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PubMedDate not supplied

[Study of clean versus aseptic technique of tracheotomy care based on the level of pulmonary infection].

The purpose of this research study was to determine whether the clean technique of tracheotomy care is the same, or more, secure from the aseptic, by testing the difference in the level of postoperative pulmonary infection between tracheotomized patients receiving aseptic and those receiving clean tracheotomy care. The sample consisted of 103 patients with tracheotomy (transient or permanent) from ENT or IC units of four big hospitals of Athens. The level of the patient's pulmonary infection was defined using the Weighted Level of Pulmonary Infection Tool, which was constructed especially for this research study. The data were analysed using the x2 statistical test, and the coefficients phi, Cramer's V and Kendall's, while, with the same statistics, the relationship between certain important external variables and the dependent variable was examined. The findings indicated that no statistically significant difference exists between clean and aseptic technique as to the level of pulmonary infection when used for tracheotomy postoperative care of tracheotomized patients.

Adult↗
PubMed2003

[An epidemiological survey of subclinical hepatic encephalopathy].

OBJECTIVE: To investigate the prevalence and correlative factors of subclinical hepatic encephalopathy (SHE) in patients with cirrhosis in China by using psychometric tests with big sample size. METHODS: 409 patients with cirrhosis and 416 patients with chronic hepatitis were investigated for the prevalence of SHE. In prevalence study questionnaire, psychometric tests (NCT and DST), laboratory data were used to estimate their liver function. RESULTS: According to age, the patients were divided into 5 groups (including<35, 35 to 44, 45 to 54, 55 to 64 and >65 groups). There was highly statistical significance on the results of NCT and DST, between the cirrhosis patients and the controls (t> or =4.108, P<0.01). The prevalence of SHE in cirrhosis patients was 51.3%. Highly statistical significance was found (chi 2=23.910, P<0.01) among the Child-Pugh A, B, C groups (39.9%, 55.2% and 71.8%). According to age, gender, smoking, etiology and education, no statistical significance was found. Logistic regression showed that there was a close relationship between the SHE prevalence and the Child-Pugh score only, and no relationship had been found between the SHE prevalence and other factors including age, gender, smoking, etiology and education. CONCLUSION: The SHE prevalence in hepatic cirrhosis patients is 51.3%, and the Child-Pugh score may be an important risk factor

Adult↗
PubMed1989

[Multidisciplinary consultation for patients with excess weight: observations following a 6-month pilot experience].

The evaluation and definition of excessive weight and obesity have greatly varied depending on the civilization and the era. These two themes have assumed importance under the influence of outside social pressures, and then medical criteria when obesity was associated with chronic illness and complications, for example, diabetes mellitus and hypertension. Everyday, articles appear taking this or that method for losing weight, methods where the effects are often described as miraculous in the short term, but uncertain in the medium-term and unsatisfying or unknown in the long term. This is mainly due to drop out rates, a ack of precise epidemiological data concerning obesity and its treatment, and lack of long-term follow-up of patients. Also in the long term at least, there does not seem to be a big difference in weight loss whatever the method chosen. Taking into account the importance of psychological and social factors frequently encountered in overweight patients, we have chosen an integrated approach (internist, psychiatrist, dietician). The following article describes the methods used and offers some reflections after a first period of six months.

Adult↗
PubMed1985

[The karyotype and character of chromosome bands in mountain sheep in Czechoslovakia].

Thirty-one moufflon (Ovis musimon) coming from eight localities in Bohemia and Moravia were examined. All animals had a diploid number of chromosomes without any numerical or structural aberrations from the standard set. On the basis of G-banding, all chromosomes were arranged into homologous pairs. C-banding was used to prove the localization of constitutive heterochromatin in the centromeric regions of the majority of chromosomes. Nucleolus organizers, demonstrated by means of A-staining, were located telometrically on the chromosomes in three big two-arm pairs and two acrocentric pairs. The number of active nucleolus organizers in individual cells ranged from 2 to 7. When these results were compared with the published data on the karyotype of sheep, the two forms were found to have much in common. It can be supposed that the karyotypes of moufflon and domestic sheep differ in the frequency of the occurrence of Ag-positive sections with nucleolus organizers.

Animals↗
PubMed1984

Ultrastructure of neuronal cell bodies in the medial cortex of Lacerta galloti.

According to ultrastructure, size, and location within the medial cortex of Lacerta galloti, seven basic kinds of neuronal somata are described in this study. In the outer plexiform layer of the medial cortex only a few somata can be detected. There, moreover some oligodendroglia and microglia cells a few neuronal somata showing conspicuous nuclear invaginations and spongious chromatin (A) can be seen. The granular layer of the medial cortex is formed by up to seven strata of tightly packed neuronal somata in a pattern which resembles that of the profound stratum of the fascia dentata of the mammalian hippocampus. In this layer four neuronal somata can be seen: somata with nuclear invaginations, generally located aside the outer plexiform layer (in the upper stratum) (B); very abundant little neuronal somata with chromatin clumps (C); vertically fusiform shaped neuronal somata with numerous polyribosomes (D); and big neuronal somata with spongious chromatin (E). In the inner plexiform layer, there are a variety of scarce neuronal somata intermingled with ependymal sprouts and fiber tracts running from other cortical areas; two main types are described: big horizontal somata which are almost covered by axonic endings making synapses (F) and somata with dense cytoplasmic matrix and some small nuclear invaginations (G). Location of soma, frequency, and biometric data of them have been used to make a comparison with neuronal types of the medial cortex of Lacerta galloti defined by Golgi impregnations.

Animals↗
PubMed1994

Endothelin-1 conversion and receptor characterization in human placental arteries.

Endothelin-1-(1-21), a potent pressor peptide, is transcribed as big endothelin-(1-38) and converted to active peptide by endothelin-converting enzyme. The current investigation tested the hypothesis that human fetoplacental blood vessels convert big endothelin-1 to active peptide and that fetoplacental blood vessels respond to endothelin-1 by binding of the peptide to specific receptor sites. In the isolated perfused placental cotyledon the addition of big endothelin-1 to the perfusate caused a time-dependent increase in perfusion pressure that corresponded to the appearance of endothelin-1 in the perfusate. The properties of human placental endothelin-1 receptors were defined in binding studies performed on a plasma membrane fraction of small arteries (<1.0 mm) dissected from the placenta. Binding was saturable, reached steady state by 3 h at 25 degrees C, and was linear with protein concentration. Scatchard analysis of binding data indicated a single class of high-affinity binding sites with a dissociation constant of 27.6 +/- 2.3 pM and a density of 856 +/- 119 fmol/mg protein (n = 5). The potency order for competitive inhibition of the binding of 125I-labeled endothelin-1 [endothelin-1 = endothelin-2 > endothelin-3 = sarafotoxin S6b >> big endothelin-1 (human) = big endothelin-1 (porcine)] is most consistent with a type A endothelin receptor subtype. Phenylephrine, bradykinin, norepinephrine, atrial natriuretic factor, diltiazem, U-46619, and angiotensin II did not displace 125I-endothelin-1 binding. Endothelin receptors were shown to have an approximate molecular weight of 36,600 by polyacrylamide gel electrophoresis.(ABSTRACT TRUNCATED AT 250 WORDS)

Arteries↗
PubMed1996

Open information systems and data security in medicine.

The realization of the German law for a new structure of health care delivery by the assurance of efficient structures and processes in hospitals calls for an optimal design of informational processes. To realize applications near to the users and just in time as well as to build up the complex functional relationships between departments and subsystems in big hospitals, a new design for Hospital Information Systems (HIS) is necessary. The features of modern HIS outlined in the paper can only be established by open systems, which guarantee portability, scalability and interoperability. This is also true in regionally distributed systems like the tumour register at Cancer Centres. In the paper the necessity and possibilities of open systems and different levels of application integration are discussed. The general statements are illustrated by practical realizations in the HIS of the Magdeburg University Hospital as well as in the tumour register at the Cancer Centre of Magdeburg/Sachsen-Anhalt. The creation of integrated structures for communications makes great demands on the assurance of data security and data protection, especially for the inclusion of external partners from the region. In the context of high sensitive data of cancer patients data protection is of top priority. The legal problems of data collection, data storage and exchange in medicine are discussed first. The paper presents some aspects of the concept for data security and data protection in the Magdeburg University HIS and of the related concept for data protection in the tumour register of the Cancer Centre Magdeburg/Sachsen-Anhalt. Appropriate steps of realization are demonstrated. The application of hardware based modern access control systems with integrated encryption of data follows. The statements are extended to the planned installation of hardware based network access control systems with integrated encryption of data in the LAN.

Computer Communication Networks↗
PubMed1991

[The importance of ADP for medical statistics].

Recent german articles concerning medical statistics give priority to data acquisition. This contribution describe the statistical analysis and presentation of the results of the Swiss accident insurance Company (SUVA) with 1.9 million of insured workers. This documentation covers per year approximately 450,000 accidents at work and in free time. The documentation include primarily the insurance-data, for medical purposes we use the adjacent diagnoses (up to 20 per accident). The new medical statistic (SUMEST) begins with the accidents of the year 1984, updated until 1988, this means, that we have a statistic of the outcome of accidents. For the analysis we use properties of the personality, details of what happened, injury, expenses for healing and results. The primary presentation is a collection of tables for every diagnosis (total 417) with the most important criteria for the cases. It is provided to publish results of special problems like time of disability, influence of algodystrophy etc. The possibility to analyse a big documentation (25 MBytes) with a personal computer give to the physician the possibility to perform the statistical analysis himself and to select the significant results immediately.

Data Interpretation, Statistical↗
PubMed1994

Spatial optimization of electrostatic interactions between the ionized groups in globular proteins.

A model approach is suggested to estimate the degree of spatial optimization of the electrostatic interactions in protein molecules. The method is tested on a set of 44 globular proteins, representative of the available crystallographic data. The theoretical model is based on macroscopic computation of the contribution of charge-charge interactions to the electrostatic term of the free energy for the native proteins and for a big number of virtual structures with randomly distributed on protein surface charge constellations (generated by a Monte-Carlo technique). The statistical probability of occurrence of random structures with electrostatic energies lower than the energy of the native protein is suggested as a criterion for spatial optimization of the electrostatic interactions. The results support the hypothesis that the folding process optimizes the stabilizing effect of electrostatic interactions, but to very different degree for different proteins. A parallel analysis of ion pairs shows that the optimization of the electrostatic term in globular proteins has increasingly gone in the direction of rejecting the repulsive short contacts between charges of equal sign than of creating of more salt bridges (in comparison with the statistically expected number of short-range ion pairs in the simulated random structures). It is observed that the decrease in the spatial optimization of the electrostatic interactions is usually compensated for by an appearance of disulfide bridges in the covalent structure of the examined proteins.

Alcohol Dehydrogenase↗
PubMed2004

Investigator and site selection and performing GCP clinical studies in India.

The optimum site and investigator selection process remains a closely guarded confidential matter and an essential part of development expertise of big pharmaceutical companies and CROs. The right and careful selection and evaluation of investigators and site is critical for successful completion of the trial within budget, timelines and generation of high quality data. The criteria for site and investigator selection in India for Good Clinical Practices (GCP) clinical trials are described for a start up company/CRO and can be applied to any country in Asia and Africa. Foreign sponsors doing clinical studies in India should pay close attention to site and investigator selection. The first GCP study in India was done only in 1995. At the dawn of 21st century, India is at the take off stage in clinical trials now. GCP studies can be done in India, as the quality of data is good, costs are lower and patient enrolment is much faster resulting in early completion of studies.

Choice Behavior↗
PubMed1998

Enhanced liver cell mutations in trematode-infected Big Blue transgenic mice.

Parasite infections in humans have long been associated with specific types of cancers. Schistosoma hematobium is a known inducer of urinary bladder cancer, Helicobacter pylori is a gastric carcinogen, and hepatitis B virus and Opisthorchis viverrini are causative agents of liver cell cancers. Another liver fluke, Fasciola hepatica, has also been identified as a neoplastic risk agent, primarily in animals. We used F. hepatica as a model agent to determine if the presence of an aggressive liver fluke could induce mutagenic events in mammalian tissue. Using the Big Blue(R) transgenic mouse assay, we found a two-fold increase in lacI mutations in cells harvested from mice harboring F. hepatica worms when compared to uninfected control animals. These data indicate that biological infections can cause increased genetic damage in surrounding host tissue.

Animals↗
PubMed2005

Clinical correlations of potential activity markers in systemic sclerosis.

The objectives of the project were the following: (1) to establish a group of patients with a confirmed diagnosis of systemic sclerosis (Ssc), (2) to perform a detailed entrance examination of each patient, (3) to determine concentrations of potential activity markers, and (4) to make a comprehensive examination of each patient 1 year after inclusion into the study. A total of 49 patients were examined, 36 with a limited form of SSc, 9 with diffuse SSc, and 4 with other forms of SSc. We determined plasma or serum levels of the N-terminal propeptide of procollagen type III (NPIIIP), interleukin-6 (IL-6), soluble receptor for interleukin-2 (sIL-2r), soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular adhesion molecule-1 (sVCAM-1), von Willebrand factor antigen (vWFAg), and big endothelin-1 (BET-1) using commercial kits, and urinary excretion of pyridinoline (PYR) and deoxypyridinoline (D-PYR) using high-performance liquid chromatography. Correlations of these markers with selected clinical data were calculated. The mean levels of all potential activity markers were increased compared with normal values, but differences were not significant. The levels of NPIIIP, D-PYR, and IL-6 were normal. The measured values after 1 year did not differ from the entry values. At entry, NPIIIP concentrations correlated with the finger-to-palm distance, and D-PYR corresponded with findings on a simplified health assessment questionnaire (FQ). IL-6 levels correlated with the leukocyte count, sIL-2r with the FQ, and ET-1 with the diffuse lung capacity for carbon monoxide. In general, we found only a few clinical correlates of potential activity markers. Our data confirmed the correlations of collagen metabolism markers with skin involvement and FQ, as was reported previously. Larger studies in this field are needed.

Adult↗
PubMed1995

Reasons for pregnancy termination: negligence or failure of contraception?

BACKGROUND: The aim of the study was to analyze the reasons for the failure of contraception and the reasons for not using any contraception among women seeking a legal abortion on social grounds. The women were also asked about their knowledge of contraception methods, including postcoital contraception. METHODS: We interviewed 200 women applying for a legal abortion within the first trimester of pregnancy about contraception, the contraceptive methods used, and the possible reasons for failure of contraception. RESULTS: Of all the women interviewed, 93% claimed to have adequate knowledge of contraception. At the time of conception 11.5% used safe methods (OCs 8%, IUDs 3.5%), 63% used less safe methods, and 26% were without contraception. Only 25% of the pill users had no explanation for the failure. 76.7% of the condom users reported that the condom was broken, had slipped off or its use had been irregular. The concern about side effects was the most common reason for not using safe contraceptives (25%). CONCLUSIONS: The women claimed to have enough information about contraceptives, and postcoital contraception was also familiar, but the knowledge on how to use them in practice was inadequate. Irregular use and breaks in contraception were common. Despite the data based on Pearl indices, pills failed twice as often as IUDs. Counseling about the proper use of contraceptives is important, although the concern about the side effects appeared to be a big, unsolved problem.

Abortion Applicants↗
PubMed1999

The assessment of Big Five Personality Factors and Temperament Domains as modifiers of cardiovascular response to occupational stress.

The aim of the study was to explore the role of Big Five Personality Factors and Temperament Domains as the factors influencing cardiovascular response to work, and their moderating effect on the relationship between occupational stress and cardiovascular reactivity. The self-reported data on occupational stress and filled in NEO-Five Factor Inventory by Costa, and McCrae and Pavlovian Temperament Survey by Strelau et al. were collected from 97 bank clerks employed in large bank branches. The subjects also responded to the questionnaire on personal and professional background factors. A 24 hour monitoring of cardiovascular reactivity (heart rate and blood pressure) was also provided. Conscientiousness was found to be the only modifier of cardiovascular response to occupational stress reflected by systolic blood pressure. Several main, independent of stress effects of personality and temperament domains were also found. The ratio of heart rate at work to heart rate during sleep was associated with the strength of excitatory process, the percentage of maximum heart rate index with Conscientiousness, and systolic blood pressure at work was influenced by the strength of inhibitory process. However, generally speaking, physiological indicators of the cardiovascular system functioning were not very sensitive to changes in values of personality and temperament variables at the level of occupational stress reported by the bank clerks who participated in the study.

Adult↗
PubMed2002

Diffusion and utilization of magnetic resonance imaging in Asia.

OBJECTIVES: An assessment of the current status of magnetic resonance imaging (MRI) was undertaken to provide input for future government decisions on the introduction of new technologies in Asia. The objective of the study is to describe and explain the diffusion pattern of this costly technology in several Asian settings. METHODS: Data on the diffusion pattern of MRI for different Asian countries (the Republic of Korea, Malaysia, Indonesia, the Philippines and Thailand) and regions (the cities of Shanghai and Hong Kong in China and the state of Tamil Nadu in India) were obtained from national representatives of professional bodies by using standardized questionnaires for the year 1997-98. In addition, utilization data were collected at the hospital level in three countries before and after the economic crisis in the region. For four countries plus Hong Kong, background information on the legal framework for "big ticket" technologies was collected. RESULTS: Since the introduction of the first MRI in the region in 1987, the number of MRIs has gradually increased both in public and private facilities in Asia. In 1998 the average number of MRI machines installed varied from less than 0.5 machine per million population to more than 5 machines per million population. The maintenance and operating costs, and not the absence of regulation, account for the low number of MRIs in the Philippines and Malaysia. Overall, installed MRIs have low magnetic field strength, vary with respect to brand and type, and are mostly in the private sector and in the urban areas of the region. The diffusion pattern of MRIs in countries of the Asian region appears to follow two types of patterns of diffusion: one set of countries seems to be composed of mostly early adopters and another set of countries appears to be composed mostly of late adopters. CONCLUSIONS: Total number of MRIs per population in this region, though quite small compared to most OECD countries, reflects a higher share of the country's health-resource devoted to expensive high-technology devices. It is difficult to state the appropriate number of MRIs for each country; however, the study shows that there are observable problems in terms of efficiency, equity, and quality of MRI services. The research team proposes a few key recommendations to counteract these problems. Purchasing and regulatory bodies must be empowered with skill and knowledge of health technology assessment. Likewise, the fundamental problems resulting from inefficient and unfair health financing should not be overlooked, so that there is more equitable use of the technology.

Asia↗
PubMed1987

[Epidemiological characteristics of meningococcal infection in a number of territories of the RSFSR (1969-1984)].

In this work the dynamics and morbidity level in respect of meningococcal infection at 11 territories of the RSFSR at the period of 1969-1984 are analyzed. The study covered altogether 16 cities and 211 districts. The role of big cities as the sources of infection spreading into rural areas and further "fixation" of this infection mainly in regions with a population of 60,000 and more had been established. The data on meningococcal morbidity and carriership among different age groups are presented. The study has shown a pronounced increase in the incidence rate of meningococcal infection among children aged up to 2 years, as well as an increase in the proportion of these children among patients with meningococcal infection in recent years.

Age Factors↗
PubMed1986

[Experiences with residential communities for psychiatric patients].

We report about 3 1/2 years experience with sheltered apartments in Bern Switzerland. Now 53 psychiatric ex-patients have been living in 9 apartments. After a survey of the literature, we describe the organizational model and the goals of the project. A big mental state hospital and a small social-psychiatric service with different needs and views of the problems work together. The two different groups of residents, their social- and illness-data are analyzed and compared. Indications, the expense of care and the results are described. The most important effect seems to be the reduction of the need of hospitalization p.a. in the group of residents in a ratio of 10 to 1.

Combined Modality Therapy↗
PubMed1997

[Units of DNA replication in S-phase human cells].

Current methods of physical mapping allow the estimation of genomic distances (i.e. DNA contents) from linear distances between DNA markers in interphase nuclei, and in this study we estimated the size of focal centers of DNA replication in cultured S-phase human cells. Our results indicate that the conformation of S-phase chromosome fibres in the range of contour lengths 0.1-3.0 microns fits the random walk model and, therefore, the quantitative methods of interphase mapping can be applied to the estimation of sizes of replication units. The obtained data show the existence of multiple non-clustered small units less than 150 kb in size, equivalent to small replicons detected by fiber DNA radioautography, and also a significant fraction of big units more than 500 kb in size, representing groups of small replicons and/or big replicons. These big units are detected as chains of small replication foci, probably reflecting the structural chromatin organization in well-known loop domains, since the experimentally induced decrease of replicons to the average size 12 kb does not lead to any change in the pattern of indicated chains.

Adenocarcinoma↗