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C Beauchamp

Publications and source records attributed to C Beauchamp.

At least 19 recordsLinked to original sources
PubMed2001

Development of a FLP/frt system for generating helper-dependent adenoviral vectors.

Helper-dependent (HD) adenoviral vectors devoid of all viral coding sequences have a large cloning capacity and have been reported to provide long-term transgene expression in vivo with negligible toxicity, making them attractive vectors for gene therapy. Currently, the most efficient means of generating HD vectors involves co-infecting 293 cells expressing Cre with the HD vector and a helper virus bearing a packaging signal flanked by loxP sites. Cre-mediated excision of the packaging signal renders the helper virus genome unpackageable but still able to replicate and to provide helper functions for HD vector propagation. HD vector titer is increased by serial co-infections. Typically, helper virus contamination is < or =1% pre- and < or =0.1% postpurification by CsCl banding. While these contamination levels are low, further reduction is desirable. Alternative methods of selection against the helper virus may achieve this goal, especially when combined with Cre/loxP. We describe the development of a system for generating HD vectors based on site-specific recombination between frt sites catalyzed by FLP recombinase and show by direct comparison that the FLP/frt and Cre/loxP systems are equivalent with respect to HD vector amplification efficiency and helper virus contamination levels. Availability of a second recombinase system for HD vector production will enhance the utility and flexibility of HD vectors.

Adenoviridae↗
PubMed2000

Improving residents' compliance with standards of ambulatory care: results from the VA Cooperative Study on Computerized Reminders.

CONTEXT: Computerized systems to remind physicians to provide appropriate care have not been widely evaluated in large numbers of patients in multiple clinical settings. OBJECTIVE: To examine whether a computerized reminder system operating in multiple Veterans Affairs (VA) ambulatory care clinics improves resident physician compliance with standards of ambulatory care. DESIGN, SETTING, AND PARTICIPANTS: A total of 275 resident physicians at 12 VA medical centers were randomly assigned in firms or half-day clinic blocks to either a reminder group (n = 132) or a control group (n = 143). During a 17-month study period (January 31, 1995-June 30, 1996), the residents cared for 12,989 unique patients for whom at least 1 of the studied standards of care (SOC) was applicable. MAIN OUTCOME MEASURES: Compliance with 13 SOC, tracked using hospital databases and encounter forms completed by residents, compared between residents in the reminder group vs those in the control group. RESULTS: Measuring compliance as the proportion of patients in compliance with all applicable SOC by their last visit during the study period, the reminder group had statistically significantly higher rates of compliance than the control group for all standards combined (58.8% vs 53.5%; odds ratio [OR], 1.24; 95% confidence interval [CI], 1.08-1.42; P =.002) and for 5 of the 13 standards examined individually. Measuring compliance as the proportion of all visits for which care was indicated in which residents provided proper care, the reminder group also had statistically significantly higher rates of compliance than the control group for all standards combined (17.9% vs 12.2%; OR, 1.57; 95% CI, 1.45-1.71; P<.001) and for 9 of the 13 standards examined individually. The benefit of reminders, however, declined throughout the course of the study, even though the reminders remained active. CONCLUSIONS: Our data indicate that reminder systems installed at multiple sites can improve residents' compliance to multiple SOC. The benefits of such systems, however, appear to deteriorate over time. Future research needs to explore methods to better sustain the benefits of reminders. JAMA. 2000;284:1411-1416.

Adult↗
PubMed1997

AANA journal course: update for nurse anesthetists--serotonin agonists and antagonists: anesthetic implications.

A number of important new pharmacologic agents in widespread clinical use share the ability of manipulate serotonin as their mechanism of action. Drugs as diverse as the antidepressants fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and venlafaxine (Effexor); the antimigraine agent sumatriptan (Imitrex); the antiobesity agent dexfenfluramine (Redux); and the antiemetics ondansetron (Zofran) and granisetron (Kytril) are routinely encountered in the perioperative patient. A thorough understanding of the pharmacology, physiologic effects, significant drug interactions and anesthetic implications of serotonin agonists or antagonists is vital for proper anesthetic management of patients receiving these drugs.

Anesthesia↗
PubMed1996

Overutilization of acute-care beds in Veterans Affairs hospitals.

The authors tested the hypothesis that the Department of Veterans Affairs (VA) hospitals would have substantial overutilization of acute care beds and services because of policies that emphasize inpatient care over ambulatory care. Reviewers from 24 randomly selected VA hospitals applied the InterQual ISD* (Intensity, Severity, Discharge) criteria for appropriateness concurrently to a random sample of 2,432 admissions to acute medical, surgical, and psychiatry services. Reliability of hospital reviewers in applying the ISD* criteria was tested by comparing their reviews with those of a small group of expert reviewers. Validity of the ISD* criteria was tested by comparing the assessments of master reviewers with the implicit judgments of panels of nine physicians. The physician panels validated the ISD* admission criteria for medicine and surgery (74% agreement with master reviewers, kappa > 0.4), whereas the psychiatry criteria were not validated (66% agreement, kappa 0.29). Hospital reviewers reliably used all three criteria sets (> 83% agreement with master reviewers, kappa > 0.6). Rates of nonacute admissions to acute medical and surgical services were > 38% as determined by the hospital and master reviewers and by the physician panels. Nonacute rates of continued stay were > 32% for both medicine and surgery services. Similar rates of nonacute admissions and continued stay were found for all 24 hospitals. Reasons for nonacute admissions and continued stay included lack of an ambulatory care alternative, conservative physician practices, delays in discharge planning, and social factors such as homelessness and long travel distances to the hospital. Using criteria that the authors showed to be reliable and valid, substantial overutilization of acute medicine and surgical beds was found in a representative sample of VA hospitals. Correcting this situation will require changes in physician practice patterns, development of ambulatory care alternatives to inpatient care, and modification of current VA policies determining eligibility for care.

Acute Disease↗
PubMed1995

A managed care workstation for support of ambulatory care in Veterans Health Administration medical centers.

This paper describes the development of a Managed Care Workstation for implementation in a Department of Veterans Affairs hospital. Each VA hospital information system contains a wealth of information in a comprehensive and well integrated M database, however, a clinician's access to the information is hampered by a lack of usable database tools. The Managed Care Workstation is designed to enhance access to VA databases. The workstation uses M (Mumps) and SQL to present the VA's M hierarchical database as relational tables on the workstation. This work reveals the benefits of using a SQL-M workstation to access data contained in an M based hospital information system and demonstrates how the workstation architecture supports the information model necessary for management of patient care outcomes.

Ambulatory Care Information Systems↗
PubMed1995

Hip arthrodesis: an important option for advanced disease in the young adult.

Despite increasing confidence in the intermediate and long-term results of total hip replacement, considerable and justifiable concern remains about its use in young, active adults. Hip arthrodesis is a valuable, although unpopular, option in this group of patients. The authors describe, step by step, the standardized technique of arthrodesis that they first used in 1981, and they review the results of their experience. The importance of precise positioning of the fusion is emphasized: 20 degrees of flexion, 5 degrees of external rotation and neutral abduction-adduction. Intraoperative radiography to check the positioning is strongly advised. Because total hip arthroplasty will likely be necessary at a later date, every effort should be made to preserve the abductors, and the greater trochanter should be fixed in place at its normal level. If these precautions are taken and if the patient is carefully selected and properly educated preoperatively, a high success rate can be expected for hip arthrodesis.

Adolescent↗
PubMed1993

A temporary antibiotic-loaded joint replacement system for management of complex infections involving the hip.

Management of the infected hip replacement associated with substantial loss of bone, especially segmental loss of the proximal femur, is a challenging problem. In this report, the authors outline the development of an immediate-fit, custom-made, antibiotic-selective replacement system for the hip and proximal femur, to help maintain limb length, joint stability, and mobility of the patient. Despite the initial relatively crude design, it was a valuable adjunct in the management of 15 consecutive cases. A more sophisticated and versatile system has since been developed for use in straightforward and complex cases.

Aged↗
PubMed1993

Soft tissue sarcomas: a plea for proper management.

Although soft tissue sarcomas are relatively uncommon, they often occur in young patients and if properly treated are often curable. Unfortunately, inappropriate approaches to biopsy before adequate staging may compromise a successful outcome. The roles of diagnostic imaging (particularly magnetic resonance imaging) in adequate preoperative evaluation and staging and the fundamental principles of surgical management are discussed.

Adolescent↗
PubMed1989

A clinical database management system for improved integration of the Veterans Affairs Hospital Information System.

The Department of Veterans Affairs (VA) Decentralized Hospital Computer Program (DHCP) contains data modules derived from separate ancillary services (e.g., Lab, Pharmacy and Radiology). It is currently difficult to integrate information between the modules. A prototype is being developed aimed at integrating ancillary data by storing clinical data oriented to the patient so that there is easy interaction of data from multiple services. A set of program utilities provides for user-defined functions of decision support, queries, and reports. Information can be used to monitor quality of care by providing feedback in the form of reports, and reminders. Initial testing has indicated the prototype's design and implementation are feasible (in terms of space requirements, speed, and ease of use) in outpatient and inpatient settings. The design, development, and clinical use of this prototype are described.

Ancillary Services, Hospital↗
PubMed1989

"Computers in medicine"--a course for students at the USD School of Medicine.

The University of South Dakota School of Medicine offers an elective course for senior medical students in the use of computer technology for patient care. The philosophy of the course, its current composition, and changes to the course in the future are described. By organizing topic information using computer tools for text, outline, data item, math, and image processing, students learn formats for information storage in the computer. In the near future, students will have the opportunity to make a hypothesis and test it with decision support tools that are present in an integrated hospital database.

Computer Systems↗
PubMed1988

Hospital-based primary prevention strategy in child abuse: a multi-level needs addressment.

The purpose of this study was to evaluate a primary prevention effort in child maltreatment, the focus of which was a community-wide endeavor (i.e., subjects were not prescreened for risk potential). Specific components of the planned intervention addressed four causal levels of maltreatment: individual, family, community, and cultural factors. That assessment was intended to build strengths in those parenting areas which are predictive of abusive or neglectful outcomes. Target areas included knowledge of child development, child-rearing attitudes, mother-infant interaction patterns, and parenting skills. A posttest-only control group design was employed. The control postpartum mothers received traditional or routine hospital services; experimental mothers received special in-hospital and after-care services by trained student nurse volunteers. These volunteers functioned in a dual educative/supportive role. Experimental mothers reported more realistic expectations of behavior, embraced more democratic child-rearing principles, providing more verbal stimulation to their infants (reflecting an increased sensitivity), and displayed increased problem-solving abilities.

Adult↗
PubMed1988

[Not Available].

Explore the source record for details and available documents.

History, Modern 1601-↗
PubMed1984

Effects of inescapable shock and norepinephrine depletion induced by DSP4 on escape performance.

The potential contribution of dorsal bundle norepinephrine (NE) in the induction of escape disturbances engendered by inescapable shock was evaluated following administration of the NE neurotoxin, DSP4. Treatment with DSP4 produced marked NE reductions in the hippocampus and cortex, a moderate reduction of NE in the locus coeruleus, but only small effects on hypothalamic NE. In contrast to the effect of inescapable shock, DSP4 was found not to influence escape behavior among naive mice or mice that had received inescapable shock. Moreover, DSP4 was without effect on escape performance irrespective of whether animals were individually or group housed, a treatment that has been shown to be sensitive to manipulations that influence escape performance. Treatment with DSP4 was found not to influence the escape interference ordinarily provoked by either haloperidol or alpha-MpT. Interestingly, the escape interference ordinarily engendered by the dopamine-beta-hydroxylase inhibitor, FLA-63, was eliminated among mice that had been pretreated with DSP4. The interference effect induced by inescapable shock is probably not attributable to NE alterations in the hippocampus and locus coeruleus. Serial or parallel effects of shock on more than a single transmitter system are likely to be responsible for the behavioral interference.

Amines↗
PubMed1984

Amphetamine-induced perseverative behavior in a radial arm maze following DSP4 or 6-OHDA pretreatment.

Mice permitted to explore an 8-arm radial maze tended to visit those arms least recently entered. Treatment with D-amphetamine engendered a perseverative tendency, wherein mice repeatedly visited two arms of the maze. Administration of the norepinephrine (NE) neurotoxin, N-2-chloroethyl-N-ethyl-2-bromo-benzylamine (DSP4), appreciably reduced NE in the hippocampus and cortex, moderately reduced NE in the locus coeruleus, and had only a small effect on hypothalamic NE. The DSP4 treatment resulted in a decrease of locomotor activity among amphetamine-treated mice, coupled with an increase of stereotyped response patterns. Although the NE depletion did not affect the pattern of exploration that mice ordinarily displayed, DSP4 appreciably increased the perseverative tendency provoked by amphetamine. Reduction of dopamine (DA) and NE by intraventricular administration of the catecholamine neurotoxin, 6-hydroxydopamine (6-OHDA), antagonized the effects of amphetamine, such that the frequency of alternation responses was increased and the proportion of perseverative responses was reduced. The effectiveness of the 6-OHDA treatment in antagonizing the amphetamine-induced perseveration was not reduced among mice that were pretreated with desmethylimipramine, which resulted in partial prevention of the NE reduction by 6-OHDA administration. It is suggested that DA neuronal activity contributes to the amphetamine -provoked perseveration , whereas NE stimulation modifies the perseverative tendency by influencing exploration or habituation.

Amines↗