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E Kelley

Publications and source records attributed to E Kelley.

18 recordsLinked to original sources
PubMed2001

The effects of an HIV-1 immunogen (Remune) on viral load, CD4 cell counts and HIV-specific immunity in a double-blind, randomized, adjuvant-controlled subset study in HIV infected subjects regardless of concomitant antiviral drugs.

OBJECTIVE: We examined the activity of an HIV-1 immunogen (Remune) on viral load, CD4 cells and HIV-1 specific immunity. METHODS: Plasma and peripheral blood mononuclear cells were obtained in a predefined random subset of subjects (n = 252) from a multicentre, double-blind, adjuvant-controlled phase III clinical endpoint study. RESULTS: The subjects treated with the HIV-1 immunogen had a significantly greater decline in viral load at multiple time points (P < 0.05), a trend towards increased CD4+ T cell counts and significantly enhanced HIV-1 specific immune responses as measured by HIV-1 lymphocyte proliferation (P < 0.001) compared to the adjuvant control group. Furthermore, in the HIV-1 immunogen treated group, enhanced HIV-1 specific lymphocyte proliferative immune responses were associated with decreased HIV-1 plasma RNA. CONCLUSION: These results suggest that, in a predefined, random subset of subjects, a beneficial effect of the HIV-1 immunogen was observed on viral load, CD4+ T cells, and HIV-specific immunity. These differences were observed in a background of multiple drug therapies. Ongoing trials are evaluating the effect of the combination of this HIV-1 specific, immune-based therapy with potent antiviral drug therapy on virological outcomes.

AIDS Vaccines↗
PubMed1994

Evaluation of a fiberoptic system for airway pressure monitoring.

OBJECTIVE: Our objective was to evaluate the accuracy of a novel fiberoptic system for airway pressure measurement at the carinal end of the endotracheal tube in an in vitro pediatric lung model. METHODS: A fiberoptic pressure measuring system was compared to the conventional method of measuring airway pressure with a pneumatic transducer using a test lung model. Pressure measurements were obtained using four endotracheal tubes of various internal diameters (ID) (3 to 6 mm) during simulated spontaneous and mechanical ventilation. Airway pressure was measured using both methods simultaneously and the results were compared by statistical analysis. RESULTS: Airway pressure measured by the fiberoptic system was not significantly different from measurements obtained by the pneumatic transducer except when using the 3-mm and 4-mm ID endotracheal tubes during mechanical ventilation. CONCLUSIONS: We conclude that the fiberoptic system provides accurate and precise measurement of airway pressure during spontaneous and mechanical ventilation. Additionally, the statistically significant differences obtained for 3- and 4-mm tubes are not large enough to be clinically significant. The fiberoptic system offers advantages over the pneumatic system for measuring the airway pressure. These advantages include decreased chance of false pressure measurement secondary to occlusion with water or mucous, less chance of kinking, and possibly, more rapid response to pressure changes due to the mechanical ventilator.

Airway Resistance↗
PubMed1991

Evaluation of once-daily levobunolol 0.25% and timolol 0.25% therapy for increased intraocular pressure.

In a three-month, double-masked, randomized clinical trial, we evaluated the once-daily ocular hypotensive efficacy of 0.25% levobunolol and 0.25% timolol in 80 patients with open-angle glaucoma or ocular hypertension. Thirty-seven of the 39 patients (95%) in the 0.25% levobunolol group and 35 of the 41 patients (85%) in the 0.25% timolol group successfully completed the three-month study period. The overall mean decrease in intraocular pressure was 5.3 mm Hg (22%) in the 0.25% levobunolol group and 5.4 mm Hg (22%) in the 0.25% timolol group. This difference was not statistically significant. In both treatment groups, effects on mean heart rate and blood pressure were minimal. The data suggest that levobunolol 0.25% and timolol 0.25%, administered once daily, are equally effective in the treatment of open-angle glaucoma and ocular hypertension.

Adult↗
PubMed1988

Urinary glycosaminoglycan levels following induced cystitis in monkeys.

Urinary glycosaminoglycan (GAG) levels were measured by the Whiteman assay in five monkeys following induction of an E. coli urinary tract infection. Urinary GAG levels rose as the infection developed and returned to baseline levels as the infection resolved. Elevated urinary GAG levels may be a marker for the tissue injury incurred by such infections and may offer insight into their pathophysiology.

Animals↗
PubMed1988

Ocular hypotensive efficacy of 0.25% levobunolol instilled once daily.

The authors evaluated the efficacy of once-daily treatment with levobunolol in patients with primary open-angle glaucoma or ocular hypertension in an open-labeled, two-phase titration clinical trial. All patients started the study using 0.25% levobunolol administered once daily for 3 months (phase I). If a patient's intraocular pressure (IOP) was not controlled with this concentration of levobunolol, the concentration was increased to 0.5% administered once daily for 3 months (phase II). During phase I, a significant reduction in IOP was observed in 21 of the 29 patients (72%), with an average IOP reduction of 24%. During phase II, in six patients whose IOP was reduced inadequately with 0.25% levobunolol, one had a significant reduction in IOP with 0.5% levobunolol. The authors concluded that levobunolol, instilled once daily at a concentration of 0.25%, was effective in significantly reducing IOP in the majority of the patients evaluated.

Adult↗
PubMed1985

Inhibition of human cytomegalovirus by combined acyclovir and vidarabine.

The inhibition of human cytomegalovirus (HCMV) isolates by acyclovir (ACV) and vidarabine (ara-A) was assessed by using an infectious-center plaque-reduction assay. When fixed concentrations of 4.5 micrograms of ACV and 250 ng of ara-A per ml were compared singly and in combination, the viral inhibition resulting from the ACV-ara-A combination was synergistic for three of four HCMV clinical isolates studied and additive for one HCMV isolate. An additional four HCMV strains obtained at postmortem examination from the lungs of bone marrow transplant patients were assessed for sensitivity to ACV-ara-A by using the dose required for 50% viral inhibition (ID50) as the endpoint. The mean ID50 of ACV for the four HCMV isolates was 12.3 micrograms/ml, whereas the mean ID50 of ara-A was 3.4 micrograms/ml. When 1 microgram of ara-A per ml (which yielded a mean plaque reduction of 23.6%) was combined with ACV, a mean of 5.2 micrograms of ACV per ml was required for 50% viral inhibition. The sum of the fractional inhibitory concentrations for each of the four HCMV isolates was less than 1, indicating synergy by the ACV-ara-A combination. Although DNA synthesis in growing human embryonic lung fibroblast (HEL) cells, as determined by [3H]thymidine incorporation, was diminished to 61% of that in untreated control cells when 22.5 micrograms of ACV and 1 microgram of ara-A per ml were used, there was no additive inhibition of DNA synthesis when the two-drug combination was used. HEL cell growth remained at 97% of control cell growth at 72 h when concentrations as high as 45 micrograms of ACV combined with 1 microgram of ara-A per ml were used.

Acyclovir↗
PubMed1983

Inhibition of human cytomegalovirus by trifluorothymidine.

The antiviral activity of trifluorothymidine (TFT) singly and in combination with other antiviral agents against human cytomegalovirus (HCMV) was evaluated by using an infectious center plaque reduction assay. The 50% inhibitory dose of TFT against six different patient HCMV strains was 0.57 (+/- 0.24, standard deviation) microM and ranged from 0.32 to 0.97 microM. The 50% inhibitory dose for the laboratory-adapted HCMV strain, AD-169, was 2.1 microM. When TFT (0.17 microM) was combined with human fibroblast interferon (25 U/ml), the combination was additive against all four HCMV isolates evaluated. Synergism was observed when TFT (0.17 microM) was combined with phosphonoformic acid (25 microM) for all strains studied or with acyclovir (20 microM) for three of the four clinical HCMV strains tested. Each of the three antiviral agents, when combined with TFT, exhibited additive effects against strain AD-169. TFT at concentrations of 0.5, 1.7, and 3.5 microM had an increasing inhibitory effect on uninfected human embryonic lung fibroblast (HEL) cell growth over 72 h, with 16% growth inhibition at 3.5 microM after 3 days. There was no increased toxicity to growing HEL cells when the paired antiviral agent combinations were evaluated. These findings suggest that TFT may be useful singly or in combination with other antiviral agents in treating HCMV infections.

Acyclovir↗
PubMed1983

Effect of different media on determination of novobiocin resistance for differentiation of coagulase-negative staphylococci.

Species identification of coagulase-negative staphylococci often requires the determination of novobiocin susceptibility. Although previous investigators have recommended the use of P agar for this purpose, most clinical laboratories do not routinely utilize this medium. For this reason, studies were performed to compare novobiocin susceptibility results obtained with 11 different species of staphylococci (10 isolates of each species), using P agar, Trypticase soy agar with 5% sheep blood, and Mueller-Hinton agar. Tests performed on 70 susceptible isolates (minimal inhibitory concentration less than 1.6 micrograms/ml) resulted in zones of inhibition around 5-micrograms novobiocin disks ranging from 19.6 to 33.9, 16.2 to 26.6, and 21.3 to 36.4 mm on P agar, Trypticase soy agar with 5% sheep blood, and Mueller-Hinton agar, respectively. Forty resistant isolates (minimal inhibitory concentration greater than or equal to 1.6 micrograms/ml) exhibited zones of inhibition ranging from 6.0 to 11.3 mm on P agar, 6.0 to 11.6 mm on Trypticase soy agar with 5% sheep blood, and 6.0 to 13.5 mm on Mueller-Hinton agar. Using the established cut off of 16 mm to define novobiocin resistance for the identification of coagulase-negative staphylococci, we correctly identified 100% of the strains tested, regardless of the media utilized.

Coagulase↗
PubMed1982

Effects of acyclovir combined with other antiviral agents on human cytomegalovirus.

At present, there is no effective therapy for human cytomegalovirus (CMV) infections. Although acyclovir inhibits in vitro clinical isolates of CMV, preliminary human trials suggest that acyclovir may not be successful as a single antiviral agent in treating CMV infections. The antiCMV activity of acyclovir in combination with human fibroblast interferon (IFN-beta), phosphonoformic acid (PFA), or trifluorothymidine (TFT) was therefore evaluated. When acyclovir (20 microM) was combined with IFN-beta (25 U/ml), additive antiviral effects were observed for the four clinical CMV isolates studied and the laboratory adapted strain, AD-169. The combination of acyclovir (20 microM) with PFA (25 microM) was synergistic for all four clinical isolates studied, but additive for the AD-169 strain. Similarly, the combination of acyclovir (20 microM) and TFT (0.17 microM) was synergistic for three of four clinical isolates, and additive for one clinical strain and the AD-169 virus. These findings suggest that acyclovir combined with other antiviral agents may be useful in the treatment of CMV disease.

Acyclovir↗
PubMedDate not supplied

Improving performance with clinical standards: the impact of feedback on compliance with the integrated management of childhood illness algorithm in Niger, West Africa.

The joint BASICS/Quality Assurance Project tested several research-based interventions in three districts in Niger, West Africa to improve case management of sick children. The research design was a non-concurrent, prospective case control design. Quality of care was determined as the degree of compliance of health care workers with the Integrated Management of Childhood Illness (IMCI) standards of assessment, treatment and counselling of sick children and their caretakers. The interventions tested were (1) structured feedback of health worker performance data and (2) formal IMCI training and (3) team-based quality improvement. Performance feedback had a significant effect on compliance. Performance feedback alone created a significant short-term impact on health care worker compliance, which improved between 34% and 85% in areas of assessment of sick children (p < 0.05). In addition, performance feedback was significantly cheaper than formal training ($108 per health worker versus $430 per worker for IMCI training). However, this impact was not universal over all areas of compliance following each feedback. Instead, performance feedback had the greatest effect in areas in which health care workers performed poorly, while areas in which compliance was high eventually saw declines. In settings such as Niger, which has the highest child mortality in the world according to UNICEF figures, low-cost techniques for supporting health workers once they have been trained in clinical standards are sorely needed. Performance feedback shows promise as a technique for improving quality of care with clinical algorithms such as IMCI.

Algorithms↗
PubMedDate not supplied

Family expenditures before and after retirement: a research model for measuring priorities.

Economic pressures of contemporary American society have had an impact on many families. This article focuses on how elderly, intact couples allocated their retirement dollars. Bureau of Labor Statistics (BLS) family budget expense categories were used as a basis to develop expense categories. The couples were asked what changes, if any, they made in expenditures after retirement and if they would allocate their money differently if they were free to do so. Most of them had changed expenses after retirement. Some of their expenditures had increased rather than decreased in importance since retirement. Only two expenditure categories, food and transportation, were ranked the same as the BLS ranking by at least 30 percent of the couples. The empirical usefulness of the methodology reported in this paper was illustrated with a sample of elderly couples. However, it seems applicable not only for the elderly but also for families in all stages of the family life cycle.

Aged↗