PubMed Health⌕ Search

Biomedical subjects

Mark Meyer

Publications and source records attributed to Mark Meyer.

13 recordsLinked to original sources
PubMed2006

A comparison of students from main and alternate admission lists at one school: the potential impact on student performance of increasing enrollment.

PURPOSE: If medical schools increase enrollment to meet anticipated physician shortages, more students from alternate lists will likely be accepted. This study compared the performance of alternate- and main-list students during and one year after medical school. METHOD: The authors assessed admission and performance measures for 1,188 students matriculating from 1997-2003 at the University of Kansas School of Medicine. Measures included Medical College Admission Test scores, basic and clinical science grade point averages, United States Medical Licensing Examination Step 1 and Step 2 scores, residency match information, and residency director ratings. Chi-square analyses, proportional analyses, and independent t-tests were performed. RESULTS: The results indicated that both the admission measures and performance of alternate-list students were generally lower than main-list students, but the differences were small and probably not meaningful. CONCLUSIONS: As long as the applicant pool does not substantially change from its current makeup, increasing enrollment by accepting more students from alternate lists may not adversely affect overall student performance.

Clinical Competence↗
PubMed2006

The circadian clock Period 2 gene regulates gamma interferon production of NK cells in host response to lipopolysaccharide-induced endotoxic shock.

The Period 2 (Per2) gene is a key molecular component in controlling mammalian circadian rhythms at the levels of gene expression, physiology, and pathogenesis. Although many immune parameters, such as the number of different subtypes of circulating immune cells and the level of cytokine production in response to infection with bacteria and viruses, have been well documented to display a circadian pattern in mammals, the basic features of molecular clock components in the immune system and the role of clock genes in regulating host immune defenses remain uncharacterized. Previously, we have reported that circadian clock genes oscillate in human mononuclear cells. Here we report that Per2-deficient mice were more resistant to lipopolysaccharide (LPS)-induced endotoxic shock than control wild-type mice. We further demonstrate that the levels of the proinflammatory cytokines gamma interferon (IFN-gamma) and interleukin-1beta (IL-1beta) in the serum were dramatically decreased in Per2-/- mice following LPS challenge, while production of tumor necrosis factor alpha, IL-6, and IL-10 was approximately normal, compared to that in control wild-type mice. Flow cytometric analyses confirmed that the cellularity of most of the immune cell subsets in the spleens of LPS-challenged mice was normal and that the impaired IFN-gamma production in Per2-/- mice was attributable to defective NK and NKT cell function. Our data suggest that Per2 is an important regulator of NK cell function, therefore providing the first direct link between the circadian clock system and innate immune responses.

Animals↗
PubMed2005

Effects of the subtalar sling ankle taping technique on combined talocrural-subtalar joint motions.

BACKGROUND: The findings of research on the effectiveness of ankle taping for protection against ligament injury have been inconsistent, and the topic remains controversial. The precise orientation of the force vectors created by tension within the various tape strip components of an ankle taping procedure may be a critical factor influencing the degree of motion restraint that is provided. We hypothesized that the addition of the subtalar sling component to the widely recognized standard (Gibney) ankle taping procedure would enhance restraint of ankle motion. This was a controlled laboratory study, with fully repeated measures (subjects served as their own controls). METHODS: An ankle arthrometer was used to quantify anteroposterior (AP) translation and frontal plane inversion-eversion (I-E) tilt of the talocrural-subtalar joints under untaped and taped conditions in normal subjects. A 15-minute exercise session was conducted to loosen the tape before measurement of its effect on motion restraint. RESULTS: The ankle taping procedure that incorporated the subtalar sling provided significantly greater restriction of postexercise AP translation (p < 0.001, eta(2) = 0.63) and postexercise I-E tilt (p < 0.001, eta(2) = 0.66). CONCLUSIONS: The subtalar sling ankle taping procedure provides greater restriction of motions associated with ankle instability than the more widely used Gibney procedure.

Adult↗
PubMed2005

Using patient data to retrieve health knowledge.

BACKGROUND: We sought to study a variety of terminologic approaches to the use of clinical data for searching on-line information resources. METHODS: We used a collection of narrative text and coded data to search a variety of text-based, concept-based, and concept-indexed resources. RESULTS: Automated retrievals using original terms could be accomplished and technically produced ample results. However, quality of the results varied with the resource. Terminology translations were difficult to accomplish and produced variable results. CONCLUSIONS: Current resources support automated retrieval; however, achieving quality results varies with the terms and the resources, with term translation productive only in select situations.

Abstracting and Indexing↗
PubMed2005

Usability factors in the organization and display of disparate information sources in the operative environment.

The integration and presentation of information from a number of disparate sources in the operative environment raises a number of usability and human factors challenges. Through a collaborative effort, a display combining persistent and dynamically switching panes provides a rich source of information to help orient team members, provide indications of case progress, and organize information into stage-based tabbed panes. This provides maximal flexibility within visibility and usability constraints.

Data Display↗
PubMed2005

Does parallel workflow impact anesthesia quality?

Redesigns of workflow to allow parallel processing of OR tasks in the Operating Room of the Future at Massachusetts General Hospital have reduced non-operative time, increasing OR throughput. Automatically gathered anesthesia times were studied to address concerns that the new process constricted anesthesia work time. Upon close examination, it was found that 'Induction Time' was the only time interval not impacted by extraneous influences that invalidated other metrics based on the automatic data. 'Induction Time' increased in the Operating Room of the Future as compared to Standard Operating Rooms.

Anesthesia↗
PubMed2005

Integration of hospital information systems, operative and peri-operative information systems, and operative equipment into a single information display.

The integration of disparate information systems in the operative environment allows access to information that is typically unseen or unused. Through a collaborative effort, a variety of information systems and surgical equipment are being integrated. This provides improved context-sensitive information display and decision support and improved access to information to improve workflow, safety and visualization of information that was previously unattainable.

Data Display↗
PubMed2005

Anesthesia Online Research & Training Aid (AORTA): developing an automated online querying tool for clinicians.

The Anesthesia Online Research & Training Aid (AORTA) has ben developed to automatically query multiple online resources using terminology with which clinicians ae already familiar and to prevent filtered results in an easy to use manner. AORTA aims to provide clinicians with higher quality results that are useful for daily care of patients and for busy clinicians to keep up to date on practices.

Anesthesiology↗
PubMed2004

Design of a standards-based external rules engine for decision support in a variety of application contexts: report of a feasibility study at Partners HealthCare System.

This project explored functional requirements for an institution-wide method, at Partners HealthCare, for interpreting clinical knowledge for decision support. Such knowledge is currently incorporated in a variety of clinical applications, yet the methods of representation and of execution vary and the ability to author/edit the rules by human experts is limited. We expanded on a 2002 "Knowledge Inventory" at Partners to evaluate feasibility of designing a single representation approach entailing: (a) exploration of specific needs of different applications, in terms of kinds of response required (synchronous/asynchronous, time criticality, etc.), context (e.g., implied patient, time frame, or episode), and kinds of actions to be triggered; (b) kind of representation of knowledge and feasibility of casting knowledge in the form of if em leader then statements; and (c) data and knowledge resources used (implied data model, and particular knowledge sources and terminology sources). The result of analysis was to design an architecture to accomplish this goal. We also did preliminary analysis of requirements for authoring for such a representation, and for implementation.

Artificial Intelligence↗
PubMed2002

Pentostatin pharmacokinetics and dosing recommendations in patients with mild renal impairment.

PURPOSE: The purpose of this study was to determine the pharmacokinetic parameters of pentostatin in renally impaired patients in order to establish dosing guidelines for this population. METHODS: Pentostatin doses were administered as 15-min intravenous infusions to patients based on their measured creatinine clearance (CLcr) as follows. Patients with normal renal function (NRF), defined as CLcr >60 ml/min, received 4 mg/m(2) repeated every14 days. Patients with impaired renal function (IRF) included those with CLcr 41-60 ml/min who received 3 mg/m(2) and those with CLcr 21-40 ml/min who received 2 mg/m(2), also repeated every 14 days. Heparinized plasma samples were collected during drug infusion and out through 96 h after dosing, except in two patients in whom sampling was extended to 144 h after dosing. Urine sampling extended to 96 h after dosing, and all samples were analyzed by a validated enzyme immunoassay for pentostatin concentrations. RESULTS: Enrolled in the study were 13 patients (7 IRF and 6 NRF), of whom 12 contributed samples for pharmacokinetic analysis. Median baseline CLcr values were 71.5 ml/min for NRF patients and 44 ml/min for IRF patients. Following the end of intravenous infusion, pentostatin plasma concentrations declined biexponentially with time. In some patients there was a transient increase in pentostatin equivalents 2 to 4 h after dosing. There was a good correlation between measured CLcr and pentostatin total plasma clearance. The AUC(0- infinity ) values seen in IRF patients, at lower doses, were within the range of the AUC(0- infinity ) values seen in patients with normal CLcr. Toxicities observed in the two groups of patients were similar. CONCLUSIONS: The pentostatin doses used in the study appear to be appropriate for administration to cancer patients with varying degrees of renal impairment.

Aged↗
PubMedDate not supplied

Physician use of e-mail: the telephone of the 21st century?

E-mail, as an element of a physician's clinical practice, can provide the means to accomplish a variety of tasks more effectively and more efficiently, increasing patients' involvement in their care and optimizing face-to-face office time. Concerns about billing, improper use, privacy, and confidentiality have complicated its introduction and acceptance. This article discusses guidelines proposed for clinical use of e-mail and barriers that will need to be overcome to move this mode of patient-physician communication into the mainstream.

Communication↗