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Biomedical subjects

T McClellan

Publications and source records attributed to T McClellan.

10 recordsLinked to original sources

Social work practitioners as researchers: is it possible?

Social workers are encouraged and often expected to conduct research in addition to their clinical duties. Unfortunately, few practitioners seem interested and there is usually a lack of tangible supports in most practice settings. To counter this, a support group of non-supervisory clinical social workers in a Department of Veterans Affairs Medical Center met regularly with a social work educator-consultant in order to strengthen research skills, maintain motivation, and promote publication. This group successfully published seven articles with an additional five in process. In contrast, a second research group at the same facility foundered after eight months. Similarities and differences between the two groups are discussed. Recommendations are made about how agencies might encourage and sustain practitioners in the development and publication of clinical research.

Curriculum↗

Data collection: are social workers reliable?

Social workers are required to collect a considerable amount of personal information about clients and their families which may be unrelated to direct clinical work. Administrators often use this for the purpose of payment, service documentation, agency planning, and accountability. The worker's concern about the appropriateness of collecting this data may result in poor compliance or even falsification of information. In a survey of Minnesota social workers, noncompliance with data collection requirements was substantial. The authors also found a significant degree of conflict about privacy and confidentiality issues. These findings suggest a basis of concern for those who must rely on accurate data for administrative planning.

Attitude of Health Personnel↗

Effect of pretransplant graft irradiation on canine intestinal transplantation.

This study was done to define the tolerance of ex vivo administered irradiation to intestinal allograft and to assess the effect of irradiation on the incidence and severity of rejection and graft versus host disease after intestinal transplantation in dogs. Excessive intestinal damage was produced by 2,500 rads, but 750 and 1,500 rads produced no detectable acute or chronic damage in dogs observed from 100 days to two years. Using cyclosporine for postoperative immunosuppression, 1,500 rads reduced the incidence of acute (p = 0.05) and chronic rejection (p = 0.08), yet did not impair intestinal absorption of cyclosporine. The greatest improvement in survival occurred with 750 rads (p = 0.02). Histologic evidence of graft versus host disease appeared in the native small intestine in two of four long term surviving dogs receiving a nonirradiated graft but in none of the dogs receiving irradiated grafts. Irradiation of the graft may be a promising adjunct in the search for a clinically applicable method of intestinal transplantation.

Animals↗

Cyclosporine disposition in the dog. Comparison of radioimmunoassay with high-performance liquid chromatographic assay and pharmacokinetics following intravenous administration.

Radioimmunoassay (RIA) and high performance liquid chromatography (HPLC) with ultraviolet absorbance detection have been compared as potential tools for cyclosporine pharmacokinetic studies in dogs. RIA clearly affords greater assay sensitivity, although crossreactivity with cyclosporine metabolites causes an over-estimation of parent drug concentrations with a subsequent reduction in the apparent values of clearance and volume of distribution. HPLC appears to be specific for parent cyclosporine. Thus, with the sacrifice of some sensitivity, HPLC-measured time-course data afford more reliable estimates of cyclosporine pharmacokinetic parameters. After the selection of a dosage regimen from preliminary studies, the pharmacokinetics of i.v.-administered cyclosporine were studied in six adult male mongrel dogs. Following administration of 20 mg/kg by constant-rate 30-min i.v. infusion the time courses of cyclosporine were studied in plasma and urine. Concentrations were measured by reversed-phase HPLC with ultraviolet absorbance detection. Data were fitted to triexponential equations using a digital computer with the CSTRIP and NONLIN programs, and pharmacokinetic parameters were calculated. Present findings suggest that cyclosporine is slowly yet extensively distributed into peripheral body regions that might serve as slowly releasing storage areas. Large volumes of distribution along with moderately slow clearances resulted in long half-lives for the disposition of cyclosporine. Less than 1% of the administered dose was recovered as parent cyclosporine in the urine, suggesting that renal clearance of cyclosporine was negligible. The potential relevance of present findings to cyclosporine therapy of transplant patients is discussed.

Absorption↗

Small cell neuroendocrine carcinoma of the urinary bladder: case report of a rare primary tumor.

Primary small cell neuroendocrine carcinoma of the bladder is a rare condition, with fewer than 140 cases having been reported. It is an aggressive tumor with an average five-year survival rate of less than 10 percent as cited by multiple case reports. We report a 73-year-old white woman with primary small cell neuroendocrine carcinoma of the bladder who was treated with radical cystectomy and adjuvant cisplatin/etoposide-based chemotherapy.

Aged↗