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At least 343 records · Page 19Linked to original sources
PubMed1997

Pulmonary artery catheters and outcome in the perioperative period.

OBJECTIVE: To review the literature addressing use of the pulmonary artery catheter (PAC) in the perioperative patient. DATA SOURCE: All pertinent English language articles dealing with the use of pulmonary artery catheterization in perioperative patients were retrieved from 1977 through 1996. STUDY SELECTION: Articles were chosen if the perioperative use of pulmonary artery catheterization was studied or reviewed. DATA EXTRACTION: From the articles selected, information was obtained about changes in therapy and changes in outcome associated with PAC use in patients undergoing cardiac surgery, aortic surgery, peripheral vascular surgery, and neurosurgery. Information was also extracted about perioperative PAC use in geriatric patients and in patients with preeclampsia. DATA SYNTHESIS: Low-risk patients undergoing cardiac surgery do not appear to benefit from PAC use. Studies looking at high-risk patients undergoing cardiac surgery are lacking, making accurate determination of patient benefit difficult. The PAC may be useful in the management of some patients undergoing aortic surgery, though recent studies have identified populations of patients that can be safely monitored by less invasive means. Use of the PAC may lead to fewer complications in high-risk patients undergoing peripheral vascular surgery. Until data are forthcoming, it is not possible to accurately assess the overall impact of PAC use on complications and mortality in patients undergoing neurosurgical procedures. However, use of the PAC to monitor and treat air embolism in this group of patients does not appear to be appropriate. Routine perioperative use of the PAC does not appear to be appropriate because of age alone. Available scientific data do not support use of the PAC in patients with uncomplicated preeclampsia; however, some experts feel that PAC use may be helpful in the management of selected patients with severe preeclampsia. CONCLUSION: There are no Grade A indications for PAC use in the perioperative period. Current available literature suffers from a lack of randomized controlled clinical trials. Multicentered randomized controlled trials are needed.

Catheterization, Swan-Ganz↗
PubMedDate not supplied

A perspective on the safety of cosmetic products: a position paper of the American Council on Science and Health.

Over the years, some activist groups have targeted cosmetics as possible human health threats, claiming that cosmetic ingredients are not adequately tested for safety and may pose risks to consumers. The groups allege that industry practices related to safety testing are flawed, that there is little government oversight, and that cosmetics contain cancer-causing chemicals and other toxicants. A critical review of the scientific data related to these claims indicates the following: (1) Industry has the primary responsibility to ensure that all ingredients, preservatives, and coformulants used in products are safe for their intended uses. (2) The U.S. Food and Drug Administration (FDA) has regulatory oversight of the cosmetic industry. Its authority includes the banning or restriction of ingredients for safety reasons. (3) The Cosmetic Ingredient Review (CIR), an independent, scientific review board, critically evaluates chemical ingredients used in cosmetics and publishes the results of its findings in the peer-reviewed literature. (4) Health-related allegations about cosmetic ingredients are generally based on the results of high-dose laboratory testing in animals and have little relevance for humans. As true now as when Paracelsus said it in the 16th century, "It is the dose that makes the poison." (5) The health-related allegations involving specific chemicals (e.g., phthalates, parabens, and 1,3-butadiene) fail to consider important scientific studies and recent regulatory conclusions about these chemicals, which have found that they are not hazardous. (6) Animal and human physiology differ in crucial ways, further invalidating simplistic attempts to extrapolate rodent testing to human health risks. The cosmetic industry should be encouraged to publish more of its toxicity studies and safety evaluations, which would aid in dispelling the uncertainty that some consumers have about cosmetic safety.

Animals↗
PubMed1995

[Dynamics of tolerance of +G loads by non-flying subjects: a longitudinal study].

Selected cosmonauts-investigators may be held on wait for many years. The longitudinal health study is of great significance in the context of prediction of tolerance to various flight stresses. The purpose of this work was to investigate the tolerance to +Gz-loads during extended (up to 18 years) dynamic longitudinal study of 50 male cosmonauts and candidates of non-flying occupations by the data of 363 medical observation runs on a centrifuge with the radius of 7.25 m. Analysis of these data showed that 82 % of the subjects sustained good tolerance of G-loads and only 18 % of the subjects displayed its decrement or instability. A new proof received the data concerning better +Gz-tolerance by subjects aged 31-35 and less tolerance by the subjects younger than 30 and older than 46-50 years. The longitudinal study allowed to identify 4 types of G-tolerance variation, i.e., stable, relatively stable with individual drops down to decreased, non-stable with periodic drops, and a distinct trend towards a decrease. These investigations provided new scientific data about the dynamics of separate physiological functions during exposure to +Gz-loads resultant from longitudinal study of the same group of subjects, and allowed to make an expert prediction of shifts in the G-tolerance.

Adult↗
PubMed2005

Modified cardiopulmonary resuscitation (CPR) instruction protocols for emergency medical dispatchers: rationale and recommendations.

BACKGROUND: International consensus guidelines now support the use of "chest compressions-only" cardiopulmonary resuscitation (CPR) instructions (CCOIs) by emergency medical dispatch (EMD) personnel providing telephone assistance to untrained bystanders at a cardiac arrest scene. These guidelines are based largely on evolving experimental data and a clinical trial conducted in one venue with distinct emergency medical services (EMS) system features. Accordingly, the Council of Standards for the National Academies of Emergency Dispatch was asked to adapt a modified telephone CPR protocol, and specifically one that could be applied more broadly to the spectrum of EMS systems. METHODS: A group of international EMD specialists, researchers and professional association representatives analyzed available scientific data and considered variations in EMS systems, particularly those in Europe and North America. RESULTS AND CONCLUSIONS: Several recommendations were established: (1) to avoid confusion, bystanders already providing CPR should continue those previously learned methods; (2) following a sudden collapse unlikely to be of respiratory etiology, CCOIs should be provided when the bystander is not CPR-trained, declining to perform mouth-to-mouth ventilation or unsure of actions to take; (3) following 4 min of CCOIs, ventilations can be provided, but, for now, only at a compression-ventilation ratio of 100:2 until EMS arrives; (4) until more data become available, dispatchers should follow existing compression-ventilation protocols for children and adult cases involving probable respiratory/trauma etiologies; (5) EMD CPR protocols should account for EMS system features and receive quality oversight and expert medical direction.

Adult↗
PubMed1990

[Production of slides using a microdatamat].

For production of dias for presentation of scientific data, a personal computer, a dias programme and a camera are necessary. A microdatamat with a 80286 precessor, 20 MB hard disc and an EGA colour screen are the minimum configurations which can be recommended. A hard disc between 40 and 85 MB and a VGA screen provide a better solution. Out of the numerous dias programmes, Harvard Graphics appears to be suitable for production of dias for scientific use. In this programme, it is easy to combine text, graphic and hand drawing. Many other excellent programmes such as 35 mm Express and Mirage are also available. In the choice of camera, a solution of at least 4,000 x 4,000 lines is required and the camera concerned must be capable of working with recognized statistical and graphic parcels as more special graphs cannot be produced in ordinary dias programmes. Among the numerous cameras, the following may be mentioned: Montage which costs of 70,000 Danish crowns (approximately 6,000 pounds), Matrix PCR at 100,000 Danish crowns (approximately 9,000 pounds), Matrix QCR-Z at 200,000 Danish crowns (approximately 18,000 pounds) and Lasergraphic's two models at 60,000 and 120,000 Danish crowns, respectively (approximately 5,000 pounds and 10,000 pounds). In the price class of about 100,000 Danish crowns, Matrix PCR can be recommended particularly as this camera has an excellent optic and advanced self calibrating system. Among the cheaper cameras. Montage is recommended which e.g. functions well with Harvard Graphics.(ABSTRACT TRUNCATED AT 250 WORDS)

Audiovisual Aids↗
PubMed2005

[What are the epidemiological data on the consequences of smoking-related increased risk in pregnant women? Dermatological consequences].

Smoking has numerous effects on skin. Some of them are well established, others are more debatable. Smoking is a cofactor of skin aging after chronic sun exposure, as demonstrated by recent histological, biochemical and cutaneous relief studies. Smoking is a well established risk factor of cutaneous, mucous membrane cancers, and some gynecologic cancers as well, in some cases increased by pregnancy. However, published studies have included small numbers of subjects. Some skin affections are worsened by smoking, and others might be improved. However scientific data on smoking and skin or pregnancy are both scarce.

Female↗
PubMed2001

The role of physical activity and fitness in children in the prevention of adult cardiovascular disease.

Research data in adults have provided convincing evidence that regular exercise creates a protective effect against the complications of coronary artery disease. Given that the atherosclerotic process begins during the pediatric years, improved physical activity and fitness has been promoted in children and adolescents as a means of preventing cardiovascular disease in adulthood. Although intuitively compelling, direct proof of this rationale for improving exercise habits of children is not available. Scientific data examining the effects of activity and fitness on coronary artery disease risk factors in the growing years do provide some evidence that promoting exercise in children might serve as a means of preventing future cardiovascular disease.

Journal Article↗
PubMed1999

An opportunistic stability strategy; simulation with real data.

A multivariate modelling procedure is proposed in order to identify factors influencing stability, to estimate shelf-life, to select new batches for further stability testing and to evaluate changes in new batches. A model developed by the proposed procedure predicts the degradation rate constant as a function of storage temperature, pH, concentration and volume. The predicted rate constants were compared with prospectively measured rate constants, primarily from new batches stored under stress conditions, which emphasised batch differences earlier than storage under normal conditions. Strong deviations from expected rate constants led to extended testing of the batches concerned. The new data were used to upgrade the multivariate model. The procedure proposed led to the formulation of an opportunistic stability strategy (OSSY). Of the 15 batches of injectable solutions, nine batches are proposed tested by using OSSY. This led to an approximately 75% reduction in analytical measurements. Hold samples are recommended for storage under several stability conditions for back up analysis. In general, a multivariate stability model should be based on scientific data obtained from early studies, such as preformulation and formulation studies to provide both a qualitative and quantitative understanding of the mechanisms involved.

Contrast Media↗
PubMed2005

What's cooking with garlic: is this complementary and alternative medicine for hypertension?

PURPOSE: To define complementary and alternative medicine (CAM); describe one type of CAM, garlic (Allium sativum L); and discuss its effects on blood pressure as a treatment for hypertension. DATA SOURCES: Literature review from professional journals, abstracts, natural therapy books, and the World Wide Web (Internet). Information from the following professional organizations and agencies: The World Health Organization, Agency of Healthcare Research and Quality, National Cancer Institute, National Center for Complementary and Alternative Medicine, American Botanical Council, and Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. CONCLUSION: Garlic is widely used throughout the world as a CAM. It is one of the most popular herbal products sold in the United States. However, while some studies have shown small positive effects in reducing blood pressure, there are insufficient scientific data to draw conclusions regarding its efficacy on clinical blood pressure outcomes. Thus, healthcare providers should be cautious in recommending this herbal product as an antihypertensive CAM. IMPLICATIONS FOR PRACTICE: CAMs may be used by clients for a variety of conditions including hypertension. Healthcare providers must be cognizant of the use, efficacy, adverse affects, and scientific evidence concerning CAM in order to provide safe and effective practice as well as appropriate and accurate information to their clients.

Evidence-Based Medicine↗
PubMed2005

Groin hernia repair: anesthesia.

The choice of anesthesia for groin hernia repair is between general, regional (epidural or spinal), and local anesthesia. Existing data from large consecutive patient series and randomized studies have shown local anesthesia to be the method of choice because it can be performed by the surgeon, does not necessarily require an attending anesthesiologist, translates into the shortest recovery (bypassing the postanesthesia care unit), has the lowest cost, and has the lowest postoperative morbidity regarding risk of urinary retention. Spinal anesthesia has no documented benefits for this small operation and should be avoided owing to the risk of rare neurologic side effects and the high risk of urinary retention. General anesthesia with short-acting agents may be a valid alternative when combined with local infiltration anesthesia, although an anesthesiologist is required. Despite sufficient scientific data to support the choice of anesthesia, large epidemiologic and nationwide information from databases show an undesirable high (about 10-20%) use of spinal anesthesia and low (about 10%) use of local infiltration anesthesia. Surgeons and anesthesiologists should therefore adjust their anesthesia practices to fit the available scientific evidence.

Anesthesia↗
PubMedDate not supplied

Risks and benefits of soy isoflavones for breast cancer survivors.

PURPOSE/OBJECTIVES: To present state-of-the-art information about the risks and benefits of soy isoflavones for breast cancer survivors. DATA SOURCES: Published research articles, pertinent articles and books, and computerized databases. DATA SYNTHESIS: Some epidemiologic data suggest that soy isoflavones play an important role in preventing breast cancer in Asian women and promoting women's health in a variety of ways. However, the use of soy isoflavones in women with breast cancer is controversial. Risks and benefits exist regarding the use of soy isoflavones by breast cancer survivors. CONCLUSIONS: The use of soy isoflavones to promote health in breast cancer survivors remains controversial because of scant scientific data. IMPLICATIONS FOR NURSING: Nurses should not only provide updated information to the public but also interpret research results carefully. More clinical trials need to be conducted on a longitudinal basis with the enrollment of breast cancer survivors.

Breast Neoplasms↗
PubMedDate not supplied

[Recent data about the LDL-atherogenesis relationship].

The steps în pathophysiology of ATS make easier the understanding of waves of processes that lead to the disfunction of the endothelial cells, hypertrophy of the arterial wall and în the end to the complication which drawn from this process. Atherogenic process which is characterised by proaterofenethic and atherogenetic mechanism imbalance suppose three phases: early, transition and terminal phase. The initial phase involve the focal influx and LDL-cholesterol accumulation în the arterial intima, the ROS (reactive oxygen species) and azot generation by smooth muscular cells, macrophages and endothelial cells and oxidative modification of LDL. Scientific data revealed that LDL oxidation is mediated by peroxinitrite (ONOO) anion which could act directly over the thiol groups or indirectly through OH and NO radicals from peroxinitrous acid breakdown and who initiate the polyunsaturated fatty acids peroxidation and the oxidation of apolipoprotein B-100. LDL completely oxidated are recognised by scavenger receptors which are not regulated by up and down regulation. The last event of the early atherogenic process is the formation of foam cells from macrophages through LDL modified captation by scavenger receptors.

Arteriosclerosis↗
PubMedDate not supplied

Prevention and treatment of acute radiation dermatitis: a literature review.

PURPOSE/OBJECTIVES: To review historical and current research data on prevention and treatment of acute radiation dermatitis. DATA SOURCES: 18 research trials and 1 case report published from 1967-2001 and 1 unpublished research trial from 1972. DATA SYNTHESIS: Washing the skin with mild soap and water and the hair with mild shampoo is safe during radiation therapy. Biafine (Medix Pharmaceuticals, Inc., Largo, FL), chamomile cream, almond ointment, topical vitamin C, and gentian violet have not been proven effective and should not be used. Transparent, hydrocolloid, and hydrogel dressings have been beneficial, as have sucralfate cream and corticosteroid cream. Aloe vera may be beneficial and is not harmful. CONCLUSIONS: The existing scientific data are lacking in quantity and quality. The current body of evidence is unable to provide clinicians with comprehensive guidelines for prevention and management of acute radiation dermatitis. IMPLICATIONS FOR NURSING: Nurse clinicians and nurse scientists must partner to conduct further research to add to the limited resources about the prevention and management of acute radiation dermatitis and develop comprehensive evidence-based clinical practice guidelines.

Acute Disease↗
PubMed2025

CaXML: Chemistry-informed machine learning explains mutual changes between protein conformations and calcium ions in calcium-binding proteins using structural and topological features.

Proteins' flexibility is a feature in communicating changes in cell signaling instigated by binding with secondary messengers, such as calcium ions, associated with the coordination of muscle contraction, neurotransmitter release, and gene expression. When binding with the disordered parts of a protein, calcium ions must balance their charge states with the shape of calcium-binding proteins and their versatile pool of partners depending on the circumstances they transmit. Accurately determining the ionic charges of those ions is essential for understanding their role in such processes. However, it is unclear whether the limited experimental data available can be effectively used to train models to accurately predict the charges of calcium-binding protein variants. Here, we developed a chemistry-informed, machine-learning algorithm that implements a game theoretic approach to explain the output of a machine-learning model without the prerequisite of an excessively large database for high-performance prediction of atomic charges. We used the ab initio electronic structure data representing calcium ions and the structures of the disordered segments of calcium-binding peptides with surrounding water molecules to train several explainable models. Network theory was used to extract the topological features of atomic interactions in the structurally complex data dictated by the coordination chemistry of a calcium ion, a potent indicator of its charge state in protein. Our design created a computational tool of CaXML, which provided a framework of explainable machine learning model to annotate ionic charges of calcium ions in calcium-binding proteins in response to the chemical changes in an environment. Our framework will provide new insights into protein design for engineering functionality based on the limited size of scientific data in a genome space.

Machine Learning↗
PubMed2000

[Contraindications to weight reduction].

It is relatively well accepted that weight gain, even within the range of normal weight, is detrimental for health. The claimed long-term benefit of intentional weight loss is mainly based on a few observational trials, confounding intentional and non-intentional weight loss. The few data on obesity-related diseases prevented by intentional weight reduction have not been replicated. Thus, for lack of level-one evidence it is to date doubtful whether voluntary weight loss should be intensively recommended to obese individuals rather than other lifestyle-interventions, e.g. exercise training. The aim of this overview is to discuss some of the contraindications to intentional weight loss often ignored in recent debates. There is no intention to question the increased risk of overweight on morbidity and the need for preventing weight gain in our population. Besides well-known consequences secondary to rapid weight loss, e.g. gallstones and electrolyte disorders, some new aspects or more debated issues are discussed. Recent compelling data indicate a significant bone density loss after weight loss of a few kilograms. Knowledge on the impact of weight cycling mainly relies on cross-sectional data. So far there is no concluding evidence of adverse pathophysiological effects from weight cycling. Repeated dieting has been associated with eating disorders, although the cause-effect relationship has not been well established. At least on an empirical basis there seems to be a tolerance effect after repeated weight losing efforts. Pharmacotherapy tends more and more to be part of weight loss interventions. Although the currently available drugs are designed for long-term treatment, in practice they are rarely used longer than a few months, and therefore their use can be entirely questioned. Nonetheless, if employed properly for weight loss and weight maintenance, i.e. "for life", additional data on long-term effects on health are needed. Such risks can then be weighed against the risk of remaining obese. Even a limited detrimental effect on blood pressure, such as known for sibutramine, could compromise the beneficial effect of the drug on weight loss and maintenance. Further, the financial burden of weight loss is not to be underestimated. Besides diets and weight loss programs being a multi billion dollar business, the cost of patient care in cases of surgery for gallstones has, among other economic implications, to be considered. Finally, with the example of the recently investigated impact of fitness level on health, exercise training may be an alternative to weight loss. Whether obese or not, cardiovascular fitness is a strong, independent predictor of cardiovascular mortality and overall mortality. Most obese being unfit, a greater preventive impact might come from becoming more fit than from losing weight. This should only illustrate that there is still a long way to go until we have sufficient scientific data to be able to tell whether in the management of obesity weight loss or other interventions are of higher priority. In part, current recommendations to lose weight are biased by societal pressure, which overrules simple scientific evidence.

Contraindications↗
PubMed1997

Disability payments and chemical dependence: conflicting values and uncertain effects.

Receipt of public support payments by people with substance abuse disorders has been a subject of intense controversy in recent years. Observing that such funds are often used to purchase addictive substances, many critics have questioned whether people with chemical dependencies are entitled to such payments and whether they should be allowed to spend these funds unsupervised. This discussion introduces a special section of five data-based papers on the relation of disability payments to chemical dependence. The papers address five questions: Do public support payments worsen substance abuse in vulnerable populations? Does assignment of a representative payee reduce substance abuse among such beneficiaries? What money management procedures are most likely to yield positive outcomes for clients? How can clients who need payees be fairly identified? And how should skilled, responsible payees or guardians be recruited, trained, and retained? In the absence of scientific data, both clinical practice and social policy are vulnerable to the whims of public opinion. These papers shed new light on a heated area of policy debate.

Eligibility Determination↗
PubMed2006

[Skills Improvement Seminar for Submitting Articles to the Prosthodontic Research & Practice Journal. Part I. Guidelines for manuscript submission].

In the scientific meetings of the Japan Prosthodontic Society, many high-level research presentations are given, and yet a large proportion of the presentations have not been published. Since 2002, the Japan Prosthodontic Society has published PRP (Prosthodontic Research & Practice), which is the official English journal of the Society, to introduce scientific data of research in the field of prosthodontics internationally. PRP will be published quarterly from 2006. The editorial committee of the Japan Prosthodontic Society tries to give advice to authors, and to publish the prepublication paper in the PRP journal not as a rejection but as a correction. In order to give members of the Japan Prosthodontic Society a better understanding of the PRP journal, we held a Skills Improvement Seminar for Submitting Articles to the PRP at the 114th scientific meeting (Niigata) and the local branch scientific meetings. This paper summarizes the first half of the seminar and describes the editing work of PRP.

Guidelines as Topic↗
PubMed1999

[The hypothesis of environmental causes of damage to the endocrine system: science of sensationalism?].

AN EMERGING TOPIC: It has been hypothesized that exposure to certain chemical compounds in the environment could lead to reproduction and development anomalies. VARIABLE MECHANISMS OF ACTION, SUSCEPTIBILITIES AND EFFECTS: The incriminated environmental agents could have several targets in the endocrine system. As hormones play a cardinal role in regulating differentiation during early stages of life, developing organisms would be particularly vulnerable. AN EVALUATION METHODOLOGY: Although the hypothesis of endocrine perturbation is theoretically plausible, solid scientific data is still lacking to conclude that environmental compounds have a deleterious effect in humans after low-dose exposure. The ubiquitous nature of the intermediary metabolism of these compounds, the existence of critical periods of life, the complexity of the cell processes involved, and the differed timing of the effects make it difficult to assess risk. Current research is being conducted to develop specific methodologies to better understand this risk. AN INTERNATIONAL EFFORT: Different international and national entities have organized scientific committees with the task of identifying chemical compounds susceptible of perturbing endocrine function. In 1998, an international convention set up regulatory control of sales of certain chemical compounds.

Endocrine System↗