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At least 685 records · Page 38Linked to original sources
PubMed1999

High thoracic epidural anesthesia does not inhibit sympathetic nerve activity in the lower extremities.

BACKGROUND: Sympathetic nerve activity was recorded in the leg during high thoracic epidural anesthesia with a segmental sensory blockade of the upper thoracic dermatomes to test the hypothesis that the sympathetic blockade accompanying thoracic epidural anesthesia includes caudal parts of the sympathetic nervous system. METHODS: Experiments were performed on 10 patients scheduled for thoracotomy. An epidural catheter was inserted at the T3-T4 or T4-T5 interspace. In the main protocol (seven patients), blood pressure, heart rate, and skin temperature (big toe, thumb) were continuously monitored, and multiunit postganglionic sympathetic nerve activity was recorded with a tungsten microelectrode in a muscle-innervating fascicle of the peroneal nerve. After baseline data collection, muscle sympathetic nerve activity was recorded for an additional 45-min period after epidural injection of 4-6 ml bupivacaine, 5 mg/ml. In an additional three patients, the effects of thoracic epidural anesthesia on skin-innervating sympathetic nerve activity were qualitatively assessed. RESULTS: Activation of thoracic epidural anesthesia caused no significant changes in peroneal muscle sympathetic nerve activity (n = 7), blood pressure, or heart rate. Skin temperature increased significantly in the hand 15 min after activation of the blockade, from 32.7 +/- 2.4 degrees C to 34.4 +/- 1.5 degrees C (mean +/- SD), whereas no changes were observed in foot temperature. The sensory blockade extended from T1 (C4-T2) to T8 (T6-T11). CONCLUSIONS: A high thoracic epidural anesthesia with adequate sensory blockade of upper thoracic dermatomes may be achieved without blockade of caudal parts of the sympathetic nervous system. This finding differs from that of earlier studies that used indirect methods to evaluate changes in sympathetic nerve activity.

Anesthesia, Epidural↗
PubMed2001

Precision cosmology and the density of baryons in the universe.

Big-bang nucleosynthesis (BBN) and cosmic microwave background (CMB) anisotropy measurements give independent, accurate measurements of the baryon density and can test the framework of the standard cosmology. Early CMB data are consistent with the long-standing conclusion from BBN that baryons constitute a small fraction of matter in the Universe, but may indicate a slightly higher value for the baryon density. We clarify precisely what the two methods determine and point out that differing values for the baryon density can indicate either an inconsistency or physics beyond the standard models of cosmology and particle physics. We discuss other signatures of the new physics in CMB anisotropy.

Journal Article↗
PubMedDate not supplied

Regional estimation of total recharge to ground water in Nebraska.

Naturally occurring long-term mean annual recharge to ground water in Nebraska was estimated by a novel water-balance approach. This approach uses geographic information systems (GIS) layers of land cover, elevation of land and ground water surfaces, base recharge, and the recharge potential in combination with monthly climatic data. Long-term mean recharge > 140 mm per year was estimated in eastern Nebraska, having the highest annual precipitation rates within the state, along the Elkhorn, Platte, Missouri, and Big Nemaha River valleys where ground water is very close to the surface. Similarly high recharge values were obtained for the Sand Hills sections of the North and Middle Loup, as well as Cedar River and Beaver Creek valleys due to high infiltration rates of the sandy soil in the area. The westernmost and southwesternmost parts of the state were estimated to typically receive < 30 mm of recharge a year.

Altitude↗
PubMed1994

Mini-markers: a brief version of Goldberg's unipolar big-five markers.

Goldberg (1992) developed a robust set of 100 adjective markers for the Big-Five factor structure found in phenotypic personality description. Because and even briefer marker set might be advantageous under certain assessment conditions, the performance of these 100 markers in 12 data sets was scrutinized, leading to the selection of an optimally robust subset of only 40 adjectives. This "Mini-Marker" subset demonstrated unusually impressive features for an abbreviated inventory, consisting of five scales that show, in comparison to the original scales, less use of difficult items, lower interscale correlations, and somewhat higher mean inter-item correlations; alpha reliabilities are somewhat lower. A format for administering this briefer inventory is appended.

Humans↗
PubMed2004

Highlights from the Tenth World Conference on Lung Cancer.

Should adjuvant chemotherapy for resected non-small cell lung cancer (NSCLC) be the standard of care? That question has been much debated since the presentation of results from the International Adjuvant Lung Cancer Trial (IALT) in May 2003 at the plenary session of the American Society of Clinical Oncology annual meeting. The IALT study showed a statistically significant survival advantage for patients treated with cisplatin-based adjuvant chemotherapy. The topic of adjuvant chemotherapy permeated the Tenth World Conference on Lung Cancer held from August 10-14, 2003 in Vancouver, Canada. Updated results of the IALT study were presented along with results from the Big Lung Trial from the United Kingdom and the Adjuvant Lung Project Italy trial, neither of which showed a significant survival benefit for adjuvant chemotherapy. How to put the IALT data into practice remains controversial, and leading lung cancer experts have not reached a consensus. Platinum-based doublets that include a taxane, vinorelbine, or gemcitabine remain the standard of care for the first-line treatment of metastatic NSCLC. However, there may soon be a new option for second-line treatment. A randomized study of pemetrexed in the second-line setting found efficacy similar to that of docetaxel given every 3 weeks, with less toxicity. Gefitinib was recently approved by the U.S. Food and Drug Administration for the treatment of advanced NSCLC following platinum-based chemotherapy and docetaxel. However, concerns have arisen about toxicity due to reports of interstitial pneumonitis from Japan. The observed incidence of interstitial pneumonitis from the data available to date is approximately 1%. Which patients derive the most benefit from gefitinib? It appears that lifetime nonsmokers and patients with bronchioloalveolar histology have the highest probability of disease response.

Antineoplastic Agents↗
PubMedDate not supplied

[The real place of infectious pathology in overall population morbidity].

The statistical decrease of the proportion of infections in the structure of morbidity of the population reflects the existing classification of diseases when only acute diseases are classified with the group "infectious and parasitic diseases". The proportion of diseases caused by infective agents remains constantly high. According to WHO data, such diseases make up one-third of all diseases in the world. In Moscow the proportion of infectious diseases in all diseases registered among the inhabitants of this big city fluctuated within 36.1% and 49.7% during the period of 1926-1997.

Communicable Diseases↗
PubMed1990

[Relations between district outpatient service and emergency care service in the treatment of elderly patients].

On the basis of analysing the state of health care delivery for the elderly and aged population at prehospital stage (provided by emergency care service and district polyclinic) in big cities with a high level of aging of the population, a number of organizational activities for improving health care delivery for this group of population has been suggested. The data on peculiarities in the level, structure and nature of emergency care visits by elderly population are provided. The reasons for the irrational use of emergency care are discussed. The requirements of the populations under study for various kinds of specialized medical care are determined. Current tasks aimed at improving medical care for the elderly provided a foundation for the necessity to strengthen the succession and correlation between all links in the chain of prehospital care and to re-calculate the workload in respect to applied public health institutions with due regard for age structure of the population in the region of health services.

Age Factors↗
PubMed2005

Drug discovery in the kinase inhibitory field using the Nested Chemical Library technology.

Kinase inhibitors are at the forefront of modern drug research, where mostly three technologies are used for hit-and-lead finding: high throughput screening of random libraries, three-dimensional structure-based drug design based on X-ray data, and focused libraries around limited number of new cores. Our novel Nested Chemical Library (NCL) (Vichem Chemie Research Ltd., Budapest, Hungary) technology is based on a knowledge base approach, where focused libraries around selected cores are used to generate pharmacophore models. NCL was designed on the platform of a diverse kinase inhibitory library organized around 97 core structures. We have established a unique, proprietary kinase inhibitory chemistry around these core structures with small focused sublibraries around each core. All the compounds in our NCL library are stored in a big unified Structured Query Language database along with their measured and calculated physicochemical and ADME/toxicity (ADMET) properties, together with thousands of molecular descriptors calculated for each compound. Biochemical kinase inhibitory assays on selected, cloned kinase enzymes for a few hundred NCL compound sets can provide sufficient biological data for rational computerized design of new analogues, based on our pharmacophore model-generating 3DNET4W QSPAR (quantitative structure-property/activity relationships) approach. Using this pharmacophore modeling approach and the ADMET filters, we can preselect synthesizable compounds for hit-and-lead optimization. Starting from this point and integrating the information from QSPAR, high-quality leads can be generated within a small number of optimization cycles. Applying NCL technology we have developed lead compounds for several validated kinase targets.

Algorithms↗
PubMed2004

Bioanalysis: its past, present, and some future.

An overview of about 100 years of bioanalysis is here disastrously attempted. The beginning of rigorous analytical systems can perhaps be traced back to the building and testing of the analytical ultracentrifuge by Svedberg and the apparatus for moving-boundary electrophoresis of Tiselius, both systems relying on expensive and hard to operate machines. In the sixties, Porath discovered porous beads for the determination of relative molecular mass (Mr) of proteins, based on the principle of molecular sieving. Concomitantly, Svensson and his pupil Vesterberg described a revolutionary principle for fractionating proteins in a nonisocratic environment, based on generation of stable pH gradients in an electric field, a technique that went down to history as isoelectric focusing (IEF). Polyacrylamide gel electrophoresis (PAGE), with the brilliant idea of discontinuous buffers, was brought to the limelight and in 1967, sodium dodecyl sulfate (SDS)-PAGE was described, permitting easy assessment of protein purity and reasonable measurements of Mr values of denatured polypeptide chains. By the mid seventies, another explosive concept was realized: orthogonal combination of two unrelated techniques, based on surface charge and mass fractionation, namely, two-dimensional (2-D) PAGE already in the very first papers by O'Farrell elaborated to its utmost sophistication. The eighties saw the systematic growth of 2-D PAGE, accompanied by systematic efforts to develop instrumentation for large-scale production of 2-D maps and computer evaluation for 2-D map analysis, based on the sophisticated algorithms adopted by astronomers for mapping stars in the sky. Another fundamental innovation in the field of IEF was the discovery of immobilized pH gradients (IPGs) that brought the much needed reproducibility in 2-D maps while allowing exquisite resolution in very narrow pH ranges. The nineties were definitely the decade of capillary zone electrophoresis, with the concomitant concept of automation and miniaturization in electrokinetic methodologies. Also 2-D map analysis witnessed a big revival, thanks to the adoption of IPGs for the first dimension. The enormous progress of mass spectrometry resulted in first reports on the analysis of macromolecules and the building of data bases on gene and protein banks. The third millennium is, perhaps, exasperating the concept of miniaturization at all costs, while not disdaining increasingly larger maps for 2-D analysis of complex protein mixtures.

Animals↗
PubMed2005

The meaning of distal sensory loss and absent ankle reflexes in relation to age: a meta-analysis.

CONTEXT: Polyneuropathy is a common disease and is more prevalent (at least 3 %) in elderly people. However, routine neurological examination of healthy elderly people may show distal sensory loss and absent tendon reflexes, which can obscure the distinction from polyneuropathy. OBJECTIVE: To investigate the relation between age and the prevalence of distal sensory loss, absent tendon reflexes, or muscle weakness, and to ascertain above which age these neurological signs could be considered as normal in ageing. DATA SOURCES: PubMed, Embase, the Cochrane Library, and Current Contents from 1960 until 2004. Reference lists of relevant studies were searched for additional studies, reviews or textbooks. STUDY SELECTION: Studies reporting on neurological signs upon routine neurological examination in generally healthy adult persons were considered for inclusion. Two reviewers independently assessed study eligibility and performed study inclusion. Of 629 studies initially identified, 50 (8 %) met the inclusion criteria. DATA EXTRACTION: Two reviewers independently performed data extraction and assessed study quality based on study design and the rigour by which confounding co-morbidity was excluded. DATA SYNTHESIS: The 50 included studies comprised a total of 9,996 adult persons. Assuming heterogeneity between studies, the prevalence data from different studies were pooled for separate age groups with a random-effects model. In healthy persons older than 60 years the prevalence of absent vibration sense at the big toes (29 % [95 % CI 18 % to 38%]) or ankles (15 % [95 % CI 11 % to 20%]), and absent ankle reflexes (23 % [95 % CI 16 % to 30 %]) was increased. CONCLUSIONS: Self-declared healthy adult persons younger than 60 years do not have neurological signs. After the age of 60 absent vibration sense at the big toes or ankles, and absent ankle reflexes are more prevalent, although the majority does not have these neurological signs. It seems more appropriate to apply different diagnostic criteria for polyneuropathy in adult persons younger and older than 60 years.

Adolescent↗
PubMed2005

Policy evaluation for the subsidy for influenza vaccination in elderly.

OBJECTIVE: In Japan, the subsidy of influenza vaccination for the elderly was introduced in November 2001. This paper examines its policy evaluation from the viewpoint of cost-benefit analysis. MATERIALS: The data of copayment of influenza vaccination, population and shot rate of the elderly are surveyed by telephone interview to the correspondents in the local governments of Tokyo metropolitan and other 12 big cities in Japan. The mortality due to pneumonia or influenza is obtained from Vital Statistics of Population. METHOD: At first, I examine the impact of amount of copayment, through its effect on shot rate, on the percentage of elderly receiving influenza vaccinations. Using these estimation results, benefit-cost ratio (BCR) is calculated. RESULTS: The estimated coefficient of copayment on shot rate is -0.007 and statistically significant. Shot rate significantly reduces pneumonia and influenza mortality and its magnitude is -0.0028. The obtained net benefit (NB) is 134.9 million yen or US$1.08 billion and benefit-cost ratio is 22.9 and its 95% confidence interval is [2.2, 43.7]. DISCUSSION: If copayment would be cut by a 1000 yen (US$8), it could avoid about 400 deaths in average big city. The benefit-cost ratio is quite high compared with the other countries or other vaccinations. CONCLUSION: We found the strong evidence in a sense of cost-benefit analysis in the subsidy for influenza vaccination in the elderly.

Aged↗
PubMed1996

Temporal integration in the echolocating bat, Megaderma lyra.

Temporal integration is a crucial feature of auditory temporal processing. We measured the psychophysical temporal integration of acoustic intensity in the echolocating bat Megaderma lyra using a two-alternative forced-choice procedure. A measuring paradigm was chosen in which the absolute threshold for pairs of short tone pips was determined as a function of the temporal separation between the pips. The time constants determined with this paradigm are a crucial characteristic of the sonar system of M. lyra, a species orientating in its environment by very short broadband sonar calls emitted at high rates. Two different carrier frequencies for the tone pips were used to obtain data from the lower and the higher half of the hearing area of M. lyra. Both in the lower and in the higher frequency range, M. lyra showed very short time constants of about 220 microseconds. Our results are comparable to data from the echolocating dolphin, Tursiops truncatus, showing click integration times of about 260 microseconds and to estimates of auditory temporal integration in the context of echo clutter interference in the big brown bat.

Acoustic Stimulation↗
PubMed1996

Resilient, overcontrolled, and undercontrolled boys: three replicable personality types.

Three replicable personality types were identified in a sample of 300 adolescent boys and shown to generalize across African Americans and Caucasians. The types had conceptually coherent relations with the Big Five dimensions, ego resiliency, and ego control, and converged with three of the types identified by J. Block (1971). The behavioral implications of the types were explored using several independent data sources. Resilients were intelligent, successful in school, unlikely to be delinquents, and relatively free of psychopathology; Overcontrollers shared some of these characteristics but were also prone to internalizing problems; and Undercontrollers showed a general pattern of academic, behavioral, and emotional problems. This research demonstrates that replicable and generalizable personality types can be identified empirically, and that the unique constellation of traits defining an individual has important consequences for a wide range of outcomes.

Achievement↗
PubMed2002

Kater-Karlsruhe Telemetry Test in Rescue Services.

The Karlsruhe Telemetry Test in Rescue Services (KATER) investigates the central role of the regional emergency dispatch center as the midpoint of the emergency medicine information network using ECG telemetry, in order to be able to draw conclusions for future development. Rescue centers today form the logistic center of the flow of information. Expanding this legally formulated role to data flows within a network is just beginning, however, since the introduction of EDP in pre-clinical emergency medicine is still in the pilot project stage. Legislators are tending toward big solutions due to economic reasons. The increasing complexity of this problem can only be handled by a networked infrastructure.

Computer Communication Networks↗
PubMed2001

[Current opinions on embryotoxic and teratogenic effects of ibuprofen].

Ibuprofen is a non-selective cyclooxygenase (COX) inhibitor with analgesic, antipyretic and antiinflammatory activity. Experimental, clinical and epidemiological studies, led on a wide scale, showed high therapeutically activity and good drug tolerability, especially for low doses in adult and children older then 6 months. Those data let to positioned ibuprofen to over-the-counter (OTC) drugs. However, unlike well-documented tolerability studies of the postnatal period the prenatal data are still unclear. Results of experimental studies showed ibuprofen-dependent: implantation disturbances, blocking of parturition, and contraction of ductus arteriosus what could produce persistent pulmonary hypertension. These data has been partially confirmed in human studies. Lack teratogenic effect was observed in in vivo animal studies. Gastroschisis is the only congenital ibuprofen-related malformation that was proved in big epidemiological human studies. Other congenital anomalies and disturbances, such as oligohydramnion, associated with maternal ibuprofen ingestion, and reported in available literature, have not been established in epidemiological studies.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

Straight talk: new approaches in healthcare. Are you ready to send HIPPA-compliant transactions? Your cash flow is at stake. Panel discussion.

The deadlines are looming for compliance with the transaction and code set requirements set forth in the Health Insurance Portability and Accountability Act of 1996 (HIPAA). If your hospital filed for an extension in October 2002, you need to begin testing transactions by April 2003 and sending transactions by October 2003. But don't rely on your technology vendors to give you the ability to send compliant transactions. While vendors can provide the correct computer data format, they can't gather the correct information. If you can't send a compliant transaction, the Centers for Medicare and Medicaid Services could reject your claims, drying up a big percentage of your cash flow.

Centers for Medicare and Medicaid Services, U.S.↗