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Biomedical subjects

R S Summers

Publications and source records attributed to R S Summers.

At least 19 recordsLinked to original sources
PubMed1998

Microbial characterization of biological filters used for drinking water treatment.

The impact of preozonation and filter contact time (depth) on microbial communities was examined in drinking water biofilters treating Ohio River water which had undergone conventional treatment (coagulation, flocculation, sedimentation) or solutions of natural organic matter isolated from groundwater (both ozonated and nonozonated). With respect to filter depth, compared to filters treating nonozonated waters, preozonation of treated water led to greater differences in community phospholipid fatty acid (PLFA) profiles, utilization of sole carbon sources (Biolog), and arbitrarily primed PCR fingerprints. PLFA profiles indicated that there was a shift toward anaerobic bacteria in the communities found in the filter treating ozonated water compared to the communities found in the filter treating nonozonated settled water, which had a greater abundance of eukaryotic markers.

Filtration↗
PubMed1993

Plasma vitamin A levels in measles and malnourished pediatric patients and their implications in therapeutics.

Measles and protein energy malnutrition (PEM) in children have been associated with low serum retinol levels. Vitamin A supplementation has reduced mortality and morbidity significantly. The purpose of this study was to determine the effect of vitamin A supplementation on plasma retinol levels in children with these conditions. Black, African children, admitted to Ga-Rankuwa Hospital with measles or PEM, were randomly allocated to either a study or a control group. The study group received, in addition to routine treatment, 150,000 units of vitamin A palmitate IM on day 1 followed by 15,000 units orally for 7 days. The patients in the control group received routine appropriate treatment, which may have included 3000 units vitamin A per day. Retinol plasma concentrations of all patients were measured on days 1, 2, and 8. The mean baseline plasma retinol levels (day 1) of both the measles and PEM patients were lower than 11 micrograms/dl. There was a statistically significant increase in plasma levels in the study and control groups for both conditions by day 8 with the mean plasma retinol levels > 30 micrograms/dl. There was no statistically significant difference between study and control groups. This study has shown that there is a high incidence of baseline hyporetinaemia in these patients. The mean retinol plasma levels return to within normal limits after 8 days of either routine treatment or vitamin A supplementation.

Child↗
PubMed1992

Immunogenicity of recombinant hepatitis B vaccine in urban black children from Ga-Rankuwa, Bophuthatswana, South Africa.

Many areas in Southern Africa have a relatively high endemicity for hepatitis B for which the only effective medical measure is vaccination. The aim of this study was to evaluate the antibody response to a recombinant hepatitis B vaccine (Engerix B; Smith Kline-Beecham) in a black urban population, with the use of the recommended regimen and a low dose, short course. One hundred eleven children seronegative for hepatitis B virus (5 to 19 years old) were randomized to receive one of the two vaccination schedules (20 micrograms at zero, 1 and 6 months or 2 micrograms at zero, 1 and 2 months). Antibody to hepatitis B surface antigen was determined 6 to 8 weeks after the last dose by radioimmunoassay (Ausab; Abbott Laboratories). The recommended schedule gave a seroconversion rate of 100% with a geometric mean titer of 585.9 mIU/ml. The low dose, short course schedule produced a seroconversion rate of 63.8% and a geometric mean titer of 73.8 mIU/ml. In the 5- to 9-year-old individuals, however, 71.6% seroconverted (geometric mean titer 114.2 mIU/ml). For cost reasons further investigations on low dose regimens are indicated.

Adolescent↗
PubMed1991

Evaluation of a communications skills workshop for hospital pharmacists.

The ability to communicate is an essential requirement for effective practice. Until recently, however, pharmacy students received no training in this area. The resultant inadequacy was carried forward into practice. Only now has the omission been recognized and attempts made to improve the situation among practising pharmacists. We designed an 8-h workshop on communication skills. It covered the basic principles of communication (Workbook A--preparatory work before the workshop) and their application (Workbook B + case studies, exercises and role-playing--during the workshop). The workshop was presented to a group of hospital pharmacists in the Western Cape. At the end of the workshop participants completed a questionnaire on its usefulness, applicability and presentation on a five-point scale. Responses were counted, averaged and analysed by sex and age. Although the ratings were uniformly high (average 4.3 out of a possible 5.0) there were differences between men and women and between older and younger pharmacists. The possible reasons for and implications of these differences are discussed.

Adult↗
PubMed1990

Benzodiazepine use in a small community hospital. Appropriate prescribing or not?

Benzodiazepine (BDZ)-prescribing patterns in relation to indications and to drug characteristics in a small short-stay hospital were examined. In a sample of 800 patients, 183 were prescribed BDZs during their stay. Female patients received more BDZs (BDZ:female patients 1.31:1.0) than males (BDZs:male patients 1.02:1.0), particularly in the 21-40-year age group in which polypharmacy was highest. BDZs were classified according to their elimination half-lives. Our data showed that the majority fell into the long-acting (half-life greater than 24 h) (55%) and intermediate-acting (half-life 12-24 h) (20.7%) categories, despite the fact that most indications (pre-anaesthetic and night-time sedation; total 71.6%) called for the shorter-acting drugs. The merits or otherwise of this situation are discussed, and a number of questions put regarding the validity of this approach. Overall, BDZs accounted for 5.8% of the calculated medications given to the 800-patient sample.

Adolescent↗
PubMed1989

Carbamazepine clearance in paediatric epilepsy patients. Influence of body mass, dose, sex and co-medication.

Carbamazepine clearance was studied in Black paediatric epilepsy patients, 90 receiving monotherapy and 17 on combination therapy. For patients on monotherapy the following relationship are shown: clearance decreases with increasing body mass (r= 0.87); clearance increases with increasing dose (r = 0.70); and mean clearance for male are higher than those for females throughout the mass ranges, though the difference is not statistically significant. In the case of patients on carbamazepine plus another anticonvulsant, clearance also decreases with increasing body mass, and increases with increasing dose. Furthermore, in the mass groups which corresponded with those on monotherapy, mean carbamazepine clearance higher by a factor varying from 1.3 to 1.7; in the corresponding dosage groups, it is higher by a factor of between 1.4 and 1.7.

Biological Availability↗
PubMed1987

Changes in pharmacy practice due to a clinical pharmacy training programme for a group of community hospitals.

Education for and the practice of Clinical Pharmacy in South Africa have been neglected. This paper describes one attempt to improve matters. An initial survey of pharmacies, pharmacists and other staff in a small group of private hospitals determined the level of Clinical Pharmacy organization and services. The results were used to design a Clinical Pharmacy (training) Programme for selected pharmacists in the group. The programme consisted of six units, each of which was presented in at least a full-day session, with strong audiovisual support, small group discussion and rigorous exercises. During and after each session, implementation and application in the respective hospitals were monitored, as were participants' reactions. Clinical Pharmacy services increased markedly as a result of the programme, as did job satisfaction and motivation among most of the participating pharmacists.

Curriculum↗
PubMed1987

Drug prescribing for TPN patients at a teaching hospital serving a developing community.

Drug prescribing for TPN patients at Ga-Rankuwa Hospital was investigated as part of a larger retrospective survey of TPN products and practices. The medical records of 45 patients who received parenteral nutrition over the period April-August 1985 were examined. Relevant information was transcribed onto survey forms, classified and analysed. The major defined complaints were gastrointestinal (50%) and perinatal (34.5%). Twelve patients had more than one major complaint. Seventy-three per cent of the patients were admitted to paediatric wards and over 24% to (adult) surgical wards. There was one medical patient in the group. The only drug categories that were prescribed in more than 10% of cases were antimicrobial agents (64.9%) and analgesics (10.4%). The most frequently used individual drugs were gentamicin (17.5%), penicillin G (14.3%), piperacillin (17%) and aminophylline (11%). The implications of this pattern of drug use for TPN patient monitoring are discussed.

Aminophylline↗
PubMed1986

Drug prescribing in paediatrics at a teaching hospital serving a developing community.

Drug prescribing for paediatric inpatients at a teaching hospital serving a developing community was investigated. A list of 695 patient record numbers was randomly generated from the 7637 children admitted over the period examined (9.1%). Prescribed drugs were computer-categorized and counted. Antibacterials (30.0%), vitamins, iron preparations and dietary supplements (20.0%), electrolytes (18.8%), analgesics (12.2%) and respiratory drugs (7.1%) comprised the most frequently-prescribed groups. The main (admitting) diagnoses of the sample were also classified. Infective diseases (42.0%), respiratory conditions (18.2%), perinatal disorders (14.9%) and nutritional deficiencies (9.9%) predominated. Data for individual drugs in the four dominant drug groups are presented. The margins between the top one or two drugs and the others in each therapeutic category are notable. Few drugs are extensively used. They include ampicillin, paracetamol, multivitamin syrup and Darrow's preparations. The implications of this picture in therapeutics are discussed.

Africa, Southern↗
PubMed1986

The effect of a specialist clinic with pharmacist involvement on the management of epilepsy in paediatric patients.

At the request of the consultant, a pharmacist attended the paediatric out-patient neurology clinic held at Ga-Rankuwa Hospital, from June 1984. After 6 months of this 'team' approach, its effect on patient care was evaluated. The study consisted of a retrospective survey of approximately 100 patient-visits before and after the establishment of the specialist clinic. Patient medication details and frequency of fits were analysed by a microcomputer. There was an increase in the number of patients seen per session. The results also showed that polypharmacy, dosing frequency and average dose per day were reduced under the new arrangement, whilst disease control, i.e. fit frequency, was no worse. The overall result has been to rationalize and improve anticonvulsant drug therapy at this clinic.

Ambulatory Care↗