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Biomedical subjects

A Daniel

Publications and source records attributed to A Daniel.

At least 37 records · Page 2Linked to original sources
PubMed1993

The effect of interdialytic weight gain on predialysis blood pressure.

Interdialytic weight gain is believed to influence predialysis blood pressure. Since interdialytic weight gains vary among treatments for individual patients, blood pressure and weight gain data could be examined to determine how weight variations correlate with differences in blood pressure. Therefore, the quantitative effect on prehemodialysis blood pressure of typical interdialytic weight gains was prospectively studied in 19 nondiabetic patients on chronic hemodialysis. Over a mean of 23.6 treatments (range 17-25), the slope of each patient's prehemodialysis blood pressure versus excess weight (prehemodialysis weight minus baseline dry weight) was determined. The mean slope of the prehemodialysis mean blood pressure/excess weight regression line was 1.2 mm Hg/lb excess weight. No significant correlation was found between individual prehemodialysis blood pressure/excess weight slopes and patient age (r = 0.20), months on dialysis (r = 0.33), dry weight (r = 0.05), or mean excess weight (r = 0.19). Slopes did not differ for 3-day versus 2-day interdialytic intervals, hypertension-treated versus untreated patients, or men versus women. In 5 patients, individual prehemodialysis mean blood pressure/excess weight slopes were significantly greater than 0, averaging 2.4 mm Hg/lb excess weight (vs. 0.8 mm Hg/lb in the remaining patients). These 5 volume-responsive patients did not differ clinically from the 14 volume-resistant patients. The weight gains commonly observed in patients undergoing chronic hemodialysis have only a modest effect on prehemodialysis blood pressure in the majority of patients.

Adult↗
PubMed1993

A spreadsheet program measuring laboratory productivity in several ways: an application of College of American Pathology scores and other data to assess the overall economics of clinical laboratories.

A spreadsheet has been designed that measures the productivity of hospital or other clinical laboratories using several methods, one of which, used as a yardstick, is based on College of American Pathology (CAP) workload test scores with some departures from CAP conventions. In this method the CAP-assessed proportion of a laboratory's time utilised in performing pathology or other tests is compared with the time allocated to non-testing departmental activities as a group. A premise in the approach is that variation in the time allocated to these latter activities, in addition to variation in the efficiency of testing, also contributes significantly to the productivity and economics of hospital laboratories. The workload measure of productivity used in the study is referred to as total staff-paid-productivity (TSPP)--allied to paid-productivity of the CAP Manual 1991--and it is suggested that it be used together with several other result parameters to assess laboratories. However, there are two differences from CAP in the TSPP parameter: the salaries and hours of all staff whether medical, technical or scientific are included; and the professional component (time necessary for test interpretation) is also included where applicable. Necessary data include the goods and services costs, the total test-generated income, the total number of full-time staff equivalents and their hours in each unit or work group, the numbers of tests and raw CAP scores and in addition, an estimation of the professional/interpretive component of each test until the generation of a report. The method is illustrated with examples from six different departments with total staff-paid-productivities covering a wide range beyond the typical values of 65 per cent to 75 per cent. When the data for the laboratories are compared, it is observed that the various admixtures of non-testing activities are a stronger influence on differences in total staff-paid-productivity than the interpretative components of tests, although the latter vary markedly from discipline to discipline. When the interpretative components are included in workload measurements, it enables the productivity of different laboratories to be compared across disciplines. It is suggested that for laboratories to generate ongoing productivity they should be staffed at a rate that produces approximately a maximum total staff-paid-productivity of about 75 per cent.

Australia↗
PubMed1992

Milwaukee Prehospital Chest Pain Project--phase I: feasibility and accuracy of prehospital thrombolytic candidate selection.

This study prospectively determined the feasibility and accuracy of prehospital thrombolytic therapy candidate selection by base station emergency physicians. During a 6-month period, paramedics acquired and transmitted prehospital 12-lead electrocardiograms (ECGs) and then applied a thrombolytic therapy contraindication checklist. Emergency physicians interpreted prehospital ECGs and prospectively selected candidates for thrombolytic therapy. A safety committee of cardiologists reviewed prehospital ECGs, checklists and hospital records to determine accuracy independently. Six hundred-eighty stable adult prehospital patients with a chief complaint of nontraumatic chest pain were initially evaluated. Two hundred forty-one patients were excluded because of (1) unsuccessful electrocardiographic transmission (149), (2) transport to nonparticipating facilities (72), and (3) unavailable medical records (20). No prehospital thrombolytic therapy was administered in this study. Of 439 cases, 91 (21%) had the final diagnosis of acute myocardial infarction, 38 (8.7%) had diagnostic prehospital ECGs, and 12 (2.7%) were selected by emergency physicians as candidates for thrombolytic therapy. Seventy percent of patients with myocardial infarction had checklist exclusions for thrombolytic therapy. Prehospital evaluation increased mean scene time (paramedic arrival on scene to scene departure) by 4 minutes. The median time from chest pain onset to paramedic arrival in patients with myocardial infarction was 60 minutes. The estimated average time saved if prehospital thrombolytic therapy had been available was 101 +/- 81 minutes. The safety committee concluded that acceptable accuracy of emergency physician prehospital electrocardiographic interpretation, checklist and case selection was achieved. It is concluded that emergency physicians can accurately identify candidates for prehospital thrombolytic therapy.

Adult↗
PubMed1991

A familial MCA/MR syndrome due to translocation t(10;16) (q26;p13.1): report of six cases.

A minute familial translocation t(10;16) (q26;p13.1) was detected in a family with 6 affected children in 2 generations and 9 carriers in 3 generations. This apparently unique translocation is associated with a deleterious syndrome which includes fetal hydrops, ascites, complex congenital heart defect, psychomotor retardation, failure to thrive, hypotonia, narrow palpebral fissures, abnormally modeled, apparently low-set ears, cleft palate, thumb abnormalities, hypogenitalism, inguinal hernia, and sparse hair. All children of known or presumed carriers have been either balanced or unbalanced carriers of this translocation.

Abnormalities, Multiple↗
PubMed1991

[The role of chlorhexidine irrigation combined with ultrasonic root planing in treatment of periodontal disease. Preliminary study].

The beneficial effects of chlorhexidine on plaque formation have been well documented. This study was undertaken to evaluate the dual effects of chlorhexidine irrigation and root planing with an ultrasonic scaler. The parameters measured were plaque and gingival indices and bleeding on probing. A statistically significant decrease in all indices measured was demonstrated when compared with the test group of patients who received ultrasonic scaling and irrigation with sterile water.

Chlorhexidine↗
PubMed1990

[Preprosthetic periodontal examination. Clinical observations].

A detailed and comprehensive clinical examination is an important and fundamental basis for establishing a proper diagnosis for prosthetic treatment. It is important to make an accurate diagnosis, a rational treatment plan and establishing a prognosis. A careful examination of teeth and periodontium must be done and the prosthetic plan must consider the periodontal status of the teeth. The prosthetic treatment plan must take into consideration problems of appliance retention, iatrogenic tooth injuries and other factors. A classification based on 6 different clinical situations suggested and their therapeutic solution proposed.

Dentures↗
PubMed1990

Evaluation of indicators of erythropoiesis stimulated by recombinant human erythropoietin in renal anemia.

Recombinant human erythropoietin (rh-EPO) was administered to 11 anemic children with end-stage renal disease who were undergoing hemodialysis. Hematocrit (Hct), absolute reticulocyte count (retics), creatine concentration of red cells and erythrocyte density test (EDT) were chosen as indicators of rh-EPO effect on erythropoiesis. In the present report the first 9 weeks shall be presented in which all patients received an identical dosage of rh-EPO per kg body weight. The pre-EPO values of retics, creatine and EDT varied considerably. In 10 patients the Hct increased to 0.30 after 9 weeks of rh-EPO treatment. Retics and creatine rose in all cases above the normal range, rates of increase and maximal values differed. Retics, creatine and EDT respond faster to rh-EPO than Hct. Retics and creatine seem to be equally good indicators of rh-EPO stimulated erythropoiesis. The EDT showed an increase only up to the 4th week.

Adolescent↗
PubMed1989

Risks of unbalanced progeny at amniocentesis to carriers of chromosome rearrangements: data from United States and Canadian laboratories.

Data on 1,237 prenatal (amniocyte) diagnoses in cases of familial chromosome rearrangements were collated from 79 American and Canadian laboratories. These were added to European data (Daniel et al: Prenatal Diagn 6:315-350, 1986) on 596 reciprocal translocations (rcp) from 71 collaborative laboratories. The total data set was examined for relationships between balanced or unbalanced result and mode of ascertainment, sex of carrier parent, chromosomes involved, and (in cases of reciprocal translocations and pericentric inversions) for potential or actual chromosome imbalance size (% haploid autosome length). Risk rates for unbalanced segregants were markedly dissimilar. These ranged from approximately 50% down to essentially a negligible risk. The risk was approximately 50% for carriers of the following: complex chromosome rearrangements (ccr); insertions (ins); and for 2:2 segregating rcp ascertained by mode 1 (term unbalanced proband) with small imbalance segments. Pooled carriers (either sex) of 2:2 segregating rcp of mode 1 had a risk of 20-25% whereas female Robertsonian (rob) translocation (D;21) carriers and pericentric inversion (pii) carriers of pii with small distal segments had a risk of 10-15%. Pooled 2:2 segregating rcp carriers ascertained by mode 2 (a couple with recurrent miscarriages) and male carriers of rob (D;21) had a risk of 1.5-5%. The risk of unbalanced segregants was 1-2% (in this data) for male and female rob (13;14) carriers and for pooled pericentric inversion carriers. However, for carriers of most "type" (recurrent breakpoints) pii, for all paracentric inversions, and (as expected) for rob not involving 13 or 21, there were no term unbalanced progeny. For 2:2 segregating reciprocal translocations plots were prepared that could be used to determine broad risk groups for carriers of such rcp. In 3:1 segregating rcp there were 3.3 times fewer male than female carriers, whereas there were 1.3 times fewer male carriers in 2:2 segregating rcp. In 2:2 segregating rcp there is little effect on the fertility of male carriers and risks of unbalanced progeny were found to be equal to those for female carriers, whereas in the 3:1 segregating rcp, risks were much less for male as compared to female carriers. This indicates that 3:1 segregating rep are more similar to Robertsonian translocations in their greater effect on the fertility of male carriers.(ABSTRACT TRUNCATED AT 400 WORDS)

Abortion, Habitual↗
PubMed1989

Treatment of a periodontal intrabony pocket in man by a mucoperiosteal free graft combined with a calcium phosphate implant.

A two-walled intrabony pocket was treated by a mucoperiosteal free graft interposed between the curetted root surface and a calcium phosphate implant. The eighteen months follow up radiography showed complete healing of the bone defect, a normal periodontal ligament space, an uninterrupted lamina dura and a well-formed septum. The use of mucoperiosteal free graft may supply the wounded area with different cells such as fibroblasts, undifferentiated mesenchymal cells, periosteal cells, intercellular fibers and biochemical substances such as glucosaminoglycans, proteoglycans etc...

Adult↗
PubMed1988

Theoretical bases for karyotype evolution. II. The fusion burst in man and mouse.

As a theoretical standard for evaluating the high incidence of centric fusion in man and mouse, the relative probabilities of occurrence of reciprocal translocation (Tr), inversion (In) and centric fusion (Fu) were estimated based on the random-contact-and-exchange model. It was shown by this model that centric fusion was extremely rare (Fu = 0.0002, In = 0.0521 and Tr = 0.9477 for a human haploid karyotype). On the other hand, the occurrence rate of centric fusion in human newborn babies and European feral mice was about 500-1,000 times higher than the theoretically expected values, which is termed here the "fusion burst". We suggest that the fusion burst may be induced by the physical proximity of telomeres on the nuclear membrane, and the exchange of DNA strands by errors of telomere replication mechanisms. The cytogenetical significance of the fusion burst is discussed with regard to the minimum interaction hypothesis proposed by Imai et al. (1986). We suggest two closely linked possibilities that (1) the fusion burst in man and mouse can theoretically be placed in karyotype evolution as a transitional phase in the main stream of the fission-inversion cycle, and (2) it may be accelerated by some unknown (mutagenic) factors other than ionizing radiation.

Animals↗