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PubMed2003

Documented allergies of patients with cancer.

The purpose of this study was to determine and quantify the types of allergies that occur in patients with cancer. The study sample consisted of computer-generated pharmacy records of 4510 inpatients from two oncology inpatient units over a 1-year period from a large urban hospital in the USA. Compliance with computer entry was monitored in order to ensure data accuracy. Results of the study indicate that the percentages of stated allergies for persons with cancer might be higher than those for overall populations. The top four medication allergies were penicillin, sulpha, codeine and contrast media. The top four food allergies were milk, eggs, chocolate and strawberries and the top four environmental allergies were bee stings, chemical sprays, dust and mould.

Drug Hypersensitivity↗

PubMed2002

Is fast mapping good mapping? A review of the benefits of high-speed orientation mapping using electron backscatter diffraction.

Orientation mapping using automated electron backscatter diffraction (EBSD) is now a common technique for characterizing microstructures. Improvements in software and hardware have resulted in high-speed mapping capabilities above 80,000 points h(-1). For 'routine' microstructural analyses of materials such as steel and aluminium (e.g. texture and grain size measurements and high angle boundary characterization), high-speed orientation mapping is an ideal approach with minimal penalty on the final statistics. However, for the accurate analysis of very low angle boundaries and for routine analyses of more difficult materials (e.g. most rock samples), we advocate a more patient approach to orientation mapping with an emphasis on data accuracy and reliability. It is important that the objectives of any EBSD analysis are carefully considered before starting--in this way the maximum potential of an EBSD system can be achieved.

Journal Article↗

PubMed2001

Validation of a stable isotope gastric emptying test for normal, accelerated or delayed gastric emptying.

To validate a 13C-Spirulina platensis breath test for measurement of accelerated or delayed gastric emptying, we measured gastric emptying of egg containing 13C-S. platensis and 99mTc-sulphur colloid by breath 13 CO2 every 15 min over 3 h and scintigraphy every 15-30 min over 5 h in 57 healthy volunteers. Thirty-three received no treatment, 10 received erythromycin, and 14 atropine. A generalized linear regression model predicted half-emptying time by scintigraphy (t1/2S) from breath 13CO2 (t1/2B) data. Accuracy was assessed by standard deviation (SD) of differences between t1/2S and t1/2B and by receiver operating characteristic (ROC) curves. Regression models using breath samples at baseline, and 45, 90, 105 and 120 min, predicted t1/2B (mean +/- SD) at 118 +/- 59 min, similar to t1/2S (118 +/- 67 min). Correlation between t1/2B and t1/2S was significant (r=0.88; P < 0.0001). Differences between t1/2S and t1/2B were: 18-19.2 min for t1/2 < 70-150 min, and 68.3 min for t1/2 > 150 min. Breath test detected abnormal emptying with a sensitivity of 86% and specificity of 80%. Thus, the 13C-S. platensis test measures gastric emptying t1/2 for solids, which is accelerated or delayed to mimic a range of conditions from dumping syndrome to severe gastroparesis, with high sensitivity and specificity. Additional breath samples are needed to increase sensitivity in detecting accelerated gastric emptying.

Adolescent↗

PubMed2001

Data analysis for the National Cardiac Surgery Database.

The planned Australian National Cardiac Surgery Database is likely to have a number of positive outcomes, including increased patient satisfaction, improved quality assurance and increased economic efficiency. In relation to cardiac surgery, performance indicators associated with the commonly performed procedure of coronary artery bypass surgery will be used for peer review and to measure outcomes. Several different risk-adjusted models are available for analysing national databases. However, the potential weaknesses of database analysis are lack of both compliance and data validity. A number of other major issues, such as location of the data analysis centre, who will hold authority over data accuracy, and the security of and access to the Database, must also be considered when setting up the National Database. Overall, however, the benefits of a national database will be enormous. Cardiologists and cardiac surgeons will benefit from a disease-based registry with shared common definitions. In addition, the provision of such a database will represent a crucial step towards developing national strategies for treating heart disease.

Journal Article↗

PubMed1997

Management of Information in Radiation Oncology: An Integrated System for Scheduling, Treatment, Billing, and Verification.

An effective information system is an essential prerequisite to delivering quality patient care at competitive costs. From scheduling and billing to complex treatment machine control and verification, the quality of the information system strongly affects the efficiency and accuracy with which patient care is delivered. The standard paper-based information system used in many clinics suffers form inefficiencies and incompleteness in scheduling and billing, no centralized database and the inability to generate routine reports and communicate with other information systems. Many of these problems are resolved by the introduction of an electronic information system. The implementation, gains, and limitations of two electronic information systems are discussed. While limitations such as the lack of complete seamless integration of all information still exist, major improvements have been made in efficiency, accuracy, data integrity, and reporting and billing completeness.

Journal Article↗

PubMed2004

Analytical second-order geometrical derivatives of energy for the self-consistent-charge density-functional tight-binding method.

Analytical formulation of the second-order geometrical derivatives of energy for the self-consistent-charge density-functional tight-binding (SCC-DFTB) method is presented. To test its quality and numerical performance, the derived formalism has been coded and applied for calculation of harmonic vibrational frequencies for a set of 17 small and medium size molecules. For this set, the average absolute deviation from experiment is 99 cm(-1) for SCC-DFTB vs 62 cm(-1) for the Møller-Plesset second-order perturbation theory with the cc-pVDZ basis set (MP2/cc-pVDZ) and 32 cm(-1) for the B3LYP density functional method with the same basis set (B3LYP/cc-pVDZ), while the maximal deviation is 465 cm(-1) vs 1,741 cm(-1) for MP2/cc-pVDZ and 112 cm(-1) for B3LYP/cc-pVDZ. The SCC-DFTB results are in reasonable agreement with experiments as well as with ab initio and density-functional results, and are better than other semiempirical methods. The SCC-DFTB method allows for considerable computational time saving when compared to other methods while retaining similar overall accuracy. Data for a series of conjugated polyenes show that an analytical formulation of SCC-DFTB is noticeably faster than its numerical formulation.

Journal Article↗

PubMed2003

Perception and priming of affective faces in temporal lobectomy patients.

Eighteen patients who had undergone standard anterior temporal lobectomy including removal of the amygdala and hippocampus (9 left, LTL; 9 right, RTL) were administered an Affective Task composed of faces depicting negative emotions, and a Neutral Task consisting of faces with different lighting and orientation conditions. Both tasks required judgment of poser identity and indication of decision by pressing a reaction time button. Subjects were shown a set of photos in an Exposure Phase, followed by a Test Phase in which the photos previously seen (primed) were mixed with new photos (unprimed). The LTL subjects performed better than the RTL subjects for both the RT and accuracy data in both the Neutral and Affective Tasks. The performance of the LTL subjects improved when the task had an affective component (Affective vs. Neutral Task), whereas the RTL subjects did not show this benefit. In terms of specific emotions, for the LTL group, pain was responded to most slowly and shock was the emotion responded to most quickly, and significantly more quickly than in the RTL group. Fear was the emotion responded to most slowly by the RTL group and significantly more slowly when compared to the LTL group. The only priming effect was a reverse priming for pain, such that stimuli seen before were respondedto less accurately than new stimuli; this was not related to lesion side.

Adult↗

PubMed1998

Passage through the rumen and the large intestine of sheep estimated from faecal marker excretion curves and slaughter trials.

External digesta markers (Yb-labelled diets and Co-EDTA) were given orally as a pulse dose to four pairs of Rasa Aragonesa twin ewe lambs, fed on either chopped or ground and pelleted lucerne hay, in order to estimate slow (k1) and fast (k2) rates of passage of liquid and solid phase from faecal marker excretion curves. After the faecal sampling period daily doses of the same markers were infused continuously for 5 d and the animals slaughtered. Concentrations of markers in the different compartments of the gut were determined and used to calculate mean retention times. The results showed that the rumen and the large intestine were the two main mixing compartments of the gut, accounting for more than 95% of total mean retention time. Rates of passage estimated from faecal marker excretion did not accurately represent marker kinetics in the compartments of the gut derived from slaughter data. Accuracy in the estimation of fractional outflow rate from rumen (kR) by k1 was higher for low values of kR whereas k2 consistently overestimated large intestine outflow rate (kLI), especially for high values of kR. The relationship between outflow rates from the main two mixing compartments was important in influencing the accuracy of prediction of faecal estimates.

Analysis of Variance↗

PubMed1978

Sampling for organic chemicals in workplace atmospheres with porous polymer beads.

Porous polymer bead collection columns are frequently used in air pollution measurements. They are also useful for industrial hygiene applications when used with miniature personal pumps. Analytical procedures using this type of collection column are described which use thermal desorption for sample recovery followed by GC or GC/MS analysis. A means is shown to modify a gas chromatograph for this type of analysis. A technique which permits splitting of the collected sample is also described. Precision and accuracy data for recovery of nineteen chemicals are presented. Advantages of porous polymer bead procedures include high sensitivity (the total collected sample is analyzed), ease of sample handling and ability to analyze polar materials not recoverable from charcoal.

Adsorption↗

PubMed1982

A rapid and precise system for lead determination in whole blood.

The paper describes a heated furnace atomic absorption method for determining lead in whole blood using an automated sample introduction system. It is direct and rapid. No sample pretreatment is required and up to 30 samples per hour can be analyzed. Precision and accuracy data are presented. The system has been applied to both macro (venipuncture) and micro (capillary) samples. The method uses physiologically-bound lead standards to compensate for matrix effects. It has been used in the screening of target populations and for confirming elevated blood lead levels in the California Department of Health Services Childhood Lead Program.

Blood Viscosity↗

PubMedDate not supplied

Age, target-distractor similarity, and visual search.

Younger and older adults were asked to find a single target in both feature- and conjunction- search conditions. Display size varied between 2 and 8 items, and target-distractor similarity ranged from relatively low to high levels. The accuracy data indicated that older adults had particular difficulty finding targets in high-similarity conjunction-search displays containing a large number of distractors. The reaction time (RT) analyses found larger age deficits in many of these same conditions. For both groups, predictions of conjunction search based on Treisman and Sato's additive model (Journal of Experimental Psychology: Human Perception and Performance, 1990: 16, 459-478) departed significantly from actual performance. The RT data of older observers were, in large part, predicted as a simple linear function of the young adults' data. These results are discussed with respect to age differences in selective attention, generalized slowing, and an age-related loss in search efficiency.

Adolescent↗

PubMed1982

Workplace air sampling and polarographic determination of formaldehyde.

A polarographic method has been developed for the determination of formaldehyde in workplace air. Samples are collected in midget fritted glass bubblers containing an aqueous solution of 10% methanol. The collected formaldehyde in the absorbent solution is derivatized with hydrazine reagent to form a formaldehyde hydrazone compound. An aliquot of the resulting solution is analyzed by differential pulse polarography at a dropping mercury electrode. The sample generation system, impinger collection, polarographic analysis, and precision and accuracy data are described. The method was validated over the range of 5.8 to 17.7 mg/cu m, which corresponds to 0.5 to 2 times the (peak) OSHA-PEL for a 30-liter sample at a flow rate of 1 Lpm. The average recovery was 103%. The pooled coefficient of variation or relative standard deviation was 0.08.

Air Pollutants↗

PubMed2006

Integration of information technology, wireless networks, and personal digital assistants for triage and casualty.

The purpose of this study was to evaluate a portable tool for use by first responders in documenting triage of victims in a mass casualty incident (MCI) more effectively. The tool presented in this study allows first responders to gather patients vital signs, injuries, and triage status in a prompt and accurate way, and enables first responders to wirelessly communicate vital health information throughout the entire care continuum. The architecture infrastructure for the portable device is called Triage and Casualty Informatics Technology (TACIT) and can expedite triage, transport and treatment procedures within an MCI. TACIT was developed by integrating handheld devices, wireless networks, global positioning system (GPS), digital cameras, and bar code scanners with customized triage software. Two MCI initial field trials verified that the TACIT software, battery life, data accuracy, and wireless transmission met the emergency response system requirements. Initial field trials also demonstrated robustness of operation, reduced triage collection time and improved collection accuracy. The TACIT system could work as an efficient prehospital response tool and platform.

Computers, Handheld↗

PubMed1991

The diagnostic accuracy of rapid dipstick tests to predict urinary tract infection.

This study summarizes the diagnostic accuracy data for dipstick nitrite and/or leukocyte esterase tests (the index tests) as predictors of bacterial urinary tract infection as defined by quantitative culture (the reference test). On-line search of the literature using the MEDLARS database identified 1,017 citations, 51 of which were relevant and contained sufficient data for further analysis. From each citation, 2 x 2 tables of true-positive, true-negative, false-positive, and false-negative results were extracted. Four categories of index test were assessed: nitrite only, leukocyte esterase only, disjunctive pairing (dipstick positive if nitrite, leukocyte esterase, or both were positive), and conjunctive pairing (dipstick positive only if both nitrite and leukocyte esterase were positive). The true- and false-positive rates were calculated from each 2 x 2 table. Plots of true-positive rates versus false-positive rates demonstrated widely scattered points, indicating heterogeneity. A receiver-operating characteristic curve was fitted to the data using logistic transforms and weighted linear regression. This analysis revealed that the disjunctive pair is the most accurate index test. However, in many clinical settings, the posterior probability of urinary tract infection given a negative dipstick is too high to exclude it. Within most clinically relevant ranges of true- and false-positive rates, a negative urine dipstick test cannot exclude the diagnosis of urinary tract infection in patients with high prior probabilities of contracting this infection. For lower prior probabilities, the clinical efficacy of these rapid tests would best be determined by decision analysis, for which these receiver-operating characteristic functions would serve as valuable analytical tools.

Diagnostic Tests, Routine↗

PubMed1999

Clinical research: ASHP guidelines and future directions for pharmacists.

ASHP guidelines on the pharmacist's role in clinical drug research and future directions for pharmacists in clinical drug research are described. Health-system pharmacists have a responsibility to the patient and to the institution to ensure that clinical research systems are sound, that patients are protected, and that research is conducted in a safe, effective way. ASHP guidelines list minimum standards that are essential for improving performance. The ASHP Guidelines on Clinical Drug Research, approved in November 1997, update information previously found in the ASHP Guidelines for the Use of Investigational Drugs in Organized Health-Care Settings, approved in 1990, but have an expanded focus. Additions include recognition of relevant business practices, implications of technology, and the expansion of clinical research beyond the academic health center. At a minimum, all pharmacists involved in clinical research should handle the record keeping for drug accountability, provide drug information to patients and to other health care providers, ensure the appropriate care of patients at sites not involved in the study, and provide accountability at nonpharmacy locations. Managing and coordinating clinical drug research is an area of growth that represents a great opportunity for clinical drug research. By providing baseline and higher-level pharmaceutical services for clinical research projects, pharmacists can help to ensure data accuracy and completeness and patient safety.

Guidelines as Topic↗

PubMedDate not supplied

Quantitation of phencyclidine in serum by enzyme immunoassay: results in 405 patients.

Phencyclidine (PCP) in serum (5 ng/mL and higher) was quantitated by a homogeneous enzyme immunoassay procedure. Precision and accuracy data indicate that the procedure meets the requirements for a clinical assay. The short turnaround time for the assay makes it superior to other available methods for the emergency determination of PCP in serum. The analytical results were comparable to those by GC/MS on 70 samples tested. The serum concentration of PCP was determined in 500 specimens from 405 patients. In 216 patients with "pure" PCP intoxication, the serum concentration did not show a direct relationship to either the clinical pattern of intoxication or to the history of the route of PCP use.

Adolescent↗

PubMed2001

Online personal medical records: are they reliable for acute/critical care?

OBJECTIVE: To provide an introduction to Internet-based Online Personal Medical Records (OPMRs), to assess their use and limitations in acute/critical care situations, and to identify potential improvements that could increase their usefulness. DESIGN: A review of publicly available Internet-based OPMRs conducted in April 2001. DATA SOURCES: Twenty-nine OPMR sites were identified in March 2000 using ten Internet search engines with the search term "Personal Medical Records." Through 2000 and 2001, an additional 37 sites were identified using lists obtained from trade journals and through the author's participation in standards-setting meetings. MEASUREMENTS: Each publicly available site was reviewed to assess suitability for acute/critical care situations using four measures developed by the author and for general use using eight measures developed in a standards-setting process described in the article. RESULTS: Of the 66 companies identified, only 16 still offer OPMRs that are available to the public on the Internet. None of these met all of the evaluation measures. Only 19% had rapid emergency access capabilities and only 63% provided medical summaries of the record. Security and confidentiality issues were well addressed in 94% of sites. Data portability was virtually nonexistent because all OPMRs lacked the ability to exchange data electronically with other OPMRs, and only two OPMRs permitted data transfer from physician electronic medical records. Controls over data accuracy were poor: 81% of sites allowed entry of dates for medical treatment before the patient's date of birth, and one site actually gave incorrect medical advice. OPMRs were periodically inaccessible because of programming deficiencies. Finally, approximately 40 sites ceased providing OPMRs in the past year, with the probable loss of patient information. CONCLUSIONS: Most OPMRs are not ready for use in acute/critical care situations. Many are just electronic versions of the paper-based health record notebooks that patients have used for years. They have, however, great promise and, with further development, could form the basis of a new medical record system that could contribute to improving the quality of medical care.

Confidentiality↗

PubMedDate not supplied

Linearizing the thermistory: a reminder that the thermistor can be tamed.

The thermistor, a preferred temperature transducer, has a non-linear resistance vs. temperature characteristic. However, the non-linear characteristic of the Wheatstone bridge circuit in which thermistors are usually used can compensate for this, so that, over a selected range, quite accurate linear voltage outputs may be obtained. A selected set of bridge resistor and excitation voltage values are presented together with accuracy data. Comments concerning the application of these circuits include safety considerations.

Electricity↗