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Biomedical subjects

C Vincent

Publications and source records attributed to C Vincent.

316 records · Page 18Linked to original sources
PubMedDate not supplied

How family physicians choose an office computer system.

BACKGROUND: Purchasing an office computer can be time consuming and frustrating. Financial costs and time demands make it difficult for the family physician, especially in solo practice, to follow the many recommendations offered in the literature. The purpose of this study was to identify the most helpful selection factors used by family physicians who had already purchased an office computer. METHODS: In May 1990 an 18-item questionnaire was mailed to a random sample of 26 percent of the 1167 active members of the Washington Academy of Family Physicians. A final response rate of 45 percent was achieved. Twenty-three percent of the nonresponders were contacted to obtain information about practice demographics and office computer status. RESULTS: Seventy-three percent of responders reported using a computer in their practice. The mean cost ranged from $17,300 for solo practitioners to $55,000 for multispecialty groups. Respondents who reported performing a prepurchase needs assessment, involving the office staff in the decision process, and making cost comparisons were more satisfied with their computer systems than those who did not (P less than 0.05). Satisfaction and acceptance were lower and negatively related to an increasing amount of time needed for the system to become fully operational (P less than 0.01). The level of involvement by the practitioner in the decision process was highly predictive of satisfaction with a computer system: those physicians who were most involved were also the most satisfied. CONCLUSIONS: Family physicians responsible for selecting an office computer for their practices are advised to become personally involved in the decision process, evaluate the practice's needs and goals, involve the office staff, and compare costs before choosing a system. A set of guidelines for selecting an office computer is presented.

Computer Literacy↗
PubMedDate not supplied

Osteitis pubis.

BACKGROUND: A 55-year-old woman was seen for pubic symphysis tenderness that started 3 weeks after bladder suspension surgery for urinary incontinence. A diagnosis of osteitis pubis was made based on the results of the physical, radiographic, and laboratory examinations. The paucity of information on this topic in primary care textbooks prompted a literature review of the subject. METHODS: A computer-assisted literature search of the MEDLINE files from 1966 to the present was performed using the terms "osteitis," "osteomyelitis," and "pubic symphysis." Older documents and papers of related interest were obtained by cross-reference of the bibliographies of the articles generated by the search. RESULTS AND CONCLUSIONS: Osteitis pubis is an infrequent complication of pelvic surgery, parturition, or athletic activities. The diagnosis is made on the basis of the typical findings of pubic tenderness and pain on hip abduction that occurs a few weeks following the inciting event. Initial treatment consists of rest, physical therapy, and oral nonsteroidal or glucocorticoid anti-inflammatory medications. The use of intra-articular glucocorticoid injections is controversial. Surgery is rarely indicated and should be reserved for patients who have severe pain or pubic instability that has not responded to conservative therapy.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMedDate not supplied

Transcervical amnioinfusion.

BACKGROUND: Transcervical amnioinfusion is a new and relatively safe, simple procedure that can be performed in most modern hospital maternity units. METHODS: We reviewed the current medical literature concerning this topic by searching MEDLINE files from 1987 to the present, using key words "amnioinfusion," "fetal distress," "premature rupture of membranes," "meconium aspiration," and "oligohydramnios." Older articles were accessed from cross-reference of the more recent publications. RESULTS: When amnioinfusion was used to treat variable fetal heart rate decelerations, it usually reduced the severity of the decelerations, as well as the Cesarean section rate for fetal distress. Prophylactic transcervical amnioinfusion has been studied in three other settings: premature rupture of membranes, meconium passage during labor, and oligohydramnios. A suggested protocol for saline amnioinfusion during labor is given. CONCLUSIONS: Further studies are needed to confirm efficacy reports and to clarify the indications for saline amnioinfusion.

Adult↗
PubMedDate not supplied

BOR and BO syndromes are allelic defects of EYA1.

Branchio-oto-renal (BOR) syndrome is an autosomal dominant disease characterized by varying combinations of branchial, otic and renal anomalies. By positional cloning, a candidate gene, EYA1, homologous to the drosophila eyes absent gene, has recently been identified at 8q13.3 and shown to underlie this syndrome. The name branchio-oto (BO) syndrome has been used to describe a similar combination of branchial and otic anomalies, without the association of renal anomalies. Whether BOR and BO syndromes involve the same gene was unknown. To address this question, we analyzed two large independent families for which each of the 8 affected members present exclusively with BO syndrome. In both families, linkage analysis mapped the causative gene to the same chromosomal region as EYA1. A search for mutations in 9 of the EYA1 coding exons identified a 2-bp insertion segregating in one family and an 8-bp deletion segregating in the other. These results demonstrate that EYA1 also underlies BO syndrome, and that BOR and BO syndromes are allelic defects of this gene.

Alleles↗
PubMedDate not supplied

Fate of antibodies bound to lymphocyte surface. II.--Degradation and release of immune complexes.

The fate of horse anti-human lymphocyte globulins, rabbit anti-human beta2 microglobulin antibodies and anti-HL-A alloantibodies radiolabelled with 125I and complexed to their corresponding lymphocyte surface antigens, was investigated. During prolonged incubation at 37 degrees C, part of these antibodies were actively released into the surrounding medium after enzymatic degradation occuring either intracellularly or at the cell surface. Metabolism of the antibodies was temperature-dependent and involved only antibodies able to react with antigens on the cell surface. Sephadex G200 filtration of the small percentage of non dialysable radioactive products in the supernatant revealed that all the 125I-anti-human lymphocyte globulin was recovered as a macromolecular structure in the void volume. Similar experiments were performed with 51Cr labelled lymphocytes coated with anti-lymphocyte globulins: treatment with anti-horse immunoglobulin precipitated part of 51Cr activity in the void volume which was therefore associated with anti-human lymphocyte globulin as an immune complex. The same protocol applied to the other two antibodies studied showed that anti-beta2 microglobulin antibodies were recovered both as macromolecular and 7 S immune complexes, whereas anti-HL-A antibodies were recovered as macromolecular, 7 S and still smaller immune complexes.

Antibodies↗
PubMedDate not supplied

Clinical risk modification, quality, and patient safety: interrelationships, problems, and future potential.

Iatrogenic injury, in which patients are unintentionally injured by medical treatment, occurs in 4% of hospital admissions and causes considerable human suffering, financial losses, and waste of healthcare resources. This article discusses why existing quality initiatives have had little impact on iatrogenic injury and suggests an approach to clinical risk modification that may enhance the safety of medical treatment.

Accidents↗