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Biomedical subjects

E L Coffey

Publications and source records attributed to E L Coffey.

7 recordsLinked to original sources
PubMed1997

Clinical training program for distributive pharmacists.

A training program to enable staff pharmacists in a state correctional system to shift their practice from distributive to clinical is described. Under a contract with the Texas Department of Criminal Justice (TDCJ), the University of Houston College of Pharmacy provides pharmaceutical services to 145,000 patients in 100 correctional facilities. An automated centralized distribution site was built in 1993 and four regional pharmacies were subsequently closed, resulting in the reallocation of eight distributive pharmacists positions to clinical services. Four of the eight pharmacists who would be displaced began a retraining program in preparation for decentralized clinical positions. The 18-month program, developed by university staff on contract to TDCJ and college faculty members, included 34 home-study modules, case studies, case presentations, seminars, and supervised practice experience. Three of the pharmacists completed the program, passed competency tests, and were certified for clinical practice privileges, including drug therapy assessment and written consultations. The three pharmacists now operate ambulatory care clinics at prison units. A clinical skills training program developed by a college of pharmacy correctional services division in cooperation with faculty members enabled staff pharmacists to convert their roles from distributive to clinical.

Education, Pharmacy, Continuing↗
PubMed1991

Extramedullary blast crisis in chronic myelogenous leukemia. Demonstration of T-cell lineage and Philadelphia chromosome in a paraspinal tumor.

A case of chronic myelogenous leukemia (CML) with penetrance of the Ph1 molecular alteration into the T-cell lineage of a paraspinal tumor is reported. The T-cell nature of the paraspinal tumor was documented by immunochemical study and genotyping. The Philadelphia chromosome was also detected by genotyping in the same tumor cell population. To the authors' knowledge, this is the first case of extramedullary T-cell blast crisis in CML demonstrated in an extranodal tumor. The clinical significance of detecting extramedullary blast crisis, and the theories for the scarcity of T-cell transformation in CML are discussed.

Blast Crisis↗
PubMed1990

Adenofibroma of the uterus: multiple recurrences following wide local excision.

The uterine adenofibroma is a form of mixed mesodermal tumor in which both epithelial and stromal components are benign. A case is presented in which a patient with this lesion was treated with excision of the tumor rather than hysterectomy. Two years later, she developed a recurrence of the lesion, which was again treated with wide local excision. A hysterectomy was done 9 months later, and a polypoid lesion was noted in the fundus of the uterus which on histologic examination was thought to be potentially either an adenofibroma precursor or a maturation of the previous cellular adenofibroma. Since uterine adenofibroma usually occurs in older patients, the standard treatment has been hysterectomy. Because of this patient's age, she was initially treated with a more conservative approach. However, despite the fact that the uterine adenofibroma is a benign lesion, it has an obvious potential to recur when treated conservatively.

Adenofibroma↗
PubMed1990

L-tryptophan induced eosinophilia-myalgia syndrome.

We describe the spectrum of clinical and histologic abnormalities of 11 women with L-tryptophan induced eosinophilia-myalgia syndrome. The illness is characterized by musculoskeletal symptoms including myalgias, arthralgias and paresthesias. The physical findings consist of muscle tenderness, neuropathies, rash, peripheral and periorbital edema. Electroneurography performed in 10 patients demonstrated a neuropathy in 5 and myopathic changes in 3. Skin and muscle biopsies showed fascial edema, inflammation and perivascular infiltrates in the skin, whereas perineural infiltrates and venulitis were identified in muscle. Seven patients were treated with prednisone; eosinophilia disappeared promptly although myalgias and neuropathy persisted.

Activities of Daily Living↗
PubMed1986

Breast and axillary tissue MR imaging: correlation of signal intensities and relaxation times with pathologic findings.

We tested a variety of inversion-recovery (IR) and spin-echo (SE) sequences by imaging the breast masses of 22 patients before surgery and 23 tissue specimens with magnetic resonance (MR) imaging at 0.6 T to determine the most effective pulse sequences to evaluate breast disease. An SE pulse sequence using a long repetition time (TR) of 1,600 msec and a long echo time (TE) of 90 msec was found to be the most sensitive in depicting carcinoma in the excised tissue specimens, with all of the carcinomas (n = 15) demonstrating irregular areas of higher signal intensity (SI) than that of the adjacent fat. However, only five of 11 breast carcinomas present in the preoperative patients produced a higher SI than that produced by fat on the same T2-weighted sequence. Five of the remaining six carcinomas in the preoperative patients appeared as localized distortions of fibroductular architecture on both T2-weighted SE and IR sequences. In axillary tissue specimens, both metastatic carcinoma and hyperplastic lymph nodes produced a high SI on T2-weighted SE sequences. However, metastatic carcinoma had a significantly longer T2 relaxation time than did hyperplastic lymph nodes.

Adenofibroma↗
PubMedDate not supplied

Impact of pharmacist-operated general medicine chronic care refill clinics on practitioner time and quality of care.

OBJECTIVE: To assess the impact of pharmacist-operated refill clinics on practitioner (physician/physician assistant) time. Secondary objectives included assessment of disease state control, drug acquisition costs, and human resource allocation. DESIGN: The study ran from October 1, 1993 through January 31, 1994. At one clinic the pharmacist performed chart review only and did not see the patient. At the second site the pharmacist also interviewed the patient. The pharmacist used no treatment algorithms. Practitioner and pharmacist time before and after implementation of the refill clinics was measured on 3 consecutive days of normal clinic operation. SETTING: Two state correctional facilities. PATIENTS: The study population consisted of patients receiving chronic care who were observed during regular clinic hours. MAIN OUTCOME MEASURES: We evaluated pharmacist and practitioner time before and after pharmacist involvement. Hypertension was the only disease state yielding sufficient numbers for statistical analysis. We used a two-tailed paired t-test with the priori level set at 0.05. We also evaluated the number of patients with disease state control before and after clinic implementation, drug acquisition costs, and human resource allocation. RESULTS: The refill clinic pharmacist reduced practitioner time commitment in both clinics. The greatest impact on practitioner time was found in the interview clinic. Quality of care was maintained equally between the two clinics, with a positive impact on human resource allocation. CONCLUSIONS: In the managed care environment, pharmacist-run refill clinics can decrease practitioner time commitment allowing reallocation of human resources while maintaining current quality of care.

Adult↗