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At least 253 records · Page 14Linked to original sources
PubMed2001

Creutzfeldt-Jakob disease: recommendations for disinfection and sterilization.

Prion diseases constitute a unique infection control problem because prions exhibit unusual resistance to conventional chemical and physical decontamination methods. Recommendations to prevent cross-transmission of infection from medical devices contaminated by Creutzfeldt-Jakob disease (CJD) have been based primarily on prion inactivation studies. The recommendations in this article consider inactivation data but also use epidemiological studies of prion transmission, infectivity of human tissues, and efficacy of removing microbes by cleaning. On the basis of the scientific data, only critical (e.g., surgical instruments) and semicritical devices contaminated with high-risk tissue (i.e., brain, spinal cord, and eye tissue) from high-risk patients--those with known or suspected infection with CJD--require special treatment.

Animals↗
PubMed1996

The role and extent of surgery in early invasive breast cancer.

The role of surgery in early invasive breast cancer is reviewed. Technologic developments and widespread use of screening mammography have allowed detection of smaller breast cancers that can be biopsied with minimally invasive procedures. Current treatment strategies include breast conservation therapy for the majority of early invasive breast cancers with local recurrence rates as low as 2%. The role of axillary dissection is being questioned in these early cancers. We review the current scientific data, which may lead to women with early breast cancers being treated with lumpectomy alone in the future, with axillary dissection being done in a scientific and highly selected fashion for the 10% to 30% of women who will benefit from that procedure.

Axilla↗
PubMed2003

Risk modeling, assessment, and management of lahar flow threat.

The 1991 eruption of Mount Pinatubo in the Philippines is considered one of the most violent and destructive volcanic activities in the 20th century. Lahar is the Indonesian term for volcanic ash, and lahar flows resulting from the massive amount of volcanic materials deposited on the mountain's slope posed continued post-eruption threats to the surrounding areas, destroying lives, homes, agricultural products, and infrastructures. Risks of lahar flows were identified immediately after the eruption, with scientific data provided by the Philippine Institute of Volcanology, the U.S. Geological Survey, and other research institutions. However, competing political, economic, and social agendas subordinated the importance of scientific information to policy making. Using systemic risk analysis and management, this article addresses the issues of multiple objectives and the effective integration of scientific techniques into the decision-making process. It provides a modeling framework for identifying, prioritizing, and evaluating policies for managing risk. The major considerations are: (1) applying a holistic approach to risk analysis through hierarchical holographic modeling, (2) applying statistical methods to gain insight into the problem of uncertainty in risk assessment, (3) using multiobjective trade-off analysis to address the issue of multiple decisionmakers and stakeholders in the decision-making process, (4) using the conditional expected value of extreme events to complement and supplement the expected value in quantifying risk, and (5) assessing the impacts of multistage decisions. Numerical examples based on ex post data are formulated to illustrate applications to various problems. The resulting framework from this study can serve as a general baseline model for assessing and managing risks of natural disasters, which the Philippines' lead agency-the National Disaster Coordinating Council (NDCC)-and other related organizations can use for their decision-making processes.

Journal Article↗
PubMed2006

Understanding population and individual risk assessment: the case of polychlorinated biphenyls.

Decisions about how to improve or protect the public health can be, and sometimes necessarily are, made on imprecise science. The regulation of potential human carcinogens in the environment entails a population-risk assessment process intended to reduce risks to less than one additional cancer in 100,000 or 1,000,000 persons. These risk assessment processes, however, may be miscommunicated or misinterpreted in the context of individual cancer risks by scientists, regulators, the lay media, and the public. This commentary will review methods for establishing a causal relationship between carcinogen exposures and cancer risk. It will use the case of polychlorinated biphenyls (PCB) as an example of how to place scientific data into the context of human exposure and cancer risk. PCBs are widespread environmental contaminants and most people have detectable levels of PCBs in their bodies. The primary source for exposure in the general population is through the diet. PCBs are carcinogens in experimental animal models, but how this information can be extrapolated to human risk remains uncertain. PCB experimental studies provide data that are used to regulate and control human exposure, although the epidemiologic evidence fails to establish PCBs as human carcinogens. Thus, what is used for population-risk assessment may not be appropriate for individual-risk assessment or concluding that a causal relationship exists between PCB exposure and cancer risk. The hazards from a carcinogen designated by regulatory and review agencies as a "probable" human carcinogen is often misunderstood out of context about the magnitude of the risk and in what settings. How scientists communicate their results in scientific articles can strongly influence how others interpret their data. Misunderstandings from both the use of regulatory and review-agency opinions and the conclusions espoused by scientists occur in the media, among private physicians counseling their patients about cancer risk, and in the legal settings where plaintiffs seek compensation for exposure and alleged harm (or future harm). This can lead to false conclusions about what caused a cancer in a specific patient, undue anxiety about future cancer risk, inappropriate cancer screening, and attendant increased morbidity due to increased uses of the medical system and complication rates from medical procedures. The communication of research findings by scientists must be presented with caution, resisting the temptation to extrapolate, inappropriately, research data to the general population.

Animals↗
PubMed2004

Hormone replacement therapy in postmenopausal women.

BACKGROUND: For many years, hormone replacement therapy (HRT) was considered an effective method of restoring the relative protection from coronary artery disease enjoyed by premenopausal women compared with men of similar age. This view has been supported by a substantial number of basic science and observational studies. DATA SOURCES: Results of recent randomized controlled trials have seriously challenged the concept of the protective value of HRT by showing that rather than decreasing the risk of coronary artery disease, HRT actually appears to increase it. In addition, it increases the risk for breast cancer, stroke, venous thromboembolism, and cholecystitis. RESULTS: Despite some benefits such as increased bone mineral density and decreased risk of fracture and colorectal cancer, these data suggest that the risks of HRT outweigh the benefits. CONCLUSIONS: HRT is no longer routinely recommended for prevention of chronic disease. We present the current scientific data, benefits, risks, and consequent clinical recommendations regarding HRT use in postmenopausal women.

Breast Neoplasms↗
PubMed1998

Hypertension in the ESRD patient: pathophysiology, therapy, outcomes, and future directions.

Cardiovascular disease remains the leading cause of death in the end-stage renal disease (ESRD), chronic renal failure, and transplant patient population. The majority of dialysis patients begin renal replacement therapy with a disproportionate cardiovascular disease risk factor burden, eg, premature atherosclerosis, hypertensive vascular disease, nonhypertensive left ventricular dysfunction, hyperlipidemia, age, and so on. Each of these accelerates the other. This report will review hypertension in the ESRD patient population. The Joint Clinical Practices Committee of the Renal Physicians Association and the American Society of Nephrology was asked to develop an evidence-based clinical practice guideline for the treatment of hypertension in chronic renal failure and the ESRD patient, to be presented to the Health Care Financing Administration (HCFA). The group was also asked to identify areas for future study and prepare an up-to-date bibliography in the field. Based on an in-depth review of the literature, the committee concluded that not enough data were available to submit an evidence-based clinical practice guideline. Thus, a treatment algorithm was not provided to the HCFA. This manuscript, based on the scientific data for the report to the HCFA, is an in-depth review of the literature on hypertension in the ESRD patient. Pathogenesis, relation to outcome, clinical therapeutic guidelines, and areas for future study are discussed. In addition, the separate exhaustive bibliography (obtainable from the National Kidney Foundation) for hypertension, renal disease, and dialysis should be a valuable resource to all nephrologists interested in clinical practice and research.

Cause of Death↗
PubMedDate not supplied

[A study on job satisfaction and its depressive factors in human relations among operating room nursing].

This study was done for the purpose of analyzing the job-satisfaction and its depressive factors in human relation of operating room nurses of university hospital. Therefore, it makes an offer the basic data to help the resolution and prevention of the problems in operating room nurses. Furthermore, this study was conducted in order to find out some kinds of scientific data for the better control of depressive factors of job-satisfaction expressed by the operating room nurses. The structured questionnaire reports of 246 operating room nurses who were employed in 5 different university hospitals which have over 1,000 beds located in Seoul, Korea were used, which wer collected from August 24th to August 30th of 1992. The author visited supervisors of operating room in each university hospital and explained the aim of this study. The most of them (90.0%) answered to the questionnaires. Analysis of the collected data were done by mean, standard deviation, percentage, t-test, F-test, Q-test, correlation analysis, one-way ANOVA, and stepwise multiple regression analysis. Major findings of this study were as follows: 1. The job of the operating room nurses were remarkably related with the satisfaction in human relation, which was defined as the behavioral job with thoughtful action rather than with mechanical action. However, the degree of satisfaction in human relation with personnel in other departments was found to be the lowest and its the main depressive factors were appeared due to the absence of interaction and uncooperative attitudes. Therefore, it was required that the members of other job need more cooperative attitude to the actual works in the operating room nurses. 2. The depressive factors in the satisfaction degree of human relation with official seniors wer significantly related with their irresponsibility and partialness. Moreover, the job attitude of the operating room nurses is abundantly required to be improved. 3. The depressive factors in the satisfaction of human relation with medical doctors were significantly related with their insincerity and the class-consciousness. It is clearly suggested that the medical doctors do more cooperative behaviors for the jobs of the operating room without the suggested that the medical doctors do more cooperative behaviors for the jobs of the operating room without the superiority feeling of class-consciousness. 4. There was a significantly positive association between the satisfaction degree of human relation of the nurses with the following characteristics.(ABSTRACT TRUNCATED AT 400 WORDS)

Analysis of Variance↗
PubMed2001

Using DNA and hemoglobin adducts to improve the risk assessment of butadiene.

The purpose of this paper is to review what we know about various biomarkers of butadiene in animal, human and in vitro studies, and to draw inferences from these data that impact on the accurate assessment of human risks for cancer. Studies comparing the DNA and hemoglobin adducts of butadiene with exposure, metabolism and genotoxicity have provided a great deal of insight that is applicable to biologically based risk assessment. First, the DNA and hemoglobin adduct data strongly support the conclusion that 3,4-epoxy-1,2-butanediol is the major electrophile available for binding to these macromolecules. Biomarker studies have also provided insight into the possibility of a sensitive population associated with the GSTT1 null genotype. While it is clear that lymphocytes from GSTT1 null individuals are more sensitive for the induction of sister chromatid exchanges (SCE) following in vitro exposure to 1,2,3,4-diepoxybutane, there was no such increase in SCE or other biomarkers of genotoxicity in workers exposed to 1-3 p.p.m. butadiene, regardless of GST genotype. The globin adduct data also demonstrate that there is roughly a tenfold range for interindividual differences in the metabolism of butadiene. This type of analysis represents an excellent means for providing scientific data for this critical determinant. Another useful application of hemoglobin adducts in risk assessment was demonstrated by regressing data for various endpoints for genotoxicity against that individual's biologically effective dose, thereby providing an independent mechanism for evaluation that excludes any possible confounding by inappropriate controls. Finally, biomarker studies have identified critical gaps in our knowledge that are needed for the accurate assessment of butadiene. Most notable of these is the lack of diepoxide-specific biomarkers in mice, rats and humans.

Animals↗
PubMed2001

Aldrin and dieldrin: a review of research on their production, environmental deposition and fate, bioaccumulation, toxicology, and epidemiology in the United States.

In the last decade four international agreements have focused on a group of chemical substances known as persistent organic pollutants (POPs). Global agreement on the reduction and eventual elimination of these substances by banning their production and trade is a long-term goal. Negotiations for these agreements have focused on the need to correlate data from scientists working on soil and water sampling and air pollution monitoring. Toxicologists and epidemiologists have focused on wildlife and human health effects and understanding patterns of disease requires better access to these data. In the last 20 years, substantial databases have been created and now are becoming available on the Internet. This review is a detailed examination of 2 of the 12 POPs, aldrin and dieldrin, and how scientific groups identify and measure their effects. It draws on research findings from a variety of environmental monitoring networks in the United States. An overview of the ecologic and health effects of aldrin and dieldrin provides examples of how to streamline some of the programs and improve access to mutually useful scientific data. The research groups are located in many government departments, universities, and private organizations. Identifying databases can provide an "information accelerator" useful to a larger audience and can help build better plant and animal research models across scientific fields.

Aldrin↗
PubMed2004

FDA: evidentiary standards for drug development and approval.

The United States Food and Drug Administration is charged with approving drug treatments that have been shown to be safe and effective. Relevant statutes and regulations provide a legal framework for establishing safety and effectiveness that is sufficiently flexible to ensure that appropriate scientific data are collected for specific treatments targeted to particular diseases. Nonetheless, all clinical trials proposed to establish effectiveness must incorporate common elements in order for the appropriate legal and scientific standards of drug approval to be met. This article will discuss the relevant laws and regulations pertaining to the current effectiveness standard and will discuss the most important clinical trial design elements currently considered acceptable for applications for treatments of neurologic and psychiatric illness.

Animals↗
PubMed1992

Literature review of research related to the Clinical Laboratory Improvement Amendments of 1988.

In conjunction with a 1990 Report to Congress on the studies required by the Clinical Laboratory Improvement Amendments of 1988 (CLIA '88), the Centers for Disease Control, Atlanta, Ga, prepared a summary of the existing scientific literature related to the five studies listed in Section 4 of the Act. Over 800 articles were identified that, by title, seemed to deal with subjects that have been assumed to be associated with the quality of clinical laboratory testing. Although our search was not exhaustive, we believe that the articles included in our search are representative of the scientific evidence that exists. Most of the articles collected in our initial search were later eliminated from additional review because they were determined to be evaluations of laboratory analytic methods, contained only anecdotal evidence, were primarily descriptions of methods or programs, or were opinion articles without specific scientific data to support the opinions. This review reports the conclusions drawn by the research investigators of the 90 referenced articles; it does not analyze each article to assess the scientific validity of the research nor does it critique each article that is included. The review points to the need for additional research to answer questions raised by CLIA '88.

Humans↗
PubMedDate not supplied

[Never say never. Reflections on infohighways or highways of information].

The indiscriminate supply of unsolicited scientific information, means an overload for the professional in his assimilative intellectual process, which sometimes forces him to put aside his capacity for developing "scientific curiosity" (the basic principle of the university culture). This may cause an intimate discord between what I should do and what I can do, which may cause negative sensations in his self-esteem. With the incorporation of new means of communication, the velocity with which this information is supplied, is much higher than our capacity for assimilation, which often leads to reactions of rejection as a protective measure against such disproportionate aggression. This protective measure may be negative in our competitive society, possibly leading to the professional and even social disqualification. As we have to incorporate these new technologies into our activities, both at the professional as at the social level, getting to know them better, shall allow us to make a correct use thereof (with the latter being proportional to the depth of the former), avoiding, on the other hand, to be manipulated by its consumer offers. In this publication we give a summary of the current possibilities of using the Network, which are useful in our scientific and cultural environment (E-mail, access to scientific data bases, telematic protocols, electronic journals, etc.), with testing the possibilities of initiating our own first telematic projects, with a single finality: to potentiate the communication between all the scientific collaborators related to the discipline of nutrition, which is an aim that every scientific journal, and ours in particular, should have among its purposes.

Computer Communication Networks↗
PubMed1999

[Second edition of the Diagnostic compass].

The second edition of the Diagnostic compass once more aims at contributing to rational use of accessory diagnostic techniques. The target group of the book consists of all physicians directly or indirectly involved in diagnosing patients clinical chemists and--from this second edition onwards--senior medical students. The number of clinical problems in the first part of the book is extended from 111 to 229. They are grouped in chapters and subsequently printed in alphabetical order. New is the interpretation of data gathered from clinical investigation. The tests in the second part are updated. Chapters on pathology and on clinical genetics have been added. The chapter on clinical chemistry has been extended with HLA diagnostics. The contents wherever possible are based on scientific data and existing standards of the Dutch College of General Practitioners and on guidelines of the Dutch Institute for Health Care Improvement CBO and of scientific associations.

Academies and Institutes↗
PubMed2000

[Chemicals toxic to the olfactory system. Analysis and description].

AN IMPORTANT PROBLEM: Occupational exposure to chemical products can have toxic effects on the olfactory system. An important number of patients have experienced olfactory disorders subsequent to the development of the chemical industry and atmospheric pollution. EPIDEMIOLOGY DATA: Straightforward data are difficult to collect because several cofactors other than the toxic product are involved. Two lists of toxic products can be made. The first list includes products for which scientific data is available and the second products for which data is lacking. Olfactory tests also differ between authors and countries. TWO TYPES OF TOXICITY: Acute, accidental toxicity is evidenced by the lesions caused by inhalation of high-doses of strongly toxic agents. Chronic intoxication caused by lower concentrations of these inhaled agents does not produce a trigeminal reflex leading to a modified respiratory rate reducing the airborne aggression. APPROXIMATIONS: Clinical data describing the olfactory toxicity of certain industrial and chemical compounds are very significant but often cannot prove a cause and effect relationship. Data obtained with experimental models in rodents are difficult to extrapolate to humans.

Air Pollutants, Occupational↗
PubMed2006

[Is the generally accepted therapeutic benefit of exercise training in patients with peripheral arterial occlusive disease evidence based? Analysis of the Cochrane review].

When assessing the quality of clinical trials in intermittent claudication, on principle the same strict biometric and medical standards need to be applied for studies on the effect of walking exercise as for conservative drug treatment studies. However, as demonstrated by a recent review of the Cochrane Collaboration, this is apparently not always the case. The review included ten randomized controlled studies published between 1966 and 1997 with a total of 258 patients. The exercise regimes varied considerably between studies with regard to mode, intensity, frequency, duration and supervision, just as the treadmill tests employed to measure walking distance and walking time, respectively (primary endpoint). None of these studies used a confirmatory approach, and they all have a number of further methodological flaws when taking current biometric and medical guidelines into account. Also unmentioned in the abstract remains the important fact that, owing to missing data, finally only 53 patients from three studies could be pooled for the actual meta-analysis. All in all, the Cochrane review under discussion here is hardly suitable to scientifically prove the generally accepted efficacy of walking exercise in intermittent claudication. At the same time, it becomes clear that even publications of well-reputed institutions such as the Cochrane Collaboration should always be critically scrutinized. On the other hand, applying modern guidance for investigation under the aspect of evidence based medicine must not lead to a retrospective discrimination of accepted historical scientific data and thereby call into question proven therapeutic strategies.

Arterial Occlusive Diseases↗
PubMed2006

Field data: a study on trend and prediction of fatal traffic injuries prevalence in Shanghai.

OBJECTIVE: The main objectives of the study are to analyze fatal traffic-injury trends in 1987-2003 in Shanghai and predict its prevalence in near future and provide scientific data for the local governmental decision on developing practical working methods on traffic-injury prevention and control. METHODS: In this study, epidemiological method and Grey dynamic model GM (1,1) were introduced to analyze and forecast traffic-injury mortality rates respectively. RESULTS: There was an apparent increasing trend of traffic-related injuries in Shanghai from 1987 to 2003 with the rate of growth in motorization. The average rates of annual increase are 3.59% in fatalities (from 7.78 per 100,000 population to 14.18 per 100,000 population) during the period. Pedestrians were the most common type of victims (29.6%), followed by bicyclists (25.1%), and motorcyclists (24.1%). Males accounted for the majority of all victims, over 69%. The population of high-school and lower high-school education level represented 66.4% victims of total road-traffic injuries. And if no special factors effect its development, the traffic fatalities would be up to 17.84 per 100,000 population in 2010, when calculating from equations we found and validated Y(t) = 359.90 x e0.027(t-1)-352.13, (t = 1, 2, ..., N) for Shanghai. CONCLUSION: Our data indicate the risk of fatal traffic injuries has increased in recent years and will go on growing in the near future in Shanghai. The findings showed that Grey dynamic model GM (1,1) is eligible on the prediction and can be a tool for injuries forecasting, implementing effective policies, programs, and interventions for reducing traffic injuries in the big cities.

Accidents, Traffic↗
PubMed2006

Could peripartum antibiotics have delayed health consequences for the infant?

Antibiotics are increasingly prescribed in the peripartum period, for both maternal and fetal indications. Their effective use undoubtedly reduces the incidence of specific invasive infections in the newborn, such as group B streptococcal septicaemia. However, the total burden of infectious neonatal disease may not be reduced, particularly if broad-spectrum agents are used, as the pattern of infections has been shown to alter to allow dominance of previously uncommon organisms. This area has been relatively understudied, and there are almost no studies of long-term outcome. Recent findings suggest that such long-term data should be sought. First, there is evidence that organisms initially colonising the gut at birth may establish chronic persistence in many children, in contrast to prompt clearance if first encountered in later infancy, childhood or adulthood. Second, there is a rapidly advancing basic scientific data showing that individual members of the gut flora specifically induce gene activation within the host, modulating mucosal and systemic immune function and having an additional impact on metabolic programming. We thus review the published data on the impact of perinatal antibiotic regimens upon composition of the flora and later health outcomes in young children and summarise the recent scientific findings on the potential importance of gut flora composition on immune tolerance and metabolism.

Anti-Bacterial Agents↗
PubMed2006

Compression of fluorescence microscopy images based on the signal-to-noise estimation.

Modern microscopic techniques like high-content screening (HCS), high-throughput screening, 4D imaging, and multispectral imaging may involve collection of thousands of images per experiment. Efficient image-compression techniques are indispensable to manage these vast amounts of data. This goal is frequently achieved using lossy compression algorithms such as JPEG and JPEG2000. However, these algorithms are optimized to preserve visual quality but not necessarily the integrity of the scientific data, which are often analyzed in an automated manner. Here, we propose three observer-independent compression algorithms, designed to preserve information contained in the images. These algorithms were constructed using signal-to-noise ratio (SNR) computed from a single image as a quality measure to establish which image components may be discarded. The compression efficiency was measured as a function of image brightness and SNR. The alterations introduced by compression in biological images were estimated using brightness histograms (earth's mover distance (EMD) algorithm) and textures (Haralick parameters). Furthermore, a microscope test pattern was used to assess the effect of compression on the effective resolution of microscope images.

Algorithms↗