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Biomedical subjects

B Chandler

Publications and source records attributed to B Chandler.

13 recordsLinked to original sources

Study and treatment of post Lyme disease (STOP-LD): a randomized double masked clinical trial.

OBJECTIVE: To determine whether post Lyme syndrome (PLS) is antibiotic responsive. METHODS: The authors conducted a single-center randomized double-masked placebo-controlled trial on 55 patients with Lyme disease with persistent severe fatigue at least 6 or more months after antibiotic therapy. Patients were randomly assigned to receive 28 days of IV ceftriaxone or placebo. The primary clinical outcomes were improvement in fatigue, defined by a change of 0.7 points or more on an 11-item fatigue questionnaire, and improvement in cognitive function (mental speed), defined by a change of 25% or more on a test of reaction time. The primary laboratory outcome was an experimental measure of CSF infection, outer surface protein A (OspA). Outcome data were collected at the 6-month visit. RESULTS: Patients assigned to ceftriaxone showed improvement in disabling fatigue compared to the placebo group (rate ratio, 3.5; 95% CI, 1.50 to 8.03; p = 0.001). No beneficial treatment effect was observed for cognitive function or the laboratory measure of persistent infection. Four patients, three of whom were on placebo, had adverse events associated with treatment, which required hospitalization. CONCLUSIONS: Ceftriaxone therapy in patients with PLS with severe fatigue was associated with an improvement in fatigue but not with cognitive function or an experimental laboratory measure of infection in this study. Because fatigue (a nonspecific symptom) was the only outcome that improved and because treatment was associated with adverse events, this study does not support the use of additional antibiotic therapy with parenteral ceftriaxone in post-treatment, persistently fatigued patients with PLS.

Adult↗

Comparison of analytical methods for quantitation of isolated porcine hepatocyte yields.

As cell-based therapies receive approval for clinical evaluation and use, the development of reliable methods to quantify cell number and control the dose of therapy delivered is becoming increasingly important. An example is the determination of the number and volume of primary porcine hepatocytes used in an extracorporeal treatment for patients with liver disease. Conventional cell counting using optical microscopy was compared against two alternate methods to quantify isolated porcine hepatocytes: (1) automated cell counting using a commercially available particle characterization instrument, and (2) quantitation by cell mass. Methods were compared based on accuracy, precision, specificity, linear range, and ruggedness. The automated method delivered substantially improved accuracy, precision, and ruggedness when compared to the conventional optical method. It also provided valuable information about the size distribution of cell preparations, which often contained clumps of cells, and showed that processing steps such as cryopreservation can alter the size characteristics of a cell population. The automated method was also faster, and was well suited to use in a commercial manufacturing process. The mass-based method was simple and inexpensive, but suffered from nonlinearity at low cell concentrations. Automated cell quantitation using a commercially available particle characterization instrument proved to be the preferred method for obtaining accurate and consistent porcine hepatocyte counts in a timely manner.

Animals↗

Nursing home residents' perceptions of the quality of their care.

This pilot study employed qualitative interviews to assess nursing home residents' perceptions of their "best" and "worst" experiences in the nursing home. Findings suggest residents are least satisfied with the care provided by nurse aides, and most satisfied with that provided by professional staff members. The quality of interpersonal relationships with staff was the basis for the majority of both residents' best and worst experiences. Qualitative analyses identified specific "adaptive responses" that were associated with how residents interpreted and responded to negative experiences with care.

Aged↗

Long-acting therapy of viral retinitis with (S)-1-(3-hydroxy-2-phosphonylmethoxypropyl)cytosine.

(S)-1-(3-hydroxy-2-phosphonylmethoxypropyl)cytosine (HPMPC), a high-potency antiherpes and anticytomegalovirus (CMV) drug was evaluated in the treatment of experimental retinitis caused by preretinal herpes simplex virus (HSV-1) injection in rabbits. HPMPC (100 micrograms/0.1 mL) was intravitreally injected 10, 15, 21, 30, or 46 days before, concurrently, or 3, 5, or 7 days after viral inoculation. Ganciclovir (200 micrograms/0.1 mL) was intravitreally injected 3, 7, or 10 days before HSV-1 inoculation, concurrent with viral inoculation, or 3, 5, or 7 days after viral inoculation. Eyes pretreated with HPMPC were protected from retinitis for 15-21 days. Ganciclovir did not protect completely even if administered 3 days before inoculation. Early treatment of established retinitis with HPMPC markedly delayed the progression of the infection. However, with ganciclovir there was delayed progression only in rabbits treated 3 days after viral inoculation. HPMPC had a remarkably potent and prolonged (< or = 1 month) antiviral effect in this retinitis model and may prove more useful than ganciclovir in local treatment of CMV retinitis.

Animals↗

Institutional loyalty and job satisfaction among nurse aides in nursing homes.

The high rate of turnover among nurse aides employed in nursing homes has been associated with the low job status and the poor job benefits accorded workers. However, this is not always the case. Competitive benefit packages and limited labor market opportunities increase the likelihood that nurse aides in some nursing homes may stay on the job despite their dissatisfaction with it. The present study investigated "institutional loyalty," an attitudinal proxy for job turnover, among 219 nurse aides for its relationship to a number of job-related factors. Somewhat unexpectedly, the quality of the social environment of the nursing home was found to be as important as attitudes toward job benefits in accounting for institutional loyalty.

Attitude of Health Personnel↗

Quantitative histology of bone: a computerized method of measuring the total mineral content of bone.

A comparatively simple quantitative method for assessing bone morphology has been evolved. Microradiographs of thin sections of mandible have been scanned with a Joyce-Loebl double beam recording microdensitometer with a scanning autodensidater attachment, using a white beam. For each image the optical densities for all the pixels (picture elements) were divided into 10 groups. The limits of the division were fixed by the maximum and minimum densities occurring within the image. A computer generated map was produced which indicated the spatial distribution of the pixels within each group to which an arbitrarily chosen shading was attached. The number of pixels within each group is also shown on the map. The computer map was compared with the photomicrograph and, where necessary, the original section. The fractional area of hard tissue was then readily determined using the numerical values of each group of pixels.

Absorptiometry, Photon↗

Student perspectives on problem-based learning in an occupational therapy curriculum: a multiyear qualitative evaluation.

OBJECTIVES: Problem-based learning (PBL) is increasingly being used within health care professional educational programs to develop critical thinking skills via a learner-centered approach. However, few studies have evaluated the effect of participation in a PBL-centered curriculum on occupational therapy knowledge and skill development over time from the perspective of the students involved. This study examined student evaluations of the first three class cohorts participating in a PBL-based curriculum. METHOD: A participatory action design study involving qualitative, student-led focus groups was conducted with 154 students across 2 years of the education program. Fourteen focus groups were audiotaped, and those audiotapes were transcribed by an outside expert, followed by two levels of analysis by program faculty members and a member check by student participants. RESULTS: Themes that emerged from the data analysis related to (a) defining elements of PBL, (b) the role of students and faculty members, (c) learning strategies used by students in a PBL versus traditional education program, (d) the challenges of a PBL approach, and (e) PBL's relationship to clinical reasoning and occupational therapy practice. CONCLUSIONS: Students perceived that a PBL approach adopted consistently across the curriculum contributed to the development of information management, critical reasoning, communication, and team-building skills; however, identified challenges were time and role management, information access, instructor versus PBL expectations and practices, and coping with the ambiguity of knowledge and reasoning.

Adult↗