Dermoscopy key points: recommendations from the international dermoscopy society.
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Dermatology↗
Biomedical subjects
D Langford
Publications and source records attributed to D Langford.
Cognitive deficits and degeneration of interneurons in HIV+ methamphetamine users.
The cellular basis for cognitive deficits in HIV+ patients with and without a history of methamphetamine (METH) use is unclear. We found that HIV+ METH users had more severe loss of interneurons that was associated with cognitive impairment. Compared with other markers, loss of calbindin and parvalbumin interneurons in the frontal cortex was the most significant correlate to memory deficits, suggesting a role in neurobehavioral alterations of HIV+ METH users.
Amphetamine-Related Disorders↗
Three-point checklist of dermoscopy: an open internet study.
BACKGROUND: In a pilot study, the three-point checklist of dermoscopy has been shown to represent a valid and reproducible tool with high sensitivity for the diagnosis of skin cancer in the hands of a small group of nonexperts. OBJECTIVES: To re-evaluate these preliminary results in a large number of observers independently from their profession and expertise in dermoscopy. METHODS: The study was conducted via the internet to provide worldwide access for participants. After a short web-based tutorial, the participants evaluated dermoscopic images of 165 (116 benign and 49 malignant) skin lesions (15 training and 150 test lesions). For each lesion participants scored the presence of the three-point checklist criteria (asymmetry, atypical network and blue-white structures). Kappa values, odds ratios, sensitivity, specificity and likelihood ratios were estimated. RESULTS: Overall, 150 participants joined the study. The three-point checklist showed good interobserver reproducibility (kappa value: 0.53). Sensitivity for skin cancer (melanoma and basal cell carcinoma) was 91.0% and this value remained basically uninfluenced by the observers' professional profile. Only 20 participants lacking any experience in dermoscopy performed significantly more poorly, but the sensitivity was still remarkably high (86.7%) when considering that they were untrained novices in dermoscopy. The specificity was 71.9% and was significantly influenced by the profession, with dermatologists performing best. CONCLUSIONS: Our study confirms that the three-point checklist is a feasible, simple, accurate and reproducible skin cancer screening tool.
Basal Cell Carcinoma↗
Analysis of result variability from high-density oligonucleotide arrays comparing same-species and cross-species hybridizations.
There exists a significant limitation in the variety of organismsfor which microarrays have been developed because of a lack of genomic sequence data. A near-term solution to this limitation is to use microarrays designed for one species to analyze RNA samples from closely related species. The assumption is that conservation of gene sequences between species will be sufficient to generate a reasonable amount of good-quality data. While there have been relatively few published reports describing the use of microarrays for cross-species hybridizations, this technique is potentially a powerful tool for understanding genomics in model organisms such as nonhuman primates. Here we describe the analysis and comparison of hybridization characteristics and data variability from a set of cross-species (rhesus macaque) and same-species (human) hybridization experiments using human high-density Affymetrix oligonucleotide arrays. The data reveal that a large fraction of probe sets are effective at transcript detection in the cross-species hybridization, validating the application of cross-species hybridizations for nonhuman primate genomics research.
Analysis of Variance↗
Crosstalk between components of the blood brain barrier and cells of the CNS in microglial activation in AIDS.
During the progression of AIDS, a majority of patients develop cognitive disorders such as HIV encephalitis (HIVE) and AIDS dementia complex (ADC), which correlate closely with macrophage infiltration into the brain and microglial activation. Microglial activation occurs in response to infection, inflammation and neurological disorders including HIVE, Alzheimer's disease, Parkinson's disease and multiple sclerosis. Microglia can be activated by immunoreactive cells independent of, but enhanced by HIV infection, from at least two routes. Activation may occur from signals originating from activated monocytes and lymphocytes in the blood stream, which initiate a cascade of stimuli that ultimately reach microglia in the brain or from activated macrophages/microglia/astrocytes within the brain. Effects of microglial activation stemming from both systemic and CNS HIV infection act together to commence signaling feedback, leading to HIVE and increased neurodegeneration. Most recent data indicate that in AIDS patients, microglial activation in the brain with subsequent release of excitotoxins, cytokines and chemokines leads to neurodegeneration and cognitive impairment. Since the presence of HIV in the brain results from migration of infected monocytes and lymphocytes across the vascular boundary, the development of novel therapies aimed at protecting the integrity of the blood brain barrier (BBB) upon systemic HIV infection is critical for controlling CNS infection.
AIDS Dementia Complex↗
Women battering in primary care practice.
BACKGROUND: The organization of health care system to emphasize managed care has placed the primary care provider in an ideal position to assess the impact of intimate partner violence (IPV) on the health of women. Primary care practice provides a setting in which women can develop an ongoing relationship with their health care provider in which they feel safe to discuss IPV and possible options to improve their lives. Women's health and safety could be dramatically improved if primary care providers were prepared to assess, intervene and appropriately refer women who are in violent relationships. OBJECTIVES: The purpose of this article is to describe the prevalence of intimate partner violence in primary care populations and review the known physical, mental health and pregnancy consequences of abuse as well as discuss the implications of intimate partner violence on primary care practice.
Battered Women↗
Measuring standards in community practice teaching.
Doreen Langford describes how a group of community practice teachers (CPTs) audited their work. Nine professional standards for the training of health visitor students were agreed and success in meeting those standards assessed using Donabedian's model of evaluation.
Community Health Nursing↗
A case-control study of diabetic end-stage renal disease in Nebraska.
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Adult↗
Increasing the supply of cadaveric kidneys for transplantation.
The number of cadaveric kidneys currently available for transplantation is insufficient. Therefore, the Center for Disease Control (CDC) undertook a collaborative project with the two transplant programs in Georgia to increase te retrieval of cadaveric kidneys. We used retrospective analysis to select productive hospitals, hospital-specific surveillance systems to identify potential donors, and procurement and retrieval evaluation to identify preventable deficiencies. During 900 hospital months of prospective surveillance, we identified a total of 555 potential donors by death record review, giving a potential donor rate of 2.3 donors/100 deaths (110 kidneys/million population/year). We observed an increase in the number of referrals, consent obtained from next of kin, and kidneys retrieved. This period of intensive activity demonstrated that additional kidneys can be retrieved by using systematic methods.
Adolescent↗
Telehealth's impact on nursing and the development of the interstate compact.
The information age has opened a new era for nursing practice. Advances in telecommunications technology now allow nurses to care for patients and their families in geographic locations throughout the country. This new practice environment challenges many of the assumptions that have created a state-based system of nurse practice acts and licensing. In response to this challenge, the creation of a new mechanism for licensure and practice, the interstate compact, is developing. In this article, the development and regulatory challenges created by telenursing and the interstate compact are discussed.
Humans↗
An epidemiologic model for diabetes mellitus: incidence, prevalence, and mortality.
An epidemiologic model is developed to describe the incidence, prevalence, and mortality of diabetes. Available data are reviewed, analyzed, and applied to the model. The model provides a framework for understanding diabetes on a population basis, and is useful in identifying needs and facilitating health care planning.
Adult↗
Using peer audit in health visiting.
South Tees Health Authority is one of 12 pilot sites for quality assurance. Most staff in the community and mental health unit are involved with the setting of professional standards. This article describes health visitors' experience of peer audit, carried out on one of the standards set within their quality assurance standard setting group. The nine health visitors attached to general practices serving Redcar and the surrounding district set professional standards based on Donabedian's structure, process and outcome model. Standards were set in areas such as communication, immunisation, health promotion, and child health clinics.
Community Health Nursing↗
Prime of Macmillans. Interview by Andrew Heenan.
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England↗