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PubMed2000

Carotenoid limitation and mate preference evolution: a test of the indicator hypothesis in guppies (Poecilia reticulata).

Under the indicator models of mate choice, female preferences evolve to exploit the condition-dependence or "indicator value" of male traits, which in turn may cause these traits to evolve to elaborate extremes. If the indicator value of a male trait changes, the payoff function of the female preference for that trait should change and the preference should evolve to a new optimum. I tested this prediction in the guppy, Poecilia reticulata, a species in which the indicator value of a sexually selected male trait, carotenoid coloration, varies geographically. Carotenoid coloration is thought to be an indicator of foraging ability and health because animals must obtain carotenoid pigments from their diet. The primary dietary source of carotenoids for guppies is unicellular algae, the abundance of which varies among natural streams because of variation in forest canopy cover. Carotenoid availability limits male coloration to a greater extent in streams with greater forest canopy cover. Thus, the indicator value of male coloration covaries positively with canopy cover. To test the indicator model prediction, I measured genetic divergence in the strength of female preferences for carotenoid coloration between high- and low-carotenoid availability streams in each of three river drainages. Second-generation laboratory-born females were given a choice between full-sib males raised on three different dietary levels of carotenoids. For all six populations, male attractiveness (as determined from the responses of females to male courtship displays) increased with dietary carotenoid levels. However, the strength of female preferences differed between populations in the predicted direction in only one of three river drainages. These results fail to support a crucial prediction of the indicator model. More studies taking an interpopulation approach to studying mate preference evolution are needed before the explanatory value of the indicator models can be rigorously assessed.

Animal Feed↗
PubMed2006

General practitioners' ranking of evidence-based prescribing quality indicators: a comparative study with a prescription database.

BACKGROUND: To ensure that indicators for assessing prescribing quality are appropriate and relevant, physicians should be involved in their development. How general practitioners (GPs) rank these indicators is not fully understood. AIMS: (i) To determine how GPs in Ireland rank a set of evidence-based prescribing quality indicators in order of importance and relevance to their practice, and (ii) to compare the GPs' ranking of the defined set of indicators with actual prescribing practice using a prescription database. METHODS: A postal questionnaire was sent to 105 GPs, who were asked to rank a set of 11 prescribing quality indicators, identified from the literature from most to least important. The results were aggregated and a weighted score for each indicator determined. These same prescribing indicators were then applied to a prescription database to compare the ranking provided with actual prescribing practice. RESULTS: Eighty-six GPs (82%) returned the completed questionnaire. The higher ranks were for quality issues-use of inhaled corticosteroids, statins and benzodiazepines. Actual prescribing data showed prolonged use of benzodiazepines in over half of the prescriptions dispensed (n = 18 171), 52.48% (95% confidence interval 51.95, 53.01) and low usage of generic drugs, 17.78% (17.70, 17.90) despite their high ranking by the GPs. CONCLUSION: While GPs have diverse views about the value of different prescribing quality indicators, the results suggest that they do rank evidence-based guidelines on patient management highly, but those based on costs and less evidence the lowest. There was considerable divergence between theory and practice in the application of quality indices.

Databases, Factual↗
PubMedDate not supplied

Are non-absorbable indicators of comparable value in the human stomach made abnormal by taurocholic acid?

1. The substances chromium-51 (51CrCl3) and phenolsulphonphthalein (phenol red; PR) were compared as non-absorbable indicators in the human stomach after alteration of ionic permeability by taurocholic acid. 2. Control and test solutions containing 10 mM taurocholic acid and indicators at pH 1 were instilled into the stomach and sampled immediately and after 15 min. The ratios of the initial and final concentrations of the indicators (Ci/Cf) were compared. 3. Correlation coefficients of the Ci/Cf ratios for the two indicators were 0 with 91 in control studies and 0 with 75 after taurocholic acid instillation; there was no significant difference between either indicator. During taurocholic acid instillation, Ci/Cf values tended to fall compared to controls. 4. In a smaller number of subjects in whom polyethylene glycol (PEG) was also measured as a non-absorbable indicator, results were similar to those obtained with 51Cr and PR. 5. 51Cr, PR and PEG are comparable indicators in the normal human stomach and when it is made abnormal by a lipid-soluble agent such as unionized taurocholic acid, though the correlation between indicators is reduced in the abnormal stomach. 6. No evidence of increased absorption of any indicator was found in spite of the increased ionic permeability produced by taurocholic acid.

Absorption↗
PubMed2005

Prescribers' indications for drugs in childhood: a survey of five European countries (Spain, France, Bulgaria, Slovakia and Russia).

BACKGROUND: Indication-based, in comparison to diagnoses-based, drug utilization studies in children are scarce in the literature. AIM: To determine the adequacy of the prescriber's indications for specific drug treatments compared to the current literature in five different European countries; and to show the possibilities of performing indication-based drug utilization studies. DESIGN: a descriptive, cross-sectional, international study. PATIENTS AND METHODS: Randomly selected sample of 12,264 paediatric outpatients seen in consultation rooms attended by paediatricians or general practitioners. Data on patient demographics, diagnoses, and pharmacological treatment, with therapeutic indications for each drug, were collected in pre-designed forms. Diagnoses and indications were coded using the ICD-9 and drugs according to the ATC classifications. RESULTS: Indications were registered for every drug prescribed in all locations. Antibiotic indications considered incorrect (common cold, upper respiratory tract infections, viral infections, general symptoms or "not specified") accounted from 24.1% of the total antibiotics prescribed in Tenerife to 67.4% in Slovakia. Incorrect indication of first-choice antibiotics prescribed in acute otitis media and tonsillitis ranged from 28.9% of total antibiotics use in Russia to 75.4% in Tenerife. Correct antibiotic indications ranged from 23.4% of total antibiotics used in Slovakia to 65.7% in Tenerife. Aspirin use in febrile viral conditions was detected mainly in Toulouse and Russia. CONCLUSION: The main areas for improvement detected were high use of mucolytics, prescription of aspirin in potential or established viral infections, overuse of antibiotics and identification of specific patterns of incorrect antibiotic prescription and clinical entities associated with each location.

Adult↗
PubMedDate not supplied

M-mode echocardiographic ratio indices in normal dogs, cats, and horses: a novel quantitative method.

A novel method for quantitative echocardiographic interpretations is introduced based on the calculation of ratio indices in which each raw M-mode measurement is divided by the aortic root dimension (Ao). "Aorta-based" indices were calculated with the animal's measured aortic root dimension (Ao(m)) as the length standard. Conversely, "weight-based" indices employed an idealized estimate of aortic dimension (Ao(w)) with a weighted least squares linear regression against the cube root of body weight (Ao(w) = kW(1/3)). Use of these indices circumvented undesirable statistical characteristics inherent in linear regression of echocardiographic dimensions against body weight and, to a lesser extent, body surface area. Compared with the regressions, ratio indices resulted in substantial refinement of the predictive range for each M-mode measurement in dogs, particularly with decreasing body size. Weight-based indices outperformed aorta-based indices in this regard. To refine the predictive range, neither type of index was clearly advantageous in cats compared with the simple average method typically employed for that species. Several of the raw M-mode measurements, however, were correlated with body weight in cats and horses, indicating the need for an appropriate correction for body size in these species. The ratio index method was suitable for this purpose. Summary statistics derived from normal dogs (n = 53), cats (n = 32), and horses (n = 17) are presented for each index, including novel clinical indices calculated from area ratios. The latter were designed to represent body size-adjusted lett ventricular stroke area (ie, volume overload) and myocardial wall area (ie, hypertrophy).

Animals↗
PubMed1996

Indicators of the quality of general practice care of patients with chronic illness: a step towards the real involvement of patients in the assessment of the quality of care.

OBJECTIVE: To develop a list of indicators of the general practice care of people with chronic illnesses considered important by both patients and practitioners and to identify the indicators that are considered relevant for patient assessment of health care quality. DESIGN: Qualitative study with focus group interviews and a written consensus procedure. SETTING: General practice in the Netherlands in 1993. SUBJECTS: 34 patients with chronic illness, mostly members of patient organisations, and 19 general practitioners with expertise in either chronic disease management or experience with patient surveys. MAIN MEASURES: Aspects of general practice care considered important for the delivery of good quality care that emerged from focus group interviews; the relevance of evaluations of 41 aspects of care for patients explored through the written consensus procedure. Those aspects of general practice care agreed to be both important and relevant by patients and general practitioners were considered to be suitable indicators for patient assessment of the quality of care. RESULTS: Patients and general practitioners differed to some extent in their assessment of the aspects of care that they considered important for quality. They agreed that most indicators of care that related to the ¿doctor-patient relation¿ and to ¿information and support¿ were relevant and therefore suitable as indicators for patient assessment of health care quality. There was less agreement about the relevance of indicators of ¿medical and technical care,¿ ¿availability and accessibility,¿ and ¿organisation of services.¿ CONCLUSIONS: Several indicators of the quality of general practice care of patients with chronic illness were thought to be suitable for the patient assessment of healthcare quality, but other indicators were not, mainly because of reservations by general practitioners. IMPLICATIONS: Qualitative methods can contribute to the selection of indicators for assessment of the quality of health care in areas where scientific evidence is limited or where patients' and providers' preferences are particularly important.

Chronic Disease↗
PubMed1994

Pulmonary capillary transport function from flow-limited indicators.

The objective of this study was to examine the use of rapidly diffusing (flow-limited) indicators for estimating the pulmonary capillary blood volume (i.e., fraction of the lung blood volume wherein the diffusible indicators equilibrate with the tissue) and the capillary transit time distribution. Supporting theory and an application to experimental data are presented. The theory leads to the following equations, which relate the mean transit time (t), the variance (sigma 2), and the third central moment (m3) of the capillary transport function, hc(t), to the moments of the venous concentration-time curves for a vascular reference indicator, CR(t), and a flow-limited diffusible indicator, CD(t), after a bolus injection of the indicators upstream from an organ: sigma 2D - sigma 2R = ([1 + (te/tc)]2-1)sigma 2c and m3D-m3R = ([1 + (te/tc)]3-1)m3c, where te = tD - tR and tc is capillary t. The moments of hc(t) can be estimated if the injected bolus includes, along with the vascular reference indicator, at least two flow-limited diffusible indicators, each with a different te. A least-squares optimization procedure can then be used to specify the moments of hc(t). This approach was applied to isolated dog lung lobes with [14C]-diazepam as the diffusible indicator. The tissue-to-perfusate partition coefficient for [14C]diazepam could be adjusted to any desired value by altering the perfusate albumin concentration. Thus, by making a number of injections, each at a different perfusate albumin concentration, data were obtained in a manner equivalent to making one injection with a number of flow-limited diffusible indicators, each with a different te. On average, the estimated capillary volume and mean transit time were approximately 48% of the total lobar volume and mean transit time, and the relative dispersion of the hc(t) was approximately 75%.

Animals↗
PubMed2005

The concentration-dependent effects of general anesthesia on spontaneous baroreflex indices and their correlations with pharmacological gains.

Beat-to-beat assessment of spontaneously occurring fluctuations in heart rate and arterial blood pressure allows noninvasive determination of cardiovagal function, but little is known regarding the effects of general anesthesia on spontaneous baroreflex (SBR) indices. We examined (a) concentration-dependent effects of sevoflurane on SBR indices, heart rate variability (HRV), and blood pressure variability and (b) correlation and agreement between pharmacological baroreflex gains and SBR indices during sevoflurane anesthesia. Continuous electrocardiogram and invasive arterial blood pressure were monitored in nine healthy volunteers before, during, and for 3 h after sevoflurane anesthesia, during which end-tidal sevoflurane was maintained at 0.7%, 1.4%, and 2.0% in random sequences. We derived three SBR indices (sequence method, alpha-index, and low-frequency transfer function) and compared them with pressor and depressor test gains by the pharmacological method. HRV and blood pressure variability were analyzed at a fixed respiratory rate (12 breaths/min) in awake and anesthetized conditions. Except for low-frequency transfer function, SBR indices were depressed by sevoflurane and remained depressed for 30 min after emergence from anesthesia, compared with the conscious baseline value. Spontaneous sequence indices and high- and low-frequency powers of HRV demonstrated concentration-dependent depression. Pharmacological gains and SBR indices during anesthesia generally correlated well, but Bland-Altman analysis revealed that SBR indices had limits of agreement as large as the baroreflex gain itself. These data suggest that spontaneous indices are inadequate estimates of, and are inconsistent with, the pharmacological baroreflex gain during sevoflurane anesthesia.

Adult↗
PubMed2004

New indicator for optimal preprocessing and wavelength selection of near-infrared spectra.

Preprocessing of near-infrared spectra to remove unwanted, i.e., non-related spectral variation and selection of informative wavelengths is considered to be a crucial step prior to the construction of a quantitative calibration model. The standard methodology when comparing various preprocessing techniques and selecting different wavelengths is to compare prediction statistics computed with an independent set of data not used to make the actual calibration model. When the errors of reference value are large, no such values are available at all, or only a limited number of samples are available, other methods exist to evaluate the preprocessing method and wavelength selection. In this work we present a new indicator (SE) that only requires blank sample spectra, i.e., spectra of samples that are mixtures of the interfering constituents (everything except the analyte), a pure analyte spectrum, or alternatively, a sample spectrum where the analyte is present. The indicator is based on computing the net analyte signal of the analyte and the total error, i.e., instrumental noise and bias. By comparing the indicator values when different preprocessing techniques and wavelength selections are applied to the spectra, the optimal preprocessing technique and the optimal wavelength selection can be determined without knowledge of reference values, i.e., it minimizes the non-related spectral variation. The SE indicator is compared to two other indicators that also use net analyte signal computations. To demonstrate the feasibility of the SE indicator, two near-infrared spectral data sets from the pharmaceutical industry were used, i.e., diffuse reflectance spectra of powder samples and transmission spectra of tablets. Especially in pharmaceutical spectroscopic applications, it is expected beforehand that the non-related spectral variation is rather large and it is important to remove it. The indicator gave excellent results with respect to wavelength selection and optimal preprocessing. The SE indicator performs better than the two other indicators, and it is also applicable to other situations where the Beer-Lambert law is valid.

Calibration↗
PubMed2006

Comparability of indices for insulin resistance and insulin secretion determined during oral glucose tolerance tests.

BACKGROUND: Impaired insulin secretion (IS) and insulin resistance (IR) play an essential role in the pathogenesis of type 2 diabetes mellitus. Several simplifying indices were developed that calculate IS and/or IR from venous insulin and glucose concentrations. The aim of the present study was to compare these indices with each other and with regard to their efficiency to differentiate between non-diseased and diabetic glucose tolerance states. METHODS: Oral glucose tolerance tests were performed in 301 subjects. The study group was divided into five groups according to WHO/American Diabetes Association (ADA) cut-off values: apparently normotolerant, diabetic, isolated 2-h post-challenge hyperglycemic, isolated fasting hyperglycemic and intermediate groups. The minimal error rate (diagnostic non-efficiency) indicating a misclassification of a diabetic tolerance state was determined for 12 indices. RESULTS: The error rate was lower than 15% for the index of Cederholm and Wibell and for the indices of Stumvoll et al. The misclassification rates for the other indices (index of Matsuda and de Fronzo, index of Myllynen et al., HOMA IR, HOMA beta-cell, FIRI, QUICKI, index of McAuley and insulinogenic index) were 20-27%; however, the diagnostic sensitivity was close to a 1:1 chance of a correct decision. The hypothesis that isolated post-prandial hyperglycemia (IPH) and isolated fasting hyperglycemia (IFH) differ in their insulin sensitivity and insulin response could not be supported by the present results. CONCLUSIONS: The indices of Cederholm and Wibell and of Stumvoll et al. were found to be appropriate as diagnostic indicators of the pathogenesis of diabetic glucose tolerance and were more closely related to the glucose tolerance state than the other indices.

Administration, Oral↗
PubMed1987

A comparative study of three indices of umbilical blood flow in relation to prediction of growth retardation.

The literature reporting Doppler ultrasound flow velocity waveform analysis of the umbilical artery and its applications for detecting intrauterine growth retardation (IUGR) is growing rapidly. Several indices originally introduced to evaluate different vascular beds in adults, are used to assess the vascular bed resistance downstream the umbilical artery (i.e. the placental bed). A higher resistance in this placental bed causes a decreased end-diastolic flow, which is described in combination with IUGR. The three most commonly used flow indices are: A/B ratio, Resistance Index (RI = (A-B)/A) and Pulsatility Index (PI = (A-B)/mean). In this study we evaluated which of these indices correlated best with IUGR. We calculated the three above mentioned indices from the same recordings of the blood flow (at a gestational age of 34 +/- 2 weeks) and correlated the results with the subsequent birthweight of the child. In the studied group (n = 48) 15 children were small for gestational age (SGA = less than P 10) and 33 children were appropriate for gestational age (AGA = greater than or equal to P 10). All three indices showed a significant difference in value between AGA and SGA children (see table III). The Spearman correlation-coefficients were calculated and were approximately one. So there was a high correlation between all three indices. This indicates that the different indices have the same relation to IUGR. Thus, no arguments were found to prefer one index above the other. In the second part of the study we investigated the validity of these indices to predict IUGR. The validity can be estimated from two components: the sensitivity and specificity. Both sensitivity and specificity are determined by the value of the index which discriminates between AGA and SGA. Changes in this discriminating value (the so-called cut-off point) will change both sensitivity and specificity. This last effect can be visualized in the Receiver-Operating-Characteristic (ROC) curve, which plots sensitivity against specificity for different cut-off points (see figures 4 and 5). Arbitrarily sensitivity and specificity were calculated for the cut-off points PI = 1.1 and A/B ratio = 3.0. Choosing these cut-off points, the same specificity of 87.9% with a sensitivity of 53.3% were found (table IV). It is concluded, that the sensitivity of the PI of the umbilical artery in predicting growth retardation with acceptable specificity is rather disappointing. A possible reason for this is discussed.(ABSTRACT TRUNCATED AT 400 WORDS)

Blood Flow Velocity↗
PubMed2005

[Indications for penetrating keratoplasty in Pernambuco].

PURPOSE: The indications for penetrating keratoplasty (PK) vary in different regions of Brazil. Keratoconus is the main indication in the state of São Paulo. However, in the state of Amazonas the main indication is ulcerative conditions. The purpose of this study was to evaluate the indications for PK in two reference centers of ophthalmology in the state of Pernambuco. The possible frequency differences in PK indications were also analyzed regarding other Brazilian states and other countries. METHODS: A retrospective analysis of the records of 814 patients who underwent PK at the "Fundação Altino Ventura", and "Hospital de Olhos de Pernambuco" from January 1998 to December 2002 was performed. RESULTS: The leading indications for PK were ulcerative conditions (21.3%), bullous keratopathy (19.9%), keratoconus (18.6%) and corneal scarring (17.8%). In 2001 the frequency of the PK indications was altered by the high frequency of regraft. This happened because of a programmed recall of these patients by the Pernambuco Transplantation Center. CONCLUSIONS: There were no significant differences between the frequencies of the leading indications during the period of study. On the other hand, the frequencies of those indications were different from those of other centers. It should be stressed that Pernambuco and Amazonas states show greater frequencies of ulcerative conditions, not similar to other centers. This fact is associated with poverty in these states.

Adolescent↗
PubMedDate not supplied

Comparison of E. coli, enterococci, and fecal coliform as indicators for brackish water quality assessment.

Escherichia coli (E. coli), enterococci, and fecal coliform data were collected and compared as potential indicators for swimmablility assessment of a brackish waterbody (Lake Pontchartrain, Louisiana). These indicators were measured during lake background conditions, in stormwater runoff (before dilution with lake water), and in the outfall plume within the lake following storm events. Microbial indicator titers associated with suspended particles and lake-bottom sediments were also investigated. Overall reduction rate constants for fecal coliform, E. coli, and enterococci in lake water and sediment were measured and reported. Attachment of microbial indicators to suspended matter and subsequent sedimentation appeared to be a significant fate mechanism. A slower reduction rate of indicator organisms in sediment further suggested that bottom sediment may act as a reservoir for prolonging indicator organism survival and added concern of recontamination of overlaying waters due to potential solids resuspension. Results indicated that enterococci might be a more stable indicator than E. coli and fecal coliform and, consequently, a more conservative indicator under brackish water conditions.

Enterobacteriaceae↗
PubMed1996

Relationship between Myers-Briggs Type Indicator and Gregorc Style Delineator.

The relationship between the Myers-briggs Type Indicator and Gregorc Style Delineator, and achievement was examined by administering these instruments to 259 first-year nursing students enrolled in an introductory human anatomy and physiology course. A principal component factor analysis using a varimax rotation of the scores from the two psychometric instruments, achievement examinations and an over-all grade point average indicated that each learning style from the Gregorc Style Delineator corresponds to certain traits on the Myers-Briggs Type Indicator. An individual who had a preference for the learning style of Concrete Sequential tended to have the traits of sensing and judging on the Myers-Briggs Type Indicator, while an individual who used the learning style of Concrete Random tended to have the traits of intuition and perceiving on the Myers-Briggs Type Indicator. One who had a preference for the learning style of Abstract Sequential tended to use the trait of thinking while another who used the learning style of Abstract Random tended to have the trait of feeling. The factor analysis also indicates no relationship of any scores of the traits on the Myers-Briggs Type Indicator or learning styles of the Gregorc Style Delineator with the examination scores achieved in the human anatomy and physiology course or to the students' over-all grade point average. However, factor analysis indicates that the Myers-Briggs Type Indicator traits of Judging vs Perceiving collapsed into the Sensing vs Intuition scale, and that the Gregorc Style Delineator consists of two bipolar scales that are different from those proposed by Gregorc.

Achievement↗
PubMed1989

Flow-cytometric DNA analysis and immunohistochemical measurement of Ki-67 and BUdR labeling indices in human brain tumors.

Cell proliferation potential was assessed by measuring the labeling indices of the monoclonal antibody Ki-67 and of 5-bromodeoxyuridine (BUdR), and the cellular deoxyribonucleic acid (DNA) content in 48 human brain tumors. The diagnostic and prognostic value of flow-cytometric DNA analysis was also evaluated using ethanol-fixed paraffin-embedded BUdR-labeled specimens; these were the same specimens as were used for measuring the BUdR and Ki-67 labeling indices. Both the Ki-67 and the BUdR labeling indices correlated with the degree of malignancy estimated from conventional histological preparations. The Ki-67 labeling index was 1.7 times greater than the BUdR labeling index. The relationship of DNA aneuploidy to the labeling indices or to morphology in cases of glioma was examined. All of the tumors with an aneuploid line corresponded to malignant glioma classified by histological criteria, although malignant glioma did not always show DNA aneuploidy. In addition, the cases with aneuploid lines showed high BUdR and Ki-67 labeling indices. The cell kinetic data, which indicate the biological character of tumors, allowed prediction of the prognosis of the patients with gliomas. In contrast, despite the presence of an aneuploid line, three of 13 meningiomas showed a benign histological pattern without an aggressive clinical course, and neither the Ki-67 nor the BUdR labeling index was high. These results indicate an unequivocal relationship between DNA aneuploidy and clinical behavior; in general, both labeling indices may prove to be objective indicators of the outcome of patients with brain tumors.

Aneuploidy↗
PubMed2001

Development of indicators for assessing the quality of prescribing of lipid-lowering drugs: data from the pharmacotherapeutic quality circles in Hesse, Germany.

OBJECTIVE: To develop indicators based on prescription analysis in order to assess adherence using guidelines and to monitor prescribing behavior. SETTING AND MATERIAL: Eleven pharmacotherapeutic circles (PTC) of the Association of Statutory Health Insurance Physicians (KV Hesse; 10 PTCs including 155 GPs as participants, mostly high prescribers; one circle with 11 moderators trained in pharmacology). These provided a total of 183,997 drug prescriptions involving 54,970 patients (prescriptions reimbursed by the substitute fund--Ersatzkassen--II. quarter 2000); claims form from 151 GPs. On average, 5.1% of the patients with prescriptions received lipid-lowering drugs. METHOD: Development and application of indicators based on the guideline for the treatment of hypercholesterolemia developed by a GP's guideline group of the quality circles in Hesse (Hausärztliche Leitliniengruppe Hessen). The ratio of prescribing for primary and secondary prevention was chosen as a top indicator for measuring adherence to the guideline. Prescribing for secondary prevention was assessed by a set of special diagnoses. The second indicator relates to patient groups (here: older than 75 years) where the benefit of prescribing is not clear. Further indicators measure the prescribing of first choice drugs, avoidance of risk combinations and costconscious prescribing. The indicators are presented in the prescription analysis and will be discussed during the circle meeting. RESULTS: On average, the moderators prescribed 34% of the lipid-lowering drugs for primary prevention, the GP circle participants 36.7%. On average, moderators and GP participants prescribed lipid-lowering drugs for 4.9% and 7.5% of patients older than 75 years, respectively (6% and 22% in primary prevention). Approximately, 28% of all lipid-lowering drugs issued by the participants involved simvastatin and pravastatin as first-choice drugs compared to 36.5% in the case of the moderators. The prescribing of statins with fibrates or macrolides in combination is seldom. Cost-conscious prescribing can be assessed for each GP by the percentage of generic prescribing and the number of different brands per active agent. Both, moderators and participants used generics when prescribing fibrates, bile acid sequestrants or other types of lipid-lowering drugs (moderators 53.8% and GP participants 78.5%). Three months is too short a period for assessing compliance of lipid-lowering drug prescribing. CONCLUSION: It is possible to derive indicators from the guidelines and to integrate them into prescription analysis. The indicators reveal prescribing problems. The evaluation of PTCs in 2002 will involve the use of indicators as an instrument to assess the success in the implementation of guidelines.

Aged↗
PubMed2002

[Analysis of indications for a repeat Caesarean section].

The aim of the study is to establish the indications for a Resectio Caesarean (RS) and to compare them with those of the first Caesarean section (CS). The Study is retrospective and covers the period from 1.1.2000 to 31.XII.2000. For this period were accomplished 3646 deliveries, 894 (24.52%) of them with S. C. The RS were 182 (20.04%) of all CS. The number and the rate of each indication is calculate on the base of the sum of the first and the second indication from all CS. The first two indications reflect well the real reason for each CS. The results show that the average age of women with RS is grater 2 years and 7 months than those with first CS. The RS are elective in 80.7% of cases and is done at 38.4 +/- 1.4 w.g. The average weight of the newborns from RS is non significantly less with 31 g than this from first CS. The indication "status post CS" is not well defined as it is used in 98.3% of RS. The indication is accepted mostly as a relative one because is added in cases with enough reasonable other obstetric indications. The analysis of the indications of RS shows That 60% of them are justifiable 40% are undertaken on the bases of unconvincing complex indication, but which don't differ from those at first CS.

Adult↗
PubMed2005

[Relation of indications of Back-shu points of zang- and fu-organs with The Bladder Channel of Foot-Taiyang].

OBJECTIVE: To study on relation of indications of Back-shu points of zang- and fu-organs with The Bladder Channel of Foot-Taiyang. METHODS: With analysis of origin of Back-shu points of zang- and fu-organs and their indications, the relation of Back-shu points with the incidental and fundamental aspects, theory of qi-flow, and the characteristics of the parts of indications of acupoints reflected by Back-shu points, relations of indications of Back-shu points of zang- and fu-organs with The Bladder Channel of Foot-Taiyang were studied. RESULTS: Indications of Back-shu points, a group of acupoints on the circulation route of The Foot-Taiyang Channel, are not found in the channel, which is difficult to explain from twelve channel theory. However, the relation of the incidental and fundamental aspects, theory of qi-flow, and the characteristics of the parts of indications of acupoints with the indications, and the branches of channels presented due to channel tropism of acupoints, etc. contribute to explain the indications of Back-shu points for diseases and syndromes of five zang-organs and six fu-organs. CONCLUSION: The relation of indications of acupoints with disease groups and circulation route of channels can not be discussed simply by Miraculous Pivot . Channels.

Acupuncture Points↗