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PubMed1999

Health informatics and community health: support for patients as collaborators in care.

Health informatics has much to offer community health care. Computer networks and telecommunications provide particular support that can enhance the collaboration among clinicians, care providers and patients. Special-purpose computer tools referred to as Consumer Health Informatics (CHI) represent the application of computer and information technologies specifically to support the health information and communication needs of patients and lay persons. Research projects like ComputerLink and CHESS demonstrate that CHI is acceptable to patients and promotes self-care and disease management. Three grand challenges must be faced to insure realization of the promise of health informatics to community health care: development of knowledge management and information discovery tools for patients, insurance of health information literacy for all persons, and re-engineering clinical practice to capitalize on patients as full partners in health care.

Community Health Services↗

PubMedDate not supplied

[Modification of one-stage urethral plastic surgery by Hodgson III in proximal hypospadia in boys].

From 1996 to 1999 45 boys with proximal hypospadia (PH) aged 8 months to 15 years were operated according to modified one-stage urethral plastic operation according to Hodgson III for correction of complicated PH. 23 of them were untreated and 22 were surgically treated with unsatisfactory results. Corpus hypospadia with gross deformity of the cavernous bodies was observed in 15 patients. 12 and 18 boys had corpus-scrotal and scrotal hypospadia, respectively. Urethral plasty was carried out by Duckett (n = 5), Hodgson I (n = 4), Hodgson III (n = 13), Hodgson III modification (n = 23). The modification consists in additional dissection of a wide scrotal graft which is sutured in a tube prolonging urethra and widening anastomosis with the graft. The external urethral orifice is created on the top of the glans penis by mobilization of the wings of the glans penis with consecutive longitudinal cuts. Longitudinal surface relaxing cuts in chess order are made on the flap skin covering corpus penis to diminish tissue tension. 6-month to 3.5-year follow-up results are available. Complications (stenosis of the urethral external orifice, urethral fistulas and stenosis of anastomotic zone) were observed in 10 patients. Thus, the modification reduced the number of complications, improved functional and cosmetic results. The paper also contains a draft hypospadia classification, techniques of changing cavernous bodies' deformity angle, methods of artificial erection.

Adolescent↗

PubMedDate not supplied

[Pathological convolutions of internal carotid arteries as one of the causes of visual dysfunction in children].

Visual evoked potentials (VEP) in response to reverse chess patterns were studied in 68 patients aged 7-14 years with pathological convolutions of internal carotid arteries and 25 healthy children. The latent period was increased and the amplitude of P100 peak decreased in the patients, which was indicative of dysfunction of the visual route. VEP changed at early stages of cerebral circulation insufficiency. The relationship between hemodynamic parameters and VEP values was proven. Increased latent period and decreased amplitude of the positive peak are the criteria of neurophysiological significance of pathological convolutions in the internal carotid arteries.

Adolescent↗

PubMed2001

Complex of rat transthyretin with tetraiodothyroacetic acid refined at 2.1 and 1.8 A resolution.

The crystal structure of rat transthyretin (rTTR) complex with 3,5,3',5'-tetraiodothyroacetic acid (T4Ac) was determined at 1.8 A resolution with low temperature synchrotron data collected at CHESS. The structure was refined to R = 0.207 and Rfree = 0.24 with the use of 8-1.8 A data. The additional 8000 reflections from the incomplete 2.1-1.8 data shell, included in the refinement, reduced the Rfree index by 1.3%. Structure comparison with the model refined against the complete 8-2.1 A data revealed no differences in the ligand orientation and the conformation of the polypeptide chain in the core regions. However, the high-resolution data included in the refinement improved the model in the flexible regions poorly defined with the lower resolution data. Also additional sixteen water molecules were found in the difference map calculated with the extended data. The structure revealed both forward and reverse binding of tetraiodothyroacetic acid in one binding site and two modes of forward ligand binding in the second site, with the phenolic iodine atoms occupying different sets of the halogen binding pockets.

Animals↗

PubMed2003

Global gamesmanship.

Competition among multinationals these days is likely to be a three-dimensional game of global chess: The moves an organization makes in one market are designed to achieve goals in another in ways that aren't immediately apparent to its rivals. The authors--all management professors-call this approach "competing under strategic interdependence," or CSI. And where this interdependence exists, the complexity of the situation can quickly overwhelm ordinary analysis. Indeed, most business strategists are terrible at anticipating the consequences of interdependent choices, and they're even worse at using interdependency to their advantage. In this article, the authors offer a process for mapping the competitive landscape and anticipating how your company's moves in one market can influence its competitive interactions in others. They outline the six types of CSI campaigns--onslaughts, contests, guerrilla campaigns, feints, gambits, and harvesting--available to any multiproduct or multimarket corporation that wants to compete skillfully. They cite real-world examples such as the U.S. pricing battle Philip Morris waged with R.J. Reynolds--not to gain market share in the domestic cigarette market but to divert R.J. Reynolds's resources and attention from the opportunities Philip Morris was pursuing in Eastern Europe. And, using data they collected from their studies of consumer-products companies Procter & Gamble and Unilever, the authors describe how to create CSI tables and bubble charts that present a graphical look at the competitive landscape and that may uncover previously hidden opportunities. The CSI mapping process isn't just for global corporations, the authors explain. Smaller organizations that compete with a portfolio of products in just one national or regional market may find it just as useful for planning their next business moves.

Economic Competition↗

PubMed1955

Problems in the diagnosis of Q fever by complement-fixation tests.

For the selection of a suitable antigen concentration for use in routine complement-fixation tests with Q-fever antisera, a rigid system of antigen units is unsatisfactory. The optimum antigen dilution should be judged after inspection of the results of full "chess-board" titrations with a variety of antisera. Non-specific reactions may occur with sera from patients with primary atypical pneumonia or sera which have deteriorated during storage. These may be detected with a typhus antigen or some similar control antigen.Nine Mile and Henzerling strain antigens, which are widely used for routine diagnosis, were compared in tests with 868 sheep sera, 1055 human blood-donor sera, 66 human convalescent sera, and 20 guinea-pig sera. Considerable discrepancies were found in the results obtained with the two antigens.Irrespective of antigen concentration, the Nine Mile strain was more sensitive than the Henzerling strain for the detection of Q-fever antibody in human and guinea-pig sera and in some sera from Welsh sheep. With antibody in Kentish sheep sera, on the other hand, the Henzerling antigen was markedly more sensitive than the Nine Mile strain antigen. It is concluded that these two strains cannot be regarded as interchangeable, and the choice of antigen must depend on the geographical area and the species to be tested.

Animals↗

PubMed2003

[Childhood malaria in endemic areas: epidemiology, acquired immunity and control strategies].

Malaria is a major cause of childhood mortality and morbidity in endemic areas. The incidence and severity of malaria depends on various entomological, parasitological, environmental, and human factors. Clinical presentation and epidemiologic features vary according to genetic factors, personal behavior, and immune status. Populations exposed to frequent infection may develop partial labile protective malarial immunity at the price of high morbidity and mortality due to ineffectiveness of antimalarials. Malarial immunity affects not only mortality and severity of malaria but also uncomplicated malarial attacks and plasmodium infection. The number of determining factors involved in relatively limited but, like a game of chess, their possible combinations are numerous. A better understanding of malaria is necessary to plan and implement effective control strategies. That is the aim of this review.

Antimalarials↗

PubMedDate not supplied

Carbon-13 chemical shift imaging of [1-13C] glucose under metabolism in the rat head in vivo.

Carbon-13 chemical shift images (metabolic maps) of [1-13C] glucose in the heads of rats were obtained and compared with proton images of the same rats in terms of signal allocation. Wistar rats were kept awake or anesthetized. [1-13C] glucose was injected intravenously in a dose of 1 g per kg of body weight. The head of the Wistar rat was placed on or into circular coils. Carbon-13 images were obtained using a 7.05 Tesla system. A simple spin echo sequence was used with a chemical shift selective (CHESS) pulse. The frequency band width was set to cover the spectral breadth of the carbon-13 signal of [1-13C] glucose. The slice thickness of the image was 4 mm or 6 mm, and the field of view (FOV) was 60 mm x 60 mm, with a matrix size of 64 x 64. The total acquisition time was 36 minutes. Strong signals were observed from the scalp muscles and tissues outside the brain, but signal strength from the brain itself was minimal. This was presumably due to the metabolism of [1-13C] glucose in the brain. Little difference was recognized between [1-13C] glucose images of the heads of rats with and without anesthesia. Chemical shift imaging of carbon-13 could be useful methods for the in vivo study of physiochemical structures and metabolic pathways of living organs.

Animals↗

PubMed2004

[Visual potentials in humans with multiple sclerosis evoked by checkboard pattern of different contrast with additional noise].

A hypothesis is advanced of an effect of internal noise upon signal conduction along visual nerve in an early stage of multiple sclerosis. Visual evoked potentials in response to chess patterns against a homogeneous background and against a noise background were studied in healthy subjects and in patients with multiple sclerosis. Contrast between internal noise in the patients was found to be twice as great as in healthy subjects.

Adolescent↗

PubMed2004

Allelic dimorphism in the merozoite surface protein-3alpha in Korean isolates of Plasmodium vivax.

To study the genetic diversity of re-emerging Plasmodium vivax in the Republic of Korea, nucleotide sequence variations at the merozoite surface protein-3alpha (PvMSP-3alpha) locus were analyzed using 24 re-emerging isolates and 4 isolates from imported cases. Compared with the well known Belem strain (Brazil), a large number of amino acid substitutions, deletions, and insertions were found at the locus of the isolates examined. The Korean isolates were divided into two allelic types; type I (15 isolates), similar to the Belem strain, and type II (9), similar to the Chess strain (New Guinea). Isolates from imported cases were classified into three types; type III (1 from Malaysia), similar to type B from western Thailand, type IV (1 each from Indonesia and India), and type V (1 from Pakistan), both being new types. Our results have shown that the MSP-3alpha locus of re-emerging Korean P. vivax is dimorphic with two allelic types coexisting in the endemic area.

Alleles↗

PubMed2005

[The prokaryotic expression and the establishment of the putative indirect ELISA assay for the HA gene for avian influenza virus (AIV) H5N1 subtype].

Using a pair of specific primers designed according to the relevant nucleotide sequence from GenBank, the HA1 gene of H5N1 subtype AIV was amplified with PCR method. The PCR product was cloned into pET-32a(+) to get a prokaryotic recombinant plasmid pET-HA1. The target gene was successfully expressed in the host cell BL21 (DE3) when induced with IPTG. The expression was optimized with proper inducing conditions of 0.8 mmol/L IPTG and 3 hours induction. The highest expression of the target protein added up to 32.7% of the total bacterial protein. Western blot analysis proved the recombinant protein has good reactive ability against H5N1 subtype AIV positive serum. The optional working circumstances for the iHA-ELISA assay (antigenicity concentration: 4 microg/mL; serum dilution: 1:200) was tried out with chess titration. The positive criterion of this ELISA assay is OD(the tested serum) > 0.5 and OD(the tested serum)/OD(the negative serum) > 2.0.

Animals↗

PubMedDate not supplied

[Treatment of depression by a combination of clomipramine and triiodothyronine].

The clinical efficacy of a treatment with clomipramine (150 mg/day) associated with a daily dose of 50 micrograms of LT3 (CMI + LT3) compared to a treatment with clomipramine (150 mg/day) (CMI + placebo) for a period of 42 days has been examined in a pilot study, randomized in double-blind conditions, including 20 patients with a normal thyroid status, but presenting a major depressive syndrome (DSM III). The minimum including score was 30 on the Montgomery Asberg Scale (MADRS). The patients were considered as remitted when the MADRS-score was < or = 10. After 28 days of treatment, the efficacy of CMI + LT3 was found to be superior to CMI + placebo (p < 0.05). Side effects (CHESS 84) were those generally described for tricyclic antidepressants (constipation, dry mouth, lipothymia, tremor). Patients of the CMI + LT3 group experienced a slight hyperthyroidism. The determination of the plasma levels of CMI and desmethylclomipramine (DCMI) showed the presence of three non-compliant patients, but also that there was no relationship between plasma levels and clinical efficacy of the drug. Significant correlations were found between CMI and DCMI levels on day 14 compared with those of day 28 and 42, respectively. LT3 was without effect on the plasma levels of CMI and DCMI.

Adolescent↗

PubMed1991

The 'Sicilian Gambit'. A new approach to the classification of antiarrhythmic drugs based on their actions on arrhythmogenic mechanisms. The Task Force of the Working Group on Arrhythmias of the European Society of Cardiology.

The Queen's Gambit is an opening move in chess that provides a variety of aggressive options to the player electing it. This report represents a similar gambit (the 'Sicilian Gambit') on the part of a group of basic and clinical investigators who met in Taormina, Sicily, to consider the classification of antiarrhythmic drugs. Paramount to their considerations were (1) dissatisfaction with the options offered by existing classification systems for inspiring and directing research, development and therapy, (2) the disarray in the field of antiarrhythmic drug development and testing in this post-CAST era, and (3) the desire to provide an operational framework for consideration of antiarrhythmic drugs that will both encourage advancement and have the plasticity to grow as a result of the advances that occur. The multifaceted approach suggested is, like the title of the manuscript, a gambit. It is an opening rather than a compendium, and is intended to challenge thought and investigation rather than to resolve issues. The manuscript incorporates first, a discussion of the shortcomings of the present system for drug classification; second, a review of the molecular targets on which drugs act (including channels and receptors); third, a consideration of the mechanisms responsible for arrhythmias, including the identification of 'vulnerable parameters' that might be most accessible to drug effect; and finally, clinical considerations with respect to antiarrhythmic drugs. Information relating to the various levels of information is correlated across categories (i.e., clinical arrhythmias, cellular mechanisms and molecular targets), and a 'spread sheet' approach to antiarrhythmic action is presented that considers each drug as a unit, with similarities to and dissimilarities from other drugs being highlighted. A complete reference list for this work would require as many pages as the text itself. For this reason, referencing is selective and incomplete. It is designed, in fact, to provide sufficient background information to give the interested reader a starting frame of reference, rather than to recognize the complete body of literature that is the basis for this paper.

Animals↗

PubMed1991

Cognitive advantage in sport: the nature of perceptual structures.

To extend and clarify the nature of the perceptual processes used by sport experts to perceive schematic sport information, two experiments used schematic football diagrams that varied in structure (structured vs. unstructured) and complexity (complex vs. easy). The primary objective was to examine and characterize the nature of the perceptual structures (chunks) that are initially encoded, stored, and subsequently retrieved. In Experiment 1, compared with nonexperts, experts recalled larger perceptual structures following the initial stimulus presentation of structured stimuli only, replicating the recall findings of previous research in other skill domains. Experiment 2 used a long-term memory recognition task and a sorting task. Experts had superior recall and recognition of structured stimuli only, along with more discriminating sorting criteria of perceptual structures within long-term memory. This suggests that experts possess a highly refined semantic network or organized, structured schematic information. This research extends and clarifies the similarities between the perceptual processes of experts in sport (i.e., football) and experts in skill domains that require obvious cognitive involvement (i.e., chess). The results are discussed with reference to the perceptual and conceptual chunking hypotheses. It is proposed that sport experts' knowledge of a conceptual category enables them to retrieve elements using a "generate-and-test process."

Attention↗

PubMed1990

CNS and PNS effects of nimodipine.

Calcium ions play a decisive role in a large number of processes dealing with development, regeneration after damage, and aging of elements of the nervous system. Nimodipine, a member of the 1,4-dihydropyridine chess of calcium-channel blockers, has proved to influence the calcium metabolism of neurons. This review focuses on the results of recent studies on the role of nimodipine in both the central and peripheral nervous system, during or after events that threaten the integrity or function of the nervous system.

Aging↗

PubMedDate not supplied

[Tolerability of tianeptine in 170 patients with depression treated during one year].

Tianeptine, a new antidepressant, has a tricyclic molecular structure. Its main biochemical activity consists of an increase in the reuptake of 5 HT both in men and animals, after acute and chronic administration. Tianeptine demonstrated its antidepressive clinical efficacy in several double-blind versus reference drug trials. A multicentre open trial, including depressed patients enabled us to evaluate the safety of tianeptine and to control the maintenance of the therapeutic efficacy in the course of its long-term prescription. Depressed patients included showed a major depressive episode, single (296.22) or recurrent (296.32) without melancholia or psychotic features, or a dysthymic disorder (300.40), according to DSM III criteria. A minimum MADRS score of a least 25, and the informed consent of the patients were required. The dose of tianeptine was 3 tablets per day (12.5 mg/tablet) with the possibility of increasing to 4 or decreasing to 2 tablets per day, depending on the symptomatology. Therapeutic efficacy was evaluated by item 1 and 2 of the Global Clinical Impression (CGI), the Montgomery and Asberg Depression Rating Scale (MADRS), the Hamilton Anxiety Rating Scale (HARS) and the Hopkins Symptom Check-List (HSCL). Clinical and paraclinical safety were evaluated by CGI item 3, standardized ratings of patients' complaints (CHESS 84), interruption for side effects, evaluation of blood pressure, weight, biological parameters, EKGs. This intermediate evaluation concerns the first 170 depressed patients treated over a one-year period as well as the total group of patients included (n = 447).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1990

The effects of noise on vision efficiency.

The aim of this study was to determine the relationship between intensity, noise duration and non-auditory effect represented by changes both in visual acuity and the near point of accommodation. Changes in vision efficiency determined by a black and white chess board were monitored during and after 1 h exposure to 4 levels of noise: 90 dB-A, 93 dB-A, 96 dB-A or 99 dB-A and 2 h exposure to 96 dB-A. Results indicated that vision impairment can be attributed to a complex relationship between the intensity and the duration of exposure to noise.

Accommodation, Ocular↗

PubMed1990

[The use of a new plastic method for consolidating a preternatural anus as prevention in paracolostomy hernias].

Once the stage of extraperitoneal evasion of the sigmoid has been achieved for definitive preternatural anus, transsection is made of the aponeurosis of m. obliqu. ext. abdominis along its tendon fibers at a length of 5-6 cm. Then an aperture is made along the muscle fibers with the same length on m. obliqu. int. abdominis and m. transversus abdominis as well and finally f. transversalis is transsected. The peritoneum is intra-abdominally detached from the fascia beneath and alongside the aperture. An "Ampoxen" layer is placed around the internal aperture of the abdominal wall. The explant is sutured to the fascia and the evaded sigmoid. The latter is sutured to the aponeurosis of m. obliqu. ext. abdominis. Another Ampoxen layer is placed over this aponeurosis and sutured to the evaded intestine and in a chess-board way to the fascia. The method was applied in 22 patients with very good postoperative result.

Adult↗