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PubMed1995

[The progress in radiopharmaceuticals in Japan--In connection with the 100-year anniversary after Prof. Röntgen discovered X-ray in 1895].

This year is the 100-year anniversary after Prof. W.K. Röntgen discovered X-rays in 1895. In connection with this point, I studied the history of radiopharmaceuticals (RP) in Japan. In 1937, the first cyclotoron was established by Dr. Yoshio Nishina in Tokyo and researches for radioisotope (RI) were started in the medical field in Japan. After the Second World War, RI research in the medical field started again using imported RI from U.S.A. in 1950. The National Institute of Radiological Sciences was established by the Japanese Government in Chiba-city in 1957 and the RP law was enacted by the Ministry of Health and Welfare of Japan. Twenty-five nuclear elements were regulated as RP by the Pharmaceutical Law in 1959. Five RP products were included for the first time in the Japanese Pharmacopoeia (JP), 7th Edition, in 1961. The Japan Radioisotope Association (JRIA) was established in 1951 for the purpose of importing and distributing RI, technical training for safety operation, collecting the RI wastes and so on. The JRIA is playing an important role in the progress of RP. Now, RP were separated officially for in vivo use and in vitro use in Japan.

History, 20th Century↗
PubMed2001

Patient and practitioner characteristics predict brief alcohol intervention in primary care.

BACKGROUND: The effectiveness of an evidence-based health care intervention depends on it being delivered consistently to appropriate patients. Brief alcohol intervention is known to be effective at reducing excessive drinking and its concomitant health and social problems. However, a recent implementation trial reported partial delivery of brief alcohol intervention by general practitioners (GPs) which is likely to have reduced its impact. AIM: To investigate patient-practitioner characteristics influencing brief alcohol intervention in primary care. DESIGN OF STUDY: Cross-sectional analysis of 12,814 completed Alcohol Use Disorders Identification Test (AUDIT) screening questionnaires. SETTING: Eighty-four GPs who had implemented a brief alcohol intervention programme in a previous trial based in the Northeast of England. METHOD: GPs were requested to screen all adults (aged over 16 years) presenting to their surgery and follow a structured protocol to give a brief intervention (five minutes of advice plus an information booklet) to all 'risk' drinkers. Anonymized carbon copies of the screening questionnaire were collected from all practices after a three-month implementation period. RESULTS: Although AUDIT identified 4080 'risk' drinkers, only 2043 (50%) received brief intervention. Risk drinkers that were most likely to receive brief intervention were males (58%), unemployed (61%), and technically-trained patients (55%). Risk drinkers that were least likely to receive brief intervention were females (44%), students (38%), and university educated patients (46%). Logistic regression modelling showed that patients' risk status was the most influential predictor of brief intervention. Also, GPs' experience of relevant training and longer average practice consultations predicted brief intervention. However, personal characteristics relating to patients and GPs also predicted brief intervention in routine practice. CONCLUSION: Interpersonal factors relating to patients and practitioners contributed to the selective provision of brief alcohol intervention in primary care. Ways should be found to remedy this situation or the impact of this evidence-based intervention may be reduced when implemented in routine practice.

Adolescent↗
PubMed2001

[An epidemiological study on pesticide poisoning with mixed preparation].

OBJECTIVE: To investigate the incidence of pesticide poisoning with mixed preparation and risk factors contributing to it. METHODS: Twenty-five administrative villages were studied in three townships of Jiangsu and Shandong Provinces with cluster sampling. The sampled villages were divided into study group (12 villages) and control group (13 villages) with approximately equal number of people each. Pesticide sprayers in the study group applied mixed preparation containing organophosphorous and dimethrin and those in the control group applied single organophosphorous preparation. All the sprayers in sampled villages were interviewed with a same questionnaire about their situation of pesticide spraying during the observation period. Cases of pesticide poisoning were ascertained by seniors physicians in occupational diseases after group discussion. RESULTS: Incidence of pesticide poisoning was higher in 2 179 sprayers of the study group (10.10 %) than that in 2 615 of the control group (2.29%), with a highly statistically difference (chi(2) = 12.46, P < 0.01) and an risk ratio (RR) of 4.45 (95% CI = 1.94 approximately 10.05) adjusted for other risk factors by logistic regression. Other risk factors for pesticide poisoning with mixed preparation were smoking or taking food during spraying, leaking or breakdown of sprayers, without washing their whole body as soon as possible after spraying, poor personal protection, spraying for a long time, spraying by women and spraying pesticide on cotton. CONCLUSIONS: If toxicity of mixed preparation of single pesticide showed a synergistic or additional effect, risk of poisoning by spraying mixed preparation increased. Health education and technical training should be strengthened for pesticide sprayers.

Adult↗
PubMed2002

[Health inequalities: self-reported complaints and their predictors in pupils from Belgium].

BACKGROUND: This paper identifies socioeconomic and sociodemographic predictors of respiratory/allergic health problems and subjective complaints in adolescents in Belgium. METHODS: A cross-sectional analysis of the 1998 cross-national study "Health Behaviour of School aged Children" (HBSC) in French-speaking Belgium was undertaken. The survey was based on a self-completed questionnaire concerning various aspects of physical, emotional and social health. The five health problems (asthma, any other respiratory difficulty, allergy, poor subjective health, overweight and depressed feeling) were considered present when a positive reply was given to close-end questions stating if the pupils suffered, or have suffered from these problems during the last six months. We analysed a representative sample of 12,012 pupils aged 11 to 19 years in fifth and sixth grades of primary school, and in all six grades of secondary school. RESULTS: socioeconomics gradients were found for subjective ill health, depressed state and overweight (p<0.01). Depressed state and overweight were linearly associated with a family economic score. Respiratory difficulties and allergies were observed mainly in pupils in technical training. CONCLUSION: Pupils with a lower economic score have a higher prevalence of subjective complaints. It remains important to define determinants of subjective ill health and moreover, to act upon these results by increasing accessibility to health services when necessary, by adapting some others to young people and by tailoring interventions to objective and self-perceived needs.

Adolescent↗
PubMed2003

[Perspectives on the standardization of surgical treatment for gastric cancer].

To obtain better outcomes of surgical treatment for gastric cancer, standardization of three major aspects, indications for treatment, surgical technique, and evaluation of the results are required. The practice guidelines for gastric cancer treatment postulated by the Japanese Gastric Cancer Association in 2001 provide optimal indications for treatment, but do not comment on the level of surgical technique and method to evaluate the results. Technical training has been performed in the traditional fashion based on apprenticeship in Japan, and there is no standardized evaluation system of the level of technique. Therefore guarantees of the level of surgical technique should be offered by medical societies and/or authorized associations. Surgical education using simulation system is a promising tool for standardization of the level of surgical technique. In the evaluation of the results of gastrectomy, the survival rate has been widely accepted as an objective evaluation. On the other hand, due to recent advances in the surgical treatment of gastric cancer and the increasing number of cases of early gastric cancer, attention has been paid not only to the survival rate but also to the quality of life(QOL) after gastrectomy. However, the general rules for evaluation of QOL have not been established. The standardization of surgical treatment of gastric cancer based on the estimation of these three aspects may offer a better prognosis and better QOL after gastrectomy.

Gastrectomy↗
PubMedDate not supplied

[Regionalization in health: an instrument for jurisdictional planning].

This study carried out the regionalization of Sanitary Jurisdiction No. III seated in Cuautla, Morelos, consisting of 16 of a total of 33 municipalities in the state of Morelos. This regionalization was carried out through the delination of areas sharing similar socioeconomical and demographic characteristics (SED). Subsequently, the major health hazards and the intraregional distribution of human health resources (physicians and nurses) and infrastructure services (institutional health centers) were identified for each region. The aim of this work was to devise an instrument for a better understanding of and approach to health problems at a juridictional level and to pave the way for health planning that would be congruent with regional characteristics and needs. Health sector efforts would be directed towards the promotion of preventive health care with greater efficiency and equity. In order to regionalize the jurisdiction, 17 SED indicators were studied in each of the 16 municipalities. Analysis was performed using the Principal Components Method (MCP) and an epidemiologic score. As a result, the sanitary jurisdiction was divided into three regions: Region I, with the best SED conditions, Region II, with moderate SED conditions and Region III with the lowest SED conditions. The results of this study show that there is an inverse relationship between the intraregional distribution of health resources with respect to the delineated regions and the health resources with respect to the delineated regions and the health needs and problems found in each one. Region III showed the worst SED conditions and the highest incidence of disease. It proved to be the region which had the greatest lack of material and human health resources, the latter having the lowest technical training level in all of the jurisdiction. In contrast. Region I had the best SED conditions and the lowest incidence of disease. It also had the highest number of material and human health resources, the latter having a high level of preparation. This situation is opposite to the national health policies in regards to equity "...give more benefits to the more vulnerable groups..."

Catchment Area, Health↗
PubMedDate not supplied

[Basic measures for prevention of the epidemiological consequences of a natural disaster in the North Caucasus in 2002].

The system of organizational and prophylactic measures, carried out with a view to prevent epidemiological aggravations in connection with the natural calamity in the Southern Federal District of the Russian Federation in 2003, is described. Proposals on the improvement of the system of preventive measures, including the monitoring of the epidemiological, sanitary and hygienic situation, personnel training, technical provision, the cooperation of different services and departments, capable of ensuring the liquidation of the consequences of emergency situations of the natural character, are made.

Communicable Disease Control↗
PubMed2004

The oxygen concentrator: an appropriate technology for treating hypoxaemic children in developing countries.

The World Health Organization (WHO) recommends supplying oxygen in developing countries by concentrators because cylinders pose considerable logistic and financial problems. This technology was employed to treat children in a hospital in Ndioum, Senegal, who met the WHO oxygenation criteria. There were clear clinical and financial benefits, but neither the nurses' knowledge of the various techniques of oxygen supply nor the maintenance service were satisfactory. The use of concentrators should be encouraged in developing countries. A strategy including technical training, maintenance and monitoring should be adopted. Corrective actions were undertaken in Ndioum, and several concentrators are now being used on a regular basis.

Child, Preschool↗
PubMed2005

[The survey on radiofrequency catheter ablation in Chinese military hospitals].

OBJECTIVE: To analyze the cumulative data of radiofrequency catheter ablation (RFCA) in the treatment of tachyarrhythmias in Chinese military hospitals. METHODS: Chinese PLA Cardiology Association sponsored the registration and statistical analysis. RFCA results were registered from January 1, 1993 to December 30, 2000 and from January 1, 2001 to December 30, 2003 respectively. RESULTS: (1) A total of 14 599 patients from 42 hospitals underwent RFCA, RFCA was successful in 14 092 of 14 599 (success rate 96.5%) with a complication rate 0.5% (72/14599) and recurrence rate 2.8% (400/14 599). (2) The number of patients with accessory pathway (AVRT) and AV nodal reentrant tachycardia (AVNRT) were 8344 and 4822 respectively. (3) High success rate was maintained in AVNRT and AVRT ablation, success rate was significantly improved in the treatment of PVCs. Atrial fibrillation and non-idiopathic ventricular tachycardia ablation presented high recurrence rate with 27% and 21.3% respectively. The total number of complication was 72 cases, in which complete AV block and cardiac tamponade accounted for 31.9% (23/72) and 26.4% (19/72) respectively. CONCLUSION: RFCA for the treatment of tachyarrhythmias was rapidly developed in Chinese military hospitals. Improving the level of technical training and practice will play an important role in reducing complication and recurrence rate.

Catheter Ablation↗
PubMed2005

Issues in drug delivery: concepts and practice.

Understanding the transport and deposition of inhaled aerosols is of fundamental importance to inhalation therapy. Herein we address issues that affect drug delivery from experimental and theoretical perspectives. Accordingly, we shall limit our comments to a focused review of laboratory work (ie, an in vitro perspective) and the development of a computer-based 3-dimensional (3D) oral morphology with related computational fluid dynamics (CFD) and particle deposition studies (ie, an "in silico" perspective). To describe the oral region, morphometric data from the literature were employed. With Maya Unlimited, a third-party animation software package, coronal images were used to create initial spline curves, which served as the foundation of a nonuniform rational B-spline surface, representing a 3D morphology. To the best of our knowledge, this study is the first medical application of Maya Unlimited. We have demonstrated that the code can be employed to construct 3D biological structures and perform 3D CFD simulations of aerosols from dry powder inhalers and metered-dose inhalers. A study was also conducted using Fluent, a commercially available software package that has been used extensively in our laboratory for 3D CFD computations. The Maya Unlimited software can generate physiologically realistic oral structures; it has great potential for use in the medical arena, because it requires neither advance technical training nor substantial peripheral ( eg, hardware) support, it allows for the introduction of medical devices ( eg, dry powder inhalers) into simulations, and it predicts 3D CFDpatterns consistent with experimental observations and results of more rigorous software ( Fluent). In the in vitro perspective we considered numerous salient topics, including the performances of dry powder inhalers and metered-dose inhalers, their respective operating characteristics, and relevance to in vivo data. We advocate that 3D CFD software be employed in a complementary manner, in real time, with aerosol therapy protocols in the medical arena, to promote the targeted delivery of inhaled drugs and thereby enhance their efficacies.

Administration, Inhalation↗
PubMed2005

Use of repetitive nerve stimulation in the evaluation of neuromuscular junction disorders.

Neuromuscular junction (NMJ) disorders are characterized by fuctuating muscle weakness. Acquired myasthenia gravis is the most common NMJ disorder with an overall prevalence in United States estimated at 60,000. Depending on the site of neuromuscular transmission failure, NMJ disorders have been classified as: (1) presynaptic (e.g., Lambert-Eaton myasthenic syndrome), (2) synaptic (e.g., cholinesterase inhibitor toxicity), and (3) post-synaptic (e.g., myasthenia gravis). Electrodiagnostic techniques used for investigation of NMJ disorders include repetitive nerve stimulation (RNS) and single fiber electromyography (SFEMG). Recent literature widely explores the use of SFEMG in the diagnosis and monitoring of myasthenia gravis, but this technique has a lesser role in the daily clinical practice outside of academic institutions. RNS is not as sensitive as SFEMG, but it is the most widely used electrodiagnostic method in the evaluation of suspected neuromuscular transmission disorders. RNS is technically easier and does not require special technical training and skill as SFEMG. Repetitive nerve stimulation was utilized first by Jolly in 1895 using an electrical drum and faradic tetanization to demonstrate a "myasthenic reaction" (weakening muscle contractions). In 1941, decremental response following the repetitive nerve stimulation was described by Harvey and Masland. While the technology has improved tremendously since then, the RNS testing is still based on supramaximal repetitive nerve stimulation and the measurement of decremental (or incremental) responses.

Electric Stimulation↗
PubMed2005

[Variation in yield of needle scars with multipuncture BCG vaccination].

PURPOSE: BCG vaccination using the multipuncture percutaneous method has long been employed in Japan. The purpose of this study is to clarify whether the number of needle scars achieved the BCG vaccination differs with the vaccinating physician. METHODS: A total of 218 babies who were vaccinated at the age of 4 months by different physicians at the Public Health Centres of Katsushika-Ward, Tokyo, were examined at the age of 3 years, in the three-year-old health check-up programme. The BCG vaccination with the multipuncture method generates 18 needle scars at a maximum. We examined each child for how many needle scars after BCG vaccination were visible, with reference to the vaccinating physician. RESULTS: The mean number of the visible scars was 9.23 (SD 6.11), and significantly smaller (P < 0.01) than that for all 22 Wards (12.18 +/- 5.64) investigated with the same method. The mean number of needle scars of the babies in Katsushika Ward was the third smallest among the 22 Wards and significantly smaller (P < 0.05) than the national average as determined in the nationwide survey conducted in 2000. Significant differences were evident among the 7 physicians performing the vaccination, the best and second best means being 15.26 (SD3.62) and 14.59 (SD3.58) respectively, and significantly larger (P < 0.01) than the means for the 7 physicians. The worst mean was 3.43 (SD4.46), significantly smaller (P < 0.01) than the mean for the 7 physicians. CONCLUSION: The mean number of needle scars after BCG vaccination of babies significantly differed with the 7 physicians in the present study. Poor technique was presumed responsible for small numbers of scars and technical training is therefore necessary in order to improve the BCG vaccination outcome.

BCG Vaccine↗
PubMed2006

How to choose an electronic medical record.

I chose a Windows-based file system over a server-based system with a proprietary database, or a web-based system which has both a proprietary database and which also required a full time Internet connection. My reasoning was that I found it uncomplicated. I was familiar with the Windows interface and it required little effort to enter my existing data and was simple to operate the system. If one laptop crashes, my other computers still work. I don't fear failure of an Internet connection source, a modem or a server, power surges or other possible single points of failure that might prevent my patient care. I can incorporate all document types, I can update jump drives with any needed medical information. I can share information instantly with other systems. I can store my own data in a flexible and open format. I have no maintenance contract and I can make changes in my system or can even change vendors at any time. Last but certainly not least, I do not need a highly trained technical staff to operate or maintain our system.

Computer Security↗
PubMed1991

Evaluation of the Quantitative Buffy Coat (QBC) method to detect malaria-infected red blood cells.

The conventional thin blood film method of detecting malaria is a long and tedious procedure, requiring significant technical expertise. In this study, we compared the Quantitative Buffy Coat (QBC) capillary tube method, which requires only minimal technical training, to the thin blood film method, and found it to be not only more rapid but also more sensitive than the thin blood film method in the detection of parasitized red blood cells. We do not suggest that the QBC capillary method can replace the conventional thin blood film method for the detection of malaria since it does not identify or quantitate the parasite species, only that it would serve as a valuable screening test.

Animals↗
PubMed2006

State diabetes prevention and control program participation in the Health Disparities Collaborative: evaluating the first 5 years.

BACKGROUND: Approximately 20.8 million people in the United States, or 7% of the population, have diabetes mellitus. Treatment for this disease costs Americans more than 130 billion dollars yearly, and it is the sixth leading cause of death. The prevalence of diabetes has grown substantially in recent decades and is expected to continue to rise. CONTEXT: The medically underserved and poor are at greater risk of developing diabetes and its complications than are other members of the U.S. population. The Health Resources and Services Administration makes health care resources and services available to economically disadvantaged populations through the Health Disparities Collaborative (HDC), a consortium formed to pool resources and services from state- and community-level donors. Since 1999, many of the Centers for Disease Control and Prevention's Division of Diabetes Translation State Diabetes Prevention and Control Programs (DPCPs) have joined the HDC to leverage resources and services. METHODS: The purpose of a 2004 evaluation was to examine the impact that DPCP involvement with the Collaborative had on aspects of diabetes care at Federally Qualified Health Centers (FQHCs). An electronic survey was administered to DPCP coordinators. They were asked about 1) their roles and experience as participants in the Collaborative; 2) the skills and expertise most useful in developing and maintaining an effective collaboration for improved health care for diabetes; 3) which DPCP contributions were viewed as being routine and which were perceived to be essential; 4) the effects of DPCP contributions on the use of the chronic care model under which FQHCs operate; and 5) which health systems improvements played the greatest role in enhancing components of the chronic care model. CONSEQUENCES: Most respondents identified themselves as DPCP coordinators with 3 years of experience in that position. Organizational skills, such as communication, leadership, conflict resolution, negotiation, and meeting management, were cited as necessary to develop and maintain collaborative partnerships. DPCP contributions to FQHCs were perceived to be training, technical assistance with clinical care and patient education, financial resources, linkages to other diabetes partners, educational materials, and improved linkages with community resources. INTERPRETATION: DPCPs contribute resources, skills, knowledge, and varied perspectives to the Collaborative that FQHCs may not have otherwise.

Centers for Disease Control and Prevention, U.S.↗
PubMedDate not supplied

[Social politics against poverty and in favor of health in Mexico].

One of the biggest challenges that Mexico faces is to fight against the poverty. The transition of a characteristic welfare model from the government in a closed economy, to an open economy where the functions of the State are limited, has modified the modalities of the social politics against poverty. Six indispensable conditions are identified for poverty's reduction: 1. Economic development with stability in order to generate more and better jobs for poor people. 2. To improve regional economies. 3. To improve home conditions of poor people. 4. To elevate education levels (to encourage an authentic heath education). 5. To diminish catastrophic expenses for health problems. 6. Technical training for all workers. The impact of poverty over health can provide valuable elements to establish effective preventive strategies on health workers.

Health Policy↗
PubMed1991

A dipstick, dot-ELISA assay for the rapid and early detection of bladder cancer.

A mouse monoclonal antibody (CK1K10) specific for keratin was developed. Enzyme immunoassays (EIAs) were performed to detect keratin in urine samples using CK1K10 and anti-mouse IgG. A high degree of sensitivity and specificity was obtained in the detection of bladder cancer patients. A fast dot-ELISA was developed in which urine is applied onto nitrocellulose (NC) sheets or dipsticks. Dipsticks coated with urine samples can be stored at room temperature for more than 5 days and at -20 degrees C for more than 3 months without loss of efficiency. A high positive correlation was found between the fast dot-ELISA and other EIAs. The assay does not require sophisticated equipment nor highly trained technical staff and can be performed in less than 30 min. The keratin dot-ELISA could be a reliable screening test for the early detection of bladder cancer.

Animals↗
PubMed1991

[Laparoscopic cholecystectomy. Results and experiences 1 year following introduction of a new surgical technique (139 cases)].

Laparoscopic cholecystectomy is on the way to become the procedure of choice for treatment of uncomplicated cholelithiasis. First experiences are summarized: Within the first year after introduction 139 patients, 100 women and 39 men, have been treated by this novel technique. 33 open cholecystectomies were carried out in the same period. In addition to simple cholecystolithiasis 11 patients had prior biliary pancreatitis and/or sphincterotomy because of choledocholithiasis, 16 patients had suffered before from acute cholecystitis, 3 patients were operated on with the diagnosis of acute cholecystitis and 3 patients underwent simultaneous laparoscopic intervention. Seven times the laparoscopic procedure had to be converted into an open one because of intraoperative complications, twice because of a lesion to the common bile duct, three times because of intractable bleeding, once because of obscure anatomic conditions and once because of a technical failure in establishing the pneumoperitoneum. Four postoperative complications could be treated conservatively. In the average, patients complained about pain for 2 days, stayed in the hospital 4.4 days and assumed their usual activity after 13 days. An extension of indications for laparoscopic cholecystectomy should be sought stepwise according to gained experience. The problem of technical training of surgeons persists and must be solved in priority.

Adult↗