about the mean regression are calculated. Most analytes showed a significant relationship between concentration and coefficient of variation. State-of-the-art precision is compared with medical goals. The relationship of precision performance standards to the state-of-the-art precision, statistical outliers, and laboratory error is discussed. Statistically significant trends of improving analytic precision are observed for most analytes in both manual and automated methods.

Autoanalysis↗
PubMed1979

Stability of mean values of organic analytes in lyophilized quality control serum. A study utilizing data from the Quality Assurance Service (QAS) Program of the College of American Pathologists.

The long-term stability of mean values of six organic analytes in 48 commercial pools of lyophilized chemistry quality control serum is evaluated. These pools, provided by five manufacturers, have been used by nine Regional Quality Control Programs participating in the College of American Pathologists Quality Assurance Service. Creatinine yielded stable mean values in 88% of the pools studied. Both albumin and urea nitrogen demonstrated manufacturer and method-related changes in mean values. Bilirubin, cholesterol, and uric acid changes in mean values were independent of control serum manufacturer, predominant in calibrator-standardized automated procedures, and were clustered by years.

Bilirubin↗