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Biomedical subjects

P A Chase

Publications and source records attributed to P A Chase.

At least 19 recordsLinked to original sources
PubMed1997

The search for synergy.

Pharmacy practice education has been part of the mission of academic medical center hospitals for a long time. Practitioners, faculty members, students, and pharmacy managers work to develop relationships that support the training of future pharmacy practitioners. Increasing financial and operating pressures created by managed care have caused hospital pharmacies and colleges of pharmacy to re-examine the nature of the relationships that support this training. The University HealthSystem Consortium Pharmacy Advisory Council undertook a survey and commissioned a study of the methods and resources used to support pharmacy practice education. Based on this assessment, relationships were characterized as educational affiliation, affiliated, and fully integrated. The current status and future prospects for each of these relationships are described.

Academic Medical Centers↗
PubMed1997

An overview of types of relationships between hospitals and colleges/schools of pharmacy.

Three vignettes describe the details of each of the three types of practice-education relationships in academic hospitals identified in a survey by the University HealthSystem Consortium. The educational affiliation at Penn State's Hershey Medical Center, the affiliated relationship of the Medical College of Virginia, and a fully integrated relationship at the University of Illinois at Chicago are described by the Director of Pharmacy at each institution. The advantages, disadvantages, and future goals are described.

Education, Pharmacy↗
PubMed1994

Clinical application of otoacoustic emissions: what do we know about factors influencing measurement and analysis?

Three electrophysiologic audiologic procedures-aural immittance measurement, auditory brainstem response (ABR), and otoacoustic emissions (OAE)- were first described in the 1970's. Immittance measurement and ABR have contributed importantly for years to the assessment of auditory function in children and adults, whereas OAEs have not yet been incorporated into the everyday audiology test battery. In this article, we argue that the transition from OAE measurement by hearing scientists in laboratory settings to routine application by audiologists in the clinic will be greatly facilitated by (1) comprehensive, large-scale studies of the effects of subject characteristics, such as gender and age (from infancy to advancing adulthood), on both transient evoked (TEOAE) and distortion product (DPOAE) otoacoustic emissions; (2) clinical investigations of TEOAE and DPOAE in sizeable patient populations with specific neurotologic diagnoses; (3) guidelines for OAE test protocols in clinical environments; and (4) clear criteria for OAE analysis in clinical populations.

Acoustic Stimulation↗
PubMed1993

Care plan for documenting pharmacist activities.

At a 393-bed hospital, a pharmaceutical care plan was developed and tested in a surgical intensive care unit (SICU). The trial care plan was developed and implemented with the following objectives: to integrate clinical and distributive elements of patient information in a care plan; to add new monitoring and intervention parameters to the pharmacy profile; and to assess and refine the care plan for implementation in other areas of the institution. One pharmacist performed and documented care for 10 patients in the SICU. The pharmacist planned appropriate drug administration schedules, noted appropriate indications for each medication ordered, established appropriate outcomes, monitored for drug-drug or drug-food interactions and allergies, recorded interventions and averted adverse drug reactions, and recorded the amount of time required for care according to disease state. Pharmacist involvement with medication administration and monitoring seemed to prevent many adverse effects and drug interactions. Because of the diversity of the patient population, there was substantial variation in the time spent on care. A trial pharmaceutical care plan in a surgical intensive care unit was useful for documenting pharmacists' productivity and effectiveness.

Colorado↗
PubMed1989

Human resources management for a hospital pharmacy department.

The concepts of human resources management (HRM) are presented, and the application of HRM concepts to a hospital pharmacy department is described. Low salaries and poor working conditions had precipitated a mass exodus of pharmacists from a 650-bed, tertiary-care medical center. The newly hired director of pharmacy sought to rebuild the department by developing a three-stage HRM model consisting of needs forecasting, performance management, and advanced management systems. In the needs-forecasting stage, the strengths and weaknesses of departmental programs were determined through analysis of existing standards of practice, situational analysis, and financial analyses; the strengths and weaknesses of departmental employees were determined through the use of talent inventories, turnover analysis, analysis of time and leave records, reevaluation of the department's job classifications, performance and productivity evaluations, and productivity evaluations, and development of a philosophy of practice and mission statement. Needs and problems were addressed by examining each existing program and developing new policies and procedures, performance standards, quality assurance mechanisms, and productivity expectations. Personnel needs and problems were addressed by designing a system of differentiated career ladders, contracting with pharmacists for career moves, developing the skills of currently employed pharmacists, and implementing a succession planning model. The model has been in place for approximately three years and is beginning to yield the desired results. Application of HRM concepts to a hospital pharmacy department appears to have been successful in improving employee morale and in helping the department to meet goals of expanded and improved services.

Hospital Bed Capacity, 500 and over↗
PubMed1987

Studies on the mechanism of T cell inhibition by the Pseudomonas aeruginosa phenazine pigment pyocyanine.

Pseudomonas aeruginosa and its products have been shown to inhibit mitogen-induced human lymphocyte blastogenesis as measured by [3H]TdR uptake. The phenazine pigment pyocyanine has been identified as one of the inhibitors present in cellfree culture supernatants. To determine the mechanism of the inhibitory action of pyocyanine, we studied its effect on the early stages of T cell activation. Pyocyanine inhibited lymphocyte stimulation induced by specific antigens, the lectin concanavalin A and the calcium ionophore, ionomycin, suggesting that its inhibitory effect is not dependent on interference with the T cell antigen receptor complex itself. Using quin-2, we showed that pyocyanine did not interfere with the mitogen-induced increase in cytosolic-free Ca2+. We also showed that pyocyanine did not interfere with the function of calmodulin stimulated Ca2+-Mg2+ ATPase activity, indicating that the mechanism of action of pyocyanine differs from that of the structurally related phenothiazine compounds. Analysis of IL 2 production and IL 2 receptor expression clearly showed that pyocyanine inhibits the production of this essential lymphokine as well as the expression of IL 2 receptors on the T cell membrane. This inhibition is dose dependent and not due to cellular toxicity. There was parallel inhibition of growth in cell volume as well as [3H]TdR uptake. Thus, our results demonstrate that pyocyanine inhibits T cell proliferation by decreasing the production of the critical lymphokine IL 2 and by decreasing the expression of the IL 2 receptor. Local suppression of lymphocyte stimulation by phenazine pigments such as pyocyanine may interfere with cellular immune responses that may be necessary for eradication of chronic infection with P. aeruginosa.

Adult↗
PubMed1986

Cell-mediated immune responses to Chlamydia trachomatis in mothers and infants.

Cell-mediated immunity to Chlamydia trachomatis was studied in pregnant women with chlamydial infection of the cervix, in infants born vaginally to these women, and in infants presenting with chlamydial conjunctivitis. Uninfected pregnant women and their infants were studied as controls. McCoy cell cultures were used to isolate C. trachomatis from clinical specimens. Cell-mediated immunity was measured by lymphocyte proliferative responses in vitro to stimulation by chlamydial antigens. Chlamydial IgG antibody in serum specimens was detected by a microenzyme-linked immunosorbent assay technique. The mean lymphocyte proliferative responses to chlamydial antigens were greater in infected women than in uninfected women both during pregnancy and in the postpartum period. Lymphocyte responsiveness in infected pregnant women, however, was less than in postpartum women. Despite failure to detect chlamydial infection in exposed infants, lymphocyte proliferative responses were greater in umbilical cord blood and later in peripheral blood samples from neonates born to infected mothers than in infants born to uninfected mothers. These responses were also greater in infants with chlamydial conjunctivitis than in infants of uninfected mothers. These data suggest that cellular immune responses to chlamydial antigens are increased in infected mothers and infants and that infants may acquire chlamydial cell-mediated immunity transplacentally.

Antibodies, Viral↗
PubMed1984

Progressive pharmaceutical services in a small community hospital.

The pharmaceutical services in an 86-bed community hospital in rural Maine are described. With a staff of two full-time pharmacists, one hospital pharmacy resident, and 2.6 full-time equivalent technicians, the pharmacy department operates a 24-hour unit dose drug distribution system with complete i.v. admixture services. In addition, the department supervises nurses on medication administration and i.v. therapy teams. Clinical pharmacy services include patient-education programs, protocols giving pharmacists responsibility for initiating and monitoring specific drug therapies when authorized by a physician, and concurrent antibiotic review. The department publishes a bimonthly newsletter for physicians and nurses and a quarterly newsletter for hospital employees and patients; it also conducts continuing-education programs for nurses. By maintaining a delicate balance between creativity and practicality, pharmacists in small hospitals can develop progressive services.

Anti-Bacterial Agents↗
PubMed1983

Suppression of in vitro lymphocyte DNA synthesis by killed Pseudomonas aeruginosa.

Whole antibiotic-killed classic Pseudomonas aeruginosa organisms elicited human lymphocyte [3H]thymidine (TdR) uptake in vitro after 5 days in culture. However, high concentrations of the same preparation did not elicit [3H]TdR incorporation. The investigation of this lymphocyte unresponsiveness revealed that a high dose of P. aeruginosa, when added to lymphocyte cultures together with optimal concentrations of lymphocyte activators (e.g., plant lectins or whole killed Staphylococcus aureus Cowan 1), caused a potent, nonspecifically expressed inhibition of lymphocyte [3H]TdR uptake in response to these mitogens. High doses of P. aeruginosa were not cytotoxic to lymphocytes, and the inhibition caused was reversed when lymphocytes were washed free of bacteria. The inhibition of [3H]TdR uptake by high-dose P. aeruginosa did not require the generation of adherent suppressor cells or prostaglandin-mediated, steroid-sensitive or radiation-sensitive suppressor mechanisms. At optimal lymphocyte stimulatory concentrations of P. aeruginosa, the addition of indomethacin or the depletion of adherent cells caused an increase in lymphocyte [3H]TdR incorporation. This is consistent with an adherent-cell population regulating [3H]TdR uptake in response to P. aeruginosa via a prostaglandin-dependent pathway. This population was not involved in the inhibition of lymphocyte [3H]TdR uptake by high concentrations of P. aeruginosa.

Cell Survival↗
PubMed1983

In vitro inhibition of lymphocyte proliferation by Pseudomonas aeruginosa phenazine pigments.

Human lymphocyte proliferation is inhibited in vitro in the presence of killed Pseudomonas aeruginosa or cell-free P. aeruginosa culture supernatants. A comparison of culture supernatants obtained under similar conditions from Staphylococcus aureus, Escherichia coli, P. aeruginosa, and Pseudomonas cepacia strains demonstrated that all P. aeruginosa supernatants were strongly inhibitory, whereas supernatants from other bacteria were mildly inhibitory or not inhibitory at all. These P. aeruginosa inhibitors prevent proliferative responses of resting cells upon mitogen activation and decrease [3H]thymidine uptake when added to human lymphocytes undergoing active proliferation in culture. The inhibitory effect is reversible and not due to cytotoxicity. Most of the inhibitory activity present in crude supernatants was detected in ultrafiltrates of molecular weights below 2,000. Purified P. aeruginosa pyocyanine, a low-molecular-weight phenazine pigment present in culture supernatant, was strongly inhibitory for lymphocyte proliferation. Extraction of pyocyanine and phenazine pigments from inhibitory P. aeruginosa supernatants eliminated their inhibitory activity. Inhibitors were recovered from reverse-phase chromatographic cartridges by both chloroform and methanol elution, indicating that pyocyanine and other phenazine pigments present in P. aeruginosa supernatants are responsible for the inhibition of lymphocyte proliferation. In addition to the identification of phenazine pigments as lymphocyte proliferation inhibitors, several criteria ruled out major contributions of P. aeruginosa polysaccharide, exotoxin A, and proteases to this phenomenon. P. aeruginosa strains selected for very low protease production or for very low exotoxin A production produced supernatants as inhibitory for lymphocyte proliferation as supernatants obtained from clinical P. aeruginosa isolates. Purified P. aeruginosa lipopolysaccharide and protease preparations failed to induce reversible lymphocyte proliferation inhibition. Finally, heat inactivation of P. aeruginosa supernatants at 100 degrees C for 60 min inactivates exotoxin A and proteases but produced only a moderate decrease of the inhibitory activity for lymphocyte proliferation.

Cell Division↗
PubMed1982

Health screening of Indochinese refugee children.

The first 100 Indochinese refugee patients screened at Oakland (Calif) Children's Hospital had a remarkably high incidence of treatable infectious and parasitic diseases. The PPD skin tests were positive in 28%, and stool parasites were present in 65%. There were wide differences among the various ethnic groups in prevalence of stool parasites, anemia, and hemoglobin E trait, with a higher rate among Cambodians accounting for these differences. There were also differences in stool parasite patterns when the refugees were separated by ethnic origin. Cambodians had predominantly hookworm and Strongyloides, Laotians harbored hookworm and Trichuris, and Vietnamese were infested with Trichuris and Giardia. Malaria. Pott's disease, and congenital syphilis were among the uncommonly encountered diseases. Results of screening will vary with ethnic origin, but health screening has a high yield for all Indochinese refugees.

Adolescent↗