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Biomedical subjects

M L McPherson

Publications and source records attributed to M L McPherson.

17 recordsLinked to original sources
PubMed2000

Development of a survey to measure parent satisfaction in a pediatric intensive care unit.

OBJECTIVE: To use classic survey methodology to develop a specific survey tool that can assess parent satisfaction with medical care in a pediatric intensive care setting. DESIGN: Application of survey design methodology to develop and analyze a parent satisfaction survey. SETTING: A pediatric intensive care unit (PICU) in a large teaching hospital. SUBJECTS: Sixty-six parents of children admitted to a PICU. RESULTS: A four-stage process of item selection, item reduction, pretesting, and test analysis was used to create a 23-item parent satisfaction survey that was statistically analyzed and developed specifically for the PICU setting. The survey tool was developed with the input of parents of children admitted to a PICU, and it was administered to parents in the PICU. The resultant survey was analyzed for validity and reliability. Both test-retest and internal consistency reliability were evaluated. This design yielded a survey with acceptable reliability, as demonstrated by a reliability coefficient of 0.8275. Test-retest reliability also showed good correlation of answers. Validity was partially established by including parents in the identification of survey topics. CONCLUSIONS: Classic survey design methodology was applied to develop a specific satisfaction survey in a pediatric inpatient setting. This stepwise method yielded a parent survey specific to one type of inpatient unit, and the resultant survey tool reliably measured levels of parent satisfaction with medical care in that area. This study demonstrates the feasibility of applying classic survey methodology to develop a statistically analyzed parent satisfaction survey for an inpatient setting.

Adult↗
PubMed2000

Absorption of phenytoin from rectal suppositories formulated with a polyethylene glycol base.

STUDY OBJECTIVE: To compare phenytoin pharmacokinetics following administration of an oral suspension and a rectal suppository formulated with a polyethylene glycol base. DESIGN: Unblinded, single-dose, randomized, crossover trial. SETTING: University-affiliated pharmacokinetics and biopharmaceutics laboratory. SUBJECTS: Six healthy subjects. INTERVENTION: Subjects were given a single 200-mg dose of phenytoin as an oral suspension and a rectal suppository separated by a 1-week washout. MEASUREMENTS AND MAIN RESULTS: Blood for plasma phenytoin concentrations was obtained at baseline and 0.5, 1, 2, 4, 6, 8, 10, 12, and 24 hours after administration. Plasma was analyzed by high-performance liquid chromatography (coefficient of variation < 6%) for total phenytoin concentration. Phenytoin maximum concentration (Cmax), time to Cmax (Tmax), time to first measurable concentration (Tlag), and area under the curve from time zero to time of last measurable concentration (AUClast) were estimated for oral and rectal administration by WinNonlin (v 1.1) and compared using Wilcoxon's signed rank test (p<0.05 for statistical significance). Two subjects did not have detectable plasma phenytoin concentrations after rectal administration. For the other four subjects, median rectal Cmax was significantly lower than oral Cmax (0.4 vs 1.9 microg/ml, p=0.028), median rectal Tmax did not differ from oral Tmax (11.9 vs 8.0 hrs, p=0.465), and median rectal AUClast, although highly variable, was significantly lower than oral AUClast (5.4 vs 36.2 microg x hr/ml, p=0.046). No Tlag was seen after oral administration, but with rectal administration the median Tlag was 2 hours. The estimated relative bioavailability of rectal phenytoin suppositories based on AUC0-24 was 4.7%, with individual values ranging from 0-58.3%. CONCLUSION: It appears that absorption of phenytoin from polyethylene glycol rectal suppositories in healthy subjects is highly variable and unpredictable. Thus this formulation is not recommended.

Administration, Rectal↗
PubMed1989

Establishment of a permanent decentralized pharmacy in the coronary and progressive care units.

Critical care units, such as Coronary Care Units (CCU) and Progressive Care Units (PCU), are patient care areas with complex and rapidly changing needs. Services that enable health care providers in these areas to function more quickly and accurately are constantly sought. A 3 week pilot project was organized in a pharmacy department to evaluate the potential impact of a decentralized pharmacy service in the CCU and PCU areas. Distributive and clinical pharmacy services were provided by two pharmacists during the study. Nursing evaluated the study period as being highly favorable, and missing doses decreased by 57%. The departments of nursing and administration responded to this pilot by funding positions from nursing toward the establishment of a permanent decentralized pharmacy in these units.

Baltimore↗
PubMed1986

Theophylline-induced hypercalcemia.

Sixty patients with theophylline toxicity were hospitalized during a 2-year period. Eleven patients had hypercalcemia; their calcium levels returned to normal as theophylline levels fell to therapeutic or subtherapeutic levels. Serum calcium levels also fell significantly in three additional patients with theophylline toxicity, although the initial serum calcium concentration was not outside normal limits. A significant increase in serum calcium levels associated with therapeutic levels of theophylline in normal volunteers was reversed by propranolol. It appears that theophylline causes elevation of serum calcium by a system subject to beta-adrenergic regulation.

Cyclic AMP↗
PubMed1979

A compact form of rat liver mitochondrial DNA stabilized by bound proteins.

A highly folded, rapidly sedimenting form of rat liver mitochondrial DNA has been released from the organelles wiht BRIJ 58 and sodium deoxycholate in the presence of 0.5 M NaCl and isolated by sedimentation velocity in sucrose gradients. Under these conditions a majority of the mitochondrial DNA labeled in vitro sedimented beyond 39 S, the sedimentation coefficient of a highly purified mitochondrial DNA supercoil, and appeared as a stable, heterogeneous population of species ranging in s values between 42 S and about 70 S. Under formamide-spreading conditions most of the rapidly sedimenting forms appeared in the electron microscope as single genome length rosettes constrained at the center in a dense core. Except for an occasional D-loop, no extraordinary structural features were evident along the smooth loops projecting radially from the central core. In sucrose gradients containing various amounts of ethidium bromide, the sedimentation velocity of the folded DNA changed in a biphasic fashion in response to increasing amounts of dye. At a dye concentration of 0.5 microgram per ml the DNA species present reached s value minima, but two major peaks sedimenting at 32 S and 42 S were present at this point. Thus, although these species were similar in superhelix density, there appeared to be additional constraints superimposed upon their tertiary structure that folded these forms to differing degrees of compactness. Direct chemical analyses showed that proteins were bound to the folded DNA at a protein to DNA ratio of about 0.3. Separation of the bound proteins on SDS-polyacrylamide gels revealed an array of proteins ranging in molecular weight between 11,000 and 150,000. Several of the lower molecular weight proteins co-migrated with proteins from the inner mitochondrial membrane, but the major DNA-bound band (Mr = 58,000) was undetectable among the proteins from any other submitchondrial fraction. Digestion of the compact DNA structure with proteinase K under various conditions indicated that the DNA was maintained in the compact conformation by the tightly bound proteins and that the portions of these proteins directly involved in stabilizing the folded DNA were proteinase insensitive unless digestion was carried out in the presence of a disulfide reductant at elevated temperatures.

Animals↗
PubMedDate not supplied

Pamidronate (Aredia, Ciba).

Pamidronate disodium appears beneficial in relieving metastatic bone pain refractory to NSAIDS and steroids. However, due to the invasiveness of administration and costs associated with the infusion, it should not be considered first line therapy. On the other hand, potential cost savings over conventional radiation therapy or surgery to relieve bone pain could make pamidronate a very attractive option.

Adult↗
PubMedDate not supplied

Career awareness roundtable.

Employment prospects are excellent for recently graduated pharmacists. New pharmacy practitioners are employing their clinical, scientific, and business skills in an expanding array of fields. Starting salaries for newly graduated pharmacists are rising, although base salaries vary depending on the employer, field of practice, and area of the country.

Employment↗