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PubMedDate not supplied

Cryofixation, cryosubstitution, and immunoelectron microscopy: potential role in diagnostic pathology.

In immunoelectron microscopic investigations, retention of antigenic sites is crucial. Methods for preparing samples for conventional electron microscopy involve chemical fixatives followed by dehydration in organic solvents and embedding in plastic resins, all procedures potentially detrimental to antigenicity. Cryomethods provide a physical fixation alternative for the preparation of biological samples for ultrastructural, immunocytochemical, and microanalysis studies without the use of any chemicals. This can be particularly useful in diagnostic pathology, providing an alternative to conventional fixation methods which sometimes destroy the antigen in question. The recent development of a portable cryofixation device, the PS1000 Portable Metal Mirror Ultra-Rapid Cryofixation Unit (Delaware Diamond Knives, Inc., Wilmington, DE, USA), provides an opportunity to freeze tissue immediately after procurement for use in diagnostic immunocytochemistry studies. This feasibility study examined the quality of tissue preservation with this device, in terms of both preservation of cellular ultrastructure and immunolabeling. Human tonsil and thymus tissue was slam frozen and, after cryosubstitution in Lowicryl K11M, was examined by immunoelectron microscopy. Good ultrastructural preservation was obtained and reasonable immunolabeling with antibodies to AE1/AE3 keratin filaments was also observed.

Cryopreservation↗
PubMed1983

Survival in childhood acute lymphocytic leukemia: effect of protocol and place of treatment.

The objective of this study was to determine the effect of place and type of initial treatment on survival from acute lymphocytic leukemia (ALL). Every one of the 327 children under 15 years of age diagnosed with ALL from 1970 to 1975 in a 31-county area designated the Greater Delaware Valley, were studied. Treatment according to protocol was associated with improved survival, yielding a 4 year survival of 60% vs 19% for nonprotocol treated patients (p less than 0.001). There was also a significantly improved survival rate among patients treated in a cancer center, especially for those with a low white blood count (WBC) at diagnosis. The prognostic importance of WBC, age, and sex was confirmed.

Adolescent↗
PubMed1998

Drug use and street crime in Miami: an (almost) twenty-year retrospective.

Researchers at the University of Delaware have been conducting field studies of drug use and crime in Miami, Florida, since 1977. This paper reviews this research and its contributions to understanding drugs-crime relationships. Early studies tested mechanisms for accessing street populations of heroin users and assessing the nature and extent of their drug use and criminality. Subsequent studies targeted a variety of crime-involved heroin and cocaine users, including women as well as men, serious delinquents, adolescent and adult crack users, and cocaine users in treatment as well as on the street. Major findings include the low risk of arrest for income-generating crimes committed by heroin users, and the prevalence of HIV-risk behaviors among both serious delinquents and women crack users. Analyses consistently show the critical importance of sample characteristics in research on drug use, including age, cohort, and street-versus-treatment status.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Implementing the picture exchange communication system (PECS).

PECS was developed in Delaware, USA over 10 years ago by Bondy and Frost (1994a). Over the last two years PECS has been introduced to this country and has raised a great deal of interest in people working in the field of autistic spectrum disorders (ASD). This paper will address some of the issues that arose during the establishment of PECS in one special school. Changes seen in 21 children with severe learning difficulties who have been taught to use PECS are reported and the use of PECS with children who do not have an ASD is discussed.

Audiovisual Aids↗
PubMed1989

Angiotensin converting enzyme inhibitor ingestion in children.

The effect of angiotensin converting enzyme inhibitors on children is not well documented. A recent increase in popularity of the angiotensin converting enzyme inhibitors has resulted in an increased availability in the home with resulting heightened probability of accidental ingestion of angiotensin converting enzyme inhibitors by children. In response to this we did a retrospective study of angiotensin converting enzyme inhibitor ingestions in children (ages 1-5 years) from two regional poison centers certified by the American Association of Poison Control Centers. The records of the Delaware Valley Regional Poison Control Center and the New Jersey Poison Information Education Systems were reviewed for 1986 and 1987. Forty-eight angiotensin converting enzyme inhibitor exposures in children 1-5 were identified. Twenty exposures (12.5-300mg captopril, 5-15mg enalapril) were managed with syrup of ipecac in a hospital emergency room. All 20 remained asymptomatic for their stay. None required admission to the hospital. Seven exposures (12.5-75mg captopril, 5-10mg enalapril) were managed at home with syrup of ipecac and 1-, 4-, 24-hour follow up by telephone. All 7 remained asymptomatic. 16 exposures (12.5-100mg captopril, 5-30mg enalapril) were managed by phone at home with observation alone and 4-6 hour follow up. All 16 remained asymptomatic. Five exposures were lost to follow up. A larger series is needed to determine risk, but home monitoring seems adequate for children ingesting no more than the therapeutic dose for adults (12.5-100 mg captopril, 5-30 mg enalapril).

Administration, Oral↗
PubMed2003

Phosphorus feeding levels and critical control points on dairy farms.

A viable and cost-effective approach to managing P on dairy farms is to minimize excess P in diets, which in turn leads to less excretion of P in manure without impairing animal performance. A questionnaire survey was conducted, coupled with on-site feed and fecal sample collection and analysis on dairy farms in New York, Pennsylvania, Delaware, Maryland, and Virginia. The purpose was to assess dietary P levels and to identify critical control points pertaining to P feeding management. Survey responses, 612 out of 2500 randomly selected farms, revealed a wide range of dietary P concentrations for lactating cows, from 3.6 to 7.0 g/kg of feed DM. The mean was 4.4 g/kg, which was 34% above the level recommended by the NRC for 27.9 kg milk/d, the mean milk yield in the survey. Higher P concentrations in diets were not associated with higher milk yields (n = 98, R2 = 0.057 for the survey farms; n = 92, R2 = 0.043 for farms selected for on-site sampling). However, higher dietary P led to higher P excretion in feces (n = 75, R2 = 0.429), with much of the increased fecal P being water soluble. Phosphorus concentrations in diet samples matched closely with P concentrations in formulated rations, with 67% of the feed samples deviating <10% from the formulations. On 84% of the survey farms, ration formulation was provided by professionals rather than producers themselves. Most producers were feeding more P than cows needed because it was recommended in the rations by these consultants. In conclusion, P fed to lactating cows averaged 34% above NRC recommendations; to reduce excess dietary P, ration formulation is the critical control point.

Animal Feed↗
PubMed2004

Phosphorus reduction through precision feeding of dairy cattle.

A study was conducted on 4 dairy farms in the Cannonsville Reservoir Basin (Delaware County, NY) to identify feeding strategies in commercial dairy herds that will reduce manure phosphorus and mass farm phosphorus balance. Lactating cow diets on all 4 farms were evaluated monthly for 28 mo using the Cornell Net Carbohydrate and Protein System. Milk production and herd reproductive performance were measured monthly. Manure phosphorus content was measured every 6 mo. Reduced phosphorus diets (precision feeding) were implemented in 2 of the herds. Mean herd phosphorus intakes in the 4 herds ranged from 107 to 165% of requirement. Dietary phosphorus intakes in the 2 herds where diets were modified were reduced from 153% of requirement to 111%, an average reduction of 25%. Predicted phosphorus intakes and manure excretions were reduced 11.8 kg/yr per cow. After dietary adjustments in the 2 herds, fecal phosphorus concentrations decreased 33%. Milk production was not adversely affected by reduced phosphorus diets. Whole farm mass phosphorus balances (amount of phosphorus remaining on the farm) on the 2 farms were reduced 49%, with the percentage of imported phosphorus remaining on the farm reduced to less than 45%. Achieving feed phosphorus reductions similar to those of this study on all of the estimated 7000 to 8000 mature dairy cattle in the Cannonsville Basin could reduce feed phosphorus imports and manure phosphorus excretions more than 64,000 kg/yr. This would slow the rate of phosphorus accumulation in agricultural soils in the Cannonsville Basin, which over time could reduce the 50,000 kg/yr average total phosphorus loading of the Cannonsville Reservoir.

Animal Feed↗
PubMed1997

The descriptive epidemiology of craniopharyngioma.

The incidence of craniopharyngioma in the United States was estimated from two population-based cancer registries that include brain tumors of benign and borderline malignancy: the Central Brain Tumor Registry of the United States (CBTRUS) and Los Angeles county. Information on additional pediatric tumors was available from the Greater Delaware Valley Pediatric Tumor Registry (GDVPTR). The overall incidence of craniopharyngioma was 0.13 per 100,000 person years and did not vary by gender or race. A bimodal distribution by age was noted with peak incidence rates in children (aged 5-14 years) and among older adults (aged 65-74 years in CBTRUS and 50-74 years in Los Angeles county). Survival information was available from GDVPTR and the National Cancer Data Base (NCDB), a hospital-based reporting system. In the NCDB, the 5-year survival rate was 80% and decreased with older age at diagnosis. Survival is higher among children and has improved in recent years. Approximately 338 cases of craniopharyngiomas are expected to occur annually in the United States, with 96 occurring in children from 0 to 14 years of age.

Journal Article↗
PubMed2004

Tracheostomy placement in patients with complete cervical spinal cord injuries: American Spinal Injury Association Grade A.

OBJECT: The authors sought to identify variables that predispose patients with acute American Spinal Injury Association (ASIA) Grade A cervical spinal cord injury (SCI) to require tracheostomies for ventilator support or airway protection. METHODS: A retrospective analysis was performed of 178 consecutive patients with a cervical ASIA Grade A SCI who were admitted through the Delaware Valley SCI Center at Thomas Jefferson Hospital during a 6-year period. Exclusion criteria included injury occurring more than 48 hours prior to admission, death within 14 days of admission or nontraumatic SCI. Twenty-two patients were excluded based on these criteria. Parameters evaluated in the remaining population (156 patients) included demographics, cervical vertebral ASIA level, tracheostomy placement, pneumonia, premorbid pulmonary disease, smoking history, evidence of direct thoracic/lung trauma, operative intervention, associated appendicular trauma, and preexisting medical comorbidities. The ASIA classification of the 156 patients included in this analysis were C-2 (eight), C-3 (11), C-4 (64), C-5 (36), C-6 (20), C-7 (13), and C-8 (four). Tracheostomies were performed in 107 of these 156 patients. Statistical analysis revealed a significant relationship between tracheostomy and patient age (p = 0.0048), preexisting medical conditions (p = 0.0417), premorbid lung disease (p = 0.0177), higher cervical ASIA level (p < 0.0001), and the presence of pneumonia (p < 0.0001). No patient with a C-8 ASIA A injury required tracheostomy, whereas all C-2 and C-3 ASIA A-injured patients underwent tracheostomies. Patients older than 45 years of age with ASIA A levels between C-4 and C-7 more commonly required tracheostomy (p < 0.005) than patients younger than 45 years of age. CONCLUSIONS: Several risk factors were identified that corresponded to the frequent tracheostomy placement in the acute injury phase after complete cervical SCI. Early tracheostomy may be considered in patients with multiple risk factors to reduce duration of stay in the intensive care unit and facilitate ventilatory weaning.

Adolescent↗
PubMed2002

Serologic survey of cattle in the northeastern and north central United States, Virginia, Alaska, and Hawaii for antibodies to Cache Valley and antigenically related viruses (Bunyamwera serogroup virus).

Bovine sera from northeastern states (Connecticut, Delaware, Maine, Maryland, Massachusetts, New York, Pennsylvania, Vermont, and West Virginia), north central states (Indiana, Illinois, Iowa, Kentucky, Michigan, Minnesota, North Dakota, Ohio, South Dakota, and Wisconsin), Virginia, Alaska, and Hawaii were examined for the presence of neutralizing antibodies to Cache Valley (CV), Lokern (LK), Main Drain (MD), Northway (NW), and Tensaw (TS) viruses. Microneutralization tests were performed using Vero cells. Ninety percent inhibition of the virus at a 1:10 serum dilution was considered positive for the presence of specific antibody. Sera having antibody to more than one virus were titrated from 1:10 to 1:640. The results indicated that 4-28% of the cattle per region had specific antibodies to CV virus. Neutralizing antibodies to NW, LK, and TS viruses were also detected, indicating possible exposure to these Bunyamwera serogroup viruses along with CV virus. Antibody titers measured against NW virus were very similar to those against CV virus. Antibodies to MD virus were present in low levels in bovine sera from Illinois, Maryland, and Ohio. Cattle from Alaska had only antibodies to NW virus. Antibodies to Bunyamwera serogroup viruses were not observed in sera from Hawaii.

Animals↗
PubMed2005

Brief communication: duration of platelet dysfunction after a 7-day course of Ibuprofen.

BACKGROUND: Despite a paucity of evidence, clinicians routinely advise that patients discontinue using nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, at least 1 week before most surgical procedures. OBJECTIVE: To define the duration of ibuprofen-induced platelet dysfunction. DESIGN: Prospective cohort study. SETTING: Denver/Aurora, Colorado. PARTICIPANTS: 11 healthy adult volunteers. MEASUREMENTS: Individuals were tested at baseline and serially after completion of a 7-day course of ibuprofen (600 mg orally every 8 hours). The platelet function analyzer (PFA-100, Dade Behring, Newark, Delaware), a test that has replaced the bleeding time in many clinical settings, was used. RESULTS: All participants exhibited normal platelet function before starting ibuprofen. Platelet dysfunction was apparent after completion of the ibuprofen course in 7 of the 11 participants and normalized by 24 hours after the last ibuprofen dose. LIMITATIONS: The sample size in this study was small, and no participants had a major illness. Correlation between PFA-100 results and clinical bleeding has not been established. CONCLUSIONS: Platelet function seems to normalize within 24 hours after cessation of regular ibuprofen use in healthy individuals. Further studies are warranted to provide a rational basis for timing of NSAID withdrawal in a range of patients undergoing surgery.

Adult↗
PubMed2005

A comparison of brand-name drug prices between Canadian-based Internet pharmacies and major U.S. drug chain pharmacies.

BACKGROUND: Many Americans have been purchasing their medications from online Canadian pharmacies. Although it is commonly perceived that medications are less expensive in Canada than in the United States, little research has been done to quantify this difference. OBJECTIVE: To compare the prices of retail brand-name medications between Canadian Internet pharmacies and major U.S. drug chain pharmacies with online pricing. DESIGN: Cross-sectional study. SETTING: 12 Canadian Internet pharmacies and 3 major online U.S. drug chain pharmacies. MEASUREMENTS: The authors calculated the per unit and annual savings (in U.S. dollars) for an American if he or she were to buy the 44 brand-name medications most commonly purchased through the Internet from Canadian Internet pharmacies instead of from an online U.S. drug chain pharmacy. RESULTS: Americans can save a mean of approximately 24% per unit of drug if they purchase their medications from Canadian Internet pharmacies instead of from major online U.S. drug chain pharmacies. Forty-one of the 44 brand-name medications examined were less expensive in Canada. The medications offering the largest mean yearly savings were Zyprexa (olanzapine) (Eli Lilly, Indianapolis, Indiana) (1159 dollars), Actos (pioglitazone) (Eli Lilly, Indianapolis, Indiana) (852 dollars), and Nexium (esomeprazole) (AstraZeneca, Wilmington, Delaware) (772 dollars). Only 3 medications, all in the erectile dysfunction category, were more expensive in Canada. LIMITATIONS: Potential savings may vary because of temporal fluctuations in drug prices. CONCLUSIONS: Brand-name medications are often substantially less expensive when purchased from Canadian Internet pharmacies instead of from major online U.S. drug chain pharmacies.

Canada↗
PubMed1993

Serologic evidence for rabbit syncytium virus in eastern cottontail rabbits (Sylvilagus floridanus) in Ohio.

Thirteen of 20 eastern cottontail rabbit (Sylvilagus floridanus) sera collected near Delaware, Ohio (USA) in 1991 were positive by indirect immunofluorescent antibody test (IFAT) for antibody to rabbit syncytium virus (RSV), a Kemerovo serogroup orbivirus. In addition, two of 10 domestic bovine sera and three of 30 sheep sera collected in southeastern Ohio gave weak positive IFAT reactions to RSV.

Animals↗
PubMedDate not supplied

Zero defections: quality comes to services.

Companies that want to improve their service quality should take a cue from manufacturing and focus on their own kind of scrap heap: customers who won't come back. Because that scrap heap can be every bit as costly as broken parts and misfit components, service company managers should strive to reduce it. They should aim for "zero defections"--keeping every customer they can profitably serve. As companies reduce customer defection rates, amazing things happen to their financials. Although the magnitude of the change varies by company and industry, the pattern holds: profits rise sharply. Reducing the defection rate just 5% generates 85% more profits in one bank's branch system, 50% more in an insurance brokerage, and 30% more in an auto-service chain. And when MBNA America, a Delaware-based credit card company, cut its 10% defection rate in half, profits rose a whopping 125%. But defection rates are not just a measure of service quality; they are also a guide for achieving it. By listening to the reasons why customers defect, managers learn exactly where the company is falling short and where to direct their resources. Staples, the stationery supplies retailer, uses feedback from customers to pinpoint products that are priced too high. That way, the company avoids expensive broad-brush promotions that pitch everything to everyone. Like any important change, managing for zero defections requires training and reinforcement. Great-West Life Assurance Company pays a 50% premium to group health-insurance brokers that hit customer-retention targets, and MBNA America gives bonuses to departments that hit theirs.

Consumer Behavior↗
PubMed1992

Recovery strategies help faltering hospital pull back from brink of bankruptcy.

Delaware Valley Medical Center was slipping fast, heading toward bankruptcy or closure. But thanks to a corrective business plan established a year ago, the Langhorne, Pa., osteopathic facility has turned profitable a year ahead of schedule. Physician recruitment, new services and a flexible hospital board have played key roles.

Bankruptcy↗
PubMed1992

Economic-impact study seen as vehicle to spur growth, deter tax.

A new report commissioned by Pennsylvania's Delaware Valley Hospital Council to quantify hospitals' value to the five-county area in services, salaries and other economic benefits could serve as ammunition for economic development leaders to help attract new businesses and by the region's hospitals in defense of their property-tax exemptions.

Community-Institutional Relations↗
PubMedDate not supplied

Retired executives link purchasers and providers in Greater Philadelphia.

A three-year project funded by the John A. Hartford Foundation of New York used retired executives and physicians to overcome Philadelphia area employers' coolness to HMOs. Acting as evaluators, facilitators, educators and advisors, the participants achieved improved understanding and helped raise HMO enrollment from 3.5% to 11.6% of the target population. The President of the Executive Service Corps of the Delaware Valley tells how.

Community-Institutional Relations↗
PubMedDate not supplied

1987 hospital costs by state.

Data collected by EQUICOR from 1,863 hospitals nationwide show "significant" increases in hospital costs between 1986 and 1987. The average charge per inpatient day was $697 nationally in 1987, up 16%. Hawaii's average charge rose 41%, to $906, while Delaware's fell 13%, to $474.

Data Collection↗