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T E Miller

Publications and source records attributed to T E Miller.

At least 55 records · Page 3Linked to original sources
PubMed1992

An experimental evaluation of the pharmacokinetics of fusidic acid in peritoneal dialysis.

Fusidic acid, an antimicrobial agent with activity against coagulase-positive and coagulase-negative staphylococci, has considerable potential for the management of staphylococcal peritonitis associated with continuous ambulatory peritoneal dialysis (CAPD). Whether fusidic acid reaches therapeutic levels in the dialysate once therapeutic serum levels have been achieved is not known. An animal model of CAPD that reproduced essential features of the clinical procedure was used to investigate this issue. Although oral administration was the preferred route, fusidic acid is not absorbed from the gastrointestinal tract of laboratory rats, and a subcutaneous injection of diethanolamine fusidate was used to achieve serum levels of the agent equivalent to those achieved clinically in man. In this model, fusidic acid concentrations up to 28 times the MIC for staphylococci were found in the dialysate when therapeutic levels of the agent were reached in the serum. The data provide support for continued experimental and clinical evaluation of the role of fusidic acid in CAPD-associated peritonitis.

Administration, Oral↗
PubMed1992

Multiple listing for organ transplantation: autonomy unbounded.

Recently, debate about the distribution of scarce organs for transplantation has focused on whether patients should have the right to place themselves on waiting lists at several transplant centers, thereby gaining an advantage over other potential recipients. This article explores the social and ethical issues raised by multiple listing, contrasting policies adopted at the national level with those implemented in New York State. It concludes by examining the implications of the debate for broader questions about entitlement and access to health care.

Advisory Committees↗
PubMed1992

Characterization of an animal model of continuous peritoneal dialysis in chronic renal impairment.

In this study we describe the successful development of a method of continuous ambulatory peritoneal dialysis in a rat with stable chronic uremia. The procedure involved the insertion of a permanent indwelling cannula into the peritoneal cavity through which a draining catheter was passed for each dialysis. Dialysis of uremic animal hosts over a 24-hour period removed 31% of the urea excreted in the urine by normal animals over the same interval. The effect of daily dialysis for 21 days on biochemical, hematologic and cytologic parameters was also determined. The model will allow the basic pathobiology of common problems such as CAPD-associated peritonitis to be investigated.

Animals↗
PubMed1991

The anti-inflammatory activity of a low molecular weight component derived from the milk of hyperimmunized cows.

"Immune" milk has been utilized as a source of biologically active compounds for many years. In the present study, a low molecular weight fraction, isolated from the milk of dairy cows hyperimmunized with a multivalent bacterial vaccine (HIMF), has been evaluated for anti-inflammatory activity. Analysis was carried out using the rat hind-paw oedema assay. HIMF was shown to have a marked anti-inflammatory effect in this model and carrageenin-induced oedema was suppressed by up to 80% in individual experiments. The agent was active following oral, subcutaneous, intramuscular, intraperitoneal or intravenous administration. Intravenous injection was particularly effective and amounts as small as 1 mg significantly reduced the inflammatory response to carrageenin. The experiments have established that milk from hyperimmunized cows contains a highly active anti-inflammatory compound and form a basis for further studies, which will attempt to isolate and further characterize the active moiety.

Animals↗
PubMed1991

Assessment of antiinflammatory agents using 125I-labeled human serum albumin to quantify footpad edema volume in the rat.

Intravenously injected human serum albumin, labeled with radioactive iodine ([125I]HSA), accumulates at inflammatory foci in proportion to the volume of the exudate, making it possible to quantify the volume of edema. This paper describes the use of [125I]HSA to measure edema formation in the carrageenin rat-footpad model, both continuously and at a single time point. In assessing antiinflammatory agents, the method was shown to be more sensitive than the most commonly used technique of thickness measurement. Because anesthetics are known to suppress inflammation, the comparative effect of five anesthetic agents on the inflammatory response was determined. Ether was the only anesthetic tested that did not substantially inhibit the accumulation of edema. The technique overcomes many of the limitations of previously used procedures and has the potential to become the method of choice when assessing edema in the rat footpad.

Anesthetics↗
PubMed1991

An empirical evaluation of the performance of antibody identification tasks.

Four empirical studies were conducted for better understanding of the nature of problem-solving activities by medical technologists and medical technology students when performing antibody identification tasks. The results indicated the importance of strategies that ensure the collection of converging evidence, as these strategies protect against the fallibility of commonly used heuristics and against errors due to simple slips. The results also indicate that not only do students make significant numbers of errors, but so do practicing technologists. In one of the studies covering a 1-year period, for instance, a group of 16 technologists made a total of 41 errors in 1057 cases. On the basis of these findings, several alternatives are proposed to reduce errors.

Adult↗
PubMed1991

Procedural errors in antibody identification.

In experimental studies of students and line technologists performing antibody identification procedures, both groups made errors. These errors included, at times, either failing to identify an antibody or misidentifying the specficity(ies)A. prospective study was undertaken to identify errors made in a laboratory setting. Errors were classified as 1) failing to follow protocol (procedural error) or 2) arriving at the wrong answer (misidentification error). Over a 1-year period, 1,057 workups were reviewed. There were 41 (3.88%) procedural errors and no misidentification errors. In 25 workups (61% of errors), the selection of cells m rule out underlying alloantibody(ies) was in error. The remaining 16 involved various "slips" (minor mistakes or memory lapses) and clerical errors. Based on an analysis of the probable causes of these errors, potential solutions include 1) developing computer aids to detect "rule-out" errors or missing tests results; 2) providing timely, careful review of workups before transfusion; and 3) designing better panel layout and cell selection.

Journal Article↗
PubMed1991

Pharmacokinetics of fusidic acid in laboratory animals.

The ability of evaluate the efficacy of fusidic acid in animal models of infectious disease is limited by the absence of pharmacokinetic data for the agent in laboratory animals. In our study, aspects of fusidic acid pharmacokinetics were compared in rats (Rattus norwegicus), mice (Mus musculus), rabbits (Oryctolagus cuniculus), and guinea pigs (Cavia porcellus). Sodium fusidate was poorly absorbed after oral administration to rats, although limited absorption occurred in guinea pigs, mice, and rabbits. Subcutaneous injections of diethanolamine fusidate to laboratory rats, however, achieved a serum profile similar to that observed in humans. There was no evidence of drug accumulation in rats given repeated subcutaneous doses of diethanolamine fusidate during a 4-day period, but rabbits showed clear evidence of a cumulative effect.

Animals↗
PubMed1991

Thielemann's diagonal law of occlusion revisited.

Thielemann's studies of malocclusal relationships and the frequently observed chain reactions created in distant localities led to the formulation of a philosophical approach to occlusion that is also of practical premeditative clinical relevance for the practitioner. Dr. Thielemann presumed to name it a law, and repeated clinical observations apparently support and reinforce his claim. All disciplines of dentistry inevitably encounter and need to know about this aspect of fission-reactive involvement with the common and seemingly innocuous malocclusions. By incorporating the law into the diagnostic, planning, corrective, and therapeutic stages of treatment, the clinician can readily categorize patients for needs assessments and future goals in treatment.

Adult↗
PubMed1991

Comparison of the results of a standardized AIDS prevention program in three geographic locations.

A standardized AIDS prevention program, Stop AIDS, was tested with gay and bisexual men in 3 different geographic locations: metropolitan Chicago; Orange County, California; and Phoenix, Arizona, employing a test of AIDS knowledge, attitudes, and behavior. Results indicted that the Chicago participants began with the most knowledge about AIDS but gained least in the workshop, ending lowest, while the Orange County participants started with the least knowledge and gained the most, ending highest. The same change pattern was demonstrated in terms of attitudes. However, all groups started the discussion group with approximately the same risk behavior for HIV transmission, and all groups committed to the same amount of change in risk behavior at workshop termination, demonstrating the independence of behavior change from knowledge and attitude changes. Additionally, all 3 groups had the same 8 of 15 significant correlations of measures with no correlation between knowledge about AIDS, attitudes toward AIDS, and post-workshop intentions regarding risk behavior. These results indicate that Stop AIDS is an effective prevention program in all 3 locations, but that this and other programs should emphasize actual risk-behavior change rather than knowledge increase or healthier attitudes to produce the greatest lethality reduction.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Ureteric catheterization in the diagnosis of pyelonephritis--an experimental evaluation.

Experimental models of renal infections have been used to determine the accuracy with which the cellular and microbiologic components of ureteric and voided urine reflected the pathologic status of the kidney in pyelonephritis. In acute pyelonephritis, the composition of the ureteric urine reflected the pathologic status of the kidney, although in a few cases ureteric samples were either sterile or cell free. Animals with chronic pyelonephritis in which the lesions were either infected or sterile commonly had sterile ureteric urine. Pyuria, however, was demonstrable in both these situations. In subclinical pyelonephritis, ureteric samples from infected kidneys were variably culture positive, although pyuria was a common observation. Discriminate function analysis based on actual renal status and ureteric data gave an overall correct classification rate of 67% and demonstrated at least 80% agreement in four of the five classification groups.

Animals↗
PubMed1990

Cyclosporin A modulation of the acute inflammatory response: an explanation for the effect of CsA on host defences in infection.

Previous studies have shown that the administration of cyclosporin A (CsA) to animals with experimentally induced pyelonephritis resulted in considerable exacerbation of infection. T-lymphocytes are not involved in the host response to pyelonephritis but neutrophils are known to be a key component in the pathogenesis of this infection, so the effect of CsA on this inflammatory component was investigated. CsA administration did not affect the metabolic activity of neutrophils in vitro nor their ability to phagocytose and kill microorganisms. However, the ability of neutrophils to mobilize to a sterile inflammatory focus in vivo was significantly impaired. Further experiments, using models of pyelonephritis and subcutaneous infection, demonstrated that the CsA-induced suppression of neutrophil mobilization was directly related to the observed increase in bacterial numbers and exacerbation of tissue damage. Additionally, the actual effect of CsA on host defences and the outcome of infection was found to be dependent on the level of the initial infectious challenge. The results of this study provide an explanation for the current pattern of infectious disease in patients treated with CsA, in whom infection with extracellular pathogens is still common. It is also clear that the effect of CsA on inflammatory mechanisms may explain the efficacy of the agent in inflammatory diseases such as rheumatoid arthritis. This suggests a wider therapeutic role for CsA than is currently recognized.

Acute-Phase Reaction↗
PubMed1990

Changes in knowledge, attitudes, and behavior as a result of a community-based AIDS prevention program.

The study evaluates the outcome of a California-based AIDS prevention program, "Stop AIDS." Community discussion groups focusing on information, attitudes, and behavior associated with HIV infection and transmission were conducted in one-time, 3 1/2-hour sessions. Participants completed different versions of the AIDS Prevention Test before and after the discussion group. Significant positive shifts in information, attitudes, and behavior were observed as a function of the discussion group participation. Whereas pretest knowledge correlated with pretest behavior and posttest knowledge, only pretest behavior correlated with the crucial variable of posttest intended behavior. When changes from pretest to posttest were analyzed, both information and attitude change correlated to changes in behavior. The intervention and evaluation procedures are proposed as a replicable national model for community-based AIDS prevention programs.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Orthodontic therapy for the restorative patient. Part II: The esthetic aspects.

By incorporating orthodontics and other specialty disciplines into the restorative and prosthodontic treatments for the adult patient presenting for improvement or enhancement of esthetics, the dentist can correct reverse over-lapped (cross-bite) relationships, retrieve and reposition unerupted (impacted) anterior teeth, and improve irregular smile lines in three dimensions. The correction or improvement of incisal guidance, incisal planes, root proximity, and embrasure spaces will enhance long-term stability and successful prognoses. This article discusses several of the daily challenges encountered by the restorative dentist regarding malposed teeth in the anterior portion of the oral cavity. By using established principles of orthodontic therapy, composite resin bonding of brackets, improved wire technology, polymer plastic force modules, and additional advances in the methods of repositioning the malposed teeth, the necessary corrections can be made.

Adult↗
PubMed1989

Orthodontic therapy for the restorative patient. Part I: The biomechanic aspects.

The integration of interspecialty treatment before the restorative and prosthodontic efforts of the dentist can eliminate conditions that have the potential to jeopardize successful completion of the proposed treatment. Adult dentitions that have deteriorated because of neglect, fear, caries, extractions, or trauma can be restored to stability, health, function, and esthetics. In "Part I, The biomechanic aspects," the orthodontic paralleling of proposed abutment teeth displays premolar (buccolingual) and molar (mesiodistal) uprighting procedures that achieve improved force distribution to these teeth. Molar intrusion (occlusoapical) to improve an occlusal plane distribution of adverse forces to the proposed opposing fixed partial denture is discussed. These vexing problems facing successful reintegration of the altered states of occlusal relationships frequently can be answered by the incorporation of preprosthodontic corrections.

Adult↗
PubMed1989

Partial anodontia: a case report.

This article describes the multidisciplinary rehabilitation of a 20-year-old white man with partial anodontia. The patient presented with only three adult teeth; the remaining dentition was deciduous. The mandibular arch was restored with a tooth-supported overlay denture, while the maxillary arch received a fixed prosthesis.

Adult↗