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At least 1,135 records · Page 63Linked to original sources
PubMed1996

Commingled grazing as a risk factor for trichomonosis in beef herds.

OBJECTIVE: To evaluate commingled grazing on public lands as a risk factor for Tritrichomonas foetus infection in beef herd bulls. DESIGN: Case-control study. SAMPLE POPULATION: Based on 1994 data from the mandatory Idaho bull testing program, all 65 infected herds (case herds), 78 randomly selected test-negative herds that tested < 10 nonvirgin bulls, and 81 randomly selected test-negative herds that tested > or = 10 nonvirgin bulls (control herds). PROCEDURE: Managers of government-owned grazing lands in Idaho identified producers who had grazing permits for an allotment under their jurisdiction in 1993 and for that allotment recorded the number of animals the producer was permitted to graze on the allotment, the number of herds with grazing permits, the total number of animals permitted, and the dates on which grazing began and ended. The number of bulls tested, number of times tested, and test results were collated from the testing database. RESULTS: The relative sensitivity of bacterial culture of preputial smegma was 81%. The attributable fraction of T foetus infection associated with commingled grazing was 33%, and the odds ratio of infection was 9.0 for herds commingled with > or = 14 other herds. The total number of animals permitted on an allotment, the use of public lands, and type of public lands used were not significantly associated with infection status. CLINICAL IMPLICATIONS: These results suggest that to control the spread of trichomonosis, the number of herds commingling on a grazing allotment should be minimized and commingled herds should be managed collectively.

Animal Husbandry↗
PubMed1998

Current list of laboratories which meet minimum standards to engage in urine drug testing for federal agencies, and laboratories that have withdrawn from the program--SAMHSA. Notice.

The Department of Health and Human Services notifies Federal agencies of the laboratories currently certified to meet standards of Subpart C of Mandatory Guidelines for Federal Workplace Drug Testing Programs (59 FR 29916, 29925). A similar notice listing all currently certified laboratories will be published during the first week of each month, and updated to include laboratories which subsequently apply for and complete the certification process. If any listed laboratory's certification is totally suspended or revoked, the laboratory will be omitted from updated lists until such time as it is restored to full certification under the Guidelines. If any laboratory has withdrawn from the National Laboratory Certification Program during the past month, it will be identified as such at the end of the current list of certified laboratories, and will be omitted from the monthly listing thereafter. This Notice is now available on the internet at the following website: http://www.health.org.

Certification↗
PubMed1986

The necessary minimal duration of final long-term toxicologic tests of drugs.

The optimal, and thus mandatory duration of final, long-term toxicologic tests of drugs in animals prior to marketing for use in human beings remains controversial. Some regulatory authorities contend that exposure for 6 or 12 months is adequate. However, the Bureau of Human Prescription Drugs of the Health Protection Branch of Health and Welfare Canada has evaluated a number of confidential reports from manufacturers in which significant, non-neoplastic, pathologic changes occurred only after exposure of animals for more than 1 year. Fifteen examples from these files and the literature are described. These studies support the current Canadian guidelines' requirement for the duration of final long-term toxicologic tests of drugs to be at least 18 months.

Animals↗
PubMed2005

Pulmonary embolism: diagnostic algorithms.

In 90% of cases the clinical suspicion of pulmonary embolism (PE) is raised by clinical signs and symptoms, while in only 10% of cases PE is suspected on the basis of electrocardiographic, arterial blood gas analysis or radiological findings. The combination of clinical signs and symptoms and the results of first-level diagnostic tests (electrocardiography, gas analysis and chest X-ray) allows a fairly accurate classification of patients with "clinical suspicion of PE" into three categories of clinical (or pre-test) probability: low, intermediate and high. The clinical diagnosis of PE is very often inaccurate making the use of additional tests, including imaging techniques, mandatory. The choice and the combination (= diagnostic algorithms) of second- and third-level diagnostic tests (D-dimer, venous ultrasound, echocardiography, lung scintigraphy, helical computed tomography and pulmonary angiography) depend primarily on the clinical conditions of patients and their pre-test probability. We propose two diagnostic algorithms: 1) a diagnostic algorithm for patients with clinically suspected PE and critical clinical conditions (unstable patients), 2) a diagnostic algorithm for patients with clinically suspected PE and non-critical clinical conditions (hemodynamically stable patients).

Algorithms↗
PubMed1988

Notification of HIV carriers: possible effect on uptake of AIDS testing.

Passing of the AIDS Prevention Bill, which demands the notification of human immunodeficiency virus (HIV) carriers, seems imminent in Japan. Its effect on people's willingness to be tested for the HIV antibody was assessed among heterosexual subjects (students, office workers) and groups at high risk of the acquired immunodeficiency syndrome (AIDS) (prostitutes, homosexual males) by means of a questionnaire. More than 70% of the 811 students and the 509 workers replied that, if notification became mandatory, they would agree to be tested but 10% of the males and 17% of the females in these two groups would prefer testing at institutes not complying with the clause; all 198 prostitutes said they would be prepared to undergo testing but 35% of them would prefer to go to non-complying clinics; 45% (410) of the 902 homosexual males replied that they would refuse testing, and 65% of those who agreed to be tested (492) would prefer to go to non-complying clinics....

AIDS Serodiagnosis↗
PubMed2002

Consent for prenatal testing: a preliminary examination of the effects of named HIV reporting and mandatory partner notification.

The effect of named reporting and mandatory partner notification in New York State on the rate of consent for prenatal HIV testing was examined by retrospective chart review. In the six months prior to the introduction of mandatory partner notification and named reporting, 318/328 patients (96.95%) accepted HIV testing. In the six months after implementation, 303/305 patients (99.34%) accepted HIV testing. Although limited in power, no significant decline in the rate of consent for testing or the number of patients receiving testing was detected. [RR 1.02 (1.00 < RR < 1.05)].

AIDS Serodiagnosis↗
PubMed1986

Diagnosis in jaundice: a contemporary approach.

In jaundiced patients, the most important diagnostic problem is to achieve a correct differentiation between nonobstructive and obstructive causes of jaundice. Several new diagnostic tests are available to the clinician. Noninvasive tests include: US, CT and CS, invasive tests are: PTC and ERC. The latter also have therapeutic potentials to be considered. For a proper selection of diagnostic tests in a particular case, clinical evaluation as to the most probable cause of jaundice is mandatory, because the new tests all have their limited field of application. The accuracies of clinical evaluation, noninvasive and invasive tests are therefore reviewed and a flow chart for the differential diagnosis in jaundice is suggested. The clinical evaluation, which may be assisted by a diagnostic chart presented, should sort out patients with probable obstructive or nonobstructive jaundice in whom direct cholangiography or liver biopsy, respectively, is the most appropriate diagnostic test. In the remaining group of patients with clinically doubtful causes of jaundice, or if liver metastases are the most likely diagnosis, US seems to be the test best suited for further differentiation before direct cholangiography or liver biopsy are used as confirmatory tests.

Cholangiography↗
PubMed1991

Cuba's response to the HIV epidemic.

BACKGROUND: Cuba's response to the human immunodeficiency virus (HIV) epidemic has been to conduct mass testing of the population to ascertain seroprevalence, to enforce mandatory relative quarantine of persons testing positive, and to implement educational interventions using media and school-based programs. METHODS: Interview with the Vice-Minister of Health and review of available data. RESULTS: Reports to date show a very low seroprevalence rate without evidence of a widespread epidemic. Sexual contact with foreign-born persons is the primary risk factor. Possible advantages of Cuba's policy include rapid reduction in the risk of HIV transmission by infected blood products, an opportunity for focused education and secondary prevention, and limitation of new infections. Possible disadvantages include the restriction of individual freedom in those who are not guilty of any illegal act, quarantine of persons with false positive HIV tests, and ongoing transmission because of the incomplete nature of the quarantine. The policy is expensive and may displace other public health priorities. The content of the media-based educational interventions has emphasized rational medical information in unimaginative formats with a limited focus on prevention. CONCLUSIONS: The issue of personal responsibility for behavioral change versus government imposed regulations is at the core of Cuba's HIV policy. The quarantine policy may paradoxically permit most Cubans to feel that they are personally invulnerable to the HIV epidemic.

Acquired Immunodeficiency Syndrome↗
PubMed1997

[Decision analysis and clinical laboratory test in general internal medicine].

OVERVIEW: We demonstrated the quantitative approach to evaluating laboratory test in a patient with hypercalcemia. CASE DESCRIPTION: 43 year-old-woman was referred to our department because of sustained hypercalcemia without subjective symptoms in the past 5 years. Physical examination showed no abnormality with laboratory tests unremarkable except for hypercalcemia (10.8 mg/dl). DIFFERENTIAL DIAGNOSIS AND PRE-TEST PROBABILITY SETTING: Based on history and physical examination, we hypothesized two possible cases of hypercalcemia; primary parathyroidism (PHP) malignant disease (MD). The pre-test probability of PHP was set at 1/3, and that of MD at 2/3. CALCULATION AND ASSESSMENT: The post-test probability using the likelihood ratio of "albumin > 4.0 g/dl", 5.1 was increased to 0.72. However, it was not considered above the test-treatment threshold. We then measured Intact PTH which has a likelihood ratio 14. Intact PTH was increased yielding the post-test probability of 0.97. We considered that this value exceeded test-treatment threshold. The patient was referred to a surgical department. CONCLUSIONS: In daily practice, we, internists have to make clinical decisions quantitatively based on test results. To make a rational and quantitative approach to diagnostic tests clinical routine, it is mandatory to determine sensitivity and specificity of all laboratory tests used in our country.

Adult↗
PubMed1990

Many people who seek anonymous HIV-antibody testing would avoid it under other circumstances.

Decreases in high-risk behavior have been observed when people have sought anonymous or confidential HIV-antibody testing accompanied by counseling. HIV-antibody testing also benefits those who are tested, since people who find that they are seropositive can receive closer medical follow-up, and, in certain cases, medical treatment. However, debates continue about appropriate testing policy. This study concerns the conditions under which people who are currently seeking anonymous testing at an alternative test site would be willing to obtain testing. On self-administered questionnaires all sexual orientation/gender groups expressed reluctance to obtain testing if anonymity were not assured. Bisexual men were especially concerned about seeking testing if there was mandatory reporting. Believing that one was infected with HIV was slightly associated with a decreased inclination to obtain testing under non-anonymous circumstances.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Attitudes of genetic counselors towards expanding newborn screening and offering predictive genetic testing to children.

There is movement to expand newborn screening (NBS) to include conditions that challenge the traditional public health screening criteria. Little is known about the attitudes of genetic counselors towards expanding NBS and offering predictive genetic tests to children. For our study genetic counselors completed an internet survey posted on the National Society of Genetic Counselors Listserv regarding five conditions: cystic fibrosis (CF), Duchenne muscular dystrophy (DMD), glucose-6-phosphate dehydrogenase deficiency (G6PD), fragile X (FraX), and type 1 diabetes (T1D). The survey addressed attitudes towards: (1) testing high-risk infants; (2) mandatory NBS; (3) population screening beyond the newborn period; and (4) testing one's own child. Two hundred sixty-seven usable surveys were received. Over two-thirds of respondents supported testing high-risk infants for all conditions except T1D (22%). CF was the only condition for which there was majority support for both mandatory NBS (56%) and later population screening (60%). For all other conditions, later population screening was preferred over NBS (P <or= 0.01). Genetic counselors were most likely to test their own child for CF (46%) and least likely to test their own child for T1D (6%). For each condition, genetic counselors were more likely to support NBS if they chose to screen their own newborn (P < 0.001). Attitudes towards NBS were not influenced by year of graduation or professional experience. We can conclude that genetic counselors are supportive of targeted testing of high-risk infants. They prefer voluntary population screening with consent to mandatory NBS for conditions that challenge Wilson and Jungner criteria. Their support for NBS correlates with their interest in testing their own children and not with professional experience.

Attitude of Health Personnel↗
PubMed2000

Multicentre study for the development of an in vivo model to evaluate the influence of topical formulations on irritation.

Although skin protective products to prevent irritant skin reactions are in wide use, neither standardized test models to prove differences in efficacy exist, nor has the quality or the reproducibility of results been evaluated in a multicentre approach. This should be mandatory when developing or testing skin care products. Therefore, we have designed a multicentre study in an approach to find a standardized test procedure for the evaluation of skin protective products. In this irritation study, a repeated short-time occlusive irritation test (ROIT) with a standardized protocol has been evaluated in 2 phases (12 days and 5 days protocol) in 4 (n=20) respectively 6 (n=33) skilled centres. The skin reaction was induced by 2 irritants (0.5% aq. SLS and toluene, 2x a day for 30 min). Its modification by 3 different cream bases with different hydrophilicity was analyzed. The irritation was monitored by bioengineering methods (TEWL measurement, colorimetry) and by clinical scoring. The evaluation showed that significant results could already be achieved with the 5-day protocol. Furthermore, in spite of the expected inter-centre variations due to heterogeneity of the individual threshold of irritation, interpretation of clinical score, and inter-instrumental variability, the ranking of the vehicles regarding reduction of the irritant reaction was consistent in all centres.

Administration, Topical↗
PubMedDate not supplied

A brief history of immunotoxicology and a review of the pharmaceutical guidelines.

This article provides a brief history of the development of the field of immunotoxicology from one individual perspective and separates the discussion into five phases: the methods development and validation phase; the compound testing phase; the many meetings and organization of the specialty section phase; the mechanistic studies phase; and the guidelines phase. During the discussion of each phase, major highlights, accomplishments, contributors and key references are provided. The immunotoxicology guidelines for the testing of pharmaceutical chemical entities across the three major geographic axes are also presented and compared, along with some of the concerns raised by industry with these guidelines. The mandatory requirement of functional tests represents the major concern and difference between the Committee of Proprietary Medicinal Products (CPMP) and the new Food and Drug Administration (FDA) guidance. The scientific basis for the recommendation of the functional tests proposed in the guidance documents based on National Institute of Environmental Health and Safety/National Toxicology Program (NIEHS/NTP)-sponsored studies is described. Experience at Sanofi-Synthelabo, with the testing of 29 new chemical drug entities developed across a broad range of therapeutic classes using this testing paradigm and functional tests to define their immunotoxic potential, yielded a low number of compounds (6.8%) that produced any abnormal reaction. The two positive compounds might have been anticipated based on their pharmacology.

Drug-Related Side Effects and Adverse Reactions↗
PubMed2001

Paying tuition and academic performance of students at the Zagreb University School of Medicine.

AIM: To assess whether the prospect of waiving tuition fees influences the academic performance of the students with the lowest admission test scores and consequent mandatory tuition. METHODS: We compared the 110 tuition-paying students with the students who did not have to pay tuition because they scored well on 1994-1997 admission tests to the Zagreb School of Medicine. We formed 3 control groups (high-, medium-, and low-ranked students on the admission test), each with the same number of students as the group of tuition-paying students. Students' performance was assessed after the first two academic years on the basis of their grades, number of tries to pass the same examination, the time needed to pass an examination after a course, and the number of repeated years. RESULTS: Of 110 tuition-paying students admitted to the School in the 1994-1997 period, 13 had their tuition permanently waived and were therefore excluded from the analysis. Tuition-paying students had an the average grade of 3.1 out of maximum 5, took each examination 1.7 times before passing it, needed more than five months to pass an examination, and repeated 1.5 years per student. Their performance parameters did not differ from those of the low-ranked group, but were significantly worse than of the medium-ranked and high-ranked groups. Students in the high-ranked group performed the best in all four parameters (the average grade was slightly above 4.0, they took each examination 1.2 times on average, needed less than 2 months to pass an examination, and repeated 0.3 years per student). CONCLUSION: The prospect of waiving tuition fees had no influence on students' performance. The students' rank on the admission test strongly correlates with their later academic success.

Adult↗
PubMed1998

Hereditary Factors in Gynecologic Cancer.

Cancer predisposition in some families is known to be the result of germ-line mutations. The most noteworthy hereditary gynecologic cancer syndromes include hereditary breast-ovarian cancer (HBOC) syndrome, wherein BRCA1 and BRCA2 germ-line mutations have been identified, and hereditary nonpolyposis colorectal cancer (HNPCC) of the Lynch syndrome II variant, wherein hMSH2, hMLH1, hPMS2, hMSH3, and hMSH6 germ-line mutations have been identified. DNA testing for specific cancer-associated germ-line mutations is now available for HBOC and HNPCC syndrome family members who are in the direct line of inheritance. Genetic counseling is mandatory prior to DNA testing and at the time of disclosure of findings. A patient found to be negative for the family's particular cancer-associated germ-line mutation can revert to general population screening recommendations. When a deleterious mutation is identified, the physician is able to predict a patient's lifetime susceptibility to breast and ovarian carcinomas in the HBOC syndrome or the cancers which characterize the Lynch syndrome II variant of HNPCC, particularly carcinomas of the colon, endometrium, and ovary. Management strategies can be offered which are designed to take advantage of the natural history of that distinct hereditary cancer syndrome. We discuss the unfolding developments concerning familial and heritable susceptibilities, molecular genetics, and possible carcinogenic co-factors of the three most common gynecologic cancers: carcinomas of the uterine cervix, endometrium, and ovary. We offer rationales for management based on current epidemiologic and clinical data and emerging technologies.

Journal Article↗
PubMed2002

Paying tuition and academic performance of students at Kragujevac University School of Medicine.

AIM: To assess whether the prospect of waiving tuition fees influenced the academic performance of students with the lowest admission test scores and consequent mandatory tuition. METHODS: We compared academic performance of 75 tuition-paying students with the students who did not have to pay tuition because they scored well on the 1996-1998 admission tests to the Kragujevac School of Medicine. We formed 3 control groups (high-, medium- and low-ranked students on the admission test), each with the similar number of students as the group of tuition-paying students. Students performance was assessed after the first two academic years on the basis of their average grades, number of tries to pass the same examination, the time needed to pass an examination after a course, and the number of repeated years. RESULTS: Of 75 tuition-paying students admitted to the School in the 1996-1998 period, 11 had their tuition permanently waived and were therefore excluded from the analysis after the first year. Tuition-paying students had the average grade of 6.8 +/- 3.2 (grade range 6-10), took each exam twice before passing it, needed more than four months of studying to pass an exam, and repeated 0.1 years per student. Their performance was statistically worse than the performance of the low-ranked group of control students in all parameters, except in the number of repeated years. The high-, medium-, and low-ranked student groups did not differ significantly in their performance, but all performed significantly better than the tuition-paying group in three following parameters: average grade (high-ranked group: 8.2 +/- 1.3), average number of tries to pass an exam (high-ranked group: 1.8 +/- 0.8), and average time of studying needed to pass an exam (high-ranked group: 119.6 +/- 65.9 days). CONCLUSION: The prospect of waiving tuition fees has no influence on students performance. The students rank on the admission test is a major predictor of their subsequent academic performance.

Education, Medical↗