Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Previous Practice”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 883 records · Page 49Linked to original sources
PubMed2001

Outpatient radical prostatectomy: impact of standard perineal approach on patient outcome.

PURPOSE: As managed care becomes more prevalent, urologists must critically evaluate the economic aspect of and patient satisfaction with urological practice patterns. We have previously reported the advantages of radical perineal prostatectomy, which decreases hospitalization and morbidity, and provides a more rapid return to normal activity, translating into cost savings. We have since evaluated the satisfaction of patients who underwent outpatient radical prostatectomy with and without laparoscopic pelvic lymph node dissection. MATERIALS AND METHODS: We evaluated the charts of 250 consecutive patients who underwent outpatient radical perineal prostatectomy with less than 24 hours of hospitalization from 1992 to 1997. Complications, pain management, blood transfusion, and bowel and urinary dysfunction were assessed. Validated quality of life questionnaires were mailed to 200 patients several months postoperatively and a 62% response rate was achieved. RESULTS: Mean followup in the series was 30 months. In the perioperative period there were rectal perforation in less than 2% of patients, anastomotic stricture in 3%, perineal fistula in 0.4% and blood transfusion in 11%. Some problems with bowel movements immediately after the procedure, such as diarrhea, constipation or soiled underwear, developed in 17% of patients, of whom up to 20% had had some bowel dysfunction before surgery. In the majority bowel problems resolved in an average of 7.3 weeks. Persistent new onset bowel trouble developed in 9 of the 124 patients (7%). The questionnaire demonstrated persistent significant urinary incontinence in 8 cases (7%). Nerve sparing was attempted in 54 patients, including 22 (41%) who achieve erection sufficient for vaginal penetration and are satisfied with sexual function. Of the patients 17% reported problems after hospital discharge that were mostly related to Foley catheter management. Overall 94.8% of patients were satisfied with treatment. Physical and social/family well-being appeared to be excellent according to the questionnaire. Only 12% of patients would have preferred longer hospitalization. The preferred method of pain control was nonsteroidal anti-inflammatory drugs. CONCLUSIONS: Radical perineal prostatectomy is a low morbidity alternative for localized prostate cancer. Outpatient radical perineal prostatectomy may be performed with good patient satisfaction and safety. There appear to be few bowel problems after long-term followup.

Aged↗
PubMed1999

Production of O-acetylated and sulfated chitooligosaccharides by recombinant Escherichia coli strains harboring different combinations of nod genes.

High cell density cultivation of recombinant Escherichia coli strains harboring the nodBC genes (encoding chitooligosaccharide synthase and chitooligosaccharide N-deacetylase, respectively) from Azorhizobium caulinodans has been previously described as a practical method for the preparation of gram-scale quantities of penta-N-acetyl-chitopentaose and tetra-N-acetylchitopentaose (Samain, E., Drouillard, S., Heyraud, A., Driguez, H., Geremia, R.A., 1997. Carbohydr. Res. 30, 235-242). We have now extended this method to the production of sulfated and O-acetylated derivatives of these two compounds by coexpressing nodC or nodBC with nodH and/or nodL that encode chitooligosaccharide sulfotransferase and chitooligosaccharide O-acetyltransferase, respectively. In addition, these substituted chitooligosaccharides were also obtained as tetramers by using nodC from Rhizobium meliloti instead of nodC from A. caulinodans. These compounds should be useful precursors for the preparation of Nod factor analogues by chemical modification.

Acetylation↗
PubMed2001

Shifts in relative prevalence of laryngeal pathology in a treatment-seeking population.

The prevalence of laryngeal pathology in a treatment-seeking population of southwestern Ohio underwent a 15-year reexamination. Relationships between pathology and demographic variables of age, gender, and occupation were investigated. Data were collected from 1,158 new patients seen by participating otolaryngologists between 1996 and 1998. The most frequent pathologies were reflux laryngitis, functional (including diagnoses of laryngeal myasthenia and hoarseness), vocal fold paralysis, nodules, and laryngitis. Pathologies were found to occur more often in females, with some pathologies more common to one gender. Pathologies occurred more often in the older age categories. The most common occupations found in the sample were retired persons, executives/managers, and homemakers. Comparisons were made to an earlier investigation of laryngeal pathology in the same otolaryngology practices. Differences from the previous study were noted in the prevalence of pathology and the distribution of demographic variables. Relationships between pathology and demographic variables reported by the two studies were examined for consistency.

Adult↗
PubMed2000

A serological survey of college students for antibody to Cryptosporidium before and after the introduction of a new water filtration plant.

In April 1997, a large city in the northeastern United States changed their drinking water treatment practices. The city, which previously provided only chlorination for their surface water sources added filtration in addition to chlorination. To assess whether Cryptosporidium infections rates declined following filtration, we tested serological responses to 15/17-kDa and 27-kDa Cryptosporidium antigens among 107 community college students 1 month before and 225 students 5 months after filtration. Results suggest that levels of Cryptosporidium infections did not decline following water filtration. However, seasonal changes in other exposures may have confounded the findings. Swimming in a lake, stream or public pool and drinking untreated water from a lake or stream predicted a more intense response to one or both markers. Residence in the city, not drinking city tap water or drinking bottled water, gender, travel or exposure to pets, young pets, diapers or a household child in day care were not found to be predictive of more or less intense serological responses for either the 15/17-kDa and 27-kDa antigen.

Adolescent↗
PubMed2000

Bipolar II depression with melancholic features.

Bipolar II depression with melancholic features has been understudied. The aims of the present study were to find the prevalence of melancholic features in bipolar II depression and in unipolar depression, and to compare melancholic with nonmelancholic bipolar II/ unipolar depression in private practice. One hundred and sixty two consecutive unipolar and bipolar II depressed outpatients were interviewed with the DSM-IV Structured Clinical Interview, the Montgomery-Asberg Depression Rating Scale, and the Global Assessment of Functioning Scale. Melancholic features were present in 19.2% of bipolar II patients and in 22.6% of unipolar patients, a nonsignificant difference. Melancholic bipolar II patients versus nonmelancholic bipolar II patients had significantly more psychosis and higher severity. All the other variables (age, age at onset, gender, illness duration, recurrences, atypical features, chronicity, comorbidity) were not significantly different. Melancholic bipolar II patients versus melancholic unipolar patients were not significantly different. Nonmelancholic bipolar II patients versus nonmelancholic unipolar patients had significantly lower age, lower age at onset, more atypical features, and more comorbidity. The prevalence of melancholic features in bipolar II depression in private practice was higher than previously reported in academic centers.

Adult↗
PubMed1996

Ankle blood pressure measurement, an acceptable alternative to arm measurements.

The use of automatic noninvasive blood pressure (NIBP) devices has become a common technique to monitor blood pressure intraoperatively. The usual cuff placement for these devices on the upper arm sometimes poses problems. As an alternative, many clinicians place the cuff on the ankle. This practice has not been previously investigated to determine its efficacy. The purpose of our study was to determine whether a noninvasive blood pressure cuff on the arm could be replaced by one on the ankle. We monitored 24 patients intraoperatively with two non-invasive blood pressure cuffs, one on the upper arm and one on the ankle. Systolic, diastolic, and mean pressures were obtained from each cuff placement at intervals of no shorter than 3 minutes. The time necessary to obtain the measurements and the presence of any artifact were also recorded. A total of 404 pairs of data were obtained and the systolic blood pressure ranged from 82 to 196 mm Hg. The mean and diastolic pressure readings were equivalent between the arm and ankle blood pressure readings. The systolic pressures were not equivalent, reflecting the fact that the ankle systolic blood pressure is physiologically higher than the arm systolic blood pressure. The difference between the times necessary to obtain the readings from arm or ankle was not statistically significant. Eight of the paired readings (2.0%) represented artifact, arbitrarily defined as a difference in mean blood pressure readings of 15 mm Hg between the arm and the ankle. Since the mean blood pressure readings obtained at the arm and at the ankle were statistically equivalent, we concluded that the ankle cuff placement provided a reliable alternative to the placement of the cuff on the arm.

Adult↗
PubMed1977

Differences in catalytic properties between cerebral cytoplasmic and mitochondrial hexokinases.

1. Clear kinetic differences between cytoplasmic and mitochondrial forms of type-I cerebral hexokinase were demonstrated from experiments performed under identical conditions on three (cytoplasmic, bound mitochondrial and solubilized mitochondrial) preparations of the enzyme. 2. Whereas the Michaelis constant for glucose (KmGlc) was consistent, that for MgATP2- (KmATP) was lower in the cytoplasmic than in the two mitochondrial preparations. The substrate dissociation constants (KsGlc and KsATP) were both higher in the cytoplasmic than in the mitochondrial preparations. A further difference in the substrate kinetic patterns was that KmATP=KmATP for the cytoplasmic enzyme, in contrast with the mitochondrial enzyme, where KmATP was clearly not equal to KsATP [Bachelard et al. (1971) Biochem. J. 123, 707-715]. 3. Dead-end inhibition produced by N-acetyl-glucosamine and by AMP also exhibited different quantitative kinetic patterns for the two enzyme sources. Both inhibitions gave Ki values similar or equal to those of Ki' for the cytoplasmic activity, whereas Ki was clearly not equal to Ki' for the mitochondrial activity. 4. All of these studies demonstrated the similarity of the two mitochondrial activities (particulate and solubilized), which were both clearly different from the cytoplasmic activity. 5. The analysis gives a practical example of our previous theoretical treatment on the derivation of true inhibition constants. 6. The results are discussed in terms of the function of cerebral hexokinases.

Acetylglucosamine↗
PubMed2000

Are patients who self-administer their medicines in hospital more satisfied with their care?

Patient self-administration of medicines in hospital prior to discharge is being seen increasingly as good practice by health professionals. Previous studies have looked for increased compliance and knowledge or asked whether patients liked self-administration and have not clearly demonstrated the benefits. This study surveys patients' views on self-administration and on their care. In particular it looks at the discharge process and the way information was given to the patient on discharge. Questionnaires were distributed to 309 patients being discharged from general medical wards of a teaching hospital in Central England to be completed by the patients after their discharge from hospital. Of these, 202 were returned to a separate university department for analysis. Although this study has been undertaken on only two wards, the survey has potential for large scale use. Findings which were consistent with previous work were that a great majority of patients who had self-administered their medicines would like to again, whilst those who had not had that opportunity were less likely to choose to self-administer in the future. However, this study found that a majority of patients under 60-years-old would choose to self-administer their medicines in hospital even if they had not been given the opportunity to do so recently. It was also found that patients who had administered their own medicines in hospital were more likely to report their overall care as excellent and were more satisfied with the discharge process than patients who had not.

Adult↗
PubMed2003

Effects of dose and schedule on the efficacy of ethyol: preclinical studies.

The chemo- and radioprotectant drug amifostine (Ethyol; MedImmune, Inc, Gaithersburg, MD) is approved for intravenous (IV) administration; however, the subcutaneous (SC) route is being explored as a practical alternative. We have previously reported equivalence between IV and SC administration using a rat model of radioprotection and active metabolite (WR-1065) tissue pharmacokinetics. To examine the more clinically relevant fractionated and hyperfractionated radiation schedules and the effects of variations in the time of amifostine administration, we expanded these studies to include radioprotection and pharmacokinetic studies of WR-1065 using multiple dosing. To measure radioprotection using a fractionated radioprotection model, rats were given amifostine over a 1-week period at various doses (25 mg/kg, 50 mg/kg, 100 mg/kg; or 162.5 mg/m(2), 325 mg/m(2), 650 mg/m(2), respectively) IV or SC daily 30 minutes before exposure to 7.5 Gy/dose. Rats were fully protected from mucositis at the highest amifostine dose, with protection diminishing as the amifostine was decreased. Equivalent protection was observed whether the drug was given IV or SC. When the number of days of amifostine administration was reduced, protection was diminished. Amifostine also protected against radiation delivered using a 1-week hyperfractionated schedule (4.5 Gy/exposure twice daily), with optimal protection occurring when the drug was administered bid 30 minutes before each exposure (50 mg/kg) or every day before the morning exposure (100 mg/kg). The need for daily dosing to achieve optimal radioprotection was consistent with the tissue pharmacokinetics of the active metabolite. We found that WR-1065 did not accumulate in tissues or in SC-implanted tumors when amifostine was administered daily for 3 weeks. In addition, tissue and tumor levels of WR-1065 declined to baseline 24 hours after each amifostine dose. In a monkey pharmacokinetic model, plasma levels of WR-1065 (characterized by a pronounced spike of WR-1065 immediately after IV administration that was absent when the drug was given SC) were similar to those of humans; however, levels of WR-1065 in the tissues were higher 30 minutes following SC administration and were equivalent 60 minutes following IV or SC administration. These results suggest that maximum tissue levels and protection occur when amifostine is given 30 to 60 minutes before radiation exposure, that treatment breaks reduce the radioprotection by amifostine, and that protection from hyperfractionated radiation is dependent on amifostine dose and schedule.

Amifostine↗
PubMed1995

Comprehensive ultrasound examination in a private perinatal practice.

A retrospective review of the types of patients seen and the accuracy of the diagnosis made was undertaken for patients referred for comprehensive ultrasound examination in a large private perinatal practice. A review of the perinatal ultrasound database, neonatal intensive care database, and hospital charts was done in 1338 patients referred to the perinatal ultrasound laboratory for comprehensive ultrasound examination during a 2-year period. Accuracy of the ultrasound diagnosis and relationships between structural anomalies seen on ultrasound examination and perinatal outcome was undertaken. Positive and negative predictive values for the ultrasonic diagnosis were 82% and 98%, respectively. There were 19 (1.4%) false-positive diagnoses and 38 (2.8%) false-negative diagnoses. There was a high correlation between structural anomalies and chromosomal anomalies, with 15 of the 87 infants (17.2%) with structural anomalies also having chromosomal anomalies. The accuracy of ultrasonic diagnosis for comprehensive examinations in a large private perinatal practice compared favorably with previous reports in the literature. The information presented in this study should be helpful to obstetric centers with similar patient populations.

Congenital Abnormalities↗
PubMedDate not supplied

The clinical importance of sociocognitive models of hypnosis: response set theory and Milton Erickson's strategic interventions.

This article documents the contributions and clinical relevance of influential sociocognitive models of hypnosis. We argue that an appreciation of the influence and interplay of sociocognitive constructs, combined with a knowledge of basic research findings, can contribute to sound clinical practice. This article extends previous statements of response set theory (e.g., Kirsch & Lynn, 1998, 1999; Lynn, 1998) by further elucidating the social and cognitive underpinnings of how response sets are established, maintained, and strengthened. It does so by providing a scientific rationale for Milton H. Erickson's most prominent strategic interventions.

Cognition↗
PubMed1992

The shape of DNA elution dose-response curves under non-denaturing conditions: the contribution of the degree of chromatin condensation.

We have re-examined the effect of detergent type, pH and temperature of lysis on the shape of the DNA elution dose response under non-denaturing conditions using plateau-phase CHO cells. Results practically identical to those previously published (Okayasu and Iliakis, 1989) were obtained, with a 1 h incubation at 60 degrees C during lysis with sodium-N-laurylsarcosine (NLS) resulting in almost linear dose-response curves. We also examined chromatin decondensation as a contributing factor in the linearization observed in the elution dose-response curve under the above conditions. When nuclei with condensed chromatin were prepared from irradiated cells, applied on the filter and lysed with NLS at room temperature, a shoulder-type elution dose-response curve was obtained only slightly higher than that of cells lysed under the same conditions. However, when nuclei prepared from irradiated cells were applied on the filter after relaxation of chromatin by incubation in low ionic strength buffer and lysed with NLS at room temperature, an almost linear dose-response curve was obtained similar to that of cells lysed with NLS at 60 degrees C. Lysis with NLS at 60 degrees C of nuclei with relaxed chromatin did not further modify the DNA elution dose-response curve. Based on these results we propose that the linearization of the DNA elution dose-response curve observed after chromatin decondensation reflects a reduction in the degree of chromatin compactness in the nuclear complexes that leads to a relatively uniform distribution of the DNA on the filter and reduces trapping of elutable material in the compact nuclear structures otherwise present. Since high radiation doses dissolve compact nuclear structures, trapping of elutable material is expected to be highest at low doses of radiation, leading to the observed reduction in the fraction of DNA eluted per Gy at low versus high radiation doses and thus to the observed shoulder. Furthermore, we propose that the linearization of the DNA elution dose-response curves observed in cells lysed in NLS at 60 degrees C may also be due to a decondensation of the nuclear complexes on the filter as a result of the combined action of detergent and high temperature. The notion of a correlation between DNA elution dose response and cell radiosensitivity was examined in two human (SQ20B, SCC61) and two Chinese hamster (V-79, irs-2) cell lines with widely different radiosensitivities.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed2003

Cancer therapy: new targets for chemotherapy.

The number two cause of mortality in developed countries is cancer. Despite the enormous effort put into cancer prevention, early diagnosis and treatment, it is likely that the incidence of the cancer morbidity and mortality will increase for the foreseeable future. This is due to various factors such as increased life expectancy, changes in environment and also the socio-economic situation around the world. Some cancer attracts more attention than others and increasingly epidemiological information is reaching the general public and is beginning to influence behavior. It is now well recognized that, for example, 1 of 8 women in the industrialized world will be diagnosed with breast cancer. Additionally, a strong correlation was established between lung cancer incidence and smoking and it is broadly accepted that the incidence of colon cancer is directly related to age and diet, and has been increasing over time. The current failure of preventive measures to significantly reduce the increasing incidence of these common tumors illustrates the importance of effective cancer treatment strategies, including chemotherapy. The combination of various anticancer drugs, given together with surgery and radiotherapy, gives hope to many patients. There has been recent evidence of improved therapeutic outcome with recent approaches and newer agents but for continuing effective chemotherapeutic treatment there is a need for a detailed understanding of their mechanisms of action and on the rationale of their application. This review attempts to provide up-to-date information regarding the development of new and innovative treatment strategies for cancer chemotherapy. Virtually, every year several of new targets for cancer therapy on both, cellular and molecular levels, are identified and new drugs enter not only clinical trials but also are included in well accepted and documented therapeutic protocols. As this review is in addition to our review published previously (Medical Principles and Practice 11, 2002, 117-125), we have tried to include new and innovative targets and drugs that attract attention at present. Although it is not possible to provide a complete list of all achievements and cover all work done in this field, we hope to be able to give some insight into this rapidly developing area.

Alkyl and Aryl Transferases↗
PubMed2005

Sexual role and transmission of HIV Type 1 among men who have sex with men, in Peru.

In Latin America, men who have sex with men (MSM) have traditionally practiced role segregation--that is, the adoption of a fixed role (insertive or receptive) rather than a versatile role (both practices) during anal sex. Previous modeling has shown that role segregation may yield a lower incidence of human immunodeficiency virus (HIV) type 1 infection, compared with role versatility; however, the modeling assumed no risk of acquiring HIV-1 during insertive sex, which is now recognized as unlikely. We reexamine the issue by use of a deterministic model incorporating bidirectional transmission and data from a cohort study of MSM in Lima, Peru, to demonstrate the potential effects of role segregation on the trajectory of the HIV-1 epidemic. In Lima, 67% of MSM reported segregated roles in their recent male partnerships. A population of MSM with identical contact rates but complete role versatility would have twice the prevalence of HIV-1 infection throughout the epidemic's first 3 decades. Preferential mixing among versatile MSM does not change overall prevalence but affects which individuals become infected.

Algorithms↗
PubMed2001

Validation study of a diary for use in acute lower respiratory tract infection.

BACKGROUND: Despite lower respiratory tract infection (LRTi) being the most common illness treated by doctors, no validated outcome measure to assess symptom duration and severity has been developed for patient self-completion. METHODS: As part of a randomized control trial researching management of acute LRTi, an easy self-completion diary was formulated and validated against the 'measure yourself medical outcome profile 2' (MYMOP2), an instrument previously validated in general practice. RESULTS: Spearman rank correlations of the diary profile versus MYMOP2 profile at baseline (r = 0.62), day 11 (r = 0.81) and change in score over time (r = 0.51) indicate that our diary correlates significantly with MYMOP2. The standardized response mean of the diary profile (mean change/SD change) = 1.48, indicating sensitivity to change. CONCLUSION: This study shows that a simple symptom diary is internally reliable, valid and sensitive to change for acute LRTi. This instrument could be used as a routine measure of LRTi in further research in both primary and secondary care.

Humans↗
PubMed1997

Symbolic kinship program.

This paper discusses a computerized algorithm to derive the formula for the likelihood ratio for a kinship problem with any arbitrarily defined relationships based on genetic evidence. The ordinary paternity case with the familiar likelihood formula 1/2q is the commonest example. More generally, any miscellaneous collection of people can be genetically tested to help settle some argument about how they are related, what one might call a "kinship" case. Examples that geneticists and DNA identification laboratories run into include sibship, incest, twin, inheritance, motherless, and corpse identification cases. The strength of the genetic evidence is always described by a likelihood ratio. The general method is described by which the computer program finds the formulas appropriate to these various situations. The benefits and the interest of the program are discussed using many examples, including analyses that have previously been published, some practical problems, and simple and useful rules for dealing with scenarios in which ancestral or fraternal types substitute for those of the alleged father.

Algorithms↗
PubMed1999

Friendship and social support: the importance of role identity to aging adults.

This article proposes role identity theory as a means of integrating the diverse frameworks and findings that populate the social support literature, and it highlights the importance of the friendship role on life satisfaction for aging adults. A sample of 800 preretirement-age working men and women were surveyed as part of a longitudinal study, Roles and Self: Factors in Development and Retirement. The results include differences in social support by gender, no significant influence of structural support variables, and the significant effect of the role of friendship on respondents' life satisfaction. Hierarchical regression analysis showed that commitment to the role of friend is significant in predicting life satisfaction when controlling for background variables, and friendship identity meanings emerged as the strongest predictor--stronger than income or marital status--when predicting well-being. Integration of theory with current and previous research, implications for practice, and directions for future research are discussed.

Adult↗
PubMed1999

Physiologically based toxicokinetic modeling of inhaled ethyl tertiary-butyl ether in humans.

A physiologically based toxicokinetic (PBTK) model was developed for evaluation of inhalation exposure in humans to the gasoline additive, ethyl tertiary-butyl ether (ETBE). PBTK models are useful tools to relate external exposure to internal doses and biological markers of exposure in humans. To describe the kinetics of ETBE, the following compartments were used: lungs (including arterial blood), liver, fat, rapidly perfused tissues, resting muscles, and working muscles. The same set of compartments and, in addition, a urinary excretion compartment were used for the metabolite tertiary-butyl alcohol (TBA). First order metabolism was assumed in the model, since linear kinetics has been shown experimentally in humans after inhalation exposure up to 50 ppm ETBE. Organ volumes and blood flows were calculated from individual body composition based on published equations, and tissue/blood partition coefficients were calculated from liquid/air partition coefficients and tissue composition. Estimates of individual metabolite parameters of 8 subjects were obtained by fitting the PBTK model to experimental data from humans (5, 25, 50 ppm ETBE, 2-h exposure; Nihlén et al., Toxicol. Sci., 1998; 46, 1-10). The PBTK model was then used to predict levels of the biomarkers ETBE and TBA in blood, urine, and exhaled air after various scenarios, such as prolonged exposure, fluctuating exposure, and exposure during physical activity. In addition, the interindividual variability in biomarker levels was predicted, in the eight experimentally exposed subjects after a working week. According to the model, raising the work load from rest to heavy exercise increases all biomarker levels by approximately 2-fold at the end of the work shift, and by 3-fold the next morning. A small accumulation of all biomarkers was seen during one week of simulated exposure. Further predictions suggested that the interindividual variability in biomarker levels would be higher the next morning than at the end of the work shift, and higher for TBA than for ETBE. Monte Carlo simulations were used to describe fluctuating exposure scenarios. These simulations suggest that ETBE levels in blood and exhaled air at the end of the working day are highly sensitive to exposure fluctuations, whereas ETBE levels the next morning and TBA in urine and blood are less sensitive. Considering these simulations, data from the previous toxicokinetic study and practical issues, we suggest that TBA in urine is a suitable biomarker for exposure to ETBE and gasoline vapor.

Biomarkers↗