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At least 1,333 records · Page 74Linked to original sources
PubMed2001

Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: a meta-analysis of controlled clinical trials.

CONTEXT: Exercise is widely perceived to be beneficial for glycemic control and weight loss in patients with type 2 diabetes. However, clinical trials on the effects of exercise in patients with type 2 diabetes have had small sample sizes and conflicting results. OBJECTIVE: To systematically review and quantify the effect of exercise on glycosylated hemoglobin (HbA(1c)) and body mass in patients with type 2 diabetes. DATA SOURCES: Database searches of MEDLINE, EMBASE, Sport Discuss, Health Star, Dissertation Abstracts, and the Cochrane Controlled Trials Register for the period up to and including December 2000. Additional data sources included bibliographies of textbooks and articles identified by the database searches. STUDY SELECTION: We selected studies that evaluated the effects of exercise interventions (duration >/=8 weeks) in adults with type 2 diabetes. Fourteen (11 randomized and 3 nonrandomized) controlled trials were included. Studies that included drug cointerventions were excluded. DATA EXTRACTION: Two reviewers independently extracted baseline and postintervention means and SDs for the intervention and control groups. The characteristics of the exercise interventions and the methodological quality of the trials were also extracted. DATA SYNTHESIS: Twelve aerobic training studies (mean [SD], 3.4 [0.9] times/week for 18 [15] weeks) and 2 resistance training studies (mean [SD], 10 [0.7] exercises, 2.5 [0.7] sets, 13 [0.7] repetitions, 2.5 [0.4] times/week for 15 [10] weeks) were included in the analyses. The weighted mean postintervention HbA(1c) was lower in the exercise groups compared with the control groups (7.65% vs 8.31%; weighted mean difference, -0.66%; P<.001). The difference in postintervention body mass between exercise groups and control groups was not significant (83.02 kg vs 82.48 kg; weighted mean difference, 0.54; P =.76). CONCLUSION: Exercise training reduces HbA(1c) by an amount that should decrease the risk of diabetic complications, but no significantly greater change in body mass was found when exercise groups were compared with control groups.

Adult↗
PubMed2004

FRAGS: estimation of coding sequence substitution rates from fragmentary data.

BACKGROUND: Rates of substitution in protein-coding sequences can provide important insights into evolutionary processes that are of biomedical and theoretical interest. Increased availability of coding sequence data has enabled researchers to estimate more accurately the coding sequence divergence of pairs of organisms. However the use of different data sources, alignment protocols and methods to estimate substitution rates leads to widely varying estimates of key parameters that define the coding sequence divergence of orthologous genes. Although complete genome sequence data are not available for all organisms, fragmentary sequence data can provide accurate estimates of substitution rates provided that an appropriate and consistent methodology is used and that differences in the estimates obtainable from different data sources are taken into account. RESULTS: We have developed FRAGS, an application framework that uses existing, freely available software components to construct in-frame alignments and estimate coding substitution rates from fragmentary sequence data. Coding sequence substitution estimates for human and chimpanzee sequences, generated by FRAGS, reveal that methodological differences can give rise to significantly different estimates of important substitution parameters. The estimated substitution rates were also used to infer upper-bounds on the amount of sequencing error in the datasets that we have analysed. CONCLUSION: We have developed a system that performs robust estimation of substitution rates for orthologous sequences from a pair of organisms. Our system can be used when fragmentary genomic or transcript data is available from one of the organisms and the other is a completely sequenced genome within the Ensembl database. As well as estimating substitution statistics our system enables the user to manage and query alignment and substitution data.

Animals↗
PubMed2000

The origin of the "ideal" body weight equations.

OBJECTIVE: To provide a historical perspective on the origin and similarity of the "ideal" body weight (IBW) equations, and clarify the terms ideal and lean body weight (LBW). DATA SOURCES: Primary and review literature were identified using MEDLINE (1966-November 1999) and International Pharmaceutical Abstracts (1970-November 1999) pertaining to ideal and lean weight, height-weight tables, and obesity. In addition, textbooks and relevant reference lists were reviewed. DATA EXTRACTION: All articles identified through the data sources were evaluated. Information deemed to be relevant to the objectives of the review were included. DATA SYNTHESIS: Height-weight tables were generated to provide a means of comparing a population with respect to their relative weight. The weight data were found to correlate with mortality and resulted in the use of the terms desirable or ideal to describe these weights. Over the years, IBW was interpreted to represent a "fat-free" weight and thus was used as a surrogate for LBW. In addition, the pharmacokinetics of certain drugs were found to correlate with IBW and resulted in the use of IBW equations published by Devine. These equations were consistent with an old rule that was developed from height-weight tables to estimate IBW. Efforts to improve the IBW equations through regression analyses of height-weight data resulted in equations similar to those published by Devine. CONCLUSIONS: The similarity between the IBW equations was a result of the general agreement among the various height-weight tables from which they were derived. Therefore, any one of these equations may be used to estimate IBW.

Adult↗
PubMed1992

Silicosis surveillance in New Jersey: targeting workplaces using occupational disease and exposure surveillance data.

To identify workplaces in New Jersey with potential for silica exposure, the New Jersey Department of Health compared four-digit Standard Industrial Classifications (SICs) identified by three different data sources: the National Occupational Exposure Survey (NOES), a new Jersey silicosis case registry, and regulatory agency compliance inspections in New Jersey. In total, the three data sources identified 204 SICs in New Jersey with potential for silica exposure. Forty-five percent of these SICs were identified by NOES only, 16% by registry cases only, 6% by compliance inspections only, and 33% by two or more sources. Since different surveillance sources implicate different SICs, this type of analysis is a useful first step in planning programs for prevention of silicosis.

Humans↗
PubMed1993

Ensuring excellence: reconceptualizing quality assurance, risk management, and utilization review.

A new conceptualization of the related activities QA, RM, and UR may allow an organization to ensure appropriate, proficient, and satisfactory care and to ameliorate the consequences of bad outcomes. Three processes incorporated into the conceptualization are essential to ensuring excellence, as are specific attributes of the care process. The difference in initiation of activities (reactive versus proactive) is part of the model; relationships among the essential activities and processes and between reactive and proactive activities are suggested; and viewing data sources or collection as separate from the processes and activities is suggested. Areas for development and research within the conceptualization that are inadequately understood include data sources and analysis methods useful for the processes needed, evaluation of the consequences of different reactive activities, and the usefulness of TQI activities for setting goals or standards and for changing behavior. Implementing such an approach to ensuring excellence would be a challenge. It is hoped that this formulation will assist in communication among those working to ensure excellence; promote analysis of whether current organizational structures for ensuring excellence and for cost containment are creating redundance, competition, or gaps in needed activities; broaden the perception of the possible and/or appropriate scope of some activities, such as the inclusion of proactive preventive care and the provision of special high-risk programs; and assist in the identification of areas of needed research and development.

Health Services Research↗
PubMed2005

Learning statistical models for annotating proteins with function information using biomedical text.

BACKGROUND: The BioCreative text mining evaluation investigated the application of text mining methods to the task of automatically extracting information from text in biomedical research articles. We participated in Task 2 of the evaluation. For this task, we built a system to automatically annotate a given protein with codes from the Gene Ontology (GO) using the text of an article from the biomedical literature as evidence. METHODS: Our system relies on simple statistical analyses of the full text article provided. We learn n-gram models for each GO code using statistical methods and use these models to hypothesize annotations. We also learn a set of Naïve Bayes models that identify textual clues of possible connections between the given protein and a hypothesized annotation. These models are used to filter and rank the predictions of the n-gram models. RESULTS: We report experiments evaluating the utility of various components of our system on a set of data held out during development, and experiments evaluating the utility of external data sources that we used to learn our models. Finally, we report our evaluation results from the BioCreative organizers. CONCLUSION: We observe that, on the test data, our system performs quite well relative to the other systems submitted to the evaluation. From other experiments on the held-out data, we observe that (i) the Naïve Bayes models were effective in filtering and ranking the initially hypothesized annotations, and (ii) our learned models were significantly more accurate when external data sources were used during learning.

Bayes Theorem↗
PubMed2005

Responding to rising cancer caseloads: family physician learning needs and challenges in cancer care.

BACKGROUND: In this study, we addressed physicians' learning needs and practice challenges throughout the continuum of cancer care using an interprofessional approach. METHODS: Data sources and tools included (1) 150 family physician questionnaires, (2) 11 oncologist interviews, (3) 13 focus groups with 125 health care providers, and (4) secondary sources. RESULTS: Family physicians wish to play a larger role in their cancer patients' care. Their self-reported learning needs were confirmed by other data sources. Important practice and systemic challenges to improving care exist. CONCLUSION: Decreasing cancer rates and improving cancer care are complex issues requiring educational interventions as well as organizational and communications initiatives.

Adult↗
PubMed1999

Simple methods for checking for possible errors in reported odds ratios, relative risks and confidence intervals.

Meta-analyses of data from epidemiological studies are often based on odds ratios (ORs) or relative risks (RRs) and their 95 per cent confidence intervals (CIs) as reported by the authors. Where possible ORs, RRs and CIs should be checked against the source data. Some simple methods are presented for checking the validity of reported ORs, RRs and CIs where the source data are not available. These methods include inferring the minimum total number of subjects in the study, the minimum total number of cases and the minimum number there must be in any disease/exposure category. Examples taken from the literature on environmental tobacco smoke exposure (ETS) illustrate that errors in published data are not infrequent and may stay undetected in meta-analyses.

Case-Control Studies↗
PubMed2006

Hyponatremia associated with selective serotonin-reuptake inhibitors in older adults.

OBJECTIVE: To review the incidence, risk factors, mechanism, times of onset and resolution, and treatment of hyponatremia associated with selective serotonin-reuptake inhibitors (SSRIs). DATA SOURCES: An English-language literature search was conducted using MEDLINE (1966-December 2005) using the search terms selective serotonin-reuptake inhibitor, hyponatremia, syndrome of inappropriate secretion of antidiuretic hormone, citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline. Additional references were identified by reviewing bibliographies of articles retrieved. STUDY SELECTION AND DATA EXTRACTION: Relevant data were extracted from published reports, letters, and studies of humans with hyponatremia and/or syndrome of inappropriate secretion of antidiuretic hormone (SIADH) secondary to SSRIs. All articles identified from data sources were reviewed for relevant information. Applicable information was included in this review. DATA SYNTHESIS: Numerous case reports, observational studies, and case-controlled studies, as well as one prospective clinical trial, have reported hyponatremia associated with SSRI use, with the incidence varying from 0.5% to 32%. Risk factors for the development of hyponatremia with SSRIs include older age, female gender, concomitant use of diuretics, low body weight, and lower baseline serum sodium concentration. In published reports, hyponatremia developed within the first few weeks of treatment and resolved within 2 weeks after therapy was discontinued. The mechanism by which SSRIs cause hyponatremia is thought to be secondary to development of SIADH. Treatment of isovolemia hypotonic hyponatremia associated with SSRI use includes water restriction and mild diuresis with a loop diuretic. More severe cases may be treated with higher doses of loop diuretics and hypertonic saline. There have been few reports of rechallenge with the same or another SSRI or substitution of another agent from a different therapeutic class. In some, but not all, cases hyponatremia recurred. CONCLUSIONS: Practitioners should be on the alert for this potentially life-threatening adverse event, especially in older adults with other risk factors for developing hyponatremia.

Aged↗
PubMed2001

Undescended testis and the risk of testicular cancer: importance of source and classification of exposure information.

BACKGROUND: The strength of the association between undescended testis and testicular cancer varies considerably across studies. Here we report the effect of various classifications of self-reported history of undescended testis and different data sources on the estimates of the risk of testicular cancer from a case-control study. METHODS: We performed a population-based case-control study including 269 testicular cancer cases and 797 controls matched on age and region. Medical history was assessed by interviews (index persons) and mailed questionnaires (mothers). We used conditional logistic regression to calculate odds ratios (OR) and kappa coefficients to assess agreement between different sources of information. RESULTS: Odds ratios for testicular cancer ranged between 2.4 and 5.4 based on the sons' self-reports and between 1.1 and 1.9 based on the mothers' reports. The agreement between the sons and mothers on undescended, gliding or retractile testis was fair (kappa 0.53) and was good when these conditions were treated by surgery (kappa 0.89). The rating of a history of undescended testis by two urologists was fair (kappa 0.54). CONCLUSIONS: The questionnaire design, the classifications of undescended testis and data sources have an important impact on the OR for the association of undescended testis and testicular cancer. These factors may partially explain the heterogeneity of the OR for this association in case-control studies relying on self-reports.

Adolescent↗
PubMedDate not supplied

Known and hidden sources of caffeine in drug, food, and natural products.

OBJECTIVE: To review the pharmacology, pharmacokinetics, adverse effects, and drug interactions associated with caffeine and to raise awareness of the caffeine content of many prescription, nonprescription, and herbal drugs, beverages, and foods. DATA SOURCES: Articles in English retrieved through a MEDLINE search (1966-August 2000) using the terms caffeine, human, and systemic. Additional product information was obtained from manufacturers' Web sites, through direct communications with manufacturers or distributors, and via Internet searches using the AltaVista search engine and the term caffeine. Only the first 10 Web sites selling caffeine products identified were visited. STUDY SELECTION: All articles and correspondence items from data sources were evaluated, and all information deemed relevant was included. Priority was given to information provided by manufacturers. CONCLUSION: With the increase in consumers' use of over-the-counter products for health maintenance and self-care, it is imperative for pharmacists to be knowledgeable about the caffeine content of all drug and herbal products. It is important to be familiar with patients' self-treatment habits in order to identify potential caffeine-drug interactions or caffeine-laboratory interactions resulting in false laboratory values. These interactions increase health care costs by creating adverse effects and causing misdiagnoses.

Caffeine↗
PubMed2006

Changes in safety on England's roads: analysis of hospital statistics.

OBJECTIVE: To compare trends in the numbers of people with serious traffic injuries according to police statistics and hospital episode statistics (HES). DESIGN: Descriptive study based on two independent population based data sources. SETTING: Police statistics and hospital episode statistics in England. MAIN OUTCOME MEASURES: Rates of injury and death and their change over time reported in each data source, for 1996 to 2004. RESULTS: According to police statistics, rates of people killed or seriously injured on the roads fell consistently from 85.9 per 100,000 in 1996 to 59.4 per 100,000 in 2004. Over the same time, however, hospital admission rates for traffic injuries were almost unchanged at 90.0 in 1996 and 91.1 in 2004. Both datasets showed a significant reduction in rates of injury in children aged < or = 15, but the reduction in hospital admission rates was substantially less than the reduction shown in the police statistics. The definition of serious injury in police statistics includes every hospital admission; in each year, none the less, the number of admissions exceeded the number of injuries reported in the police system. CONCLUSIONS: The overall fall seen in police statistics for non-fatal road traffic injuries probably represents a fall in completeness of reporting of these injuries.

Accidents, Traffic↗
PubMed1998

Recommended data elements for firearm-related injury surveillance.

During 1994, the Centers for Disease Control and Prevention (CDC) funded seven states to develop and evaluate surveillance systems for firearm-related injuries. In addition, New York City and California had related experience with firearm-related injury surveillance. At the time these nine jurisdictions began developing their surveillance systems, no standardized definitions or recommendations were available about the best methods or procedures of collecting data or suggested data elements of a firearm-related injury surveillance system. The nine jurisdictions and CDC developed a list of recommended data elements (RDEs) for fatal and nonfatal firearm-related injuries. We describe the process used to develop the RDEs, the 21 data elements suggested by the funded projects, the data sources that may be able to provide those data elements, and an indication of which sources may be most useful. We encourage all developing surveillance systems to strive to include these data elements, although some of the elements will be more easily attainable for fatal injury events than nonfatal ones, and no single data source will be able to provide all the desired information about both morbidity and mortality from firearm-related injuries. The RDEs capitalize on the preliminary experiences of the small group of jurisdictions, but they need to be pilot tested and revised as we collect more information about how well these elements capture the desired information and whether the information obtained is useful.

Centers for Disease Control and Prevention, U.S.↗
PubMed2005

Convergence of self-report and archival crash involvement data: a two-year longitudinal follow-up.

This study constructively extends Arthur et al. (2001) by assessing the convergence of self-report and archival motor vehicle crash involvement and moving violations data in a 2-year longitudinal follow-up. The relationships among these criteria, conscientiousness, and driving speed were also assessed using both predictive and postdictive criterion-related validation designs. Data were collected from a 2-year follow-up sample of 334 participants. Results suggested a lack of convergence between self-report and archival data at both Time 1 and Time 2. In addition, the predictor/criterion relationships varied across research design and data source. An actual application of our findings is that the interpretation of relationships between specified predictors and crash involvement and moving violations must be made within the context of the criterion-related validation design and criterion data source. Specifically, predictive designs may produce results different from those of postdictive designs (which are more commonly used). Furthermore, self-report data appear to include a broader range of incidents (more crashes and tickets), and thus researchers should consider using self-report data when they are interested in including lower threshold crashes and tickets that may not be reported on state records (e.g., because of the completion of a defensive driving course).

Accidents, Traffic↗
PubMed2004

The changing face of antibiotic prescribing: the mutant selection window.

OBJECTIVE: To describe the mutant selection window, discuss supporting evidence and limitations, and suggest potential applications for clinical practice. DATA SOURCES: A MEDLINE search (1990-December 2003) of the English-language literature was conducted using the key words antibiotic, antimicrobial, resistance, mutant, selection window, prevention, MPC, and MSW in various combinations. Original investigations and reviews evaluating the mutant selection window, including abstracts and proceedings, were considered for inclusion. Published articles were also cross-referenced, and experts were contacted to locate additional pertinent data. STUDY SELECTION AND DATA EXTRACTION: All data sources identified were evaluated and all information deemed relevant was included. DATA SYNTHESIS: Until recently, physicians have had few ways to preserve antimicrobials from resistance other than by prescribing the agents less often. The mutant selection window hypothesis may modify this paradigm by shifting the focus to dosing strategies that reduce the growth of resistant mutants. Conventional dosing strategies have been formulated on the likelihood of curing an individual patient. Unfortunately, doses that cure patients appear to enrich resistant subpopulations of bacteria, thus promoting resistance. Antimicrobial-pathogen combinations can be identified that minimize mutant selection and cure patients while possibly restricting the progression of resistance. CONCLUSIONS: The mutant selection window hypothesis provides a framework for considering the contribution of dosing to resistance, and it offers ideas for restricting the enrichment of resistant mutants and antimicrobial resistance.

Anti-Bacterial Agents↗
PubMedDate not supplied

Neuromotor development and the physiologic effects of positioning in very low birth weight infants.

OBJECTIVE: To provide a comprehensive literature review of neuromotor development and related physiologic effects of positioning in very low birth weight infants. DATA SOURCES: MEDLINE, CINHAL, Health Star, Current Contents, and the Australian Medical Index (1966-2000) databases were searched. Unpublished studies (e.g., dissertations, conference proceedings) and all relevant references listed in articles also were examined. STUDY SELECTION: One hundred and eighty theoretical writings, research studies, and clinical papers related to neuromotor development, the physiologic effects of positioning, and interventions to minimize or prevent short- and long-term effects of positioning in very low birth weight infants were reviewed. DATA EXTRACTION: Studies were assessed for scientific rigor, evidence of theoretical foundation, and clinical relevance. Comparisons were made across data sources to determine the most reliable, valid, and consistent findings. DATA SYNTHESIS: Three compelling results emerged: (a) The development of posture and mobility in newborn infants requires an optimal balance between active and passive muscle tone, (b) the prone position is physiologically more beneficial for the preterm infant than supine and lateral positions, and (c) the prone position can lead to short- and long-term postural and associated developmental problems. CONCLUSION: Use of empirically tested postural interventions appropriate for an infant's gestational age, health status, and overall organizational capacity is recommended.

Child Development↗
PubMed2006

Can we talk? Importance of random-digit-dial surveys for injury prevention research.

Prevention research in public health requires quality data. In injury prevention research, "official" data sources, such as medical or law enforcement data, often do not possess the required depth or completeness. Self-reported data can fill this gap. Such data allow us to understand knowledge, attitudes, exposures, and behaviors associated with injury risk. Self-reported data are also needed to understand outcomes that are often missing from official sources, such as victimization by an intimate partner that is not reported because of concerns about legal consequences and less severe injuries from suicide attempts that go untreated. Data on risk and protective factors and specific types of violence exposures can often only be obtained by directly asking those affected. In addition, "official" data sources are rarely representative. Random-digit-dialing (RDD) surveys are a method of obtaining representative self-reported data. The RDD approach is relatively cost effective, handles non-English-speaking households with relative ease, and possesses a well-developed theory for constructing sample weights. However, there are significant challenges to using RDD surveys. These include declining participation rates; possible self-selection bias, since potential respondents can choose to opt out of the survey; and, with sensitive topics such as intimate partner violence, the need to anticipate potential risks for participants. This theme issue provides suggestions for how we can improve the design and implementation of RDD surveys in a manner that is both practical and ethical.

Behavioral Risk Factor Surveillance System↗
PubMed2004

Current applications of flow cytometry in the diagnosis of primary immunodeficiency diseases.

CONTEXT: To review the applications of flow cytometry in the diagnosis and management of primary immunodeficiency disease. DATA SOURCES: Articles describing the use of flow cytometry in the diagnosis of several primary immunodeficiency diseases were obtained through the National Library of Medicine database. STUDY SELECTION: Publications that described novel and known applications of flow cytometry in primary immunodeficiency disease were selected. Review articles were included. Articles describing the different immunodeficiency diseases and methods of diagnosis were also selected. DATA EXTRACTION: Approximately 100 data sources were analyzed, and those with the most relevant information were selected. DATA SYNTHESIS: The diagnosis of many primary immunodeficiency diseases requires the use of several laboratory tests. Flow cytometry has become an important part of the workup of individuals suspected to have such a disorder. Knowledge of the pathogenesis of many of these diseases continues to increase, hence we acquire a better understanding of the laboratory tests that may be helpful in diagnosis. CONCLUSIONS: Flow cytometry is applicable in the initial workup and subsequent management of several primary immunodeficiency diseases. As our understanding of the pathogenesis and management of these diseases increases, the use of many of these assays may become routine in hospitals.

Antigens, CD↗