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At least 1,387 records · Page 77Linked to original sources
PubMed2001

Improved identification of acute coronary syndromes with delta cardiac serum marker measurements during the emergency department evaluation of chest pain patients.

Current findings from the American College of Emergency Physicians (ACEP) are that no serum marker reliably identifies or excludes acute myocardial infarction (AMI) within 6 h of symptom onset. The ACEP recommends repeat serum marker testing 6-10 h after symptom onset for CK-MB mass and subform, and 8-12 h after symptom onset for cardiac troponin I and T before making an exclusionary diagnosis of non-AMI chest pain. A new approach for identifying myocardial necrosis is to rely on time changes in the serum marker value over an abbreviated time interval (slope or delta values) as opposed to the traditional approach of relying on a value exceeding the threshold of normalcy. As assays become ever more sensitive and precise, this approach has the potential for both reliably identifying and excluding AMI (and subsets of high-risk unstable angina) at earlier time intervals with no loss in specificity. This article discusses some of the experimental evidence for this delta approach and some preliminary evidence for the potential of utilizing second-generation cTnI assays for the identification of acute coronary syndromes. Finally, we discuss a unique way of viewing receiver-operating characteristic (ROC) curves as catalogs of likelihood ratios, which we believe will be more useful to the clinician in the proper interpretation of serum marker values.

Biomarkers↗
PubMed2005

Databases, models, and algorithms for functional genomics: a bioinformatics perspective.

A variety of patterns have been observed on the DNA and protein sequences that serve as control points for gene expression and cellular functions. Owing to the vital role of such patterns discovered on biological sequences, they are generally cataloged and maintained within internationally shared databases. Furthermore,the variability in a family of observed patterns is often represented using computational models in order to facilitate their search within an uncharacterized biological sequence. As the biological data is comprised of a mosaic of sequence-levels motifs, it is significant to unravel the synergies of macromolecular coordination utilized in cell-specific differential synthesis of proteins. This article provides an overview of the various pattern representation methodologies and the surveys the pattern databases available for use to the molecular biologists. Our aim is to describe the principles behind the computational modeling and analysis techniques utilized in bioinformatics research, with the objective of providing insight necessary to better understand and effectively utilize the available databases and analysis tools. We also provide a detailed review of DNA sequence level patterns responsible for structural conformations within the Scaffold or Matrix Attachment Regions (S/MARs).

Animals↗
PubMed2004

Invertebrates yield a plethora of atypical guanylyl cyclases.

Invertebrate model systems have a long history of generating new insights into neuronal signaling systems. This review focuses on cyclic GMP signaling and describes recent advances in understanding the properties and functions of guanylyl cyclases in invertebrates. The sequencing of three invertebrate genomes has provided a complete catalog of the guanylyl cyclases in C. elegans, Drosophila, and the mosquito Anopheles gambiae. Using this data and that from cloned guanylyl cyclases in Manduca sexta, C. elegans, and Drosophila, plus predictions and models from vertebrate guanylyl cyclases, evidence is presented that there is a much broader array of properties for these enzymes than previously realized. In addition to the classic homodimeric receptor guanylyl cyclases, C. elegans has at least two receptor guanylyl cyclases that are predicted to require heterodimer formation for activity. Soluble guanylyl cyclases are generally recognized as being obligate heterodimers that are activated by nitric oxide (NO). Some of the soluble guanylyl cyclases in C. elegans may heterodimeric, but all appear to be insensitive to NO. The beta2 soluble guanylyl cyclase subunit in mammals and similar ones in Manduca and Drosophila are active in the absence of additional subunits and there is evidence that Drosophila and Anopheles also express an additional subunit that enhances this activity.

Amino Acid Sequence↗
PubMed2006

Cell cycle alterations and lung cancer.

It is now widely accepted that human carcinogenesis is a multi-step process and phenotypic changes during cancer progression reflect the sequential accumulation of genetic alterations in cells. The recent progress of scientific research has notably increased knowledge about biological events involved in lung cancer pathogenesis and progression, thanks to the use of molecular biology and immunohistochemistry techniques. Lots of the genetic alteration found in small cells lung cancer (SCLC) and in not small cells lung cancer (NSCLC) concern the expression of cell cycle genes, actually recognized as onco-suppressor genes and the lack of equilibrium between oncogenes and oncosuppressor genes. The present review of literature widely describes the cell cycle control, the lung cancer molecular pathogenesis, the catalog of known genetic alterations and the recent advances in global expression profiles in lung tumors, on the basis of the various hystological types too. Such data suggest the potential use of this knowledges in clinical practice both as prognostic factors and innovative therapeutic possibilities and they impose the necessity of new studies about cell cycle control and lung carcinogenesis.

Carcinoma, Non-Small-Cell Lung↗
PubMed2004

Male-male homosexology: seven short discourses.

Homosexology is that branch of the science of sexology that deals with same sex relationships. It is subdivided into ideation, imagery, and praxis. Praxeology is the science of praxis. There are two doctrines by which homosexuality is defined: elective and developmental. Elective is like joining a political party and is more likely bisexual than exclusively homosexual. Complete developmental homosexuality is a state of being and is characteristically immutable. Both types of homosexuality are determined multivariately and sequentially, not univariately. Male and female mammals are phylogenically programmed to be reciprocal, not identical, in the praxeology of their courtship and mating. In primate, notably human, evolution, the eyes have taken over from the nose as organs of erotic arousal, but the molecular biology of how this happens in individual development, gay, straight or ambivalent, remains to be ascertained. The different personal histories of homosexual development also remain to be ascertained and cataloged.

Bisexuality↗
PubMed2004

The effects of tonic locus ceruleus output on sensory-evoked responses of ventral posterior medial thalamic and barrel field cortical neurons in the awake rat.

In mammals, the pontine nucleus locus ceruleus (LC) is the sole source of norepinephrine (NE) projections to the forebrain. Increasing tonic discharge of LC neurons elevates extracellular levels of NE in the cortex and thalamus. Tonic LC discharge is linked to the level of wakefulness and behavioral performance, demonstrating an optimal firing rate during sustained attention tasks. Iontophoretic application of NE to target neurons in the forebrain has been shown to produce a diverse set of neuromodulatory actions, including augmentation of synaptically evoked discharge as well as suppression of spontaneous and stimulus-evoked firing patterns. Iontophoretic studies cataloged potential NE effects; however, the context in which such actions could occur in awake behaving animals remained controversial. To address this issue, the current study examined the effects of increasing tonic LC output on spontaneous and stimulus-evoked discharge of neurons within the ventroposterior medial (VPM) thalamus and barrel field (BF) somatosensory cortex of awake animals using multichannel extracellular recording strategies. The present findings indicate two primary outcomes that result from increasing frequencies of LC stimulation, either an inverted-U facilitating response profile or monotonic suppression of sensory-evoked neuronal responses. Increased tonic LC output generally decreased neuronal response latency measures for both BF cortical and VPM thalamic cells. LC-mediated effects on target VPM and BF cortical neuron sensory processing are consistent with previous demonstrations of NE modulatory actions on central neurons but indicate that such actions are cell specific. Moreover, clear differences were observed between the modulation of VPM and BF cortical cells. These data suggest that sensory signal processing is continually altered over the range of tonic LC discharge frequencies that occur in the waking animal. Such changes may account for LC-mediated shifts in sensory network performance across multiple stages of arousal and attention.

Action Potentials↗
PubMed2006

Signaling networks in neuronal polarization.

A mature neuron is typically polarized both structurally and functionally, with a single long axon and several dendrites. Neuronal polarity is essential for unidirectional signal flow from somata or dendrites to axons. The initial event in establishing a polarized neuron is the specification of a single axon. Early in neuronal development, one immature neurite becomes differentiated from other neurites to form an axon. Although studies in the past two decades have yielded a catalog of structural, molecular, and functional differences between axons and dendrites, we are only now beginning to understand the molecular mechanisms involved in the establishment of neuronal polarity. In the last few years, neuronal polarity-regulating molecules have been revealed. There are two major signaling cascades in neuronal polarization. Several groups, including ours, reported that the phosphatidylinositol 3-kinase (PI3-kinase)/Akt/glycogen synthase kinase-3beta (GSK-3beta)/collapsin response mediator protein-2 pathway is important for axon specification and elongation. Recent studies have revealed that the positive feedback loop composed of Rho family small GTPases and the Par3/Par6/atypical protein kinase C complex plays a role in the initial events of neuronal polarization downstream of PI3-kinase. Here, we discuss the roles of signaling molecules for axon specification.

Animals↗
PubMed2006

Factors affecting rapid turnover of novice nurses in university hospitals.

Rapid turnover of novice nurses eventually results in a shortage of veteran nurses. This study aimed to clarify the factors affecting rapid turnover of novice nurses in a prospective manner. We carried out an investigation in 20 university hospitals whose directors of nursing service departments accepted our request to cooperate with our research program. These hospitals were selected from all of the 102 university hospitals listed in The Hospital Catalog of Japan. The subjects were 1,203 novice hospital nurses who gave their informed consent for participation in our study. The questionnaires, which dealt with burnout, assertiveness, stressful life events, reality shock, ward assignment preference, transfer preference, job satisfaction (workplace, salary, workload, and overtime), social support and coping mechanisms were completed by 923 novice nurses in June 2003. Then, their turnover was investigated in December 2003. Thirty-seven novice nurses (4.0%) quit during this period. Multiple logistic regression analysis showed that the factors affecting rapid turnover were 1) graduation from vocational nursing schools, 2) dissatisfaction with assignment to a ward contrary to their desire, and 3) no peers for support. Assignment of novice nurses to wards they choose as far as possible, avoidance of assigning novice nurses to wards alone, and establishment of a support system for nurses who graduate from vocational nursing schools seem to be important for preventing rapid turnover of novice nurses.

Adult↗
PubMed2003

Length of stay for common pediatric conditions: teaching versus nonteaching hospitals.

OBJECTIVE: Pediatric teaching hospitals provide particular expertise in caring for children with complex or severe illnesses, yet most patients within teaching hospitals have common pediatric conditions. No study has determined whether children with common conditions remain hospitalized at teaching institutions longer than at nonteaching institutions. The objective of this study was to compare length of stay (LOS) for common pediatric conditions between teaching and nonteaching hospitals. METHODS: This study uses Massachusetts's hospital data for all discharged children ages 0 to 17 years for 1995 and 1996. Discharges were included when the principal diagnosis indicated asthma, bacterial pneumonia, convulsions, dehydration, failure to thrive, gastroenteritis, or urinary tract infections. Hospitals were classified as either teaching or nonteaching using the 1995-1996 American Hospital Association Guide. Children were identified as having a chronic condition when any discharge diagnosis was 1 of those on a previously published catalog of chronic childhood illnesses. The analysis tested the association of hospital type with LOS, controlling for chronic conditions, insurance type, age, race, diagnosis, mortality, and disposition using multivariate linear regression. RESULTS: Of 17 890 discharges for a common pediatric condition during the study period, 52.3% were from teaching hospitals. Twelve percent of common condition discharges also had a chronic disease diagnosis; 75.1% of these were discharged from a teaching hospital. LOS from nonteaching hospitals was shorter than from teaching hospitals (2.42 days vs 3.20 days). Although LOS for stays with a chronic diagnosis were longer than those without (4.75 days vs 2.56 days), controlling for chronic illness and other covariates did not eliminate the difference between LOS for nonteaching hospitals versus teaching hospitals (1.65 days vs 2.23 days). CONCLUSION: Pediatric patients with common conditions have a shorter LOS in nonteaching hospitals than those admitted to teaching hospitals by a little more than half a day. These results are unchanged when accounting for chronic conditions despite the expected results of preferential admissions to teaching hospitals for this group of patients. Additional studies should better characterize differences in patient populations, describe differences in processes, and identify differences in patient experience and outcomes to understand better the potential benefits of treating children with specific conditions at particular types of hospitals.

Asthma↗
PubMed2000

Subterranean medicine: an inquiry into underground medical treatment protocols in cave rescue situations in national parks in the United States.

Caving and spelunking have become increasingly popular over the years, with hundreds of thousands of amateur spelunkers across the country visiting caves. National parks in the United States offer hundreds of caves for all levels of spelunkers and, in fact, many national parks boast caves as either their main or major attraction. In an effort to increase visitor safety and establish subterranean medical treatment protocols, we began an investigation into cave rescue, medical protocols, previously published recommendations concerning cave safety, and visitor and rescue statistics in the national parks. Our inquiry provided little guidance from either the literature or the present US National Parks database for treating underground injuries. However, 2 predominant trends did appear. First, despite the nearly 2 million visitors to the caves in the 14 parks surveyed, there were only about 200 total calls for medical care. The vast number of those calls were for minor injuries. Second, no strict evidence-based treatment protocols for underground injuries exist, probably because they are not feasible. A caving incident database for the national parks would facilitate suggestions for preventative measures for the minor injuries and would help catalog the creative solutions for the rare serious subterranean medical incident.

Emergency Treatment↗
PubMed2006

Tissue detection of biomolecular predictors in breast cancer.

One of the promises of modern biotechnology is to improve medical care by providing accurate diagnosis and targeted treatment to patients who will derive the maximum benefit. Delivery of this promise in the 21st century is the result of major advances in biotechnology over the past 20 years. Sequencing of the human genome and other high-volume data discovery has become possible, owing to relatively inexpensive computation power and automation. The same forces that drove the human genome project are now being focused on cataloging various disease processes at the DNA, RNA and protein levels. As these high-throughput technologies are entering the clinical care environment, the major task at hand is to integrate the complex data and derive clinically useful information. In spite of major breakthroughs in molecular approaches to the diagnosis and prognostication of cancer, there remain significant obstacles in applying these technologies to clinical samples. The time-honored conventional histopathology, for example, is still the backbone of tumor diagnosis and prognostication. The traditional fixation and processing methods are, however, rapidly losing ground, as they do not protect important tissue macromolecules. Formalin, the common universal fixative, is losing its place in histopathology. In addition to its toxicity, it alters macromolecules and renders the tissue unfit for most advanced molecular studies. This has prompted the use of fresh or fresh-frozen biopsy material for most biomolecular discoveries and clinical assays. This of course is impractical, or even impossible, in most clinical settings, particularly since tumors are being detected earlier and smaller. Also, many preneoplastic conditions are impossible to triage for freezing since their accurate diagnosis requires the use of the entire sample for detailed microscopic examination. The focus in this report is on breast cancer, where the value of the innovative approaches of the tissue detection of biomolecular predictors is examined. To this end, novel tissue handling platforms are introduced that are not only suitable for histological diagnosis, but allow the detection of tumor proteome and expression profiles on the same biopsy sample.

BRCA2 Protein↗
PubMed2004

Future potential of the Human Epigenome Project.

Deciphering the information encoded in the human genome is key for the further understanding of human biology, physiology and evolution. With the draft sequence of the human genome completed, elucidation of the epigenetic information layer of the human genome becomes accessible. Epigenetic mechanisms are mediated by either chemical modifications of the DNA itself or by modifications of proteins that are closely associated with DNA. Defects of the epigenetic regulation involved in processes such as imprinting, X chromosome inactivation, transcriptional control of genes, as well as mutations affecting DNA methylation enzymes, contribute fundamentally to the etiology of many human diseases. Headed by the Human Epigenome Consortium, the Human Epigenome Project is a joint effort by an international collaboration that aims to identify, catalog and interpret genome-wide DNA methylation patterns of all human genes in all major tissues. Methylation variable positions are thought to reflect gene activity, tissue type and disease state, and are useful epigenetic markers revealing the dynamic state of the genome. Like single nucleotide polymorphisms, methylation variable positions will greatly advance our ability to elucidate and diagnose the molecular basis of human diseases.

CpG Islands↗
PubMed2005

Host-pathogen interactions: a proteomic view.

Host-pathogen interactions reflect the balance of host defenses and pathogen virulence mechanisms. Advances in proteomic technologies now afford opportunities to compare protein content between complex biologic systems ranging from cells to animals and clinical samples. Thus, it is now possible to characterize host-pathogen interactions from a global proteomic view. Most reports to date focus on cataloging protein content of pathogens and identifying virulence-associated proteins or proteomic alterations in host response. A more in-depth understanding of host-pathogen interactions has the potential to improve our mechanistic understanding of pathogenicity and virulence, thereby defining novel therapeutic and vaccine targets. In addition, proteomic characterization of the host response can provide pathogen-specific host biomarkers for rapid pathogen detection and characterization, as well as for early and specific detection of infectious diseases. A review of host-pathogen interactions focusing on proteomic analyses of both pathogen and host will be presented. Relevant genomic studies and host model systems will be also be discussed.

Animals↗
PubMed2003

[Clinical and macroscopic variables that influence the prognosis of colorectal carcinoma].

BACKGROUND AND AIMS: The paradoxical evolution of approximately one third of patients with neoplasms cataloged in Dukes stages B and C demonstrates the desirability of utilizing other prognostic criteria that are capable of broadening the information provided by these two important variables. Only a small number of investigators have dedicated themselves to the study of the prognostic value of clinical and macroscopic parameters of colorectal neoplasms, and the results obtained have been shown to be controversial. The principal aim of this work was to evaluate the prognostic importance of these parameters. PATIENTS AND METHODS: A study was made of 320 patients with colorectal cancer who underwent curative extirpation. They had a median age of 58 years, and there were 199 females (62.2%) and 121 males (37.8%). The patients were divided into three age groups: under 40 years old, between 40 and 60 years old and over 60 years old. The tumors were distributed in three intestinal segments: right colon, left colon and rectum. The neoplasms were classified as small (diameter less than or equal to 35 mm) and large (diameter greater than 35 mm). With regard to their form, they were classified as exophytic, when characterized by luminal growth, and endophytic, when there was intramural growth. The involvement of the intestinal circumference at the site of the neoplasm was considered as partial or total. RESULTS: Of the 320 patients, 22 (6.9%) were aged under 40 years, 159 (49.7%) from 40 to 60 years and 139 (43.4%) presented an age of over 60 years. Seventy-three (22.8%) of the neoplasms were located in the right colon, 130 (40.6%) in the left colon and 117 (36.6%) in the rectum. Regarding the size, 280 (87.5%) were large and 40 (12.5%) small; exophytic lesions predominated over endophytic ones - 173 (54.1%) vs 147 (45.9%). A greater number of tumors presented total involvement of the intestinal circumference - 216 (67.5%) - while 104 (32.5%) presented partial involvement. The 5-year survival of the patients was not influenced by their age and sex, or by the location and size of the neoplasms. Exophytic lesions conferred greater survival on their sufferers (65.9%), in comparison with endophytic lesions (49.0%). The survival of patients with lesions partially involving the intestinal circumference was greater than for those with total involvement - 72.1% vs. 51.4%. CONCLUSIONS: Clinical variables had no influence on the patients' prognosis. Among the macroscopic variables, the form of the neoplasia and its involvement in the intestinal circumference did influence the patients' prognosis. These last two variables are important data capable of contributing to the identification of patient subpopulations with greater or lesser prognostic risk.

Adult↗
PubMedDate not supplied

[Bioethical focus in the scientific production of nurses: characterization and analysis].

Bioethics raises ethical questions inherent to life, stimulated by biomedical and technological advances. Nursing has taken an interest in bioethical studies with the appearance of the first ethical studies based on gender relations. Here we undertake a quantitative-qualitative study of the scientific production of nurses in Brazil into Bioethics. The bibliographical survey considered postgraduate studies through CEPEn catalogs and articles published in national Nursing journals between 1990 and 2002. Reading and analysis of the material revealed that bioethical studies carried out by nurses are principally focused on the nursing professional. Production is seen to be sparse, with post-graduate studies containing the most examples.

Bioethical Issues↗
PubMedDate not supplied

[Health education: object of study in dissertations and theses by Brazillian nurses].

This study was aimed at surveying the quantity of dissertations and theses written by nurses on health education, identifying and analyzing their methodological steps. 17 Catalogs of Information about Research and Researchers from CEPEn/ABEn--published from 1979 to 1999--have been examined. The sample comprises 105 dissertations and 15 theses about the theme. Chronic diseases, pregnancy-puerperal cycle, health education, management and perisurgery situation have stood out as objects of study. The populations were adults, nursing professionals, women, children and adolescents. Interviewing was the most used technique. Authors indicated the need to improve educative practices and considered that health education motivates changes in lifestyle. It was concluded that there is a need to strengthen research into the everyday of Nursing in a historical and social context.

Academic Dissertations as Topic↗
PubMedDate not supplied

[The (in)visible gender of old age in the knowledge of nursing].

It is a bibliographical study in which the scientific production of Nursing regarding Women in Old Age was surveyed. The study was based on the Catalog of Dissertations and Theses from the CD-ROM of the Center for Studies and Research on Nursing (CEPEn) of the Brazilian Nursing Association (ABEn), from 1979 to 1999. It was aimed at getting to know the deviations and/or approximations in the knowledge of Nursing by way of the object of study of the Ph.D. thesis 'Health practice and knowledge of old women in the gender perspective'. It was found out that old women have been investigated in few studies. In addition, the objects of these investigations have strongly deviated from gender issues, demonstrating the sexless aspect of old age and the denial of women's social roles.

Academic Dissertations as Topic↗
PubMed2006

[Mental illness in the view of patients and their families].

With the aim of studying the comprehension of mental illness of patients and their families, we conducted a bibliographical study of articles in Brazilian periodicals, theses and dissertations in the period between 1993 and 2003. The identification of the sources was done through the automated search systems Latin American Literature on Health Sciences (LILACS) and the University of São Paulo's Bibliographic Data Bank On-line Global Catalog (DEDALUS). Nineteen papers were selected and four categories identified: family difficulty in the relationship with the patient; prejudice and stigma; organic/ biological explanation for the illness; and fear and pain of insanity. Most of the papers show that, regarding assistance, there is a need for support and expansion of the public health system in order to meet the demands. It is believed that the number of publications is small considering the importance of the problem, showing the need for new research.

Brazil↗