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Biomedical subjects

W Clarke

Publications and source records attributed to W Clarke.

50 records · Page 3Linked to original sources

Stability of reacted Chemstrip bG.

Reacted Chemstrip bG glucose reagent strips have been reported to retain their color changes for up to 7 days. Thus, patients could theoretically measure their blood glucose and mail their reacted test strips to their physicians for reanalysis. To test the stability of reacted Chemstrip bG blood glucose measurements, 268 Chemstrip bG test strips were reacted with blood obtained from 67 insulin-dependent diabetic patients, stored in desiccator vials, and read daily for 5 consecutive days with an Accu-Chek II blood glucose meter. Although Chemstrip bG blood glucose values significantly correlated with initial reference Beckman glucose analyzer glucose determinations for all 5 days, a steady significant decay in blood glucose readings over time was observed, and clinically accurate strip readings declined from 94% to 68%. Because this decay appeared consistent, correction factors were calculated with regression analyses. The correction factor for day 5 Accu-Chek II readings reduced measurement error by 77%. When applied to a different validation sample, this correction factor decreased day 5 error by 73%. Hence, it seems that correction factors may be applied to delayed readings of Chemstrips obtained with Accu-Chek II that would correct for the observed reduction in blood glucose readings. From these results, we conclude that delayed readings of Chemstrip bG test strips with the Accu-Chek II are not sufficiently accurate for clinical decision making or research purposes unless mathematically corrected.

Blood Glucose↗

Vaccination against schistosomiasis in mice with killed schistosomula without adjuvant.

Attempts to develop a killed vaccine against schistosomiasis have generally resulted in failure. There are two recent reports, but unfortunately, harsh adjuvants were used in conjunction with the antigenic materials. In our laboratory, a killed vaccine was developed by freezing (-196 degrees C) and thawing the schistosomula of S. mansoni. The use of such a preparation without adjuvant was effective in vaccinating mice. A worm reduction of 36.4-41.1% was achieved by one vaccinating injection, a 60.2% worm reduction by 3 injections, and a 63.7-66.0% reduction by 5 injections. The sequence of the development and the expression of the immune reactions were similar to those previously found in hosts immunized with highly X-irradiated schistosome organisms. Delayed hypersensitivity was demonstrated in histological sections of the skin in the challenged mice after one vaccination, showing that an adjuvant was not necessary to initiate the induction of cellular immunity.

Animals↗

Health outcomes of a community-based therapy program for children with cancer--a shared-management approach.

Critical to providing cancer therapy to children in rural areas is finding dependable sources of therapy near the patients' homes. In this study, comparison was made of 668 visits by 24 patients to nearby private practitioners, who carried out 70% of the therapy, with 712 visits by 22 other patients for whom all care was managed by pediatric hematologist-oncologists. There was no significant difference by Wilcoxon rank sum test between the two groups in the accuracy with which protocol rules were followed, in the incidence of neutropenia, infection, fever, thrombocytopenia, drug toxicity, or the proportion of days hospitalized. The findings indicate that the private practitioners participating in a shared-management system were a dependable resource for providing 70% of the total cancer therapy to these patients.

Antineoplastic Agents↗

Efficacy of graded-compression antiembolism stockings in patients undergoing total hip arthroplasty.

A prospective randomized trial evaluated graded-compression antiembolism stockings for prevention of leg vein thrombosis as assessed by Doppler ultrasound, in patients undergoing total hip replacement. The study was terminated after the evaluation of 18 patients revealed a significantly greater incidence of deep vein thrombosis, documented by phlebography, in patients without stockings (5 of 10) compared to those with stockings (none of 8, p less than 0.03). Three of the patients with thrombosis developed pulmonary emboli. Although the sample size of this study is small, the implication that graded-compression stockings reduce the incidence of leg vein thrombosis is strong and is supported by the results of other recent trials. These findings are at variance with earlier studies which failed to document efficacy of elastic stockings, which involved products which did not provide graded limb compression.

Aged↗

Value of concomitant sympathectomy in aortoiliac reconstruction. Results of a prospective, randomized study.

The efficacy of concomitant lumbar sympathectomy in improving results of aortoiliac reconstruction was assessed by a prospective, randomized study of 51 patients undergoing operation for occlusive or aneurysmal disease. Sympathectomy was performed on 50 limbs, while 52 extremities served as controls. Sympathectomy resulted in a significant reduction in foot vascular resistance determined by plethysmography. However, the procedure had no effect on leg circulation, assessed by ankle/arm pressure indices determined by Doppler ultrasound. In the sympathectomy group, there were three early postoperative amputations for ischemia, despite patent grafts. In the control group, there was one late graft occlusion, caused by progressive atherosclerotic disease. Although sympathectomy may improve pedal circulation, the procedure does not appear to improve the results of aortoiliac reconstruction.

Adult↗

A simplified method of echocardiographic data analysis.

Rapid accurate analysis of echocardiographic data is accomplished using a sonic digitizer and programmable calculator. This method allows the echocardiographer to select technically optimal areas of the recording for analysis. The resolution of the measuring device is 0.1 mm. A hardcopy printout of both measurement and calculation is provided. Instead of expensive on-line computer, an inexpensive programmable calculator is used.

Computers↗

Kinetic studies on the immobilization of antibodies to high-performance liquid chromatographic supports.

Several factors can potentially affect the rate of immobilization of proteins onto solid supports, such as those used in affinity-based high-performance liquid chromatography. This study examined several of these factors and their influence on the coupling of periodate-treated rabbit immunoglobulin G antibodies to dihydrazide-activated silica. Items considered included the number of potential coupling sites on the antibodies, the density of activated sites on the support, the relative amount of antibody combined with the support, and the density of the overall reaction slurry. In each case, the rate of change in the solution-phase antibody concentration gave biphasic behavior which could be described by two competing pseudo-first-order reactions. The overall immobilization rate was essentially independent of the density of the support's activated sites (when present at a coverage of 0.1-0.4 micromol/m2) but was strongly influenced by the number of available coupling groups on the antibodies. Increasing the slurry density had no appreciable effect on the immobilization rate, and the reaction rate showed only a small change when using different types of reagents for support activation (e.g., adipic vs oxalic dihydrazide). These results are consistent with a mechanism in which the rate-limiting step during immobilization is the covalent attachment of antibodies to the support and not mass transfer of antibodies to the support's surface.

Animals↗

Intensive versus standard blood glucose awareness training (BGAT) with insulin-dependent diabetes: mechanisms and ancillary effects.

Insulin-dependent diabetes mellitus (IDDM) patients make critical daily self-care decisions on the basis of what they estimate their blood glucose (BG) levels to be. This study: a) replicated efficacy of Standard Blood Glucose Awareness Training (BGAT), b) evaluated the relative efficacy of an Intensive Blood Glucose Awareness Training (BGAT) to enhance patient accuracy of BG estimation, and c) evaluated the mechanisms and ancillary effects of BGAT. Thirty-nine subjects were randomly assigned to one of three groups. Compared with Control, both Standard and Intensive BGAT improved accuracy (p less than 0.001). Intensive BGAT post-treatment accuracy relative to Standard BGAT did not reach statistical significance (p = 0.177). Greater improvement in accuracy was associated with poorer pretreatment accuracy. Only Intensive BGAT improved metabolic control (glycosylated hemoglobin), and this improvement was associated with poorer pretreatment control. The effects of BGAT were highly specific, affecting only accuracy and metabolic control, and not affecting fear of hypoglycemia, diabetes knowledge, of frequency of blood glucose monitoring.

Adult↗

Sterilization using pulsed white light.

Pulsed light is a non-thermal sterilization method that uses brief intense pulses or flashes of white light to kill micro-organisms. This article discusses tests performed on blow/fill/seal containers. The results suggest that pulsed light has potential as a terminal sterilization method for filled and sealed transmissive products and packages. It also examines the effectiveness of pulsed light in eliminating water-borne pathogenic organisms.

Animals↗