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At least 127 records · Page 7Linked to original sources
PubMed1999

Early development of descending supraspinal pathways: a tracing study in fixed and isolated rat embryos.

Early brainstem-spinal cord projections were studied in the rat using the carbocyanine dye DiI in fixed embryos and biotinylated dextran amine (BDA) in an isolated embryonic brain-spinal cord preparation. A system of staging embryos was used that allows direct comparison with data in other mammals. With both techniques it was shown that in embryos of at least 12 days of age (E12), i.e., at the time of closure of the posterior neuropore, already a variety of brainstem centers innervate the spinal cord. In the interstitial nucleus of the fasciculus longitudinalis medialis and various parts of the reticular formation - mesencephalic, pontine as well as medullary - DiI or BDA labelled neurons were observed. Mainly large immature, bipolar neurons were labeled. In later stages (E13, E14) the number of labeled neurons increased and more mature, multipolar cells were found. Labeled neurons were also observed in the vestibular nuclear complex and in the medullary raphe. Just below the cerebellum a conspicuous small group of neurons was found labeled in a position reminiscent of the locus coeruleus. Comparison with available data on the time of neuron origin of brainstem neurons suggests that interstitiospinal and reticulospinal neurons start projecting spinalwards shortly after they are generated. The earliest brainstem projections to the spinal cord all pass via the fasciculus longitudinalis medialis.

Animals↗
PubMed2001

Sharing medical data for patient path analysis with data mining method.

The Agora Data project started in October 1997 in France. The objective was to share medical data between several medical institutions to analysis medical care pathways for patients that suffer from low back pain. The analysis of the medical records decomposed in three steps allowed us to produce knowledge on medical contacts of patients with the health care system. In order to study the relations between these contacts, we created medical path of patients within the framework of the possible contacts we had isolated. This work relates the implementation and the first results of the pilot study.

Confidentiality↗
PubMed2003

Algebraic structure of central molecular chirality starting from Fischer projections.

The construction of algebraic structure of central molecular chirality is provided starting from the empirical Fischer projections for tetrahedrons. A matrix representation is given and the algebra of O(4) orthogonal group for rotations and inversions is identified. The result can be generalized to chains of connected tetrahedrons.

Journal Article↗
PubMed1987

Longitudinal studies of femur growth in normal fetuses.

As an indicator of fetal limb growth, change in the femur diaphysis length (FDL) between 15 and 38 weeks, menstrual age, has been evaluated in a longitudinal study of 20 normal fetuses, as determined by prenatal biparietal diameter, head circumference, and abdominal circumference growth patterns as well as postnatal pediatric assessment. Individual FDL growth curves were uniformly parabolic and followed very similar trajectories. The projected start points [mean: 9.7 (+/- 1.5 SD) weeks] for these curves were in complete agreement with embryologic data, and the curves themselves were well characterized by the Rossavik model [R2 99.5 (+/- 0.5 SD)%]. No differences between males and females were detected, and good agreement was obtained between the average longitudinal growth curve and the cross-sectional growth curve derived from a previously studied data set. Individual growth curve standards, determined from Rossavik models based on data obtained before 26.1 weeks, menstrual age, were within 7% of actual measurements in 94% of the 97 time points studied after 26 weeks. These results indicate that the Rossavik model and its associated individual growth curve standards can be used to evaluate the growth of the femur and thus provide an improved means for detecting skeletal dysplasias and fetal growth retardation.

Adult↗
PubMed2002

Diagnostic and prognostic value of 99mTc-tetrofosmin scintigraphy in maxillofacial flaps.

In oro-maxillofacial malignancies, new therapeutic approaches are placing changing demands on the diverse diagnostic modalities. In contradistinction to mandibular reconstruction of former years, the transplants (microvascular anastomosed pedicled flaps, "flaps") now consist of one or more arteries feeding a soft tissue component attached to a piece of bone suitably fitted to fill the defect. We addressed the diagnostic value of technetium-99m tetrofosmin scintigraphy in differentiating between viability and non-viability of the soft tissue portion of flaps in the immediate postoperative assessment. A total of 60 patients who had received flaps for reconstruction of the mandible after partial resection were investigated with (99m)Tc-tetrofosmin 3-5 days after surgery. Scintigraphy consisted of (a) radionuclide angiography, (b) static planar imaging in four projections starting at 10 min post injection, and (c) single-photon emission tomography (SPET) performed immediately after the planar imaging. Normal perfusion associated with no defects throughout the soft tissue portion of the transplant was observed in 46/60 patients. This scintigraphic pattern was identical to viability and normal postoperative follow-up. Hypoperfusion and small defects on planar and SPET images indicated viability and uncomplicated postoperative healing in 6/60 patients, but non-viability/inadequate healing of the flap in 4/60 patients. Absence of perfusion combined with a large defect on static planar and SPET images definitively showed the non-viability of the flap (4/60 patients). It is concluded that (99m)Tc-tetrofosmin scintigraphy is a sensitive diagnostic tool for the immediate postoperative assessment of the viability and the adequacy of implantation of the soft tissue portion of flaps. Therefore tetrofosmin scintigraphy is an important modality in order (a) to define the optimal therapeutic regimen in the immediate postoperative period and (b) to provide better prognosis.

Adult↗
PubMed1990

Effect of diarrhoeal disease control on infant and childhood mortality in Egypt. Report from the National Control of Diarrheal Diseases Project.

The effect of the National Control of Diarrheal Diseases Project, started in 1983, on infant and childhood mortality in Egypt was assessed by means of national civil registration data, nationwide cluster sample surveys of households, and local area studies. Packets of oral rehydration salts are now widely accessible; oral rehydration therapy is used correctly in most episodes of diarrhoea; most mothers continue to feed infants and children during the child's illness; and most physicians prescribe oral rehydration therapy. These changes in the management of acute diarrhoea are associated with a sharp decrease in mortality from diarrhoea, while death from other causes remains nearly constant.

Cause of Death↗
PubMed1991

Spatial visualization of DNA in solution.

An image analysis method is presented which allows for the reconstruction of the three-dimensional path of filamentous objects from two of their projections. Starting with stereo pairs, this method is used to trace the trajectory of DNA molecules embedded in vitreous ice and leads to a faithful representation of their three-dimensional shape in solution. This computer-aided reconstruction is superior to the subjective three-dimensional impression generated by observation of stereo pairs of micrographs because it enables one to look at the reconstructed molecules from any chosen direction and distance and allows quantitative analysis such as determination of distances, curvature, persistence length, and writhe of DNA molecules in solution.

DNA, Bacterial↗
PubMed2002

Recent situation of schistosomiasis in Indonesia.

Schistosomiasis in Indonesia is limited to two very isolated areas, the Napu and Lindu valleys, in the province of Central Sulawesi. The disease was initially found in 1937 in the village of Tomado. In 1940, a study on schistosomiasis in the Lake Lindu area was initiated and an infection rate of 56% among the people in the three villages of Anca, Tomado and Langko was found. Before a comprehensive control programme was initiated, the infection rate among the population of approximately 4000 people in the Napu valley was very high, e.g. 72% in the village of Winowanga. In 1982, more coordinated and intensive schistosomiasis control measures in the Napu and Lindu valleys were initiated. The average infection rate after control measures were greatly decreased-in Napu valley it was 1.83%, while in Lindu valley it was 0.46%, in 1999. The control approaches can be described over five phases, from 1982 to 1986, up to 1998 to present. In 1998, an agreement between the Government of Indonesia and the Asian Development Bank was signed to develop the schistosomiasis endemic areas of Central Sulawesi into a better socio-economic condition. The objectives of the project are not only to control schistosomiasis, but mainly to protect the National Park which is located between the Lindu and Napu valleys. It is an integrated project named 'Central Sulawesi Integrated Area Development and Conservation Project' and many relevant sectors have been involved in the implementation of this project for the development of the area, including control of schistosomiasis. The implementation of the integrated project started in 1999.

Adolescent↗
PubMed1999

The Consumer Assessment of Health Plan Study (CAHPS) survey of children's health care.

BACKGROUND: Little is known about the experience of children and families with pediatric care. Asking parents about their experiences and the treatment of their children in health care plans can yield important information about selected aspects of medical care quality. Such data can be used to motivate, focus, and evaluate quality improvement efforts. METHODS: Development of the Child Core Survey followed the survey development principles of the Consumer Assessment of Health Plan Study (CAHPS) project, starting with assembly of existing instruments, consultation with experts, focus groups, and cognitive testing. A field test of the survey was conducted by mail among members enrolled in 1 of 25 plans originally identified as providing health care services to the public employees of the state of Washington (response rate, 52%). RESULTS: The 3,083 respondents rated personal doctors most highly, with overall care and specialty care rated nearly as well, and plan administration rated lowest. Parent-clinician and child-clinician communication, as well as spending sufficient time with the child were the strongest correlates of assessments of overall care and of personal doctors. Plans differed significantly in their performance along all the dimensions of child health care assessed in the survey except for aspects of access ("getting the care you need"). IMPLICATIONS: The Child Core Survey from the CAHPS provides a readily accessible method to assess the interpersonal care of children. Such data could be used to make plans accountable to the needs of children, to focus specific improvement initiatives, or both.

Adolescent↗
PubMedDate not supplied

[Concomitant radiochemotherapy for cancer of the cervix: critical analysis based on the Standards, Options and Recommendations methodology].

INTRODUCTION: The "Standards, Options and Recommendations" (SOR) project, started in 1993, is a collaboration between the National Federation of the French Cancer Centres (FNCLCC), the 20 French Cancer Centres (CRLCC) and specialists from French public universities, general hospitals and private clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and outcome for cancer patients. The methodology is based on literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. OBJECTIVES: To update, according to the methodology of SOR, the Standards, Options and Recommendations for the management of patients with cancer of the cervix, and in particular, the place of concomitant radiochemotherapy. METHODS: Data have been identified by a literature search using Medline (to April 1999) and the personal reference lists of experts. Once the guidelines were defined, the document was submitted for review to independent national and international reviewers and to the medical committees of the CRCC. RESULTS: The principle recommendations concerning the place of radiochemotherapy in the treatment of cancer of the cervix are 1/ the available data shows a significant increase in local control (level of evidence A) and of overall survival (level of evidence B1) following concomitant radiochemotherapy as compared to radiotherapy alone or the combination of radiotherapy-hydroxyurea. For stages IB, IIA, proximal IIB with bad prognostic factors (tumour size greater than 4 cm and/or invasion of pelvic nodes and/or microscopic invasion of the parametrium) and without lumbo-aortic nodal invasion, concomitant radiochemotherapy can be considered as standard treatment. This benefit is less clear for stages distal IIB, III and IVA without para-aortic nodal invasion (level of evidence C) and must be confirmed (expert agreement). 2/ the toxicity of radiochemotherapy is essentially haematologic and gastrointestinal (level of evidence B1) and is greater than that of radiotherapy alone (level of evidence B1). 3/ these results have been obtained by the combination of chemotherapy based oncisplatin alone, or in combination with 5-FU. Although of equal benefit, the toxicity of the cisplatin/5-FU/ hydroxyurea combination was greater than that of cisplatin alone in a trial comparing the two protocols. A significantly longer survival have also been obtained by the combination of chemoradiation and adjuvant chemotherapy with epirubicin (level of evidence C). These results must be confirmed. 4/ the exact means of delivering the chemotherapy has not been clearly established. In fact, in these trials, some protocols use cisplatin weekly at a dose of 40 mg/m2 and others every three or four weeks at doses ranging from 50 to 75 mg/m2. Subsequent randomised studies are likely to establish optimal schema for the delivery of chemotherapy when combined with external radiotherapy and brachytherapy.

Combined Modality Therapy↗
PubMed2003

PropeR: a multi disciplinary EPR system.

This article describes the architecture of an EPR system developed for the PropeR project. This EPR system not only aims at supporting home care of stroke patients, but is also designed in such a way that it can be ported to other medical services without much effort. We will briefly describe the Stroke Service and the related PropeR project. Starting from a list of requirements to construct a generic EPR system we will outline the architecture and describe the standards and methods used. Subsequently we describe the implementation and the problems encountered. In the discussion, we will go into the advantages and disadvantages of the tools and techniques we have used.

Computer Systems↗
PubMed2003

Electronic healthcare record; a way to empower the patient.

BACKGROUND: Patients are demanding a bigger role in the management of their own health and health care. METHODS: The Dutch Federation of Patient and Consumer Organizations (NPCF) has initiated several projects in this area. One project started in 2001 and aims at contributing to the development of a nation-wide EPR system. RESULTS: the NPCF participates in the National Institute for the Care Sector (NICTIZ). The NPCF plays an important role in defining the requirements regarding authorization and security of the EPR as well as for the legal framework in which optimal use can be made of the EPR. NPCF strongly promotes an active role of NICTIZ in developing a master plan for the EPR and an active role in its implementation. CONCLUSION: Patients and their organizations have to play an active role in designing and implementation of an ICT infrastructure for health care and in particular of the EPR.

Humans↗
PubMed1988

Evidence against linkage of schizophrenia to markers on chromosome 5 in a northern Swedish pedigree.

Schizophrenia is a severe mental illness with a typically chronic course affecting nearly 1% of the human population. It is generally accepted that genetic factors have an important pathogenic role in a substantial portion of schizophrenia cases; however, despite decades of family studies, there is no agreed-upon mode of inheritance. The discovery of genetic aetiologic factors and resolution of the inheritance pattern(s) will undoubtably emerge from genetic linkage studies. With these objectives in mind, we undertook a linkage project, starting in 1985, in a previously well-documented kindred from north Sweden. Multipoint linkage analyses were used to screen the proximal long arm of chromosome 5 using restriction fragment length polymorphism (RFLP) markers at five loci and the distal long arm using RFLPs at two loci, one of which was the locus for the glucocorticoid receptor. We found strong evidence against linkage between schizophrenia and the seven loci. These results, together with the positive evidence for linkage of schizophrenia with markers in the proximal long arm of chromosome 5 lead us to conclude that the genetic factors underlying schizophrenia are heterogeneous.

Chromosomes, Human, Pair 5↗
PubMedDate not supplied

A student-directed community project to support sexually abused women veterans suffering from post-traumatic stress disorder.

While awareness of post-traumatic stress disorder (PTSD) and sexual abuse continues to grow, it has only been during the past few years that the military has realized the prevalence and impact of sexual abuse inflicted upon women while on active military duty. Though Veteran Administration (VA) agencies throughout the United States have given concerted attention to this problem, published resources specific to PTSD and military sexual abuse have been limited. In this article the authors present the results of a 2(1/2)-year endeavor to address the problem of PTSD and military sexual abuse at the Tulsa VA Outpatient Clinic. The project started with a research study and the subsequent initiation of a PTSD women veterans support group, and culminated in the development of resource manuals for both professional staff and women veterans.

Education, Nursing↗
PubMed1999

Screening of diabetic patients for microalbuminuria in primary care--The PROSIT-Project. Proteinuria Screening and Intervention.

The PROSIT (Proteinuria Screening and Intervention) Project started in 1993 in order to obtain data on the prevalence of micro- and macroalbuminuria in diabetic patients treated in primary care, to establish an easy screening programme for microalbuminuria, in which also diabetic patients can participate in self-responsibility, and to implement a specific intervention programme for incipient nephropathy. In 58 representative doctor's offices 647 diabetic patients were included, who performed at home self-tests for microalbuminuria on three days within one week using the early morning urine and a newly developed qualitative immunologic test-strip for microalbuminuria. After storage they returned the same urine samples to their doctors' offices for semiquantitative retesting with the immunologic test-strip Micral-Test II. In case of positive results the proteinuria dipstick Combur-9-Test was applied in order to exclude other causes of positive microalbuminuria (e.g. urinary tract infection). Data of 569 patients (6% Type 1, 88% Type 2 and 6% secondary diabetes) could be analysed. Both qualitative self-testing for microalbuminuria at home and semiquantitative retesting in doctors' offices were found to be feasible. Based on semiquantitative retesting the prevalences of microalbuminuria (macroalbuminuria) were 19.6% (0%) in Type 1 diabetes, 17.2% (10.8%) in Type 2 diabetes and 11.7% (7.8%) in secondary diabetes. Type 2 diabetic patients showed a clear correlation between albuminuria and diabetes duration, HbA1c, serum creatinine, triglycerides as well as micro- and macrovascular complications. 227 patients with micro- or macroalbuminuria were included into the ongoing PROSIT intervention programme.

Adult↗
PubMed2002

Global view on functional foods: Asian perspectives.

There is an old Chinese thought meaning that medicine and food are isogenic. In Japan, a national research project started to endorse the thought scientifically, with the birth of functional foods that are now known to function to reduce the risk of life-style related diseases. The science gave rise to a national policy in which some functional foods were legally approved in terms of Foods for Specified Health Use. China has also constructed a unique system for approving some functional foods. This paper pinpoints a recent trend of functional foods characteristic to Asia, with special reference to relevant topics in Japan.

Aging↗
PubMed1995

Epidemiology and control of schistosomiasis mansoni in communities living on the Cuando River floodplain of East Caprivi, Namibia.

The Cuando River area of eastern Caprivi, Namibia, is highly endemic for Schistosoma mansoni whereas S. haematobium transmission, due to the scarcity of its intermediate host snail, Bulinus africanus, does not occur. Chemotherapy (6-monthly blanket treatments with praziquantel) combined with focal mollusciciding (monthly application of niclosamide) was used in a project in the area to control the disease. Although as many adults and pre-school children as possible were tested and treated, the project concentrated largely on school-age children. It took 3 years for prevalence to decline from > 80% to 20% because of a lack of proper sanitary facilities and piped water supplies and high rates of absenteeism and re-infection. However, intensity of infection decreased more rapidly, from an arithmetic mean of > 200 to < 5 eggs/g faeces. Hepatomegaly was common among school children when the project started but could be seen in only a small percentage of them after 3 years of control. Neither the bovine schistosome, S. mattheei, nor the lechwe schistosomes, S. margrebowiei and S. leiperi, were observed in the excreta of humans living in the area.

Adolescent↗
PubMed1998

Interdisciplinary rehabilitation of hospital employees with musculoskeletal disorders.

At Lund University Hospital a cooperation project started in 1989 between the Rehabilitation Clinic and the Occupational Health Service Unit for the rehabilitation of 34 hospital employees with musculoskeletal problems and a median sick-listing time of 6 months, treated as day-patients by an interdisciplinary team. Evaluation instruments used were the Nottingham Health Profile (NHP), Pain Drawing, Visual Analogue Scale for pain, and the Disability Rating Index (DRI). The most prominent immediate effect was a significant increase of perceived energy and significant improvement of the total score of health-related quality of life (NHP). After 12 months, 25 out of 34 (74%) subjects had returned to work. The reference group used consisted of 57 subjects referred earlier from the Occupational Health Service Unit to the Personnel Department, for vocational rehabilitation. The groups were followed by 2-4 years using questionnaires concerning working conditions and current health status. There was a significant difference (p = 0.038) in return to work: intervention group 77%, reference group 58%.

Adult↗