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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.

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PubMed1999

Accessible dental care for children.

The development of a school-based comprehensive and cost-efficient oral health care program requires careful planning centered on the needs expressed by the community. Gaining the support and the cooperation of school officials and parents creates an environment that has a significantly greater opportunity for success. Location, appropriate design of the facility and support from a local charitable organization further insure excellent access and expeditious care.

Child↗
PubMed1999

Elevated levels of serum creatinine: recommendations for management and referral.

BACKGROUND: The potential benefits of earlier referral to a nephrologist of patients with elevated levels of serum creatinine include identifying and treating reversible causes of renal failure, slowing the rate of decline associated with progressive renal insufficiency, managing the coexisting conditions associated with chronic renal failure and facilitating efficient entry into dialysis programs for all patients who might benefit. METHODS: A subcommittee of the Canadian Society of Nephrology, which included representatives from family practice and internal medicine, conducted a MEDLINE search for the period 1966 to 1998 using the key words referral and consultation, dialysis, hemodialysis, peritoneal dialysis, renal replacement therapy and kidney diseases. Where published evidence was lacking, conclusions were reached by consensus. GUIDELINES: Earlier referral to nephrologists of patients with elevated creatinine levels is expected to lead to better health care outcomes and lower costs for both the patients and the health care system. All patients with newly discovered renal insufficiency (as evidenced by serum creatinine elevated to a level above the upper limit of the normal range of that laboratory, adjusted for age and height in children) must undergo investigations to determine the potential reversibility of disease, to evaluate the prognosis and to optimize planning of care. All patients with an established, progressive increase in serum creatinine level should be followed with a nephrologist. Adequate preparation for dialysis or transplantation (or both) requires at least 12 months of relatively frequent contact with a renal care team. Nephrologists should provide consultation in a timely manner for any patient with an elevated serum creatinine level. In addition, they should provide advice about what aspects of the condition require particularly urgent or emergency assessment. SPONSORS: This clinical practice guideline has been endorsed by the Canadian Society of Nephrology and the College of Family Physicians of Canada. Meeting, teleconference and travel expenses of the Referral Guideline Subcommittee were covered by The Momentum Program, a collaboration between Baxter Corp. and Janssen-Ortho Inc. However, the authors are solely responsible for the editorial content of this article.

Clinical Protocols↗
PubMed1999

[Prevalence of hypertension in Valparaíso. Results of the base survey of the CARMEN project (Set of measures for the multifactorial reduction of non-transmissible diseases)].

BACKGROUND: There is little information about the real prevalence of hypertension in Chile. AIM: To assess the adjusted prevalence of hypertension and its main therapeutic measures among adults living in Valparaiso, Chile. MATERIALS AND METHODS: A random sample of dwellings in Valparaiso was chosen. Among these, an individual of 25 to 64 years old was randomly surveyed for risk factors for chronic diseases and sociodemographic parameters. Blood pressure, weight, height, oral glucose tolerance test, fasting cholesterol and triglycerides were also measured. Prevalence was pondered according to age, sex, and probability of selection in the dwelling interior. RESULTS: Three thousand one hundred twelve individuals were studied. The adjusted prevalence of hypertension was 11.4% (11.6% among females and 10.6% among men). The prevalence increased along with age from 3 and 1.9% in men and women of 25 to 34 years old respectively, to 18.2 and 27.4% among men and women of 55 to 64 years old (p < 0.01). People of low socioeconomic level had a higher prevalence of hypertension than those of high socioeconomic level (14.2 and 9.3% respectively, P < 0.05). Diabetes, obesity and hypercholesterolemia were significantly more frequent in subjects with hypertension than in the general population. Forty-four percent of diagnosed hypertensives were receiving medications (angiotensin converting enzyme inhibitors 40%, calcium antagonists 34%, beta blockers 22%). Twenty five percent of patients were treated with a combination of medications. Of those treated, only 22% had normal blood pressure levels at the moment of examination. CONCLUSIONS: High blood pressure is an important public health problem that requires more efficient detection and treatment programs.

Adult↗
PubMed2000

[Incidence of ischemic heart disease: its relation with main risk factors and effectiveness of long-term multifactorial prevention at an industrial enterprise].

AIM: To study the prevalence of ischemic heart disease (IHD) and its various clinical forms depending on both sexes, age, profession, risk factors and efficiency of active prevention programs. MATERIAL AND METHODS: 1848 males and 1643 females were inspected as a control group. 8326 males and 13,116 females volunteers were included into the groups of active prevention and observation. RESULTS: Risk factor correction produced a significant decrease in both systolic and diastolic BP mean levels, prevalence of ECG abnormalities together with smoking habits occurrence, overweight and their combination. The general mortality rate, IHD and stroke mortality were significantly less in the group of prevention as well as the number of days of temporary disability. CONCLUSION: Primary and secondary "in office" prevention for 5 to 10 years diminished the prevalence of risk factors and events of IHD. The presence of IHD, risk factors increased general mortality rates and cardiovascular mortality rates in both groups. The multifactorial prevention of IHD contributed to a decline in general mortality rates and cardiovascular mortality rate.

Adult↗
PubMedDate not supplied

[Knowledge and practice concerning pediculosis in a health district].

Pediculosis is an endemics that has recently intensified world wide and also in Cuba as of 1970. A study was performed in the schools located in the health area of the Vedado Polyclinics in the City of Havana to find out the level of knowledge acquired and the practices followed that may have an effect on the control of this disease. Two qualitative techniques i.e. group analysis and non-participatory observation allowed to gather information. Wrong pieces of knowledge and ill practices were detected such as the belief that nits can fly, the use of a drug called Lindano 1% to treat children as a preventive method while they are in class, application of products in a wrong way, use of harmful products and no taking out of nits in a systematic way. These mistaken concepts and practices affect the analysis of cases and thus, they should be taken into consideration to increase the efficiency of the control program.

Adult↗
PubMedDate not supplied

Noise-excluding enclosure for audiometry.

Excessive ambient noise adversely effects the efficiency of hearing conservation programs. Noise-excluding enclosures generally reduce the masking effects of such noise more effectively than standard earphones only. Research has shown, however, that pure-tone thresholds obtained with some enclosures may not be valid. The present study examines one particular type of enclosure, the Audiocup. The results revealed (1) that pure-tone thresholds obtained with Audiocups are almost identical to those measured with standard earphones only and (2) Audiocups more effectively reduce the masking influence of white noise. It is concluded that Audiocups may be used for screening and for threshold audiometry in less than ideal testing environments without fear of invalidating the results.

Adult↗
PubMed2001

Modernizing the Medicare Program using global payment policies.

This article describes efforts by HCFA to implement global payment demonstrations for Medicare fee for service inpatients. The Medicare Heart Bypass Center Demonstration operated from 1991 to 1996, and used global payments to pay for bypass surgery inpatient episodes. The demonstration operated effectively, with significant cost reductions at many sites and improvements in quality of care. The Medicare Program and its beneficiaries saved over $52 million in that demonstration. The planned Medicare Participating Centers of Excellence Demonstration and the Medicare Provider Partnerships Demonstration will also use global payment methods. These demonstrations will include cardiac and orthopedic care in the Centers demonstration, and all types of medical and surgical cases in Provider Partnerships. Successful implementation of these demonstrations could lead to expansion of global payment methods in the Medicare Program, with increases in efficiency and cost savings anticipated.

Aged↗
PubMed2001

A high-order splitting scheme for the advection-diffusion equation.

A high-order splitting scheme for the advection-diffusion equation of pollutants is proposed in this paper. The multidimensional advection-diffusion equation is splitted into several one-dimensional equations that are solved by the scheme. Only three spatial grid points are needed in each direction and the scheme has fourth-order spatial accuracy. Several typically pure advection and advection-diffusion problems are simulated. Numerical results show that the accuracy of the scheme is much higher than that of the classical schemes and the scheme can be efficiently solved with little programming effort.

Diffusion↗
PubMedDate not supplied

Role of a University Medical Center in the education of radiologic technologists: advanced education in radiologic technology.

The development of new and sophisticated imaging equipment, the rapidly changing medical diagnostic techniques, and larger and busier radiology departments put increasingly heavy demands on radiologic technologists. To cope with these demands, superficial knowledge and experience is not enough. The technologist who wished to advance on the career ladder must have more solid facts at his disposal and know how and when to use them if he is to perform efficiently and satisfactorily. The program described here provides a type of education that will permit the technologist to so advance with a feeling of security in the knowledge that he has the foundation needed to meet the challenges of his profession.

Curriculum↗
PubMed1988

Lesotho Housing and Land Development Corporation Order, 1988 (No. 12 of 1988).

This Order establishes the Lesotho Housing and Land Development Corporation, managed by a Board of Directors appointed by the Minister of the Interior, Chieftainship Affairs, and Rural Development. The objectives of the Corporation are the following: "1) implementing on a self-financing basis a broad array of schemes including self-help housing, sites and services, land development, and cooperative housing; 2) assisting private parties to develop land and deliver housing; 3) engaging in the development and management of rental housing schemes where it is deemed to be in the economic interest of the Corporation to manage the property; 4) assisting in the mobilization of capital available to the shelter sector by emphasizing in its activities efficiency and cost recovery programs to ensure a good return on investment; 5) developing a longterm capital program that will assure the Corporation's continuing financial viability and ability to remain a vital participant in Lesotho's shelter sector." Further provisions of the Order deal with administration and membership of the Board, financing, accounts, and annual reports, among other things.

Africa↗
PubMed1976

Functional status measurement and medical rehabilitation outcomes.

An on-stream method for describing patients' functional abilities is used to develop analyses of medical rehabilitation outcomes. Outcomes are the changes in status between admission, discharge and follow-up. Standardized observation and reporting make it possible to compare one date with another, one case with another or one agency or facility with another to determine program characteristics, effectiveness and efficiency.

Activities of Daily Living↗
PubMed1992

[Prophylaxis and therapy of infections in allogenic bone marrow transplantation in patients with hematologic diseases].

Infection and acute graft versus host disease (GVHD) are the most common complications of allogeneic bone marrow transplantation, which compromise this therapeutical method for hematologic diseases. Beside the appreciation of customary preventive measures and the treatment of infections, it is necessary for every bone marrow transplantation center to analyze the development of bacterial, fungal and viral infections in the patients and to generate the most efficient and most rational program for their prevention and treatment. At the Hematology Department in Novi Sad seven allogenic bone marrow transplantations were performed in patients with malignant hematologic diseases and severe form of aplastic anemia. Prevention of the infection by isolation of the patient in a sterile unit, selective decontamination of the digestive tract with sterile food, skin and mucus hygiene and prophylactic drug administration proved rather beneficial and adequate for patients with the graft accepted, hematopoiesis recovered and immunity reconstructed. Risks of infections were increased by permanent vein catheter, acute GVHD and rejection of the bone marrow graft. Prompt isolation and identification of bacteria and fungi, especially in blood, the establishment of a minimal suppressing and bactericide antibiotic concentration, along with the assessment of their synergism, as well as early diagnosis of cytomegalovirus and administration of specific drugs, can significantly contribute to the more successful treatment of infections in transplanted patients.

Adolescent↗
PubMedDate not supplied

[What is evidence-based public health?].

Evidence based Public Health is the execution and evaluation of the efficiency of interventions, plans, programs, projects and politics in public health through the application of the scientific principles of reasoning, including the systematic use of information and information systems. Evidence based public health involves the use of methodologies similar to those applied in evidence-based clinical medicine, but differs in its contents. In public health two types of evidence are described. The type I evidence in which a strong relation exists between the preventable risk and disease, and type II evidence in which there exists a relative effectivity of the public health interventions. In evidence based Public Health research designs more appropriate for the social sciences are used, as the observational and quasi-experimental studies. Likewise the decisions are more of interdisciplinary teams.

Evidence-Based Medicine↗
PubMed2004

Big problem, many people, one goal. Improving patient financial services performance.

A multispecialty organization, faced with growing patient complaints about its billing services, developed a large-scale plan to make the billing process more effective and efficient--a service recovery program. Strong organizational support, leadership commitment and vision, thorough planning and follow-through, and dedicated staff drove the project to surpass expectations.

Arizona↗
PubMed1992

Effects of head-down tilt for 10 days on the compliance of the leg.

The purpose of this investigation was to measure lower leg compliance before, during and after a 10-day period of bedrest at head-down tilt to test the hypothesis that leg compliance and the capacity for venous pooling is increased by the adaptation to stimulated microgravity. Venous occlusion plethysmography with multiple proximal occlusion pressures was used to obtain compliance measurements in six male subjects. Calf circumference decreased significantly during the tilt (corresponding to a decrease in cross sectional area of 7%) and had not returned to baseline seven days after the end of tilt. Compliance post-tilt was significantly greater than pre-tilt, probably mainly due to a reduction in muscle mass. This study supports the need for investigations to define: (a) the degree of protection against orthostatic hypotension that can be achieved by maintaining leg muscle mass and tone, and (b) efficient and specific exercise programs to prevent loss of muscle mass and function-particularly during spaceflight.

Adaptation, Physiological↗
PubMed1992

The multi-trellis software architecture and the intelligent cardiovascular monitor.

A real-time, intelligent cardiovascular monitor is complex. It must process multiple waveforms, recognize artifacts, extract pertinent parameters, recognize a patient's clinical state, analyze the problem and formulate a response. This paper presents the multi-trellis (a collection of process trellises), a software architecture for building such a monitor. A process trellis is a uniform hierarchical framework for heterogeneous program modules. The multi-trellis extension allows one to compile several process trellis programs with widely varying run-time requirements into a single executable program that it is efficient, predictable and usable. Our prototype consists of two process trellises. The lower trellis contains processes to analyze three different analog signals: the blood pressure from a non-invasive monitor and an arterial catheter, and the ECG. The upper trellis contains processes to help detect evolving hemodynamic trends, identify abnormalities, and present a succinct summary to the clinician. Our prototype shows that the multi-trellis is a demonstrably useful software architecture for building these real-time, intelligent monitors.

Artificial Intelligence↗
PubMedDate not supplied

A brief introduction to the National Data Bank for Rheumatic Diseases.

The National Data Bank for Rheumatic Diseases (NDB) is a research data bank with a broad agenda and approach to important clinical, regulatory, epidemiological, safety, effectiveness, outcome and patient care questions that cannot be answered by conventional data banks. It has systematic, ongoing quality control programs that assure high quality data. NDB-developed programs result in very efficient analytic capabilities and rapid publication.

Biomedical Research↗