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At least 973 records · Page 54Linked to original sources
PubMed1996

Factors associated with maintenance antipsychotic treatment of patients with bipolar disorder.

BACKGROUND: Although recent surveys suggest that a substantial number of patients with bipolar disorder receive maintenance treatment with antipsychotic agents, little is known about the clinical factors associated with such treatment in this patient population. The purpose of this study was to identify clinical factors associated with maintenance antipsychotic treatment in patients with bipolar disorder. METHOD: Seventy-seven patients who had bipolar disorder and were hospitalized for acute manic or mixed episodes were evaluated according to demographic, diagnostic, illness severity, treatment, and compliance variables at admission and at follow-up 6 months after discharge to determine differences between patients receiving ongoing antipsychotic medications and those maintained on thymoleptics alone. RESULTS: Fifty-two patients (68%) continued to receive antipsychotics 6 months after discharge. Maintenance antipsychotic treatment at 6-month follow-up was associated with being male, medication noncompliance in the month prior to the index hospitalization, severity of manic symptoms, and prescription of antipsychotic medication at time of discharge. CONCLUSION: Despite the risks of neurologic and behavioral side effects associated with protracted antipsychotic treatment and the availability of agents with mood-stabilizing properties such as lithium, valproate, and carbamazepine, antipsychotic maintenance treatment of bipolar disorder is common and associated with several important clinical factors.

Adult↗
PubMed1996

[A randomized controlled study of maintenance therapy with (2"R)-4'-O-tetrahydropyranyladriamycin for advanced and recurrent breast cancer. Clinical Study Group of THP for Breast Cancer in Japan].

We conducted a randomized controlled study to evaluate the clinical usefulness of (2"R) -4'-O-Tetrahydropyranyladriamycin (THP)-based combination therapy subsequent to induction therapy which was consisted with THP, 5'-DFUR, and CPA in the treatment of advanced or recurrent breast cancer. In maintenance therapy, Arm C received CPA and TAM, and Arm T received these two drugs plus THP. Survival time of 50% for all cases in which maintenance therapy was conducted was 26.9 months in Arm T and 20.9 months in Arm C, showing no significant difference by the log-rank test (p = 0.64). Survival time in all cases in which therapy had been completed was 54.6 months in Arm T and 28.1 months in Arm C, showing a significant difference by the log-rank test (p = 0.03) although the number of cases was few. A few cases showed a decrease in total leukocyte count to below 2,000/mm3 at the time of induction therapy, but this was transient in all cases. No significant difference in count was noted between two arms at the time of maintenance therapy. However, many cases in Arm T showed decreased total leukocyte count and hemoglobin content, and thrombocytopenia. These results suggest that combination therapy including THP conducted as maintenance therapy after induction is useful in the prolongation of survival time in patients with advanced or recurrent breast cancer.

Adult↗
PubMed1996

Predicting daily maintenance dose of fluindione, an oral anticoagulant drug.

Due to large inter-individual variations, the dose of vitamin K antagonist required to target the desired hypocoagulability is hardly predictible for a given patient, and the time needed to reach therapeutic equilibrium may be excessively long. This work reports on a simple method for predicting the daily maintenance dose of fluindione after the third intake. In a first step, 37 patients were delivered 20 mg of fluindione once a day, at 6 p.m. for 3 consecutive days. On the morning of the 4th day an INR was performed. During the following days the dose was adjusted to target an INR between 2 and 3. There was a good correlation (r = 0.83, p < 0.001) between the INR performed on the morning of day 4 and the daily maintenance dose determined later by successive approximations. This allowed us to write a decisional algorithm to predict the effective maintenance dose of fluindione from the INR performed on day 4. The usefulness and the safety of this approach was tested in a second prospective study on 46 patients receiving fluindione according to the same initial scheme. The predicted dose was compared to the effective dose soon after having reached the equilibrium, then 30 and 90 days after. To within 5 mg (one quarter of a tablet), the predicted dose was the effective dose in 98%, 86% and 81% of the patients at the 3 times respectively. The mean time needed to reach the therapeutic equilibrium was reduced from 13 days in the first study to 6 days in the second study. No hemorrhagic complication occurred. Thus the strategy formerly developed to predict the daily maintenance dose of warfarin from the prothrombin time ratio or the thrombotest performed 3 days after starting the treatment may also be applied to fluindione and the INR measurement.

Administration, Oral↗
PubMed1996

Enhanced detection, maintenance, and differentiation of primitive human hematopoietic cells in cultures containing murine fibroblasts engineered to produce human steel factor, interleukin-3, and granulocyte colony-stimulating factor.

To determine whether the sensitivity of the human long-term culture-initiating cell (LTC-IC) assay could be increased, we have evaluated a spectrum of different fibroblast cell lines for their abilities to influence the number of cells detectable as LTC-IC, to influence LTC-IC maintenance, and/or to influence LTC-IC differentiation into colony-forming cells (CFC) in cocultures containing various sources of LTC-IC. In a series of initial experiments with highly purified subpopulations of CD34+ cells from normal human marrow, no significant difference could be found between any of 3 different murine stromal fibroblast cells in terms of their support of either LTC-IC detection (CFC production) or maintenance (over a 6-week period), and all were equivalent to primary human marrow feeders (HMF). On the other hand, murine M2-10B4 fibroblasts engineered to produce high levels of both human granulocyte colony-stimulating factor (G-CSF) and interleukin-3 (IL-3; 190 and 4 ng/mL, respectively), either alone or mixed 1:1 with SI/SI fibroblasts engineered to produce high levels of soluble Steel factor (SF), with or without production of the transmembrane form of SF (60 and 4 ng/ mL, respectively), stimulated the production of up to 20-fold more CFC in LTC of cells from normal human marrow, G-CSF-mobilized blood or cord blood when compared with parallel cocultures containing HMF. Limiting dilution analysis of the CFC output from all three sources of LTC-IC showed that most of this increase was due to an ability of the engineered feeders to increase the plating efficiency of the LTC-IC assay (approximately 14-fold for marrow LTC-IC and approximately 4-fold for cord blood or mobilized blood LTC-IC). Analysis of the phenotype of these additionally recruited LTC-IC from marrow showed they had the same primitive CD34+CD45RA-CD71- phenotype as conventionally defined LTC-IC. The limiting dilution studies also showed that the average number of CFC produced per LTC-IC was additionally and independently increased to yield values of 18 CFC per LTC-IC in marrow, 28 for LTC-IC in cord blood, and 25 for LTC-IC in G-CSF-mobilized blood. Replating of cells from primary LTC with different feeders into secondary LTC-IC assays containing the best combination of engineered feeders showed that LTC-IC maintenance could be significantly enhanced (up to 7-fold as compared with primary cocultures containing HMF). However, this enhancement was still not sufficient to amplify the number of LTC-IC present after 6 weeks above the input value. Thus, engineering murine fibroblasts to produce sufficient SF, G-CSF, and IL-3 can markedly enhance the detection as well as the maintenance in vitro of a very primitive population of human progenitor cells present in normal adult marrow, mobilized blood, and cord blood by providing the most sensitive assay conditions thus far described. The present findings also provide new evidence of biologic heterogeneity between different cell populations that can be operationally identified as LTC-IC, thus re-emphasizing the importance of limiting dilution analyses to distinguish between quantitative and qualitative effects on these cells.

Animals↗
PubMed1997

Use of xylazine, butorphanol, tiletamine-zolazepam, and isoflurane for induction and maintenance of anesthesia in ratites.

Anesthetic effects of xylazine, butorphanol, tiletamine-zolazepam, and isoflurane in ratites (9 emus, 3 rheas, 6 ostriches) were determined. Anesthetic treatments included 4 regimens: induction and maintenance of anesthesia with isoflurane, preanesthetic tranquilization with xylazine and butorphanol followed by induction and maintenance of anesthesia with isoflurane, induction of anesthesia with tiletamine-zolazepam and maintenance with isoflurane, and preanesthetic tranquilization with xylazine and butorphanol followed by induction of anesthesia with tiletamine-zolazepam and maintenance with isoflurane. None of the birds developed irreversible adverse effects, but 2 developed brady cardia (1 was treated with atropine and responded) and 2 others developed transient apnea. Intravenous administration of tiletamine-zolazepam produced rapid and smooth induction of anesthesia in adult ostriches.

Adjuvants, Anesthesia↗
PubMed1996

Cytomegalovirus retinitis in AIDS patients: a comparative study of intravenous and oral ganciclovir as maintenance therapy.

OBJECTIVES: To compare the safety and efficacy or oral ganciclovir with intravenous ganciclovir for the maintenance therapy of cytomegalovirus (CMV) retinitis in AIDS patients. DESIGN: Multicenter, randomized, open-label study, with both masked and unmasked ophthalmic assessments. METHODS: Patients with AIDS and stable CMV retinitis were randomized after an induction course of intravenous ganciclovir (5 mg/kg twice daily) to receive maintenance therapy with oral ganciclovir (500 mg six times daily) or intravenous ganciclovir (5 mg/kg once daily). MAIN OUTCOME MEASURE: The primary endpoint of the study was time to progression of CMV retinitis from the start of maintenance therapy. RESULTS: The mean time to progression, evaluated by funduscopy was 109 days for the intravenous group, and 86 days for the oral group (P = 0.02). The masked photographic assessment revealed shorter time to progression for both oral and intravenous groups, as compared with funduscopy data, and showed no significant difference between the two treatment groups: 62 days for intravenous ganciclovir and 51 days for oral ganciclovir (P = 0.15). Diarrhea and neutropenia were the most frequent reported events in both groups, with the incidence of sepsis more than double in the intravenous compared with the oral ganciclovir group (3 versus 8.5%). CONCLUSIONS: Oral ganciclovir offers a reasonable alternative to intravenous ganciclovir for the maintenance therapy of CMV retinitis in AIDS patients.

AIDS-Related Opportunistic Infections↗
PubMed1997

Postsynaptic inhibitors of calcium/calmodulin-dependent protein kinase type II block induction but not maintenance of pairing-induced long-term potentiation.

The role of postsynaptic kinases in the induction and maintenance of long-term potentiation (LTP) was studied in the CA1 region of the rat hippocampal slice. A peptide inhibitor for the catalytic domain of calcium/calmodulin-dependent protein kinase type II (CaM-kinase) was applied through a perfused patch pipette. The inhibitor completely blocked both the short-term potentiation and LTP induced by a pairing protocol. This indicates that the kinase or kinases affected by the peptide are downstream from depolarization in the LTP cascade. The ability to block LTP required that measures be taken to interfere with degradation of the peptide kinase inhibitor by endogenous proteases; either addition of protease inhibitors or modifications of the peptide itself greatly enhanced the effectiveness of the peptide. Protease inhibitors by themselves or control peptide did not block LTP induction. To study the effect of kinase inhibitor on LTP maintenance, we induced LTP in one pathway. Subsequent introduction of the kinase inhibitor blocked the induction of LTP in a second pathway, but it did not affect maintenance of LTP in the first. The implications for the role of kinases in LTP maintenance are discussed.

Animals↗
PubMed1997

Distinct mechanisms for the induction and maintenance of allograft tolerance with CTLA4-Fc treatment.

A murine CTLA4/Fc gamma2a heavy chain (mCTLA4-Fc) chimeric fusion molecule was used in B6AF1 recipients of BALB/c pancreatic islet allografts to study the induction and maintenance of tolerance following inhibition of the CD28-B7 pathway for T cell activation. Donor-specific tolerance was achieved by administering 100 microg of mCTLA4-Fc on alternate days for 14 days (8 total doses) or a single 500 microg dose of mCTLA4-Fc on day 2 after transplant. Tolerance was mediated by long-lived peripheral lymphocytes and showed features of organ and alloantigen specificity. Whereas tolerance could not be established in allograft recipients receiving simultaneous mCTLA4-Fc and rIL-2, previously tolerant animals did not reject their grafts when given IL-2, suggesting that the induction and maintenance phases of tolerance were distinct and separate. The maintenance of donor-specific tolerance was an active immunologic process that was CD4+ T cell dependent and could be adoptively transferred to naive lymphocytes, but could not be explained by apoptosis or deletion of alloreactive T cells. Although an IL-2-sensitive mechanism such as anergy may contribute toward the induction of tolerance, its maintenance involves active suppression.

Abatacept↗
PubMed1997

Safety and efficacy of hydroxychloroquine as maintenance therapy for rheumatoid arthritis after combination therapy with methotrexate and hydroxychloroquine.

OBJECTIVE: To evaluate the ability of hydroxychloroquine sulfate (HCQ) to extend the response to combination therapy with HCQ and methotrexate (MTX) and the safety of longterm HCQ maintenance therapy in patients with active rheumatoid arthritis (RA). METHODS: Two-part study consisting of an open label segment evaluating combination HCQ/MTX therapy followed by a double blind segment evaluating maintenance therapy for a total of 60 weeks. First, all patients were treated with HCQ 400 mg/day and MTX 7.5 to 15 mg/week for 24 weeks. Then, responders were randomized into 3 groups: (1) HCQ with MTX as needed for disease flare (n = 40), (2) HCQ 400 mg/day (n = 41), or (3) placebo with MTX as needed for disease flare (n = 40), each for 36 weeks. RESULTS: Clinical disease and laboratory variables improved significantly during initial combination therapy with HCQ and MTX. After MTX withdrawal, HCQ-containing maintenance regimens delayed the onset of disease flare (p = 0.023). There were no unexpected adverse events at any time or between-group differences in the distribution of adverse events during the double blind segment. CONCLUSION: Combination of HCQ and MTX appeared to be effective and well tolerated for 24 weeks. After withdrawal of MTX, HCQ extended the response seen with combination therapy and was well tolerated for 36 weeks. Initial therapy with HCQ and MTX, followed by maintenance HCQ, may be a useful alternative for the treatment of RA.

Aged↗
PubMed1997

Patterns of symptom complaints in methadone maintenance patients.

AIM: Not all maintenance patients respond to methadone in the same manner, and many complain of withdrawal symptoms during the 24-hour inter-dosing interval (i.e. the dose does not 'hold'). The persistence of these complaints are a source of concern as they may signal unsanctioned drug use and poor treatment outcome. This study examined the prevalence and profile of symptom complaints in methadone maintenance patients who report that their methadone dose does not 'hold'. DESIGN: In the first phase, a cross-sectional survey of 114 methadone patients examined a range of symptoms including direct opioid effects and withdrawal. Phase 2 involved a comparison of the temporal pattern of symptom complaints between patients who reported the oral dose not 'holding' and those who did not. SETTING: Participants in this study were enrolled in the South Australian Public Methadone Maintenance Program. MEASUREMENTS: In Phase 1, a checklist of 21 commonly reported symptom complaints associated with methadone maintenance treatment was administered. In Phase 2, this checklist was modified to include only those symptoms that changed in the 24-hour inter-dosing interval. The checklist was administered eight times over this period. Further data were collected using the Morphine Benzedrine Group Scale of the Addiction Research Centre Inventory, a measure of positive opioid effect. FINDINGS: In Phase 1, it was found that approximately one-third of the sample reported that the methadone dose was consistently inadequate in preventing withdrawal symptoms for the entire inter-dosing interval. They could not be differentiated by demographic, health, other drug use or treatment characteristics. In Phase 2, despite having a higher oral methadone dose, patients reporting that their daily dose did not 'hold' experienced a smaller degree of opioid effect, and a greater intensity of opioid withdrawal, during the 24-hour period. CONCLUSION: These data demonstrate that there is a change in pharmacodynamic response over the 24-hour period for all methadone patients, but the degree of change is greater in a subgroup of patients. Charting symptom presentation throughout the inter-dosing interval can aid in identifying those patients who are experiencing difficulties with their treatment regime.

Adult↗
PubMed1998

Immunohistochemical study of human advanced glycation end-products (AGE) and growth factors in cardiac tissues of patients on maintenance dialysis and with kidney transplantation.

Cardiovascular disease is one of the most common complications of dialysis and renal transplant patients, and high levels of AGE are present in end-stage renal failure. To address the potential involvement of AGE and growth factors in the pathophysiology of cardiovascular complications, we performed immunostaining using cardiac tissues from autopsy cases of patients on maintenance dialysis (10 cases), long-term surviving renal transplant patients with functioning grafts (8 cases), control subjects with normal renal function (7 cases) and non diabetic subjects with mild renal insufficiency (8 cases). We used two types of AGE-antibodies, 6D12 [monoclonal anti-AGE antibody, recognizing N epsilon-(carboxymethyl) lysine(CML)-modified AGE] (oxidative AGE) and non-CML-PA [polyclonal, not recognizing CML], and antibodies against PDGFs, PDGF receptors and TGF beta. Positive 6D12 staining was observed in the coronary arterial walls and in macrophages. The accumulation of 6D12-reactive AGE in the coronary arterial walls of maintenance dialysis patients was significantly greater than that of control subjects (p < 0.05). Renal transplantation significantly reduced this accumulation (p < 0.05). On the other hand non-CML-PA mainly detected AGE in intracardiac arterioles and neural tissues. There was little difference in the accumulation of non-CML-AGE among the four groups. PDGFs and PDGF receptors were mainly detected in vascular endothelial cells and infiltrating cells of cardiac tissues of renal transplant patients, but not of maintenance dialysis patients. TGF beta was not detected in cardiovascular tissue of transplant patients. Our results indicated that the accumulation of oxidative AGE (CML-AGE) in the cardiac vascular tissue is one of the factors for cardiovascular complications of maintenance dialysis patients, and also that renal transplantation has a reducing effect on CML-AGE accumulation. PDGFs may be involved in the cardiovascular complications after renal transplantation.

Adult↗
PubMed1998

Acute lymphoblastic leukemia: dental health of children in maintenance therapy.

The dental health of 41 children aged 4-16 years who were in maintenance therapy from acute lymphoblastic leukemia (ALL) was examined in relation to the period of time in maintenance. There was no significant difference in dental experience and salivary flow rate between the control group and patients with leukemia. Performed treatment index (PTI) and required treatment index (RTI) scores reflected that children, who were in maintenance therapy had insufficient dental care and needed more dental treatments. A statistically significant difference in salivary pH was found between the children, who were in maintenance therapy for 12-24 months and less than 12 months and also the control group; but the pH scores of all groups were observed in normal limits.

Adolescent↗
PubMed1998

Maintenance hemodialysis in patients with HIV-associated nephropathy.

OBJECTIVE: End-stage renal disease (ESRD) patients infected with human immunodeficiency virus (HIV) have poor survival on maintenance hemodialysis. Only a few studies have evaluated survival time on the basis of demographic and clinical factors. The clinical category of the HIV infection and total CD4 counts are commonly considered determining factors of survival in these HIV-infected dialysis patients. PATIENTS AND METHODS: A retrospective case review of all ESRD patients with HIV infection on maintenance hemodialysis, from January 1987 through December 1996, was performed to determine the impact of different clinical categories of HIV infection and CD4 counts on survival and to see if there are other factors that can predict survival among these patients. From a total of 75 ESRD patients with HIV infection, 58 patients with ESRD due to HIV-associated nephropathy (HIVAN) on maintenance hemodialysis are reported here. RESULTS: During the 10 year study period, 52 of 58 ESRD patients with HIVAN expired. Infection (60%), cardiogenic conditions (13%), cerebro-vascular accidents (6%), HIV wasting (8%) and noncompliance with dialysis (11%) were common causes of death. Fifty patients who were on long term hemodialysis (Group I), had a median survival time of 11 months (4-69). Among 44 diseased patients in Group I, various demographic, clinical and laboratory markers, including age, sex, race, acquired immunodeficiency syndrome (AIDS)-associated conditions, HIV clinical categories, hemodialysis access and initial serum albumin level were not significantly associated with mean or median survival time. Those with initial CD4 counts of more than 50 had a significantly longer median survival (11.3 months) than those whose counts were below 50 (5.3 months). Patients with < or = 2.5 g/100 ml initial serum albumin level and < or = 50 initial CD4 counts had a median survival time of 5.3 months compared to 13.6 months in the group of patients with initial serum albumin level of > 2.5 g/100 ml and initial CD4 counts > 50. Both of these findings were statistically significant. CONCLUSIONS: Our 10 year experience of maintenance hemodialysis in ESRD patients with HIVAN shows that long term survival is possible. Initial CD4+ T cells of < or = 50 in these patients is a poor prognostic marker. HIV clinical categories, as reported by others, failed to predict survival in our long term experience. Initial serum albumin of < or = 2.5 g/100 ml was associated with poor survival, though statistically not significant. When initial serum albumin of < or = 2.5 g/100 ml was combined with CD4+ T cells of < or = 50, it became another marker of poor survival.

AIDS-Associated Nephropathy↗
PubMed1998

Compliance with national asthma management guidelines and specialty care: a health maintenance organization experience.

BACKGROUND: To improve asthma disease management, the National Asthma Education Program (NAEP) Expert Panel published Guidelines for the Diagnosis and Management of Asthma in 1991. OBJECTIVES: To compare the current status of asthma disease management among patients in a large health maintenance organization with the NAEP guidelines and to identify the factors that may be associated with medical care (eg, emergency department visits and hospital admissions) and adherence to the guidelines. METHODS: Analyses of 1996 survey data from 5580 members with asthma (age range, 14 to 65 years) covered by a major health maintenance organization in California (Health Net). RESULTS: In general, adherence to NAEP guidelines was poor. Seventy-two percent of respondents with severe asthma reported having a steroid inhaler, and of those, only 54% used it daily. Only 26% of respondents reported having a peak flowmeter, and of those, only 16% used it daily. Age (older), duration of asthma (longer), increasing current severity of disease, and treatment by an asthma specialist correlated with daily use of inhaled steroids. Ethnicity (African American and Hispanic) correlated negatively with inhaled steroid use but positively with emergency department visits and hospital admissions for asthma. Increasing age and treatment by an asthma specialist were also identified as common factors significantly related to the daily use of a peak flowmeter and, interestingly, to overuse of beta2-agonist metered-dose inhalers. CONCLUSIONS: Although the NAEP guidelines were published 7 years ago, compliance with the guidelines was low. It was especially poor for use of preventive medication and routine peak-flow measurement. Furthermore, the results showed that asthma specialists provided more thorough care than did primary care physicians in treating patients with asthma. Combining the results of the regression analyses revealed that some of the variation in rates of emergency department visits and hospitalizations among some subpopulations can be explained by the underuse of preventive medication. This study serves the goal of documenting the quality of care and services currently provided to patients with asthma through a large health maintenance organization and provides baseline information that can be used to design and assess effective population-based asthma disease management intervention programs.

Adolescent↗
PubMed1993

Health maintenance organizations and children with special health needs. A suitable match?

OBJECTIVE: To address how well health maintenance organizations (HMOs) meet the needs of almost 700,000 children with disabilities due to chronic conditions enrolled in these plans. DESIGN: A cross-sectional survey. MEASUREMENTS/MAIN RESULTS: Health maintenance organizations offered better protection than conventional plans against out-of-pocket expenses and were much more likely than fee-for-service plans to cover ancillary therapies, home care, outpatient mental health care, and medical case management. In addition, few HMOs maintained exclusions for preexisting conditions. Other aspects of HMO policies, however, were found to operate against the interest of families with chronically ill children. In particular, HMOs commonly made specialty services available only when significant improvement was expected within a short period. Also, HMOs typically placed limits on the amount and duration of mental health, ancillary services, and certain other services frequently needed by chronically ill children. Probably the most serious problems for chronically ill children enrolled in HMOs were the lack of choice among and access to appropriate specialty providers. PARTICIPANTS: Individual HMO plans. SELECTION PROCEDURE: A sample of 95 geographically representative HMOs were selected; 59 (62%) responded. INTERVENTIONS: None. CONCLUSIONS: Health maintenance organizations offer several advantages over traditional fee-for-service plans for families whose children have special health needs. However, the results also indicate that HMOs do not always operate effectively as service provision systems for these children. To a large extent, the availability and quality of services available to a child with special needs is likely to depend on the parents' ability to maneuver within the system.

Adolescent↗
PubMed2004

Long-term outcomes after radical prostatectomy performed in a community-based health maintenance organization.

BACKGROUND: Radical prostatectomy is used widely for the treatment of patients with localized prostate carcinoma. No long-term analysis has been reported on a series of radical prostatectomies performed in a community-based health maintenance organization. METHODS: Charts and histologic slides were reviewed from 750 patients who underwent radical prostatectomy between 1970 and 1996 at a community-based health maintenance organization. The influences of a number of variables were analyzed for their impact on progression free survival (PFS) and overall survival (OS). RESULTS: With a median follow-up of 6.2 years among survivors, 137 patients (18%) had progressive disease, and 149 patients (20%) died from all causes. The median OS from the date of diagnosis was 15.7 years (95% confidence interval, 13.6-17.2), similar to the expected median survival of 16.2 years. The median PFS from diagnosis was not reached, but 75% of patients were progression free > or = 10.6 years after undergoing prostatectomy. The prognostic factors included Gleason score, age at diagnosis, and T stage. Outcomes were comparable with reports of surgical series from university-based practices. CONCLUSIONS: The patient characteristics that had important, favorable correlation with survival included Gleason score < or = 6, T1 or T2 tumor status, and younger age at diagnosis. Lower prostate-specific antigen values at diagnosis, together with the former two parameters, also had a favorable correlation with PFS. Radical prostatectomy in a community-based health maintenance organization was followed by long-term PFS and OS comparable to outcomes reported from university-based practices. The impact of radical prostatectomy on survival remains to be demonstrated.

Adenocarcinoma↗
PubMed1985

Laboratory equipment maintenance contracts.

The increasing level of technical sophistication and complexity found in clinical laboratory instrumentation today more than ever demands careful attention to maintenance service needs. The time-worn caution for careful definition of requirements for acquisition of a system should also carry over to acquisition of maintenance service. Guidelines are presented for specifications of terms and conditions for maintenance service from the perspective of the laboratorian in the automated clinical laboratory.

Commerce↗
PubMed1990

A personal computer-based maintenance management expert system for hospitals.

In this paper a Maintenance Management Expert System (MMES) is developed. This system is suitable for hospitals as well as for manufacturing organizations. This expert system consists of five sections. These are work order management, equipment management, craftsmen management, material and supply control, and monitoring of maintenance activities. In addition the MMES provides several reports that can be utilized for improving maintenance effectiveness.

Expert Systems↗