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Biomedical subjects

J D McCue

Publications and source records attributed to J D McCue.

At least 55 records · Page 3Linked to original sources
PubMed1986

Urinary tract infection and dysuria. Cost-conscious evaluation and antibiotic therapy.

Recent research into the pathogenesis and treatment of urinary tract infection (UTI) clearly indicates that our traditional approach has overestimated the need for extensive evaluation and prolonged antibiotic therapy. The great majority of UTIs can be managed adequately with urinalysis and single-dose or three-day antibiotic regimens; only complicated UTIs or those occurring in unusual hosts require cultures and longer courses of treatment.

Anti-Bacterial Agents↗
PubMed1986

Residents' leadership styles and effectiveness as perceived by nurses.

Although physicians are required to act as leaders in a variety of situations, leadership ability and leadership training have been largely ignored by medical educators. The leadership styles and leadership effectiveness of 17 residents in a community hospital were studied as part of a leadership training seminar. Self-ratings and ratings of the residents by nurses who had worked with them were used to assess the residents' leadership style and the nurses' perceptions of the effectiveness of those styles. Styles that emphasized relationships with co-workers (encouraging and coaching styles) predominated over low relationship-oriented styles (delegating and structuring). The nurses perceived individual residents who exhibited encouraging and coaching leadership styles as being distinctly more effective leaders than the residents who exhibited structuring and delegating styles. The residents, however, rated all four styles as similarly effective. Leadership training programs and studies of the type reported here may provide an opportunity for faculty members to help residents learn more appropriate and productive styles of leadership.

Female↗
PubMed1986

Physicians' opinions of the accuracy, accessibility, and frequency of use of ten sources of new drug information.

We surveyed internists, surgeons, and general practitioners in a six-county area of North Carolina to determine how accurate and accessible they believed ten sources of new drug information to be and how frequently they used each of the sources. Evaluable questionnaires were returned by 119 of the 336 physicians. The majority indicated that all sources were accessible. Commercial sources were thought to be less accurate than noncommercial sources, but were used more frequently (P less than .0002), especially by physicians who had practiced more than 15 years (P less than .02). Written sources were thought to be more accurate (P less than .0001) and were preferred over oral sources of new drug information (P less than .0004). Pharmacists and pharmacology textbooks were believed to be both accurate and accessible, but were relatively infrequently used.

Adult↗
PubMed1986

P&T Committee guidelines for antibiotic cost comparisons.

P & T Committees are focusing much effort and attention on controlling the costs of antibiotic therapy in their hospitals. In their efforts, committee members must understand not only the basic costs of acquisition in determining cost-effective therapy, but also the many expenses involved with dosing and administration. The author provides guidelines for assessing the various costs involved with antibiotic therapy based on his observations of hospitals' attempts to control costs. Suggestions of ways to make most effective use of the formulary and staff resources are presented.

Anti-Bacterial Agents↗
PubMed1985

Influence of medical and premedical education on important personal qualities of physicians.

Three interrelated personal qualities of physicians are believed important for sensitive patient care and optimal individual adjustment to the stresses of medical practice: maturity, social competence, and moderation in aggressive competitive (exaggerated "type A" behavior). Despite widespread recognition of the importance of these qualities by patients and physicians alike, they have commonly been neglected in favor of scientific and scholastic excellence in the selection process for medical schools. In addition, some aspects of premedical and medical education may actually have an adverse influence on these personal qualities of future physicians. More emphasis in premedical and medical education on the importance of physicians' noncognitive abilities, and more individualized feedback to students and residents on the interactions between their personal qualities and their success and happiness as physicians, are needed.

Education, Medical↗
PubMed1985

Effects of clorazepate on breathlessness and exercise tolerance in patients with chronic airflow obstruction.

Five patients with severe chronic lung disease were given placebo or 7.5 mg of clorazepate, a benzodiazepine, at bedtime for two weeks using a double-blind cross-over study design. Exercise tolerance, arterial blood gases, pulmonary function tests, self-rated breathlessness, and self-administered depression and anxiety scores were similar during drug treatment, placebo treatment, and washout periods. Higher doses of clorazepate were not tolerated by three of five patients. Nonanxious patients with chronic lung disease seem not to benefit subjectively or objectively from a low-dose benzodiazepine regimen.

Aged↗
PubMed1985

Cefoxitin resistance in community-acquired gram-negative bacillary bacteremia. Associated clinical risk factors.

Among 185 patients with nonneutropenic, community-acquired gram-negative bacillary bacteremias, clinical risk factors for cefoxitin resistance included any antibiotic taken within the last three weeks (25.6% cefoxitin resistance), long-term bladder catheterization or surgical urinary diversion (23.3%), hospitalization within the last 30 days (22.9%), and nursing home residence before admission (20.8%). Patients with none of these risk factors were less likely to have cefoxitin-resistant bacteremias (0.9%). When these risk factors were examined in the subgroups of urinary tract and non-urinary tract sources of community-acquired gram-negative bacillary bacteremia, they were also helpful in predicting sensitivity to trimethoprim-sulfamethoxazole and gentamicin. The presence of one or more of the risk factors identified may be a useful adjunct in determining initial empiric antimicrobial therapy for community-acquired gram-negative bacillary bacteremia.

Cefoxitin↗
PubMed1985

Improved mortality in gram-negative bacillary bacteremia.

From 1979 to 1982, the four years of this study, episodes of gram-negative bacillary bacteremia occurred in a 489-bed community teaching hospital--an increase of 15.9%. Mortality related to bacteremia was 19.4% overall and only 3.2% for the 158 episodes involving nonfatal underlying illnesses, lower figures than those reported in the past. The severity of underlying illnesses in bacteremic patients dominated all other clinical variables that were studied as prognostic factors for the outcome of the episode. The same bacteremia-related mortality was seen in patients who had empirically received (1) multiple-antibiotic regimens in which one or more drugs were active against the pathogenic organism(s), (2) either an appropriate aminoglycoside or beta-lactam antibiotic alone, or (3) both an aminoglycoside antibiotic and a beta-lactam antibiotic active against the pathogenic organism(s).

Adolescent↗