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At least 1,315 records · Page 73Linked to original sources

Validation in the clinical process.

Validation has several meanings in psychoanalysis. The scientific validation of psychoanalytic theories or of clinical effectiveness can be contrasted with validation in the clinical process. Originally, this referred to the external confirmation of specific memories or reconstructions. Recently, interest has shifted to the impact of the analyst's interventions on the analytic process. The analyst's quest for validation may lead to overemphasis on specific features of the analytic data, or an episodes of invalidation. The analyst's response to the latter is an important aspect of psychoanalytic technique.

Communication↗

[Immunoprophylaxis of superficial tumors of the bladder with interferon alfa-2b. Our experience].

OBJECTIVE: The present study was conducted to determine the usefulness of prophylactic therapy with alpha 2b interferon for superficial bladder tumors. METHOD: Following complete TUR, alpha 2b infereron was administered to 36 patients at a dose of 50 million IU weekly for 3 months and monthly for 9 months. Patients were evaluated every 3 months on the basis of their clinical and analytical data and the cystoscopic findings. RESULTS: Twenty-six patients completed treatment and were evaluable. The follow up and disease-free period was 25.70 months. Recurrence was observed in 38.4% of the patients and tumor progression in 3.8%. CONCLUSIONS: Alpha 2b interferon is useful in the prevention of tumor recurrence. Its utility is similar to that of other drugs currently used.

Aged↗

[Bilateral avascular necrosis of the femur head in an HIV-positive male].

We present a case of bilateral avascular necrosis at the hips of a HIV-positive male, without other predisposing antecedents. The only relevant analytic data was the positivity of anticardiolipin antibodies (aCL AB). We discuss the possibility that both in this case as in those previously described, HIV may have played a main role in the development of osteonecrosis.

Adult↗

[Peroperative transfusion and postoperative infections in patients with benign pathology of the digestive tract].

A prospective study of 136 patients submitted to elective surgery for benign digestive tract pathology, submitted to elective surgery, has been done to evaluate the influences of the nutritional state and the perioperative transfusions on the development of postoperative infections. All patients were given a nutritional evaluation protocol based on anthropometric parameters, analytical data and delayed-type hypersensitivity skin tests (DHST). The criteria for undernourishment were a standard weight percentage lower than 90% and/or an albumin level lower than 3.5 g/dl. Transfusion indication was established at hemoglobin levels lower than 10 g/dl and/or hematocrit values below 30% with perioperative transfusion being considered as that which took place within three weeks prior to the surgery, that taking place during the surgery, and that which took place within the first 48 postoperative hours. The infections were qualitatively evaluated as wound infection, intraabdominal infection and respiratory infection, and quantitatively by means of the Elebeute and Stoner index. 32 of the patients (23.5%) presented undernourishment, and 18 of the patients (13.2%) were transfused. A total of 20 patients (14.7%) presented a postoperative infection. A significant association between under nourishment and infection has been shown (p =), as between transfusion and undernourishment (p < 0.001). Finally, we confirm that the combination of the factors undernourishment and transfusion leads a significance increase (f = 28,462, p < 0.001) of infectious complications.

Adult↗

A perspective on doing a consultation and making the recommendation of analysis to a prospective analysand.

This paper explores the premise that the analyst's optimistic attitude toward the efficacy of analysis significantly enhances the possibility of success in helping prospective analysands accept the recommendation of analysis. This enthusiastic attitude reflects the author's opinion that analysis is the optimal treatment, the best form of psychotherapy for most adults. From this perspective, all patients seen in consultation are regarded as analyzable; this attitude is maintained until a prospective analysand proves he/she is unanalyzable in a trial of analysis. Analytic data from six consultations conducted from this perspective are presented and discussed.

Adult↗

[Cryofibrinogenemia: apropos of a case].

We describe the case of a 70-years-old woman with ischemic-hemorrhagic lesions in the cutaneous surface of both feet and analytical data of disseminated intravascular coagulation, in which the studies conducted were negative except for the presence of cryofibrinogen in plasma. We also review the clinical manifestations and the diseases associated to cryofibrinogenemia previously described in the literature.

Aged↗

[Folic Acid Reference Standard (Control 921) of National Institute of Health Sciences].

Folic acid was tested for the preparation of "Folic Acid Reference Standard (Control 921)". The quality of the raw material was examined and compared with the previous Folic Acid Reference Standard (Control 862). Analytical data obtained were as follows: water content, 7.52%; free amines, 0.1%; infrared spectrum, the same as that of the JP Reference Standard; thin-layer chromatography, three impurities were detected; high-performance liquid chromatography (HPLC), two impurities were detected; assay, 101.2% by spectrophotometry at 550 nm and 100.4% by HPLC. Based on the above results, the raw material was authorized as the Japanese Pharmacopoeia Reference Standard (Control 921).

Chromatography, High Pressure Liquid↗

[Cortisone Acetate Reference Standard (Control 921) of National Institute of Health Sciences].

The raw material of cortisone acetate was tested for the preparation of "Cortisone Acetate Reference Standard (Control 921)". The quality of the raw material was examined and compared with the previous Cortisone Acetate Reference Standard (Control 743). Analytical data obtained were as follows: loss on drying, 0.06%; melting point, 245.9 degrees C (decomposition); optical rotation, [alpha]20D = +215.5 degrees; UV spectrum, lambda max = 239 nm and specific absorbance E 1%1 cm (239 nm) = 393; infrared spectrum, the same as that of the previous Reference Standard (Control 743); thin-layer chromatography, no impurities were detected up to 100 micrograms; high-performance liquid chromatography (HPLC), three impurities were detected; assay, 100.5% by HPLC. Based on the above results, the raw material was authorized as the Japanese Pharmacopoeia Reference Standard (Control 921).

Chromatography, High Pressure Liquid↗

[Riboflavin Reference Standard (Control 921) of National Institute of Health Sciences].

The raw material for riboflavin was tested for preparation of the "Riboflavin Reference Standard (Control 921)". Analytical data obtained were as follows: melting point, 283.8 degrees C (decomposition); specific absorbance, E1%1 cm = 852 (267 nm), 275 (373 nm), 325 (446 nm); infrared spectrum, the same as that of JP Riboflavin Reference Standard; optical rotation [alpha]20D = 138.5 degrees; thin-layer chromatography, no impurities were detected up to 6 micrograms; high-performance liquid chromatography, a small amount of 9 impurities were detected; loss on drying, 0.16%; assay, 100.3% by spectrophotometry. Based on the above results, the raw material was authorized as the Japanese Pharmacopoeia Reference Standard (Control 921).

Chromatography, High Pressure Liquid↗

[Ergocalciferol Reference Standard (Control 921) of National Institute of Health Sciences].

The raw material for ergocalciferol was tested for preparation of the "Ergocalciferol Reference Standard (Control 921)". Analytical data obtained were as follows: melting point, 118.1 degrees C; UV and infrared spectra, the same as those for the JP Ergocalciferol Reference Standard; specific absorbance, E1%1 cm = 457.5 (265 nm); thin-layer chromatography and high-performance liquid chromatography (HPLC), no impurities were detected; assay, 101.0% by HPLC. Based on the above results, the raw material was authorized as the Japanese Pharmacopoeia Reference Standard (Control 921).

Chromatography, High Pressure Liquid↗

[Cholecalciferol Reference Standard (Control 921) of National Institute of Health Sciences].

The raw material for cholecalciferol was tested for preparation of the "Cholecalciferol Reference Standard (Control 921)". Analytical data obtained were as follows: melting point, 89.9 degrees C; UV and infrared spectra, the same as those for JP Cholecalciferol Reference Standard (Control 901), respectively; specific absorbance at 265 nm E1%1 cm = 472.2; optical rotation, [alpha]20D = 107.1 degrees; thin-layer chromatography and high-performance liquid chromatography (HPLC), no impurities were detected; assay, 99.97% by HPLC. Based on the above results, the raw material was authorized as the Japanese Pharmacopoeia Reference Standard (Control 921).

Cholecalciferol↗

Screening, identification and determination of the two new hypnotics zolpidem and zopiclone.

This article reports basic analytical data for screening and detection of the hypnotics zolpidem (CAS 82626-48-0) and zopiclone (CAS 43200-80-2) by using corrected hR-values, GC (gas chromatography) retention indices, UV solvent spectra and remission spectra. Beside this a HPTLC (high-performance thin-layer chromatography)-procedure for quantification is described.

Azabicyclo Compounds↗

[Constituents of food aromas].

A comprehensive review is given on the nature of the volatile compounds which participate to the aromas of foods. Its seems that light compounds, which are present in every food stuffs, give the fresh impression, and that more heavy components give the characteristic aromas. Although it is very important to consider that these volatile compounds have very different olfactory detection thresholds. The characteristic components of a food are often those which have very low detection thresholds and which are present at very low concentrations. The new analytical techniques have permitted the identification of more than two thousands compounds often present in minute amounts in foods (less than a gram per ton). But the problem is now to correlate these analytical data with the olfactory impression of tasters. Some correlations have already been obtained when a specific flavor corresponds to a small number of components, as it is often the case for off-flavors. An other problem for the food technologist is the study of the origins of the more interesting components. Some examples are given on raw materials (fruits and vegetables) and on fermented or cooked foods.

Chromatography, Gas↗

Structural studies on rabbit muscle glycogen synthase. I. Subunit composition.

Essentially glycogen-free, fully converted rabbit muscle glycogen synthase I and D forms were purified to a specific activity of 30 approximately 35 units/mg, higher than that previously reported. Polyacrylamide gel electrophoresis of the synthase I and D forms in the presence of sodium dodecyl sulfate revealed two species with molecular weights of 85,000 and 81,000 (I form) and one species with molecular weight of 85,000 (D form), respectively. The 81,000 subunit of the synthase I form is a product of proteolysis, since its proportion decreased when the enzyme was purified in the presence of a proteinase inhibitor and ethylene glycol bis(beta-aminoethyl ether)-N,N'-tetraacetic acid. Two-dimensional chromatography and high voltage electrophoretic maps of the peptides produced by exhaustive tryptic digestion of synthase I and D forms gave 78 and 85 peptides, respectively. These values agreed with the expected theoretical number of peptides assuming that the molecular weight of the enzyme subunit is 85,000 based on the analytical data of arginine and lysine content. Pro-Leu- was found as the NH2-terminal dipeptide sequence of synthase D form by the dansyl Edman method. The automated sequential degradation of synthase I form by the method of Edman provided the following NH2-terminal octapeptide sequence: Pro-Leu-Ser-Ser-Thr-Leu-Ser-Val-. The molecular weight of the subunit was also determined to be 80,000 approximately 90,000 by the quantitative analysis of phenylthiohydantoinproline. The purified synthase I and D forms each show two protein bands on gel electrophoresis in the absence of sodium dodecyl sulfate, which were also found to be enzymatically active by employing an activity stain directly on the gels. The molecular species of the I and D forms have molecular weights of 155,000 and 340,000 (I form), and 278,000 and 350,000 (D form), respectively, as measured by gel electrophoresis. Thus, the native synthase I and D forms as visualized on gels under these conditions consist of dimer and tetramer, and trimer and tetramer, respectively.

Amino Acids↗

Synthesis and chromatographic properties of cysthationamine. A substrate for diamineoidase.

Details are reported for the preparation of the 2-aminoethyl, 3-aminopropyl sulfide from 3-bromopropylamine and 2-mercaptoethylamine. For this compound, the shorter name cystathionamine is proposed. The corresponding sulfoxide and sulfone have been also prepared. Some analytical data and chromatographic properties are reported. Preliminary results show that cystathionamine is a good substrate for the pig kidney diamineoxidase.

Amine Oxidase (Copper-Containing)↗

[Effectiveness of the treatment of systemic lupus erythematosus with methotrexate].

BACKGROUND: To evaluate the efficacy of methotrexate in patients with systemic lupus erythematosus (SLE) without major organ involvement resistant to medium-high doses of prednisone. METHODS: Crossover, open clinical trial with two treatment periods, the first of 3 months and the second of 6 months, an intermediate control period of 3 months and another at the end of 6 months. A sample of 15 consecutive patients with SLE who, with no major organ damage, had active disease in spite of receiving more than 10 mg/day of prednisone or who relapsed on reduction of this doses during a period of at least 3 months. 7.5 mg/week of methotrexate were administered orally, divided into three doses of 2.5 mg/12 hours. Statistical significance was evaluated by Student's paired t test and chi 2; the strength of association by the Mantel-Haenzel odds ratio (OR) method and the precision, by Miettinen's confidence interval (CI). A p value of less than 0.05 was considered significant. RESULTS: Two patients failed to finish the study; one for worsening of cutaneous lesions of necrotizing vasculitis which she already had previously, and the other for an increase in her transaminase levels. In the remaining 13 there were 10 flares of disease activity during the control phases, 2 severe, versus 2 flares during the periods of methotrexate use (OR 7.69 (95% confidence interval, 1.67 to 33.33; p = 0.021). There were no significant changes in analytical results or prednisone requirements. During treatment six patients had oral aphthae and five had dyspepsia; three had an increase in transaminase levels, which in one caused the treatment to be stopped. There were two urinary infections, one community acquired pneumonia and one upper airway symptoms requiring antibiotic treatment; one female patient had acute cholecystitis with cholelithiasis necessitating surgical intervention. CONCLUSIONS: Weekly low doses of methotrexate may prevent flares of activity of SLE in this type of patients, but it does not reduce the requirements of prednisone, nor modify analytical data. Toxic effects are rare and reversible upon interrupting medication.

Adult↗

[Thoracic actinomycosis].

BACKGROUND: Thoracic actinomycosis is an rare disease in our medium. This fact, together with the variability of its forms of presentation and the difficulty in isolating its etiologic agent, make its diagnosis, particularly difficult. METHODS: A series of 8 cases diagnosed in the years 1988, 1989 and 1990 in two centers (Hospital de Bellvitge-Prínceps d'Espanya and Hospital de l'Esperança) is described with evaluation of the clinical and analytical data and the therapy applied. RESULTS: Species were only identified in 3 cases with Actinomyces israelii in two and Actinomyces odontolyticus in the third. The proven association with Mycobacterium tuberculosis, the presence of distant septic metastasis and eosinophilic pleuritis as forms of presentation are of note. Medical treatment was penicillin or derivatives in all the cases except one which was treated with diagnostic/therapeutic segmentectomy. CONCLUSIONS: It is concluded that when any subacute involvement of the thoracic and/or pleuropulmonary wall specific cultures should be carried out to discard eventual thoracic actinomycosis.

Actinomyces↗

Effect size as a measure of symptom-specific drug change in clinical trials.

A data-analytic strategy is proposed for identifying the symptom-specific effects of each medication in a clinical trial. The within-group effect size is a standardized ratio of the pre-post change relative to the stability of change for each treatment group. Advantages of using this descriptive approach are illustrated by examining antidepressant effects of alprazolam, imipramine, and placebo in a clinical trial for patients meeting criteria for both panic disorder and depression. There was a significant difference between active medication and placebo on the Hamilton Rating Scale for Depression (HAM-D) total, but no difference between the anti-depressant effects of the active medications despite their diverse psychopharmacologic properties. Examination of effect sizes for each HAM-D item revealed distinct symptom-specific effects of each active medication in this study sample. Although these descriptive findings cannot be used for inferential conclusions, they can be used to guide the design of future trials.

Adult↗