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Biomedical subjects

Gordon M Trenholme

Publications and source records attributed to Gordon M Trenholme.

7 recordsLinked to original sources
PubMed2006

Learning by doing: developing fellows' academic skills through collaborative research.

Physicians in postgraduate training are expected to learn research methods but how best to achieve that curricular goal is unclear. This article describes a novel educational approach to develop research skills among infectious disease fellows. Five infectious disease fellows and two faculty members participated in a collaborative research project as a vehicle for active, problem-based learning. During the learning experience several tasks with specific learning objectives were achieved. The authors evaluated the weaknesses and strengths of the collaborative research project as an educational program. This problem-based approach for learning research methods seems more effective than traditional methods and may be applicable to a broad range of training programs.

Cohort Studies↗
PubMed2004

Why don't they listen? Adherence to recommendations of infectious disease consultations.

The effectiveness of an infectious diseases (ID) consultation is dependent on adherence to the recommendations. To delineate the factors that affect adherence, we conducted a prospective cohort study of 465 consultations at 2 academic institutions in which we evaluated the consultation process, patient and consultant characteristics, types of recommendations, and compliance with recommendations. The overall compliance rate was 80%, with 85% adherence to crucial recommendations. Multivariate analysis revealed that adherence to ID recommendations was higher when the recommendations were therapeutic instead of diagnostic, when they related to a specific clinical question, when recommendations were deemed crucial by the ID service, if the primary service was medicine, and if the consultation note was legible and organized. Whether modification of consultant practice will lead to improved recommendation compliance and patient outcomes warrants further study.

Adolescent↗
PubMed2004

Evolution of vaccinia virus-specific CD8+ cytotoxic T-lymphocyte responses in primary vaccinees and revaccinees.

Determination of successful vaccination with vaccinia virus is based on visual confirmation of a dermal response (take). Some revaccinees do not manifest a take, which may be due to a preexisting immunity rather than to poor technique or inadequate virus. Cytotoxic T-lymphocyte (CTL) response appears to be the most important immune defense in limiting response to vaccination. We evaluated vaccinia virus-specific CTL responses in revaccinees. Subjects with and without takes displayed comparable CTL responses. Vaccinia virus-specific CD8+ CTL responses may be useful in interpreting the response to vaccination, particularly in individuals who are revaccinated and have difficult-to-interpret visual takes.

Adult↗
PubMed2003

Problems in the therapy for imported malaria in the United States.

BACKGROUND: Errors in the diagnosis of imported malaria are increasingly recognized. However, there are few data on the treatment of malaria in the United States. METHODS: Medical records were reviewed for 83 patients with microscopically confirmed malaria at Cook County Hospital, Chicago, Ill, between 1991 and 1999. RESULTS: Errors in drug treatment occurred in 25% of patients in this study. The most common error in therapy was the failure to prescribe primaquine to eradicate the liver forms of Plasmodium vivax. Another 5 patients with P vivax received an inappropriate drug regimen. Errors in Plasmodium falciparum therapy occurred in 5 patients. All patients received an inappropriate drug regimen. While the clinical symptoms and signs do not help distinguish the infecting Plasmodium species, the travel history is extremely helpful in guiding drug selection. Non-infectious diseases specialists are more likely to make errors in therapy than are infectious diseases specialists. CONCLUSIONS: Despite widely published guidelines on the treatment of malaria, there are frequent errors in the therapy for malaria. A detailed travel history emphasizing the duration and country of travel should be sought. Primaquine should be included in the primary prescription for the treatment of P vivax infection. Improvements in the therapy for malaria can be made with the aid of an infectious diseases specialist and/or a tropical medicine specialist.

Adolescent↗
PubMed2003

Q fever: a biological weapon in your backyard.

Coxiella burnetii, which causes Q fever, is a highly infectious agent that is widespread among livestock around the world. Although the culture process for coxiella is laborious, large amounts of infectious material can be produced. If used as an aerosolised biological weapon, coxiella may not cause high mortality, but could provoke acute disabling disease. In its late course, Q fever can be complicated by fatal (eg, endocarditis) or debilitating (eg, chronic fatigue syndrome) disorders. The diagnosis of Q fever might be delayed because of non-specific and protean presentations. Effective antibiotic treatment is available for the acute form of disease but not for the chronic complications. Vaccination and chemoprophylaxis in selected individuals may be used in the event of bioterrorism.

Animals↗
PubMed2002

Protein-free phospholipid emulsion treatment improved cardiopulmonary function and survival in porcine sepsis.

Lipoprotein phospholipid (PL) plays a major role in neutralization of endotoxin. This study tested the hypothesis that prophylactic administration of a PL-enriched emulsion (PRE), which augments PL content of serum lipoproteins and neutralizes endotoxin in vitro, would preserve cardiovascular function and improve survival in porcine septic peritonitis. A control group was compared with low-, mid-, and high-dose treatment groups that received PRE by primed continuous infusion for 48 h. A fibrin clot containing live Escherichia coli 0111.B4 was implanted intraperitoneally 30 min after the priming dose. Survival increased in a dose-dependent manner and was correlated with serum PL. Infused PL was associated with high-density lipoprotein in the low-dose group and all serum lipoproteins at higher doses. Treatment significantly lowered serum endotoxin and tumor necrosis factor (TNF)-alpha, preserved cardiac output and ejection fraction, and attenuated increases in systemic and pulmonary vascular resistances. This study demonstrated that augmentation of lipoprotein PL via administration of PRE improved survival and offered a novel therapeutic approach to sepsis.

Animals↗