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PubMed2001

Clearance of Tc-99m DTPA aerosol in mismatched and matched pulmonary perfusion defects.

PURPOSE: To evaluate clearance changes of Tc-99m DTPA aerosol in mismatched and matched pulmonary perfusion defects. MATERIALS AND METHODS: Twenty-one patients (14 women, 7 men; mean age, 51 +/- 14 years) with possible pulmonary embolism were included in the study. On the day after perfusion (Q) scintigraphy with 5 mCi Tc-99m MAA, radioaerosol inhalation scintigraphy was performed using 45 mCi Tc-99m DTPA. Immediately and 45 minutes after the inhalation, early and delayed inhalation images (EI and DI, respectively) were obtained. Group 1 included 11 patients with mismatched defects who had a high probability of pulmonary embolism according to the Q/EI scan results. Group 2 included 10 patients with matched defects who had a low probability of PE. Contralateral normal lungs of 7 patients in group 2 served as controls (group 3). In groups 1 and 2, regions of interest were drawn over the mismatched and matched perfusion defects where they were best visualized, and this region of interest was mirrored to the same region on EI and DI images. For the control group, this was done in the contralateral normal lung. Mean counts in each region of interest were used for quantitative analysis, and the percentage clearance ratio was calculated using the following formula: early counts - late counts/early counts x 100. RESULTS: The average percentage clearances for the three groups were as follows: group 1, 37% +/- 10%; group 2, 21% +/- 4%; group 3, 24% +/- 7%. Differences between groups 1 and 3 were significant, as were those between groups 1 and 2 (P < 0.05). Patients with mismatched perfusion defects had increased DTPA clearance compared with the control group and those with matched defects. CONCLUSIONS: Vascular occlusion may lead to impairment of the alveolar-capillary barrier and consequently an increase in the clearance of Tc-99m DTPA aerosol in embolized regions. Immediately after inhalation, Tc-99m DTPA imaging should be started in the projection where perfusion defects are best seen to avoid potential misinterpretation of pulmonary embolism.

Administration, Inhalation↗

PubMed1995

One center's perspective on participation in The Program to Strengthen Primary Care Health Centers: a slow harvest.

This article presents an account of one center's experience participating in The Program to Strengthen Primary Care Health Centers. The center developed a multifaceted strategy that aimed to increase and diversify revenue, both earned and nonearned. The first year got off to an uneven start, although the project eventually progressed according to plan but on a slower time line than anticipated. By the end of the three-year project period, most of the initiatives had become fully integrated into center operations. The center was able to increase financial reserves. However, their financial stability remained tenuous.

Arizona↗

PubMed2001

Advanced database methodology for the Collation of Connectivity data on the Macaque brain (CoCoMac).

The need to integrate massively increasing amounts of data on the mammalian brain has driven several ambitious neuroscientific database projects that were started during the last decade. Databasing the brain's anatomical connectivity as delivered by tracing studies is of particular importance as these data characterize fundamental structural constraints of the complex and poorly understood functional interactions between the components of real neural systems. Previous connectivity databases have been crucial for analysing anatomical brain circuitry in various species and have opened exciting new ways to interpret functional data, both from electrophysiological and from functional imaging studies. The eventual impact and success of connectivity databases, however, will require the resolution of several methodological problems that currently limit their use. These problems comprise four main points: (i) objective representation of coordinate-free, parcellation-based data, (ii) assessment of the reliability and precision of individual data, especially in the presence of contradictory reports, (iii) data mining and integration of large sets of partially redundant and contradictory data, and (iv) automatic and reproducible transformation of data between incongruent brain maps. Here, we present the specific implementation of the 'collation of connectivity data on the macaque brain' (CoCoMac) database (http://www.cocomac.org). The design of this database addresses the methodological challenges listed above, and focuses on experimental and computational neuroscientists' needs to flexibly analyse and process the large amount of published experimental data from tracing studies. In this article, we explain step-by-step the conceptual rationale and methodology of CoCoMac and demonstrate its practical use by an analysis of connectivity in the prefrontal cortex.

Animals↗

PubMed1998

Sequencing microbial genomes--what will it do for microbiology?

In 1995, Haemophilus influenzae became the first free-living organism to have its entire genome sequence published. Since then, many similar projects have been started and, by the millennium, the genomes of a significant number of important human pathogens will have been sequenced. During this period of increasing access to microbial sequence data, parallel advances have occurred in techniques that allow the large-scale study of the entire genetic complement of micro-organisms. In the near future, these approaches will enable researchers to unravel further the complexity of microbial pathogenesis and identify new virulence determinants. Many of these will be suitable targets for development as diagnostic reagents, antimicrobial agents and vaccine candidates. Although it is difficult to predict the full impact that this almost overwhelming volume of information will have on the practice of microbiology, it is clear that it will result ultimately in new ways of diagnosing and combating infectious diseases.

Bacteria↗

PubMed2005

Impact of genomics on research in the rat.

The need to translate genes to function has positioned the rat as an invaluable animal model for genomic research. The significant increase in genomic resources in recent years has had an immediate functional application in the rat. Many of the resources for translational research are already in place and are ready to be combined with the years of physiological knowledge accumulated in numerous rat models, which is the subject of this perspective. Based on the successes to date and the research projects under way to further enhance the infrastructure of the rat, we also project where research in the rat will be in the near future. The impact of the rat genome project has just started, but it is an exciting time with tremendous progress.

Animals↗

PubMed2001

Bicritical and tetracritical phenomena and scaling properties of the SO(5) theory.

By Monte Carlo simulations on a 3D SO(5) rotator model it is shown that, in contrast to the epsilon expansions of the renormalization group, the bicritical point is stable to biquadratic perturbations of AF-SC (antiferromagnetism-superconductivity) repulsions, which are produced by quantum fluctuations originated from the Gutzwiller projection. Therefore, the present work completes the link from a physical projected SO(5) starting point to an asymptotic SO(5) symmetry point. The tetracritical point is stable for attractive AF-SC interactions. Critical exponents and ratios are evaluated by scaling analysis. Bicritical and tetracritical scaling functions are derived for the first time. Suggestions on experiments are given.

Journal Article↗

PubMed1996

Health education for community-based malaria control: an intervention study in Ecuador, Colombia and Nicaragua.

A malaria study was undertaken in 98 rural communities of the Pacific coast of Ecuador (n = 14), Colombia (n = 22) and Nicaragua (n = 62). In-depth interviews on people's knowledge and practice regarding malaria aetiology, symptoms and treatment were conducted and complemented by formal household interviews. On the basis of this information, an educational programme was set up which included the training of village health promoters and community workshops organized by the health workers and used a set of methods of interactive learning. After the baseline survey the communities were paired and randomly allocated to the intervention and control groups. Malaria education took place only in the intervention communities. At the start of the project people's knowledge about malaria-transmitting mosquitoes and malaria symptoms was correct and widespread in those areas where the community exposure to formal health services was pronounced. However, knowledge of the recommended dose of chloroquine was poor everywhere, and self-treatment of malaria episodes deficient. The educational intervention achieved a high level of participant satisfaction which was expressed in a high and continuous attendance rate at the monthly workshops. The knowledge of malaria aetiology and symptoms was 33-61% better in the intervention group than in the control group. Knowledge of the recommended doses of chloroquine increased significantly (34% in Ecuador, 93% in Colombia but not in Nicaragua) and correct use of chloroquine in the treatment of malaria episodes also improved (26% in Ecuador, 85% in Colombia). In Nicaragua the results were less satisfactory due to the short period of promotional activities and the health services' policy of delivering only supervised treatment to the population. It is concluded that health education should play a major role in malaria control.

Colombia↗

PubMed1986

Caries status at the moment of total tooth extraction in a rural and an urban area in the Netherlands.

Edentulousness varies with the availability and accessibility of dental care. Comparing the dental status of groups of patients getting full dentures might give insight into the effect of different levels of supply of dental care on the dental condition. Therefore a research project has been started in the Netherlands in an urban and a rural area, having dentist-patient ratios of 1:2,500 and 1:5,700 respectively. In the urban and rural area an equal proportion had partial dentures prior to losing the last of their teeth. However, in the urban area 33% of the patients wearing partial dentures had full maxillary or mandibular dentures; in the rural area this figure was 73%. In the rural area a larger proportion had lost 21 or more teeth at the moment of total extraction. Therefore, it was concluded that in the urban area more effort was spent in maintaining the natural dentition. Looking at DMF-T figures and separate components of DMF-T, no differences could be established between people living in areas with a high and a low dentist-patient ratio.

Adult↗

PubMed1989

Localized lipodystrophy with panniculitis: light and electron microscopic studies.

A 41-year-old woman with localized lipodystrophy histologically showed lymphohistiocytic inflammation within adipose tissue at the periphery and loss of adipose tissue in the center of the lesion. Ultrastructurally, various degrees of lipophagocytosis by macrophages and giant cells were seen, starting with the projection of cytoplasmic processes into the fat droplet and engulfing pieces of the fat droplet which finally were digested. Laboratory investigations revealed a high serum gamma-globulin level and a positive antinuclear antibody, suggestive of a connective tissue disease or autoimmune disease.

Adipose Tissue↗

PubMed1982

Practical use of a word processor in a histopathology laboratory.

Some of the facilities available with a commercially purchased word processing program, linked to a DEC PDP 11/23 computer are described, together with an account of the practical histopathological use. The system is based on a share of the computer with a Clinical Chemistry Department. Development was time-consuming and required the constant availability of the Department of Physics. However, once working, considerable saving in secretarial time has resulted and a number of projects have been started which would not have been contemplated without the use of the word processor and its linked computer.

Computers↗

PubMed2005

Violence, misconduct and schizophrenia: Outcome after four years of optimal treatment.

BACKGROUND: Aggressive behaviour in patients with schizophrenic disorders is an ongoing source of concern to community-based services. It has been suggested that optimal treatment may reduce the risk of serious misconduct. OBJECTIVE: To assess prospectively aggressive and sexual misconduct in a cohort of patients receiving continued evidence-based community treatment. METHOD: Fifty patients with a DSM-IV diagnosis of a schizophrenic disorder were treated for 4 years with integrated biomedical and psychosocial strategies. The frequency and context of all aggressive and sexually inappropriate behaviour were assessed throughout. Correlations between an index of misconduct and demographic and clinical variables were examined. RESULTS: Levels of serious misconduct were low at the start of the project and declined as treatment progressed. Close examination of predictors of misconduct supported larger epidemiological studies imputing persistent psychotic symptoms, personality disorders and substance use. CONCLUSION: The study supports the hypothesis that effective treatment reduces aggressive and sexual misconduct in schizophrenic disorders.

Journal Article↗

PubMed1999

The UK FIM+FAM: development and evaluation. Functional Assessment Measure.

BACKGROUND AND AIMS: The aim of this study was to develop and evaluate the UK version of the Functional Assessment Measure (UK FIM+FAM). DESIGN: Before and after evaluation of inter-rater reliability. DEVELOPMENT: Ten 'troublesome' items in the original FIM+FAM were identified as being particularly difficult to score reliably. Revised decision trees were developed and tested for these items over a period of two years to produce the UK FIM+FAM. EVALUATION: A multicentre study was undertaken to test agreement between raters for the UK FIM+FAM, in comparison with the original version, by assessing accuracy of scoring for standard vignettes. METHODS: Baseline testing of the original FIM+FAM was undertaken at the start of the project in 1995. Thirty-seven rehabilitation professionals (11 teams) each rated the same three sets of vignettes - first individually and then as part of a multidisciplinary team. Accuracy was assessed in relation to the agreed 'correct' answers, both for individual and for team scores. Following development of the UK version, the same vignettes (with minimal adaptation to place them in context with the revised version) were rated by 28 individuals (nine teams). RESULTS: Taking all 30 items together, the accuracy for scoring by individuals improved from 74.7% to 77.1% with the UK version, and team scores improved from 83.7% to 86.5%. When the 10 troublesome items were taken together, accuracy of individual raters improved from 69.5% to 74.6% with the UK version (p <0.001), and team scores improved from 78.2% to 84.1% (N/S). For both versions, team ratings were significantly more accurate than individual ratings (p <0.01). Kappa values for team scoring of the troublesome items were all above 0.65 in the UK version. CONCLUSION: The UK FIM+FAM compares favourably with the original version for scoring accuracy and ease of use, and is now sufficiently well-developed for wider dissemination.

Activities of Daily Living↗

PubMed2003

The effectiveness of palliative care education delivered by videoconferencing compared with face-to-face delivery.

As part of a four-year study into the use of videoconferencing in palliative care, the delivery of workshops on palliative care to community nurses was evaluated by the Open University. Twenty nurses were randomly allocated to alternating videoconferencing and face-to-face modes of presentation. The quantitative study measured the amount of learning that occurred in each workshop with pre-tests and post-tests, and the mode of presentation. Forty-nine workshop attendances were analysed. The qualitative study used observation and analysis of videorecordings to assess the activity and attention spans in interactive communication during workshops, while a combination of interviews and questionnaires was used to assess the participants' level of satisfaction with presentation. The results showed that the nurses' level of satisfaction with the instructional presentation was high in both modes of presentation. Despite difficulties at the start of the project in the videoconferencing presentation, there was little difference between the modes of presentation in achievement scores or the gain in achievement scores. Although the learners preferred face-to-face workshops, they learnt as much from a videoconferenced workshop. Videoconferencing was less suitable for psychological or emotional discussions, but this may have been due to the time constraints on the workshops. Some features of videoconferencing suggest it could be used effectively in helping learners discuss sensitive issues. The Current Learning in Palliative Care (CLiP) worksheets were found to be an effective means of delivering learning.

Attitude of Health Personnel↗

PubMed2001

A new visualization approach for identifying mutations that affect differentiation and organization of the Drosophila ommatidia.

The Drosophila eye is widely used as a model system to study neuronal differentiation, survival and axon projection. Photoreceptor differentiation starts with the specification of a founder cell R8, which sequentially recruits other photoreceptor neurons to the ommatidium. The eight photoreceptors that compose each ommatidium exist in two chiral forms organized along two axes of symmetry and this pattern represents a paradigm to study tissue polarity. We have developed a method of fluoroscopy to visualize the different types of photoreceptors and the organization of the ommatidia in living animals. This allowed us to perform an F(1) genetic screen to isolate mutants affecting photoreceptor differentiation, survival or planar polarity. We illustrate the power of this detection system using known genetic backgrounds and new mutations that affect ommatidial differentiation, morphology or chirality.

Animals↗

PubMed1990

Assessment and comparison of chest radiography techniques in the United States and Sweden.

The United States Center for Devices and Radiological Health and the Swedish National Institute of Radiation Protection started a collaborative project in 1983. The purpose of the project was to test the adequacy and practicability of the United States (US) Nationwide Evaluation of X-ray Trends (NEXT) programme in Sweden. The NEXT protocol for the postero-anterior chest projection was modified and expanded to make it both "statistical" and "investigational" (in the US, NEXT gives mainly "statistical" information). All chest X-ray units in Sweden were surveyed in 1986-87. The project showed that the NEXT programme is applicable to countries other than the United States and provides a standardized protocol that enables intercomparison of the radiological techniques. This paper presents the comparison of the radiological techniques used in Sweden and the United States. The results of the investigational modifications made to the protocol used in Sweden are discussed. Recommendations concerning expansion of the NEXT protocol to include these valuable tools for investigational surveys are presented.

Data Collection↗

PubMedDate not supplied

Self-directed and student-centred learning in nurse education: 2.

Based on a study of student nurses' expectations at the start of their Project 2000 training, this article, the second of two, argues for the need to develop a new approach to self-directed learning. Termed the cooperative model, it places emphasis on tutors providing initial direction and leadership so that students can gradually develop the skills needed to become self-directed. This requires the use of pedagogical approaches which recognize the value of didactic as well as experiential teaching strategies. The characteristics of the cooperative model, which is located within the continuum of self-directed learning suggested by D'A Slevin and Lavery (1991), are outlined.

Education, Nursing, Baccalaureate↗

PubMedDate not supplied

[Educating a nurse for basic health care].

This work aims at describing the experience of the 1st grade class in the Nursing Course at the Faculty of Medicine of Marilia (FAMEMA) in 2002. In 1998, a new Political-Pedagogical Project (PPP) was started aiming at educating a critical and reflexive professional, capable of teamwork, by promoting nursing care in a humane way. An integrated curriculum and the problematisation methodology were adopted as strategies to implement the PPP, tailoring education to the job market. Among the competencies to be developed toward basic health care, they employed a strategy to integrate 1st and 2nd grade classes in a microarea by applying the MAPP technique.

Curriculum↗

PubMed2006

The antimelanoma immunocytokine scFvMEL/TNF shows reduced toxicity and potent antitumor activity against human tumor xenografts.

The immunocytokine scFvMEL/TNF, a fusion protein composed of human tumor necrosis factor (TNF) and a single-chain Fv antibody (scFv) scFvMEL targeting the melanoma gp240 antigen, demonstrates impressive cytotoxic effects against human melanoma cell lines in vitro. Pharmacokinetic studies of 125I-scFvMEL/TNF in BALB/c mice showed that the construct clears from the circulation with a terminal-phase half-life of 17.6 hours after intravenous administration. The maximum tolerated dose of scFvMEL/TNF in nude mice was 4 mg/kg, i.v., on a daily x5 schedule. There were no changes in gross pathology, clinical chemistry, or hematologic parameters in mice treated at doses of up to 3 mg/kg. Therapeutic studies at a dose of 2.5 mg/kg on athymic mice bearing established (approximately 50 mm3) human melanoma A375GFP xenograft tumors transfected with green fluorescent protein demonstrated potent tumor suppression and complete tumor regression of all lesions. There was no subsequent outgrowth of tumors from mice rendered tumor-free. These data show that scFvMEL/TNF can target melanoma cells in vivo and can result in pronounced antimelanoma effects after systemic administration. Toxicology studies indicate the relative safety of this agent at doses that are therapeutically effective and provide guidance to projected phase I starting doses on patients at this schedule.

Animals↗