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At least 1,099 records · Page 61Linked to original sources
PubMed1998

Evaluating local differences in breast cancer incidence rates: a census-based methodology (United States).

OBJECTIVES: We used readily accessible, existing data to assess whether or not geographic variation in breast cancer incidence rates in the San Francisco Bay Area was related to the unequal distribution of known breast cancer risk factors. METHODS: Cancer registry and 1990 census block-group data were used to look at the associations between breast cancer incidence and known risk factors (including parity, urban/rural status, and socioeconomic indicators) in 25 California counties. Average annual age-adjusted invasive breast cancer incidence rates were calculated for the period 1988-1992, and adjusted morbidity ratios were computed. RESULTS: While breast cancer incidence in Marin County was 9 percent higher than that of the other 24 counties combined (relative risk = 1.09, 95 percent confidence interval = 1.01-1.18), this increase appeared to be due to the unequal distribution of known risk factors. Block-groups that had a high level of any risk factor had higher incidence rates, regardless of geographic location. After multivariate adjustment, breast cancer incidence no longer differed between Marin and the other counties (adjusted morbidity ratio = 1.02). CONCLUSIONS: The results suggest that the unequal distribution of known risk factors was responsible for Marin County's high breast cancer incidence rate.

Adolescent↗
PubMed2002

Genomic instability in pituitary adenomas.

Pituitary adenomas most commonly are identified as small, incidental microadenomas. They however may progress to macroadenoma forming intra and later suprasellar tumors which in about 1/3 of cases invade surrounding structures at the time of diagnosis. Mechanism of pituitary tumorigenesis remains still elusive. Because the value of karyotyping is limited by the technical problems related to cytogenetic methods, we studied the spectrum of chromosomal imbalances associated with pituitary adenoma using comparative genomic hybridization (CGH). Copy number aberrations on all 22 autosomes were evaluated by CGH using advanced computer software. In total, fifteen patients were included in the study of 9 non-invasive, 4 invasive and two recurrent adenomas. The mean age of the patients were 48 years ranging from 36 to 68 years. Five tumors showed hormonal activity. The histogram of all 15 cases representing the DNA imbalances as an incidence curve along each chromosome showed losses particularly for chromosomes 1p, 2q, 4, 5, 6, 11q, 12q, 13q and 18q as well as overrepresentation on 9q, 16p, 17p, 19, 20q. Functioning adenomas carried more imbalances than non-functioning, specifically deletions on chromosome 4 and 18q as well as overrepresentations of chromosomes 17 and 19. Invasive adenomas carried more overrepresentations at 1p34 than non-invasive tumors. Recurrent adenomas harbored more alterations than primary tumors, particularly DNA gains. The primary data is accessible at our CGH online tumor database at http://amba.charite.de/cgh. Reviewing the existing literature on the genetics of pituitary adenoma and discussing our results in this context, we hope that our study will contribute to the knowledge of this neoplasm.

Adenoma↗
PubMed2006

A text-mining analysis of the human phenome.

A number of large-scale efforts are underway to define the relationships between genes and proteins in various species. But, few attempts have been made to systematically classify all such relationships at the phenotype level. Also, it is unknown whether such a phenotype map would carry biologically meaningful information. We have used text mining to classify over 5000 human phenotypes contained in the Online Mendelian Inheritance in Man database. We find that similarity between phenotypes reflects biological modules of interacting functionally related genes. These similarities are positively correlated with a number of measures of gene function, including relatedness at the level of protein sequence, protein motifs, functional annotation, and direct protein-protein interaction. Phenotype grouping reflects the modular nature of human disease genetics. Thus, phenotype mapping may be used to predict candidate genes for diseases as well as functional relations between genes and proteins. Such predictions will further improve if a unified system of phenotype descriptors is developed. The phenotype similarity data are accessible through a web interface at http://www.cmbi.ru.nl/MimMiner/.

Chromosome Mapping↗
PubMed2000

Structures of prevention: a safe-sex/safe-injecting audit of Mount Alexander Shire, a methodological pilot.

This paper reports the findings of a methodological pilot project that examined the availability of safe-sex and safe-injecting products in a rural shire in central Victoria. The study mapped the distribution and audited the availability of condoms, water-based lubricants, needles/syringes and needle disposal units to provide baseline data on access to and the availability of products that are directly related to the prevention of the human immunodeficiency virus, sexually transmissible infections and blood-borne viruses. Clear disparities were observed in the availability and pricing of safe sex/safe use materials between regional centres and outlying areas in the Shire. The findings make it clear that an emphasis on overcoming structural impediments to the adoption of safe sex/safe injecting practices is required.

Condoms↗
PubMed2002

Mind-body-environment: George Engel's psychoanalytic approach to psychosomatic medicine.

OBJECTIVE: To provide an overview of George Engel's psychoanalytic approach and contributions to psychosomatic medicine. METHODS: Engel's publications were reviewed to identify his use of psychoanalytic methods and concepts to explore and conceptualize the interrelationships among mind, body and environment in health and disease. RESULTS: Engel's contributions include an interviewing method for accessing psychological data; insights into the psychobiology of anaclitic depression; a psychosomatic theory concerning the influence of relationships and loss on susceptibility to disease; an elucidation of psychodynamic factors in the pathogenesis of chronic pain; and a longitudinal self-analytic study of anniversary reactions. CONCLUSIONS: Engel successfully bridged the disciplines of medicine, psychiatry, and psychoanalysis, and broadened the scope of psychosomatic research and clinical practice by identifying the role of interpersonal relationships throughout life in regulating mental and bodily processes.

History, 20th Century↗
PubMed2001

Legal issues relating to a cardiac surgery database.

The proposed Cardiac Surgery Database project is a venture shared between the Victorian Department of Human Services and the Australasian Society of Cardiac and Thoracic Surgeons (ASCTS). The aim is to provide a readily available and comprehensive information base on cardiothoracic procedures carried out in Victoria, with a view to raising the standards of cardiothoracic surgery, and to facilitate long-term patient care. Important issues for consideration are ownership and protection of the Database and the information within it, as well as the patient consent process, privacy and patient access to data, commercial use of the Database for ongoing funding, risk management, and protection of the ASCTS and surgeons from litigation.

Journal Article↗
PubMed2002

Hemodialysis catheters and ports.

Percutaneous placement of cuffed tunneled catheters for hemodialysis access has become a firmly established method of providing vascular access to patients with end-stage renal disease. Considerable evidence supports the right internal jugular vein as the preferred site for catheter insertion. The use of real-time imaging using both ultrasound and fluoroscopy permits simple, safe, and effective placement of the catheter for hemodialysis. The use of these imaging techniques has significantly reduced the number of and severity of complications associated with catheter placement. A specific method of placement is described including variations for specific catheter types. The new subcutaneous port as an alternative to the cuffed tunneled catheter appears to provide another option for vascular access; preliminary data suggests higher flow rates and lower infection rates compared with externalized cuffed tunneled catheters. Finally, the criteria for obtaining training and proficiency in placement of cuffed tunneled catheters are outlined.

Catheterization, Central Venous↗
PubMed2002

Medical privacy and its value for patients.

OBJECTIVES: To review privacy issues of medical information and current legal guidelines. DATA SOURCES: Government regulations and reports. CONCLUSIONS: Patients must have trust and confidence that the health care system will safeguard their health information and that it will not be used to discriminate against them through insurance or employment. IMPLICATIONS FOR NURSING PRACTICE: Health care professionals must be sensitive to the privacy needs of patients during the collection and storage of data, the access to information, and the sharing of patient information.

Confidentiality↗
PubMed2000

[Methods for the costing process in the field of economic evaluation of a rehabilitation program for patients with chronic obstructive lung diseases].

Studies in health economics especially economic evaluations of health care technologies and programmes are getting more and more important. However, in Germany there are no established, validated and commonly used instruments for the costing process. For the economic evaluation of a rehabilitation programme for patients with chronic lung diseases such as asthma and chronic bronchitis we developed methods for identification, measurement and validation of resource use during the inpatient rehabilitation programme and during the outpatient follow-up period. These methods are based on methodological considerations as well as on practical experience from conducting a pilot study. With regard to the inpatient setting all relevant diagnostic and therapeutic resource uses could be measured basing on routine clinical documentation and validated by using the cost accounting of the clinic. For measuring the use of resources during the follow-up period in an outpatient setting no reliable administrative data are accessible. Hence, we compared a standardised retrospective patient questionnaire used in a 20-minute interview (n = 50) and a cost diary for the continuing documentation by the patient over a period of 4 weeks (n = 50). Both tools were useful for measuring all relevant resource uses in sufficient detail, but because of higher participation rates and lower dropouts the structured interview appears to be more suitable. Average total costs per month were 1591 DM (interview), respectively 1867 DM (cost diary). Besides productivity loss, costs for medication and GP visits caused the relatively highest resource uses. Practicable instruments were developed for the costing process as part of an economic evaluation in a German rehabilitation setting for pulmonary diseases. After individual modification, these could also be used for different indications and in other institutional settings.

Adolescent↗
PubMed2004

[Surveillance of notifiable infectious diseases in Bavaria - results in 2002].

In 2002 nearly 36 000 cases of notifiable infectious diseases were reported in Bavaria representing a 10 % increase compared to 2001 (33 000 cases). As in 2001, around 75 % of reported cases were gastrointestinal infections. Every third infection was due to salmonella. As compared to last year, the incidence of Norwalk-like virus infections increased fivefold. These infections occurred mostly as outbreaks in nursing homes, hospitals or other institutions, affecting as many as 200 persons. Other frequently reported infections in Bavaria are tuberculosis and hepatitis. The relatively high incidence of measles is mainly due to an outbreak in Coburg. The decline in the incidence of tuberculosis observed over the last years has ceased. Around 70 % of reported hepatitis cases were due to hepatitis C. It should be noted that these cases were a mixture of new infections and ongoing infections diagnosed for the first time. Of great epidemiological importance are diseases caused by meningitis pathogens. The incidence of meningococcal infections was practically unchanged as compared to last year. Around half of them were caused by serotype B, which is currently not preventable by vaccination. Meningitis caused by Haemophilus influenzae B is continually declining due to the high vaccination rate and is very rarely reported. Several cases of FSME were described. According to investigations carried out by health departments these infections were acquired in countries not yet classified as FSME risk areas. Hence, the endemics maps of FSME have to be revised. Two years of reporting according to IfSG (infectious disease control law) yielded very encouraging results, i. e. rapid accessibility of data, flexibility, complete and standardised reporting with high quality of data. We thank all the reporting physicians and laboratories and the staff of the Bavarian health departments for their continuous support.

Adolescent↗
PubMed1999

The "Phoenix" ADR database of the Drug Commission of the German Medical Profession--a clinically useful approach to optimize evidence-based medicine in Germany.

The innovative "Phoenix" database system of the Drug Commission of the German Medical Profession (AkdA) permits rapid access to data on adverse drug reactions. It enables the user to conduct searches covering a wide variety of questions within a short period of time. No one needs to be an "expert" to extract scientific knowledge from a database that currently already contains some 106,000 reports on adverse drug reactions. While our traditional apprenticeship model of physician training has served us well, an adaptation will be required for the new millennium. New tools are needed to allocate the available resources. Clinical proposals of experts or opinion leaders, guidelines, and highly graded clinical studies, like the use of clinical databases may help to improve safety and efficacy of drug administration. Evidence-based critical care medicine is therefore a potential tool for improving the effectiveness of drug therapy and for the patient's outcome. Over and above, the Phoenix database might be interpreted as an initiative instrument, which is easy to use and contributes to highlight the determinants of clinical decisions.

Databases, Factual↗
PubMed1992

Removal of selected infralabyrinthine lesions without facial nerve mobilization.

The infralabyrinthine approach can be modified for the removal of certain lesions without facial nerve mobilization. This procedure is to be used for lesions falling under the three following categories: glomus jugulare tumors, infralabyrinthine cholesteatomas, and cholesterol cysts of the temporal bone. This report includes three glomus jugulare tumors (C1 Fisch type) and five infralabyrinthine cholesteatomas operated on with such a technique. Some anatomic data concerning access to the infralabyrinthine area are analyzed. This technique requires very good preoperative imaging screening and is made easier by intraoperative facial nerve monitoring. It can be combined with the translabyrinthine and transcochlear approaches and, if necessary, be modified into an infratemporal approach at any time.

Journal Article↗
PubMed1985

New ways in counselling on prenatally diagnosed congenital malformations. An experimental information project using Bildschirmtext/Videotex.

A bibliometric analysis of source items recently published in German-language gynaecology journals and one German-language journal covering a broader field of medicine yielded but one publication linked with prenatally diagnosed congenital malformations and their surgical treatment. Thus, journals usually assessed by the gynaecologist are in this respect at present not a useful source of information for the practitioner outside specialised centres. In order to explore the usefulness of Bildschirmtext (BTX, Videotex), a new electronic medium, as an alternative in counselling for congenital malformations and similar rare medical problems, an experimental database was constructed. Pages giving data on diagnostic pathways, incidence, prognosis, specialised treatment centres and suggested further reading on abdominal wall defects were compiled and are stored in a central computer of the German Federal Postal Services. Data are accessible via the regular telephone network and a specially equipped TV set. The method, although still experimental, is considered useful for offering medical intelligence to the medical professional outside specialised centres.

Abdominal Muscles↗
PubMed2005

Computing the Soret coefficient in aqueous mixtures using boundary driven nonequilibrium molecular dynamics.

We have computed the Soret coefficient in aqueous mixtures using a boundary driven nonequilibrium molecular dynamics algorithm and standard molecular force fields. The choice of this specific approach is justified by the nature of the mixtures studied here. Four aqueous solutions, including methanol, ethanol, acetone, and dimethyl-sulfoxide (DMSO) have been studied at ambient conditions for different compositions. The experimental behavior of water-alcohol mixtures was reproduced, including the change of sign of the Soret coefficient with composition, in excellent agreement with existing experimental data. The methodology has been applied to obtain pure predictions for water-acetone and water-DMSO where no experimental data are accessible. A change of sign is also observed in the same range of composition as in water-alcohol mixtures. It is suggested that the nature and strength of the molecular interactions, rather than the mass or shape ratio of the components, dominates the behavior of the Soret coefficient versus composition for the aqueous associating mixtures studied here.

Journal Article↗
PubMed1998

Mutational analysis of invariant arginines in the IIAB(Man) subunit of the Escherichia coli phosphotransferase system.

The mannose transporter of bacterial phosphotransferase system mediates uptake of mannose, glucose, and related hexoses by a mechanism that couples translocation with phosphorylation of the substrate. It consists of the transmembrane IIC(Man)-IID(Man) complex and the cytoplasmic IIAB(Man) subunit. IIAB(Man) has two flexibly linked domains, IIA(Man) and IIB(Man), each containing a phosphorylation site (His-10 and His-175). Phosphoryl groups are transferred from the phosphoryl carrier protein phospho-HPr to His-10, hence to His-175 and finally to the 6' OH of the transported hexose. Phosphate-binding sites and phosphate-catalytic sites frequently contain arginines, which by their guanidino group can stabilize phosphate through hydrogen bonding and electrostatic interactions. IIB(Man) contains five arginines which are invariant in the homologous IIB subunits of Escherichia coli, Klebsiella pneumoniae and Bacillus subtilis. The IIA domains have no conserved arginines. The five arginines were replaced by Lys or Gln one at a time, and the mutants were analyzed for transport and phosphorylation activity. All five IIB mutants can still be phosphorylated at His-175 by the IIA domain. R172Q is completely inactive with respect to glucose phosphotransferase (phosphoryltransfer from His-175 to the 6' OH of Glc) and hexose transport activity. R168Q has no hexose transport and strongly reduced phosphotransferase activity. R204K has no transport but almost normal phosphotransferase activity. R304Q has only slightly reduced transport activity. R190K behaves like wild-type IIAB(Man). Arg-168, Arg-172, and Arg-304 are part of the hydrogen bonding network on the surface of IIB, which contains the active site His-175 and the interface with the IIA domain (Schauder, S., Nunn, R.S., Lanz, R., Erni, B. and Schirmer, T. (1998) J. Mol. Biol. 276, 591-602) (Protein Data Bank accession code 1BLE). Arg-204 is at the putative interface between IIB(Man) and the IIC(Man)-IID(Man) complex.

Arginine↗
PubMed1998

Single point mutations distributed in 10 soluble and membrane regions of the Nicotiana plumbaginifolia plasma membrane PMA2 H+-ATPase activate the enzyme and modify the structure of the C-terminal region.

The Nicotiana plumbaginifolia pma2 (plasma membrane H+-ATPase) gene is capable of functionally replacing the H+-ATPase genes of the yeast Saccharomyces cerevisiae, provided that the external pH is kept above 5.0. Single point mutations within the pma2 gene were previously identified that improved H+-ATPase activity and allowed yeast growth at pH 4.0. The aim of the present study was to identify most of the PMA2 positions, the mutation of which would lead to improved growth and to determine whether all these mutations result in similar enzymatic and structural modifications. We selected additional mutants in total 42 distinct point mutations localized in 30 codons. They were distributed in 10 soluble and membrane regions of the enzyme. Most mutant PMA2 H+-ATPases were characterized by a higher specific activity, lower inhibition by ADP, and lower stimulation by lysophosphatidylcholine than wild-type PMA2. The mutants thus seem to be constitutively activated. Partial tryptic digestion and immunodetection showed that the PMA2 mutants had a conformational change making the C-terminal region more accessible. These data therefore support the hypothesis that point mutations in various H+-ATPase parts displace the inhibitory C-terminal region, resulting in enzyme activation. The high density of mutations within the first half of the C-terminal region suggests that this part is involved in the interaction between the inhibitory C-terminal region and the rest of the enzyme.

Enzyme Activation↗