Medicine and Health Sciences Commons^™

Reducing Medication Mismanagement In Adult Care Residences, Mary Ann F. Kirkpatrick

Case Studies from Age in Action

Educational Objectives

1. Describe the prevalence of medication mismanagement in adult care facilities in Virginia.

2. Explain the significance of selected medication management errors.

3. Recommend practices to improve medication management task performance in adult care facilities.

State Regulation Of Assisted Living Facilities, Sonya A. Sterbenz

Case Studies from Age in Action

Educational Objectives

1. To define the role of assisted living facilities in the continuum of long-term care options for older adults.

2. To present the various arguments concerning the regulation of the assisted living industry.

Medications And Falls, Patricia W. Slattum

Case Studies from Age in Action

Educational Objectives:

1. To describe potential causes of falls and ways to prevent them.

2. To illustrate how medications can contribute to an increased risk of falls and recommend strategies for reducing this risk.

Virginia Dental Journal (Vol. 75, No. 1, 1998)

Virginia Dental Journal

No abstract provided.

A Comparison Of Rectal Diazepam Gel And Placebo For Acute Repetitive Seizures, Fritz E. Dreifuss , M.D., N. Paul Rosman , M.D., James C. Cloyd , Pharm.D., John M. Pellock , M.D., Ruben I. Kuzniecky , M.D., Warren D. Lo , M.D., Fumisuke Matsuo , M.D., Gregory B. Sharp , M.D., Joan A. Conry , M.D., Donna C. Bergen , M.D., Walter E. Bell , Ph.D

Neurology Publications

ABSTRACT

Background Acute repetitive seizures are readily recognizable episodes involving increased seizure frequency. Urgent treatment is often required. Rectal diazepam gel is a promising therapy.

Methods We conducted a randomized, doubleblind, parallel-group, placebo-controlled study of home-based treatment for acute repetitive seizures. Patients were randomly assigned to receive either rectal diazepam gel, at doses ranging from 0.2 to 0.5 mg per kilogram of body weight on the basis of age, or placebo. Children received one dose at the onset of acute repetitive seizures and a second dose four hours later. Adults received three doses — one dose at onset, and two …

Virginia Dental Journal (Vol. 75, No. 4, 1998)

Virginia Dental Journal

No abstract provided.

Virginia Dental Journal (Vol. 75, No. 2, 1998)

Virginia Dental Journal

No abstract provided.

Virginia Dental Journal (Vol. 75, No. 3, 1998)

Virginia Dental Journal

No abstract provided.

Market And Organizational Factors Associated With Teaching Hospital Participation In Strategic Hospital Alliances, James D. Bramble

Theses and Dissertations

This research investigated market and organizational factors that influence the strategic decisions of teaching hospitals to participate in strategic hospital alliances (SHAs). It described the characteristics of both teaching hospitals and the health care environment in which they operate. This research also examines the association of these factors with the strategic position of teaching hospitals in terms of their dominance in the market or within their organizations.

The theoretical model used two concepts from institutional theory--coercive and normative pressures. It was argued that coercive pressures in the market facilitated the decision to participate in SHAs and gain market and Organizational …

The Structural Response And Performance Of General Hospitals In A Managed Care Environment, Denise M. Mccollum

Theses and Dissertations

The study purpose is to link hospital structure, represented by each hospital’s professional contingent, service mix, and inpatient capacity; and its environment, characterized by the penetration of managed care enrollees. The secondary purpose is to test the relationship between hospital structural change and subsequent hospital performance.

The study employs a non-experimental panel design, with a sample of 1882 community hospitals (service type: general medical and surgical). Environmental variables are measured for the base year 1989. Hospital structural variables are measured for 1989 and 1994, with change variables computed. Performance variables are measured for 1989 and 1995, with change computed for …

Adenosine 3', 5'-Cyclic Monophosphate Activation Of Islet Chloride Channels, Anjali Varandani

Theses and Dissertations

The objective of this thesis was to understand the regulation of islet Cl⁻ current by cAMP. This current, known as I_cl,islet flew is the first Cl⁻ channel current characterized in pancreatic �� cells. I_cl,islet has been hypothesized to modulate insulin secretion through changes in islet electrical activity. Both 5 ��M forskolin and 100 ��M IBMX (3-isobutyl-1-methylxanthine), agents that increase intracellular cAMP, were shown to activate an outwardly-rectifying ionic current in HIT cells that closely resembled I_cl,islet. The current was blocked when iodide was substituted for external Cl⁻ or when the Cl⁻ channel blocker niflumic acid was …

Changes In Gabaa̳ Receptor Expression And Alterations In Ca⁺⁺/Calmodulin-Dependent Protein Kinase Ii Activity In A Hippocampal Neuronal Culture Model Of Epilepsy, Robert Eagan Blair

Theses and Dissertations

Expression levels of GABAA receptor subunits and activity of the Ca++ /calmodulin-dependent protein kinase II (CaM kinase II) enzyme system were evaluated in an in vitro hippocampal neuronal culture model of epilepsy. Treatment of hippocampal neuronal cultures with Mg++-free media for 3 hours results in the induction of an enduring "epileptic" state as evidenced by the expression of spontaneous recurrent seizure (SRS) discharge. The induction of the SRS activity was shown to be a N-methyl-D-aspartate (NMDA) receptor, Ca++-dependent mechanism (Sombati and DeLorenzo, J Neurophys., 73 (4), 1995). Significant and long-lasting decreases in mRNA expression for the GABAA α2 and α5 …

Gene Expression Following Traumatic Brain Injury, Rajiv Malhotra

Theses and Dissertations

The pathology which results from traumatic brain injury (TBI) have long been believed to be immediate and irreversible. However, recently it has been shown that, although the primary effects are virtually unavoidable, the secondary effects manifest themselves through biochemical processes set in motion at the time of the injury. These events are frequently mediated through the process of excitotoxicity, which results from a widespread release of excitatory neurotransmitters. These neurotransmitters go on to activate both ionotropic and metabotropic receptors. The signal transduction initiated through these receptor populations gives rise to changes in gene expression.

One result of this release of …

Diffusion Behavior Of Lipid Vesicles In Entangled Polymer Solutions, X. Cao, R. Bansil, D. Gantz, E.W. Moore, N. Niu, Nezam H. Afdhal

Internal Medicine Publications

ABSTRACT

Dynamic light scattering was used to follow the tracer diffusion of phospholipid/cholesterol vesicles in aqueous polyacrylamide solutions and compared with the diffusive behavior of polystyrene (PS) latex spheres of comparable diameters. Over the range of the matrix concentration examined (Cp = 0.1-10 mg/ml), the diffusivities of the PS spheres and the large multilamellar vesicles exhibited the Stokes-Einstein (SE) relation, while the diffusivity of the unilamellar vesicles did not follow the increase of the solution's viscosity caused by the presence of the matrix molecules. The difference between the diffusion behaviors of unilamellar vesicles and hard PS spheres of similar size …

Standing Up To Osteoporosis, Robert W. Downs

Case Studies from Age in Action

Educational Objectives

1. To provide basic information about osteoporosis, including risk factors, diagnostic testing, treatment, and prevention.

2. To get you to help us spread the word that osteoporosis can be diagnosed and treated, and that there are things you can do to decrease your future risk for developing osteoporosis.

Virginia Dental Journal (Vol. 74, No. 3, 1997)

Virginia Dental Journal

No abstract provided.

Virginia Dental Journal (Vol. 74, No. 2, 1997)

Virginia Dental Journal

No abstract provided.

Analysis Of Phosphorescence In Heterogeneous Systems Using Distributions Of Quencher Concentration, A.S. Golub, A.S. Popel, L. Zheng, R.N. Pittman

Physiology and Biophysics Publications and Presentations

ABSTRACT

A continuous distribution approach, instead of the traditional mono- and multiexponential analysis, for determining quencher concentration in a heterogeneous system has been developed. A mathematical model of phosphorescence decay inside a volume with homogeneous concentration of phosphor and heterogeneous concentration of quencher was formulated to obtain pulse-response fitting functions for four different distributions of quencher concentration: rectangular, normal (Gaussian), gamma, and multimodal. The analysis was applied to parameter estimates of a heterogeneous distribution of oxygen tension (P02) within a volume. Simulated phosphorescence decay data were randomly generated for different distributions and heterogeneity of PO2 inside the excitation/emission volume, consisting …

Virginia Dental Journal (Vol. 74, No. 1, 1997)

Virginia Dental Journal

No abstract provided.

Virginia Dental Journal (Vol. 74, No. 4, 1997)

Virginia Dental Journal

No abstract provided.

Comparison Of Epidural And Intravenous Fentanyl Patient-Controlled Analgesia After Cesarean Section Under Epidural Anesthesia With Chloroprocaine, Kim M. Larsen

Theses and Dissertations

This study compared two methods of postcesarean fentanyl patient- controlled analgesia (PCA). Fentanyl was administered intravenously (PCA_I) or epidurally (PCA_E) following cesarean section under epidural chloroprocaine anesthesia. Twenty-one ASA I and II parturients were randomly assigned to receive fentanyl PCA_I (n = 9) or PCA (n = 12). At surgical completion fentanyl 1.0 mcg/kg was given and the PCA initiated with a dose of 30 mcg, a lockout interval of 10 minutes, a maximum dose of 180 mcg/hr, and no basal rate. Data were collected over 24 hours including visual analog scale (VAS) pain scores, …

Tumor Immunity Following Adenovirus Mediated Herpes Simplex Thymidine Kinase Gene Transfer To Experimental Rat Gliomas, Maulik Raj Shah

Theses and Dissertations

Previous studies have determined adenovirus mediated herpes simplex thymidine kinase gene transfer (AV-TK) to be effective for the treatment of experimental gliomas. In this study we report three distinct phenomenon. First, animals with complete regression of subcutaneous tumors upon intratumoral injections of AV-TK with concomitant Ganciclovir® (GCV) administration developed tumor immunity. These animals had the ability to reject a subsequent inoculum of lethal doses of tumor cells. This tumor immunity was long standing and protective as far as 6 months from the time of initial tumor ablation. Of interest, adoptive transfer of splenocytes from AV-TK treated-tumor ablated animals to naive …

Adverse Cerebral Outcomes After Coronary Bypass Surgery, Gary W. Roach , M.D., Marc Kanchuger , M.D., Christina Mora Mangano , M.D., Mark Newman , M.D., Nancy Nussmeier , M.D., Richard Wolman , M.D., Anil Aggarwal , M.D., Katherine Marschall , M.D., Steven H. Graham , M.D., Ph.D., Catherine Ley , Ph.D., Gerard Ozanne , M.D., Dennis T. Mangano , Ph.D., M.D., Ahvie Herskowitz , M.D., Vera Katseva , Ph.D, Rita Sears , R.N., M.S.

Anesthesiology Publications

ABSTRACT

Background Acute changes in cerebral function after elective coronary bypass surgery are a difficult clinical problem. We carried out a multicenter study to determine the incidence and predictors of — and the use of resources associated with — perioperative adverse neurologic events, including cerebral injury.

Methods In a prospective study, we evaluated 2108 patients from 24 U.S. institutions for two general categories of neurologic outcome: type I (focal injury, or stupor or coma at discharge) and type II (deterioration in intellectual function, memory deficit, or seizures).

Results Adverse cerebral outcomes occurred in 129 patients (6.1 percent). A total of …

Pharmacokinetics Of Vancomycin In Critically Ill Infants Undergoing Extracorporeal Membrane Oxygenation, R. Davis Maker, Joseph T. Dipiro, Jatinder Bhatia

Publications from the Office of the Dean

Extracorporeal membrane oxygenation (ECMO) is a widely used therapy for neonates with respiratory failure. Because of sepsis, many of these infants require antibiotics like vancomycin during ECMO treatment. ECMO transiently alters renal function and increases the circulating blood volume by 75%. Initial vancomycin pharmacokinetics were determined in 12 infants undergoing ECMO to determine an adequate drug administration regimen. Vancomycin dosage was based on current recommendations for weight and gestational age. Pharmacokinetic parameters were determined by fitting the data to a two compartment model. This study yielded a mean steady-state volume of distribution of 1.1 +/- 0.5 (range, 0.6 to 2.1) …

Decreases In Ovarian Cytochrome P450c17 Alpha Activity And Serum Free Testosterone After Reduction Of Insulin Secretion In Polycystic Ovary Syndrome, John E. Nestler , M.D., Daniela J. Jakubowicz , M.D.

Obstetrics and Gynecology Publications

BACKGROUND

Insulin resistance and increased ovarian cytochrome P450c17α activity are both features of the polycystic ovary syndrome. P450c17α, which is involved in androgen biosynthesis, has both 17α-hydroxylase and 17,20-lyase activities. Increased activity of this enzyme results in exaggerated conversion of progesterone to 17α-hydroxyprogesterone in response to stimulation by gonadotropin. We hypothesized that hyperinsulinemia stimulates ovarian P450c17α activity.

METHODS

We measured serum steroid concentrations during fasting and the response of serum 17α-hydroxyprogesterone to leuprolide, a gonadotropin-releasing hormone agonist, and performed oral glucose-tolerance tests before and after oral administration of either metformin (500 mg three times daily) or placebo for four to …

Periodic Lateralized Epileptiform Discharges, Nathan Watemberg , M.D., Lawrence D. Morton , M.D.

Neurology Publications

No abstract provided.

Virginia Dental Journal (Vol. 73, No. 4, 1996)

Virginia Dental Journal

No abstract provided.

Virginia Dental Journal (Vol. 73, No. 2, 1996)

Virginia Dental Journal

No abstract provided.

Virginia Dental Journal (Vol. 73, No. 3, 1996)

Virginia Dental Journal

No abstract provided.

Virginia Dental Journal (Vol. 73, No. 1, 1996)

Virginia Dental Journal

No abstract provided.