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PubMed1995

Young teenagers and access to alcohol in a Swiss canton: evidence from observational testing and from a telephone survey.

In the first part of the study, the readiness of bartenders and waiters to serve alcoholic beverages to young teenagers was studied. The fieldwork was conducted in a random sample of bars and restaurants in Lausanne and in villages of the canton of Vaud, where 13-year-old and 15-year-old boys ordered either beer or pastis (an aniseed-flavoured aperitif). Results showed that alcoholic beverages were very accessible to 13-year-old and 15-year-old youths although the minimum legal age for purchasing and consuming beer is 16 years and for pastis is 18 years: 81% of the test orders were served. An analysis of interaction of patterns between servers and clients suggested that time necessary to refuse orders may play an important role in explaining this result. In the second part of the study, knowledge and attitudes of owners and managers of bars, restaurants and different kinds of commercial outlet were studied in a telephone interview survey about the minimum legal age for purchasing and consuming alcoholic beverages. Only 17% of the respondents knew the correct minimum legal ages for purchasing and consuming alcoholic beverages.

Adolescent↗
PubMed1980

Tracing the time course of picture--word processing.

A number of independent lines of research have suggested that semantic and articulatory information become available differentially from pictures and words. The first of the experiments reported here sought to clarify the time course by which information about pictures and words becomes available by considering the pattern of interference generated when incongruent pictures and words are presented simultaneously in a Stroop-like situation. Previous investigators report that picture naming is easily disrupted by the presence of a distracting word but that word naming is relatively immune to interference from an incongruent picture. Under the assumption that information available from a completed process may disrupt an ongoing process, these results suggest that words access articulatory information more rapidly than do pictures. Experiment 1 extended this paradigm by requiring subjects to verify the category of the target stimulus. In accordance with the hypothesis that picture access the semantic code more rapidly than words, there was a reversal in the interference pattern: Word categorization suffered considerable disruption, whereas picture categorization was minimally affected by the presence of an incongruent word. Experiment 2 sought to further test the hypothesis that access to semantic and articulatory codes is different for pictures and words by examining memory for those items following naming or categorization. Categorized words were better recognized than named words, whereas the reverse was true for pictures, a result which suggests that picture naming involves more extensive processing than picture categorization. Experiment 3 replicated this result under conditions in which viewing time was held constant. The last experiment extended the investigation of memory differences to a situation in which subjects were required to generate the superordinate category name. Here, memory for categorized pictures was as good as memory for named pictures. Category generation also influenced memory for words, memory performance being superior to that following a yes--no verification of category membership. These experiments suggest a model of information access whereby pictures access semantic information were readily than name information, with the reverse being true for words. Memory for both pictures and words was a function of the amount of processing required to access a particular type of information as well as the extent of response differentiation necessitated by the task.

Form Perception↗
PubMed1993

Laboratory evaluations of interproximal access of two differently bristled manual toothbrushes.

The Colgate Rippled Bristles toothbrush was compared to the Oral-B 40 toothbrush using a laboratory device which simulates horizontal and vertical brushing movements under pressures of 250, 500 and 750 grams. Interproximal access was determined by measuring the width of the brushing stroke on pressure-sensitive paper surrounding anterior or posterior tooth shapes. The Colgate Rippled toothbrush was consistently superior to the Oral-B 40 toothbrush in accomplishing interproximal access in the laboratory tests performed here. On anterior-shaped teeth, the superiority (p < 0.05-0.01) was evident at all pressures tested, with both horizontal and vertical brushing movements. On posterior tooth shapes the Colgate Rippled toothbrush was superior (p < 0.01) to the Oral-B 40 toothbrush at all brushing weights and with both vertical and horizontal motions. When total interproximal access efficacy means were calculated for all brushing weights, the Colgate Rippled toothbrush was superior (p < 0.05-0.01) to the Oral-B 40 toothbrush on both anterior and posterior tooth shapes in the vertical and horizontal brushing motions.

Analysis of Variance↗
PubMed1979

Spontaneous locomotor activity and food and water intake in rats with medial amygdala lesions.

Locomotor activity was studied with the method of electromagnetic activity meters, before and after operation in rats bilaterally lesioned in medial amygdala, and in a sham-operated control. Two activity tests were performed daily. In the first test spontaneous activity was recorded for a 30 min period without access to food or water. The second test measured 12 h of nocturnal activity with full access to food and water. Bilateral destruction of the medial amygdala resulted in an increase of locomotor activity in the 30 min test and a decrease in locomotor activity in the 12 h test. Postoperative decrease in food and water intake and body weight were only transient. These results point to a participation of the medial amygdala in the complex mechanism of locomotor activity and alimentary motivation.

Amygdala↗
PubMed1991

A new complement fixation test for the diagnosis of neurocysticercosis in cerebrospinal fluid.

As a modification of the classical complement fixation test, a new test for immunodiagnosis in cerebrospinal fluid (CSF) was developed. When the assay was used for the diagnosis of neurocysticercosis in 149 CSF samples from patients and 1036 from controls, results showed 93% concordance with positives and 97% with negatives when compared with the results obtained by ELISA; in addition, it was positive in 12 of 16 cases of neurocysticercosis in which negative results had been obtained by ELISA. The new complement fixation test is particularly useful in CSF because of the immunological peculiarities of the subarachnoid space, where local synthesis of oligoclonal antibodies is induced by infectious agents. Reagents used for the assay are easy to produce and preserve, and the test is inexpensive, reliable and easy to perform. As this test detects the immunobiological consequence of the antigen-antibody reaction, it can be used in conjunction with other assays, such as ELISA, that measure the reaction directly, thus increasing the diagnostic possibilities. It may also be used where financial or technical limitations hinder access to other immunodiagnostic tests.

Animals↗
PubMed1989

Effects of cholesteryl esters on the accessibility of LH/hCG receptors and membrane lipid fluidity in rat testes.

Incubation of rat testicular membranes with cholesteryl hemisuccinate resulted in an increase in both membrane lipid microviscosity and 125I-labelled hCG specific binding. The purpose of this investigation was to establish which functional groups of cholesteryl hemisuccinate are important for the stimulatory effects. The data obtained showed that only esters of cholesterol with dicarboxylic acids, not those of monocarboxylic acids, increase the accessibility of LH/hCG receptors and membrane rigidity. Experiments with cholesteryl sulfates showed that there are polar groups on C3 carbon of cholesterol having no stimulatory effect on receptors, although an increase in membrane rigidity occurred. The side-chain of cholesterol is important for the stimulatory action. Androstenolone hemisuccinate was ineffective in this respect. On the other hand, partially modified side-chains (hemisuccinates of beta-sitosterol and stigmasterol) did not result in a marked reduction of the stimulatory action. The carboxyl group of cholesteryl hemisuccinate must be 'free': its esterification abolishes the stimulatory effect of cholesteryl hemisuccinate on both the LH/hCG receptor and membrane microviscosity. These results suggest that an intact carboxyl group of ester and the side-chain of cholesterol are indispensable for the stimulatory effect of cholesteryl hemisuccinate on the accessibility of LH/hCG receptors.

Animals↗
PubMed1980

The measurement of distortion: concluding remarks.

The means by which fine measurements can be made and distortions computed have been discussed in this series. However, the fact remains that research of this nature is time consuming and demanding. At every step, and in all machined components, care must be taken to eliminate local inaccuracies. Precalibration, postcalibration, and an ongoing program of maintenance are essential if quality results are to be anticipated. An attempt has been made to introduce automatic reading devices with the ability to compute distortions by having the raw data sent directly to a computer. This latter step can be highly dangerous unless at least one "test case" can be programmed into the system as a check on the data access and computational procedures. These test cases should simulate as closely as possible the actual computational requirements of the system, in order that all program "bugs" be corrected before the research is run. In this area, the GIGO rule, "Garbage in-Garbage out," holds true. Unfortunately, if the computational errors are small and of the order of magnitude of the measured distortions the researcher can accept the results without realizing there is a computational problem.

Chemical Phenomena↗
PubMed1993

From bench to bedside: research and testing of Internet resources and connections in community hospital libraries.

Access to information becomes more valuable with the continuing proliferation of medical knowledge and the increasing economic pressure being experienced by health care organizations. This is particularly so for community hospitals in rural or isolated areas, where the economic pressures are at least as great as in urban areas and where access to information is often inadequate. These conditions have implications for the quality of patient care and for economic viability. In response to this, the National Library of Medicine, the University of Washington, and seven community hospitals in five Pacific Northwest states have joined forces in a broad-scale technology diffusion project to facilitate the application of research work to clinical care. There are three components to the project: 1) a pilot connections component to extend Internet access to the community hospitals, 2) a research component to test the performance of a client/server model for network access to anatomical text and images, and 3) a clinical component to develop a registry of DNA diagnostic laboratories facilitating the provision of genetic information to clinicians. The pilot connections component is described and preliminary findings are reported.

Computer Communication Networks↗
PubMedDate not supplied

Development of a central matching system for the allocation of cadaveric kidneys: a simulation of clinical effectiveness versus equity.

OBJECTIVES: 1) To develop a computer-based simulation to prospectively study the impacts of explicitly incorporating different equity criteria into the process of allocating kidneys to recipients, given the scarcity of this resource. 2) To assess the tradeoffs between systems that allocate kidneys based only on medical criteria, systems that allocate kidneys based only on equity criteria, and systems that consider both medical and equity criteria. METHODS: A computer-based simulation was developed that describes the flows of patients and kidneys. This model provides information at various time points about the number of patients in the system who are awaiting transplants, the number of kidneys available for transplantation, the number of transplantations performed for each matching algorithm, and the number of kidneys discarded (when applicable), as well as the means and standard deviations of the HLA-match scores, number of days from registration to transplantation, and number of days (from registration) of those who are still waiting for transplants. Five different matching algorithms were compared, ranging from determination of the allocation by a single medical criterion (i.e, HLA match) to determination by a single equity criterion (i.e., relative position in the waiting queue). The remaining algorithms represent different strategies of weighting these two considerations. Estimates regarding the main parameters of the model were derived utilizing data collected through the Multiple Organ Retrieval and Exchange Programme of Ontario, Canada. RESULTS: The simulation was set to run for a period of ten years. A tradeoff between graft survival (or improved HLA matching) and equal treatment of patients regardless of their likelihood to benefit was found. It is clear that an algorithm that allocates kidneys based only on temporal location of patient on the waiting list is likely to be unacceptable because of the very poor average HLA-match scores that it yields. Pool size was found to be a major determinant in the attainment of optimal matching from a medical perspective. CONCLUSIONS: 1) The final choice about any allocation algorithm to be used requires that a value judgment be made, i.e., how great a reduction in HLA-match score should be traded in order to improve equity score (or vice versa). 2) A computer-based simulation model is a feasible way to prospectively test the impact of any given allocation algorithm on any given system.

Algorithms↗
PubMed1992

Cancer in south Louisiana. Part III: Cancers of the breast and the reproductive system.

Cancers of the breast and reproductive system are less common in South Louisiana than other parts of the nation. The only exception is invasive cervical cancer. Incidence rates for breast cancer in South Louisiana women are 20% lower than the SEER combined rates, and rates for cancer of the uterine corpus and the ovary among white women are 43% and 32% lower respectively than the SEER averages. South Louisiana men also have risks 14% (whites) and 30% (blacks) less than the national of developing prostatic cancer. These significantly low rates are observed for all regions in South Louisiana. The reasons for the low rates are not clearly understood. Possible explanations include: less frequent use of cancer screening tests, high prevalence of hysterectomy, lower risk exposures, and host/genetic factors. The low incidence rates for these cancers are not accompanied by more favorable mortality outcomes, suggesting a poorer survival among Louisiana cancer patients partially due to late stage disease at the time of diagnosis and treatment. Programs to increase the accessibility of cancer screening tests and improve early detection are greatly needed.

Breast Neoplasms↗
PubMed1990

Identification of seven surface-exposed Brucella outer membrane proteins by use of monoclonal antibodies: immunogold labeling for electron microscopy and enzyme-linked immunosorbent assay.

A panel of monoclonal antibodies (MAbs) to seven Brucella outer membrane proteins were characterized. These antibodies were obtained by immunizing mice with sodium dodecyl sulfate-insoluble (SDS-I) fractions, cell walls, or whole bacterial cells of Brucella abortus or B. melitensis. Enzyme-linked immunosorbent assays were used to screen the hybridoma supernatants and to determine their binding at the surface of rough and smooth B. abortus and B. melitensis cells. The outer membrane proteins (OMPs) recognized by these antibodies were the proteins with molecular masses of 25 to 27 kDa and 36 to 38 kDa (porin) (major proteins) and the proteins with molecular masses of 10, 16.5, 19, 31 to 34, and 89 kDa (minor proteins). Surface exposure of these OMPs was visualized by electron microscopy by using the MAbs and immunogold labeling. Binding of the MAbs on whole rough bacterial cells indicates that the 10-, 16.5-, 19-, 25- to 27-, 31- to 34-, 36- to 38-, and 89-kDa OMPs are exposed at the cell surface. However, enzyme-linked immunosorbent assay results indicate a much better binding of the anti-OMP MAbs on rough strains than on the corresponding smooth strains except for the anti-19-kDa MAb. Immunoelectron microscopy showed that on smooth B. abortus cells only the 89- and 31- to 34-kDa OMPs were not accessible to the MAbs tested. Binding of the anti-31- to 34-kDa MAb at the cell surface was observed for the rough B. abortus cells and for the rough and smooth B. melitensis cells. These results indicate the importance of steric hindrance due to the presence of the long lipopolysaccharide O side chains in the accessibility of OMPs on smooth Brucella strains and should be considered when undertaking vaccine development.

Animals↗
PubMedDate not supplied

Merkel cell carcinoma of the ear.

All the consultants agree that, given this patient's history, a common skin tumor like squamous cell or basal cell carcinoma is unlikely. Melanoma or Merkel cell carcinoma belong in the differential. Interestingly, the consultants all suggest a biopsy of the lesion prior to other testing, and because this tumor is so accessible, a biopsy should not interfere with further testing or treatment. Drs. Weymuller and Marks would then proceed with a CT scan; Dr. Ridge favors an MRI scan. While a chest-ray is in order to rule out metastases, Dr. Weymuller also suggests immunocytochemistry. All the experts agree that the primary tumor should be excised. Dr. Weymuller would perform a total parotidectomy with facial nerve preservation, while Drs. Marks and Ridge suggest a superficial parotidectomy with facial nerve preservation. Drs. Weymuller and Ridge would also perform a modified radical neck dissection. In the absence of cervical disease, Dr. Marks would treat the neck primarily with radiotherapy. Only Dr. Weymuller favors immediate reconstruction and would use a lower trapezius island flap or a large rotational flap. Drs. Marks and Ridge prefer primary closure or skin graft. Drs. Weymuller and Ridge would treat this patient with combined therapy, giving radiotherapy to the primary area and the neck postoperatively at a dose of 55-60 Gy. However, Dr. Marks would treat the primary site postoperatively and the neck primarily with radiotherapy. He would treat the primary site with 59.40 Gy and the neck with 50.40 Gy.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1985

The centralization of operations and access to treatment: total hip replacement in Manitoba.

The impact of centralized facilities on access to care was tested by studying total hip arthroplasty in the Province of Manitoba, Canada. Data from the Manitoba Health Services Commission, which insures costs of all medical services in the Province, show that the availability of this surgical procedure has increased steadily over the 1973-78 period at a rate similar to that elsewhere in North America. Although Manitoba's population is geographically dispersed, specialized orthopedic services are concentrated in two urban centers. No important difference in access to care for this condition was found between urban center residents and residents distant from the surgical facilities.

Adult↗
PubMed1994

A novel bombesin receptor antagonist selectively blocks the satiety action of peripherally administered bombesin.

To investigate the effect of a new, specific antagonist for bombesin receptors on the satiating action of exogenous bombesin, adult male rats were adapted to a nondeprivation test regimen with daily access to a palatable liquid food. In a prefeeding paradigm, rats received intraperitoneal injections of the bombesin receptor antagonist, BW2258U89 (6.25, 25, 50, or 100 micrograms kg-1) or vehicle 20 min before, and then a second injection of either bombesin (4 micrograms kg-1), gastrin-releasing peptide (GRP; 16 micrograms kg-1), the C-terminal octapeptide of cholecystokinin (CCK-8; 4 micrograms kg-1), or vehicle 5 min before a 2-h feeding test. BW2258U89 pretreatment antagonized the satiating actions of bombesin and GRP18-27 in a very potent, dose-related manner, but did not antagonize the satiating action of CCK-8. These differential results with BW2258U89 are consistent with prior results showing the potency of this antagonist for bombesin receptor-mediated effects in visceral systems; in addition, they demonstrate the selectivity of the compound for the satiating actions of peripherally administered bombesin and bombesin-like peptides.

Animals↗
PubMedDate not supplied

[Effectiveness (accessibility and compliance) of a program of early diagnosis of pulmonary tuberculosis in a penitentiary population].

The aim of the study was to determine the effectiveness of a pulmonary tuberculosis detection Program in a Spanish prison (280-320 inmates) with a high turn-over rate (500 entries annually). 754 prisoners without antituberculous chemotherapic or chemoprophylaxis were included. 642 (85.1%) had access to the Program; the highest percentage of access was obtained when tuberculin test was performed at the entrance (96.4%) versus 80.5% when it was differed (P < 0.000001). The compliance observed was 82.2%, with no evidence that a greater accessibility was influential al all. The effectiveness was 70%, greater when tuberculin test was performed at the entrance in prison (76.7%) versus 66.8% when it was differed (P < 0.000001). We conclude that since pulmonary tuberculosis rates in prisons are so high and since it is possible to obtain a high effectiveness in detection programs, if were generalize these programs in concurrence with an adequate treatment of tuberculosis cases we shall obtain high efficiency rates.

Adolescent↗
PubMed1994

Electronic verification of donor-recipient compatibility: the computer crossmatch.

BACKGROUND: This article describes standard operating procedures (SOPs) for a computer crossmatch to replace the immediate-spin crossmatch for ABO incompatibility between patient blood samples submitted for pretransfusion testing and the blood component selected for transfusion. These SOPs were developed following recent changes to the Standards for Blood Banks and Transfusion Services of the American Association of Blood Banks (AABB). STUDY DESIGN AND METHODS: SOPs were developed, utilizing currently available software, for pretransfusion testing. The SOP for donor unit processing entails bar code entry of the unit number, component name, and ABO/Rh type; computer entry and interpretation of serologic reactions; warning of discrepancies between bar code-entered blood type and result interpretation; and quarantine of the donor unit in such instances. The SOP for patient sample testing requires bar code entry of specimen accession number, which accesses patient demographics; computer entry and interpretation of ABO/Rh tests; repeat blood typing at the time of crossmatch if only one patient blood type is on record; and warning if there are nonconcordant current and historical blood types. The computer crossmatch SOP requires bar code entry of specimen accession and donor unit numbers; release of group O red cells pending resolution of discrepancies; and immediate-spin crossmatch during computer downtime. Tables validated on-site prompt warning messages and prevent both computer crossmatch and release if blood components of the wrong ABO type are selected. RESULTS: These SOPs meet the requirements of the 15th edition of the AABB Standards. Projected annual time savings at this institution are > 100,000 workload recording units. Further benefits include reduced patient sample volume requirements, less handling of biohazardous material, and elimination of unwanted positive or negative reactions associated with the immediate-spin crossmatch. Release of incompatible blood components when the wrong patient blood type is on record is addressed by requiring the use of group O red cells in the absence of two concordant blood types, one of which must be from a current sample. CONCLUSION: A combination of existing computer programs and carefully developed SOPs can provide a safe and efficient means of detecting donor-recipient incompatibility without performance of serologic crossmatch.

ABO Blood-Group System↗
PubMed1987

Implications of memory and language dysfunction in the naming deficit of senile dementia.

Young normals, elderly normals, and patients with either mild-to-moderate or severe senile dementia of the Alzheimer type (SDAT) were administered several tests of language function and remote memory. On all of the language tests examined, elderly normals exhibited a mild, nonsignificant performance decrement relative to the young normals. Advanced SDAT patients were markedly impaired on all of the tests. Early dementia patients were most impaired, relative to aged normals, on tests of object naming, category instance fluency, and remote memory. The deficit was smaller on the WAIS vocabulary subtest, on selecting the name of a visually presented object, and on recalling the function of an object. Early SDAT patients were least impaired in selecting the picture of an object after its name had been provided and in selecting objects that belong to a specified functional category. The results are consistent with the notion that the language dysfunction in early SDAT is due to a deficit in semantic memory function in which general, categorical information remains available whereas information about specific attributes becomes less accessible. The object naming test might be useful in the assessment of treatment effects upon SDAT because of its sensitivity and specificity to dementia, its high face validity, and its independence of recent memory.

Aged↗
PubMed1990

Efficacy of behavioral management and patient education on vascular access cleansing compliance in hemodialysis patients.

Compared four treatment conditions to test their ability to enhance compliance with vascular access cleansing (VAC) procedures in a group of 56 hemodialysis patients. The conditions were patient education, behavioral management with monetary incentive, patient education/behavioral management, and attention control. Behavioral observers rated VAC behavior at pretreatment, posttreatment 1-month follow-up, and 1-year follow-up. Knowledge of VAC procedures was also assessed via a questionnaire at pretreatment and posttreatment. Data were analyzed using repeated-measures multivariate analyses of variance. Results indicated that the patients in the education/behavioral, behavioral, and education groups gave significantly more correct answers on our VAC knowledge questionnaires at posttreatment than did patients in the attention control group. Further, patients in the education/behavioral and behavioral groups completed significantly more VAC steps at posttreatment and 1-month follow-up than did patients in the education group and in the attention control group. Differences were not maintained at 1-year follow-up, although more than 50% of the patients were lost to follow-up. Implications of the present findings for behavioral and educational interventions are discussed.

Adult↗