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At least 1,207 records · Page 67Linked to original sources
PubMed1996

Trauma system development in Armenia.

UNLABELLED: A medical partnership program between Boston University School of Medicine and the the Emergency Hospital, of Yerevan, Armenia, has been developed to improve the care of the injured in that city. The Emergency Hospital, a trauma center, was site-visited by experts from a Level I trauma center who evaluated prehospital and hospital-based emergency and trauma services and made system-wide recommendations. Recognizing local limitations, the hospital was found to have the leadership commitment, staff complement, and basic infrastructure to meet the American College of Surgeons' criteria for Level II trauma centers. The goal of integration of the academic, clinical, and research roles of a medical center consistent with Level I-type trauma centers was formulated. After 36 months, several issues raised in the assessment are being addressed notwithstanding political and economic turbulence. The Emergency Hospital has established an accredited residency program in emergency medicine; implemented programs for postgraduate medical education of its staff; begun to develop medical information systems; expanded the scope of its activities to other institutions; and restructured the emergency admissions area. Management systems remain largely undeveloped as the discipline lacks recognition as an analytic tool for institutional improvement. CONCLUSIONS: The use of existing published resources for assessment and improvement of health services in dissimilar health-care systems has been validated as a systematic approach. For system advances to be well-founded, a combination of education, management, and clinical approaches needs to be addressed. Of these, our experience is that management issues are the most resistant to change.

Armenia↗
PubMed1996

The diffusion of computer-based information technology into health institutions of Republic of Serbia (FR Yugoslavia).

The basic purpose of this study was to analyze the diffusion of computer-based information technology into the health care institutions of the Republic of Serbia in the year 1994, and to compare the results with a similar investigation in 1992 in order to determine the state and progress of its development. The instrument of investigation was a questionnaire with 24 questions, distributed to all the independent health institutions in Serbia (total 238). The overall response rate was 40.8%. Of the number of responding health institutions, 92.8% own computers which are in use, six PCs on average, and on average use two application softwares, obligatory one for accounting and billing. In conclusion, health care institutions in the Republic of Serbia are unsatisfactorily equipped with information technology and without the developed institutional information system, except on the level of the project. So, careful planning, selection, implementation and management with national coordination will be needed to ensure the appropriate use of technology and information systems in health care.

Analysis of Variance↗
PubMed1991

Application of scale-down experiments in the study of citric acid biosynthesis.

Problems associated with the development of submersed citric acid biosynthesis on sugar beet molasses for process improvement were solved by scale-down experiments: the determination of optimal temperature profile, optimal pH value, influence of OTR and inoculum quality. The optimal pH value at the start of the process was 6.4 with 3% of inoculum volume and temperature profile between 28-30 degrees C. In the case of OTR which is scale-dependent, we prefer to use DOC pilot plant data for the transfer of technology.

Aspergillus niger↗
PubMed1999

[Biomaterials, human tolerance and integration].

Biomaterials and related process engineering in order to obtain optimal surface and structural biocompatibility of implants and devices are presented. Vital-avital composites for tissue engineering, cell culture models, porous ceramics and degradable polymers are introduced as examples. Emphasis is laid on the conversion of basic research results into clinical applications and on the exchange of technologies from the non-medical into the medical field and vice versa.

Animals↗
PubMed2004

[Malignant lymphoma competence network].

The competence network Malignant Lymphomas is one out of 3 oncological networks which have been funded by the German Federal Ministry of Education and Research since 1999. The network's activities are based on the work of the German lymphoma research groups, which have led to significant progress in the diagnosis and therapy of malignant lymphoma over the last few years. Based on this infrastructure, the network aims to establish a professional quality management for the diagnostics and treatment of malignant lymphomas. Key aspects of activity include: 1st the establishment of an IT-based information and communication platform, 2nd IT-based networking of study groups and collaborating centres of pathology and radiotherapy, 3rd epidemiological and health care-economical research, 4th research on improved and new therapeutical approaches, 5th evidence-based medicine. Further information is presented in http://www.lymphome.de.

Biomedical Research↗
PubMed2004

[Hepatitis (Hep-Net) competence network].

In Germany almost 1 million people are affected by chronic viral hepatitis. Despite of the improved therapy options for the treatment of hepatitis B and C, several questions regarding epidemiology, pathophysiology and therapy are still unclear. Vaccines against hepatitis C and D viruses are still not available. Additionally, many patients and their relatives need information about infectiosity, course of the disease and therapy options. By the integration of doctors' practices and patient advocacy groups, Hep-Net aims at the educational information on the infection and tries to give access to qualified therapy strategies for all patients with an indication for therapy. After 18 months the Hep-Net Homepage already shows more than 9000 hits per day. Consultation hours via telephone, email-services and numerous activities in cooperation with the Deutsche Leberhilfe e.V. are highly frequented. In the Hep-Net study-house high-standard clinical studies with first successful results are centrally organized. Further, basic questions in the fields of epidemiology, virology and immunology are processed in cooperative research projects within the network.

Biomedical Research↗
PubMed2004

[Competence network "community acquired pneumonia" (CAPNETZ). A first interim report].

Community acquired pneumonia (CAP) is a disease with high morbidity and mortality in Germany. However, no reliable data are available about spectrum and resistance of pathogens, course of the disease, evidence based guidelines for treatment, and pathogen-host interactions. The German Ministry of Education and Research recognized these deficits and therefore decided to fund CAPNETZ, a network of competence for community acquired pneumonia. CAPNETZ integrates components of health research as well as clinical and basic research (horizontal network) on one hand and supports cooperation among general practitioners, community hospitals and universities (vertical network). Since October 2002, 1547 patients with CAP have been recruited within the network. First results indicate, that new observations made in terms of symptoms, spectrum of pathogens involved, and treatment modalities will impact on the formulation of new guidelines for the management of community acquired pneumonia.

Biomedical Research↗
PubMed2004

[HIV/AIDS competence network research group presents first results].

Germany's clinical HIV research efforts are underrepresented on an international level. This deficit is primarily due to a lack of clinical studies involving patients from across the country and the fact that no national patient cohort system exists in Germany which could provide a basis for such clinical studies. The competence network HIV/AIDS is filling this shortcoming by serving as a comprehensive, nationwide research alliance. The establishment of a patient cohort is linked to 20 projects. The success of this new structure is becoming visible.

Acquired Immunodeficiency Syndrome↗
PubMed2004

[Chronic inflammatory bowel diseases competence network ].

Inflammatory bowel diseases (IBD) are intermittently appearing, often chronic diseases mostly affecting young people between 20-30 years of age influencing their quality of life and socioeconomic efficiency. The triggering factors for the development of IBD are not completely understood: besides environmental factors there is clear evidence for additional genetic factors influencing the risk of disease and the pattern of gut inflammation in Crohn's disease. Pathopysiological discoveries are leading to new therapeutic opportunities which are conducted in large clinical studies with main participation of the competence network IBD. The disseminated structure of the network comprising universitary and nonuniversitary hospitals and labs, the self-help-organization DCCV and its vertical cooperation with general practitioners nationwide gives opportunity to describe the diseases from the point of view of the scientist and the physician simultaneously. Therefore the competence network IBD yields the basis for the standardized integration of patient information, for the development of guidelines and the establishment of a quality management system thus leading to an improvement of scientific and clinical research.

Biomedical Research↗
PubMed2003

Coupled plasma filtration adsorption.

BACKGROUND: Severe sepsis and septic shock are perhaps the major cause of morbidity and mortality in Intensive Care. Their pathogenesis is only partly understood. Circulating peptides and lipid-derived substances (so-called mediators), however, appear to participate in the development of organ dysfunction. It might be possible to treat plasma in such a way that the injurious effect of mediators can be attenuated. INVESTIGATIONS: Several ex vivo studies have shown that it is technically possible to adsorb mediators by means of specially developed sorbents. The application of these sorbents to the treatment of plasma in animals with experimental sepsis has shown that several markers of inflammation can be attenuated and that animal survival can be increased. We have recently transferred such technology to the treatment of human septic shock using a technique called Coupled Plasma Filtration Adsorption (CPFA). CPFA was found to attenuate the hypotension of septic shock and to dramatically alter the immuno-paralytic toxicity of septic plasma. Monocytes of patients treated with CPFA underwent a major improvement in their ability to respond to endotoxin. CONCLUSIONS: CPFA represents a promising new approach to blood purification in sepsis. The findings associated with its application to humans highlight the importance of continuing to investigate blood purification as a possible approach to the treatment of septic shock, the potential usefulness of the humoral theory of sepsis, and the dominant state of immunosuppression associated with established septic shock.

Adsorption↗
PubMed2004

Biomolecular features of clinical relevance in breast cancer.

Breast cancer is a heterogeneous disease and its consequent complexity is a major challenge for physicians and biologists. Notwithstanding its potential curability due to the availability of treatment modalities which are effective in the presence of favourable clinical or pathobiological features, there is still a great deal of controversy over its clinical management. In recent decades, tumour biomarkers that are indicative of or related to cell traits characterising malignancy--that is self-sufficiency in proliferative growth signals, insensitivity to growth inhibitory signals, evasion of apoptosis, limitless replicative potential, and activation of pathways leading to neo-angiogenesis, invasion and metastasis--have provided information that has been proven to be associated with disease progression. However, when these biomarkers have been analysed individually, their prognostic relevance has been found to be modest, the only remaining clinically useful biomarkers being cell proliferation and plasminogen activation-related factors for prognosis, and steroid hormone receptors and the oncogene HER2/neu for prediction of response to hormonal therapy or to the novel targeted anti-HER2/neu therapy. It therefore remains necessary to reduce the intrinsic complexity of breast cancer in order to improve its clinical outcome. One way to achieve this objective derives directly from the concept that cancer is a genetic disease at the somatic level and from the recent availability of high-throughput post-genomic analytical tools such as gene and protein expression techniques for global gene expression analysis. Following these novel approaches, a number of recent studies have produced gene expression profiles in breast cancer that are markedly associated with disease progression and directed to answer different clinical and biological questions. However, the outcome of these novel studies still needs to be validated, which will entail cooperation between different specialists and integration of all the different skills involved in translational research in oncology.

Biomarkers, Tumor↗
PubMed2005

General consumer communication tools for improved image management and communication in medicine.

We elected to explore new technologies emerging on the general consumer market that can improve and facilitate image and data communication in medical and clinical environment. These new technologies developed for communication and storage of data can improve the user convenience and facilitate the communication and transport of images and related data beyond the usual limits and restrictions of a traditional picture archiving and communication systems (PACS) network. We specifically tested and implemented three new technologies provided on Apple computer platforms. (1) We adopted the iPod, a MP3 portable player with a hard disk storage, to easily and quickly move large number of DICOM images. (2) We adopted iChat, a videoconference and instant-messaging software, to transmit DICOM images in real time to a distant computer for conferencing teleradiology. (3) Finally, we developed a direct secure interface to use the iDisk service, a file-sharing service based on the WebDAV technology, to send and share DICOM files between distant computers. These three technologies were integrated in a new open-source image navigation and display software called OsiriX allowing for manipulation and communication of multimodality and multidimensional DICOM image data sets. This software is freely available as an open-source project at http://homepage.mac.com/rossetantoine/OsiriX. Our experience showed that the implementation of these technologies allowed us to significantly enhance the existing PACS with valuable new features without any additional investment or the need for complex extensions of our infrastructure. The added features such as teleradiology, secure and convenient image and data communication, and the use of external data storage services open the gate to a much broader extension of our imaging infrastructure to the outside world.

Communication↗
PubMed2005

Developing a community science research agenda for building community capacity for effective preventive interventions.

Research has shown that prevention programming can improve community health when implemented well. There are examples of successful prevention in local communities, however many continue to face significant challenges, demonstrating a gap between science and practice. Common strategies within the United States to address this gap are available (e.g., trainings), but lack outcomes. Building community capacity to implement high quality prevention can help communities achieve positive health outcomes, thereby narrowing the gap. While there is ample research on the efficacy of evidence-based programs, there is little on how to improve community capacity to improve prevention quality. In order to narrow the gap, a new model of research-one based in Community Science-is suggested that improves the latest theoretical understanding of community capacity and evaluates technologies designed to enhance it. In this article, we describe this model and suggest a research agenda that can lead to improved outcomes at the local level.

Community Mental Health Services↗
PubMed2004

World Health and the Oxford International Biomedical Centre.

Some of the problems associated with World Health are considered. The Oxford International Biomedical Centre (OIBC) was launched in 1992 to respond to those challenges. Its mission and goals, track record, and new programmes are described.

Biomedical Research↗
PubMed1988

The health benefits of mechanization at the Nigerian Coal Corporation.

Nigerian Coal Corporation started operations in 1916 and in October 1977 introduced full mechanization at its coal mine in Enugu. An appraisal of the mining accidents between 1975-1980 showed an overall downward trend following mechanization, from 1073 per 1000 in 1975 to 425 in 1980 (a 60% reduction). The underground accidents were reduced from a monthly average of 63 to 26 but those at the surface remained basically unaffected. Changes were also recorded in sickness absences indices, with the most significant occurring with respect to the severity index which dropped from 9.2 in 1975 to 3.0 in 1980. The distribution of injury remained essentially the same except that injuries to the upper limbs became more common than the more serious pelvic injury prior to mechanization. The impact of mechanization in industries in developing countries are discussed and ways of ensuring optimum benefits from this transfer of technology suggested.

Absenteeism↗
PubMed1987

Enzyme-based detection of glycoproteins on blot transfers using avidin-biotin technology.

Avidin-biotin technology has been employed for the improved nonradioactive detection of glycoproteins on blots. Periodate oxidation of samples on blots converts the glycoprotein-based carbohydrate residues to the corresponding aldehydes. The latter undergo interaction with preformed complexes consisting of either avidin hydrazide or streptavidin hydrazide combined with biotinylated alkaline phosphatase. The sensitivity of the new assay exceeds the previously described enzyme hydrazide method by a factor of at least 10. The approach can be rendered selective for sialoglycoproteins, and approximately 12 sugar-containing bands could be observed in erythrocyte membrane preparations. Problems of nonspecific binding and high levels of background label were alleviated using a nonglycosylated basic protein (lysozyme) for quenching.

Alkaline Phosphatase↗