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Biomedical subjects

C M Gilbert

Publications and source records attributed to C M Gilbert.

At least 19 recordsLinked to original sources
PubMed2000

A time-resolved fluorescence immunoassay for the determination of a novel respiratory therapeutic agent, AR-C68397XX (Viozan) in human plasma.

A dissociation-enhanced lathanide fluorescence immunoassay (DELFIA) method has been developed for the determination of AR-C68397XX, a novel respiratory therapeutic agent, in human plasma. The method is a 'direct' immunoassay and provides an alternative to the solid phase extraction RIA described in a previous publication, which employs the same specific antiserum. The DELFIA method is suitable for the determination of the analyte at pg ml(-1) concentrations. The non-isotopic label was prepared by complexation of a DTPA derivative of AR-C68397XX with free europium cation (Eu3+). Plasma samples were diluted at least 5-fold prior to analysis to eliminate matrix interference. The calibration range is 10-2000 pg ml(-1), and the LOQ of the method is 50 pg ml(-1) using 50 microl of diluted human plasma sample.

Adrenergic beta-Agonists↗
PubMed2000

Challenges for the millennium.

Health sciences librarians will face many new challenges in the new millennium. Some we can predict and some we cannot. The Hospital Information Services columns will explore some of these challenges in this and subsequent issues.

Copyright↗
PubMed1999

Latanoprost and herpes simplex keratitis.

PURPOSE: To report three cases in which herpes simplex keratitis developed after initiation of latanoprost therapy. METHODS: Case report. RESULTS: One patient with a history of herpes simplex keratitis had recurrence of herpes simplex keratitis with latanoprost treatment, resolution when latanoprost was stopped, and another recurrence when rechallenged with latanoprost. A second patient with a history of herpes simplex keratitis had bilateral recurrence with initiation of latanoprost; antiviral therapy could not eradicate herpes simplex keratitis until the latanoprost was discontinued. The third patient with latanoprost-associated herpes simplex keratitis cleared with the discontinuation of latanoprost and start of antiviral therapy; reinstitution of latanoprost with prophylactic antiviral medication kept the cornea clear, but as soon as the antiviral suppression was discontinued, herpes simplex keratitis reappeared. CONCLUSION: Latanoprost, among its diverse pharmacologic effects, may mediate inflammation in the eye. Prostaglandins may be a final common pathway for stimulating recurrence of herpes simplex keratitis. Clinicians should be aware of this possible association.

Aged↗
PubMed1995

Nonoperative management of blunt hepatic trauma.

Abdominal CT scanning makes nonoperative management of liver injury possible. We reviewed medical records of 56 blunt trauma patients with hepatic injury who received initial abdominal CT scan. We examined: 1) Indications for delayed surgery; 2) Disposition or cause of death; 3) Results of follow up CT scans; 4) Long term complications. Over a 53 month period, 1597 patients were admitted for blunt trauma, of which 76 patients were found to have hepatic injury. Twenty patients presented either clinically unstable or with an acute abdomen and underwent diagnostic peritoneal lavage or immediate laparotomy without a CT scan. Abdominal CT scan was performed on 56 patients, 19 of whom had hepatic injury or associated major abdominal injury and underwent laparotomy. One patient died of cardiac arrhythmias following CT scanning. The remaining 36 patients received initial nonoperative management of their hepatic injury. Three patients in this group underwent delayed abdominal surgery. Two developed an acute abdomen. One had a planned nephrectomy. No patient required surgical treatment of their liver injury at the time of laparotomy. Four deaths occurred in the 36 patients managed nonoperatively, all due to associated extra-abdominal injuries. Nineteen patients had 27 CT scans taken as follow up examination at intervals of 1 to 94 days postinjury. All of the CT scans showed stabilization or improvement of hepatic injury. Three patients who had CT scans taken at 3 months postdischarge were asymptomatic, with radiologic resolution of their hepatic injury. Nineteen patients were followed for an average of 61.8 days (range 7-203 days) after discharge with no complications from liver injury.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Effect of online literature searching on length of stay and patient care costs.

PURPOSE: To examine the associations between (1) the economic indicators of hospital costs, charges, and length of stay (LOS) for inpatient cases and (2) the use of MEDLINE searches for such cases. METHOD: An outcome-based, objective, prospective study with an economic evaluation was conducted from September 1989 to September 1990 at three metropolitan Detroit teaching hospitals representing both allopathic and osteopathic care. The study consisted of (1) 192 test cases, derived from a consecutive sample of inpatients of all ages for whom MEDLINE searches were requested at the participating medical libraries, and (2) 10,409 control cases, which were of the same diagnosis-related groups (DRGs) as the test cases but did not involve identified MEDLINE searches. Statistical analysis included the use of multivariate analyses of variance and correlation coefficients. Comparisons of cases were made on case-by-case and DRG bases regarding total patient costs, charges, and lengths of stay for cases with or without MEDLINE searches. RESULTS: The test cases were found to have a higher severity of illness. Among test cases, statistically significant relationships existed between (1) hospital expenses and LOS and (2) hospital expenses and the timing of the search during hospitalization when controlling for LOS. When cases were matched for DRG and LOS, the cases with early searches (i.e., conducted during the first half of hospitalization) had significantly lower expenses. CONCLUSION: Of the test-case patients (for whom MEDLINE searches were conducted during hospitalization), those whose searches were conducted earlier had statistically significantly lower costs, charges, and lengths of stay than those whose searches were conducted later.

Adolescent↗
PubMed1989

Characteristics of the cellular response of the rat conjunctiva to topically applied leukotriene B4.

Cellular events in the rat conjunctiva were studied at 1, 6 and 24 h following the topical application of leukotriene B4. A significant increase was noted in the number of eosinophils (p less than 0.01) and neutrophils (p less than 0.05) at 1 h and only in eosinophils at 6 h after leukotriene B4 application at the 2-micrograms dose. At the 200-ng dose, the eosinophil count was significantly elevated at 1 h only, and the number of neutrophils was not significantly changed at any time point. No significant increase in cell counts was observed at the 20-ng dose. In conclusion, certain doses of topically applied leukotriene B4 significantly increased the number of eosinophils and neutrophils in the rat conjunctiva.

Administration, Topical↗
PubMed1988

Sustained reduction of intraocular pressure in humans with the calcium channel blocker verapamil.

We investigated the effect of the calcium channel blocker verapamil on intraocular pressure in human volunteers. In the initial trial, 15 subjects with untreated ocular hypertension were tested. After a baseline measurement was obtained with applanation tonometry, a 40-microliter drop of verapamil, 1.25 mg/ml, was instilled in one eye. After 30 minutes, a second reading was taken. In a subsequent trial of 12 untreated ocular hypertensive subjects, the duration of action was determined using the same dose and method of delivery. Results showed that verapamil elicited a mean +/- S.E.M. change in intraocular pressure of -3.8 +/- 0.900 mm Hg in the treated eye, and -1.6 +/- 0.400 mm Hg in the untreated eye. This reduction was statistically different in both eyes (treated eye, P = .0007; untreated eye, P = .005). This decrease in intraocular pressure remained statistically significant when compared to predrug baseline values for up to ten hours.

Administration, Topical↗
PubMed1988

Sexual abuse and group therapy.

This article described the formation of a structured, open-ended, time-limited, repeatable group for sexually abused girls. The sexually abused pre-adolescent and young adolescent must address developmental tasks while attempting to cope with tremendous guilt, shame, and loss of self-esteem. The value of group therapy as a support to sexually abused children was explored and a format was devised to help them deal with their issues. Discussion questions and topics designated for each session helped meet their specific needs. The group members evaluated the group as being helpful overall. In conclusion, the expansion of psychotherapeutic services to sexually abused children through a structured group format has been proposed. If others are encouraged to engage in such work, then the purpose of this article has been achieved.

Adolescent↗
PubMed1987

Nonsimultaneous primary choroidal and cutaneous melanomas. Report of a case.

The authors report a patient with nonsimultaneous choroidal and cutaneous melanomas. The patient did not display the dysplastic nevus syndrome phenotype, and there was a negative family history for cutaneous or uveal melanomas. This sporadic case might suggest a common etiologic factor in the pathogenesis of multicentric malignant melanomas.

Choroid Neoplasms↗
PubMed1987

A two-year prospective study of penetrating ocular trauma at the Wilmer Ophthalmological Institute.

A prospective study of 91 consecutively admitted patients with penetrating ocular trauma was performed. Clinical follow-up of six months or more (mean, 15 mo) was obtained for 77% of the patients. Domestic accidents and assault each accounted for approximately one third of the injuries. Penetrating injuries caused by sharp objects resulted in better visual outcome than did those caused by blunt objects. Visual outcome was better for eyes with lacerations less than 10 mm in length and with initial visual acuity greater than 20/200. Injuries limited to the anterior segment had a better prognosis than did those involving the posterior segment.

Adult↗
PubMed1986

The effect of argon laser trabeculoplasty on the rate of filtering surgery.

We examined the impact of argon laser trabeculoplasty (ALT) on the overall rate of filtering surgery on a resident service. From 1981 through 1984, 121 eyes underwent ALT for treatment of uncontrolled primary open-angle glaucoma despite maximum tolerated medical therapy. Mean intraocular pressure decreased from 27 +/- 4 mmHg to 20 +/- 5 mmHg (median follow-up, 9 months). From 1978 through 1981, the mean annual rate of filtering surgery was 16. Only one filtering procedure was performed in 1982, the first full year of ALT use. However, 15 filtering procedures were performed in 1983 and 18 were performed in 1984. Despite a large number of apparently effective ALT treatments and despite an overall reduction in outpatient visits of 20%, the rate of filtering surgery has returned to the pre-ALT level. This suggests that ALT may be effective in delaying the need for surgery, but in many cases it probably does not prevent surgery.

Argon↗
PubMed1984

Successful treatment of postoperative Candida endophthalmitis in an eye with an intraocular lens implant.

Candida endophthalmitis developed in the left eye of a 71-year-old man two months after he underwent extracapsular cataract extraction and intraocular lens implantation. The symptoms included decreased vision and redness but no pain. The discovery of the cause of the endophthalmitis was delayed because it was initially treated as a sterile postoperative inflammation. Vitrectomy with intracameral amphotericin B and treatment with topical and systemic amphotericin B and flucytosine led to resolution of the infection and a final visual acuity of 20/80. It was not necessary to remove the intraocular lens.

Aged↗