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At least 1,423 records · Page 79Linked to original sources
PubMed2000

Citalopram in the treatment of depression.

OBJECTIVE: To review the efficacy and safety of citalopram in the treatment of depression. DATA SOURCES: MEDLINE search (1966-April 2000), Current Contents search, additional references listed in articles, and unpublished data obtained from the manufacturer were used to identify data from scientific literature. Studies evaluating citalopram (i.e., abstracts, clinical trials, data on file with the manufacturer) were considered for inclusion. STUDY SELECTION: English-language literature was reviewed to evaluate the pharmacology, pharmacokinetics, therapeutic use, and adverse effects of citalopram. DATA EXTRACTION: Controlled animal and human clinical studies published in the English-language literature were reviewed and evaluated. Clinical trials selected for inclusion were limited to those in human subjects and included data from animals if human data were not available. DATA SYNTHESIS: Citalopram is an antidepressant belonging to the class of selective serotonin-reuptake inhibitors (SSRIs) available for the treatment of depression. Citalopram offers therapeutic efficacy similar to that of the other SSRIs and a more favorable adverse effect profile than that of the tricyclic antidepressants (TCAs). Citalopram does not cause anticholinergic or cardiovascular adverse effects associated with the TCAs. Citalopram is the most selective SSRI and, unlike other SSRIs, seems to be relatively free of interaction mediated by the cytochrome P450 system. Citalopram is also the least expensive antidepressant available to date. This review of citalopram includes data from clinical trials comparing safety, tolerability, efficacy, and pharmacoeconomics with TCAs and SSRIs. CONCLUSIONS: Clinical trials demonstrate that citalopram's therapeutic efficacy is significantly greater than that of placebo and is comparable with that of other antidepressants. Citalopram has a favorable adverse effect profile, and thus may be useful in treating depressed patients who cannot tolerate anticholinergic or cardiovascular adverse effects associated with TCAs. It may also be useful in patients with comorbid illnesses requiring concomitant medicines.

Antidepressive Agents, Tricyclic↗
PubMed2001

[Computerized acquisition and elaboration of clinical data in Rheumatology during ten years: state of art and prospectives]

The well known complexity to collect the clinical data of patients and in particular in the area of rheumatology push us to develop a computerized clinical chart in order to facilitate the classification, evaluation and monitoring of these patients. The proposed computerized clinical chart is easy to use but at the same time is a very potent tool that allow the clinicians to organize the classic rheumatological pathologies as well as the more complexes or even rare. The proposed clinical chart is based on a relational database (FileMaker Pro 5.0v1) available for both the actual operative systems implemented on personal computers (Windows and Macintosh); this allow the full compatibility among the two systems, the possibility of exchanging data without any loss of information. The computerized clinical chart is structured on modules for specific pathologies and for homogeneous groups of illnesses. Basically the modules are defined correlated files of data for a specific pathology but that can be used also as a common pool for different pathologies. Our experience, based on ten years of use, indicates in the computerized rheumatological clinical chart an indispensable tool for rheumatologists with a real friendly use.

Journal Article↗
PubMedDate not supplied

[Use of computerized data in pharmacoepidemiology].

Positive and negative effects of long-term therapy are sometimes difficult to highlight, for instance in gerontology or in respiratory medicine, and the use of computerized data may be a good alternative. Data collection is made of three steps. First, a study population is identified from disease criteria. All treatments used during a given study period are then extracted from computerized files; these data may be linked, when needed, to detailed patient surveys. Finally, all outcomes of the study period are retrieved, possibly using validated proxies. This method also allows for assessment of the quality of prescribing and the burden of disease. Asthma studies are used as examples.

Anti-Asthmatic Agents↗
PubMed1988

Survey concerning international computer files of road accidents.

A survey concerning international harmonization of accident reporting was distributed to 80 experts in accident reporting and analysis. Completed surveys were received from 50 persons in 13 countries; 74% of the respondents had more than 10 years of experience in the field of traffic safety. The main findings of this survey are: (1) 86% of the respondents think that an international computer file of disaggregated fatal-accident data would contribute to understanding of traffic safety, and 84% would use such a file. (2) An international non-fatal-accident file was considered to be of value in research on human factors and accident causation (60%), and in determining black spots in the road network (57%). (3) Police was the most frequently mentioned source of data for both the fatal and non-fatal international data files. Nevertheless, fewer than one-quarter of respondents considered police as the suitable exclusive source of either data. (4) The majority view was that the data for both types of files should come from more than one agency. (5) In the case of the fatal-accident file, 78% of the respondents considered it important that the data be cross-checked with the public health records. (6) The 10 most useful variables for a fatal-accident file were traffic unit type (e.g. car), accident type (e.g. angle), road class, driver age, date/time of day, age of person killed, number of killed persons, number of injured persons, drinking or drug use, and restraint usage of person killed.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents, Traffic↗
PubMedDate not supplied

Exploratory data analysis of the Mediterranean component of the BEEP programme.

Work Package 3 (WP3) uses the data generated by ecotoxicologists from 11 laboratories who sample twice per year at four sites (France, Italy, Spain and Greece) to conduct the Mediterranean portion of the BEEP programme (Biological Effects of Environmental Pollution in marine coastal ecosystems). The WP3 data have been compiled into files using a data base structure (one record=one measurement) that eases statistical analysis and importation of new data. Here we present our first attempt of exploratory analysis based on a subset of data from the campaigns in May and September of 2001 and 2002. For most biomarkers, data plot revealed a strong station*campaign interaction, confirmed by two-way ANOVAs. This could be "true" variability with biomarkers responding to contaminant inputs that have changed among the four sampling times. Alternatively it could betray analytical problems and inadequate sampling designs or a lack of stability in the biomarkers themselves whereby they change in random ways unrelated to environmental factors.

Acetylcholinesterase↗
PubMed2001

An integrated system for high throughput TaqMan based SNP genotyping.

UNLABELLED: We have developed an integrated laboratory information system that allows the flexible handling of pedigree, phenotype and genotype information. Specifically, it includes client applications for an integrated data import from TaqMan typing files, Mendel checking, data export, handling of pedigree and phenotype information and analysis features. AVAILABILITY: The SQL source code, sources and binaries of the client applications (NT and Windows95/98 platforms) and additional documentation are available at http://www.mucosa.de/.

Clinical Laboratory Information Systems↗
PubMed2005

Physician visits, hospitalizations, and socioeconomic status: ambulatory care sensitive conditions in a canadian setting.

OBJECTIVE: To determine whether rates of physician visits for ambulatory care sensitive (ACS) conditions are lower for people of low-socioeconomic status than of high-socioeconomic status in an urban population with universal health care coverage. DATA SOURCES/STUDY SETTING: Physician claims and hospital discharge abstracts from fiscal years 1998 to 2001 for urban residents of Manitoba, Canada. The 1996 Canadian Census public use database provided neighborhood household income information. The study included all continuously enrolled urban residents in the Manitoba Health Services Insurance Plan. STUDY DESIGN: Twelve ACS conditions definable using 3-digit ICD-9-CM codes permitted cross-sectional and longitudinal comparison of ambulatory visits and hospitalizations. Neighborhood household income data provided a measure of socioeconomic status. DATA COLLECTION/EXTRACTION METHODS: Files were extracted from administrative data housed at the Manitoba Centre for Health Policy. PRINCIPAL FINDINGS: All conditions showed a socioeconomic gradient with residents of the lowest income neighborhoods having both more visits and more hospitalizations than their counterparts in higher income areas. Six of nine conditions with a sufficient N showed individuals living in the lowest income neighborhoods to have significantly more ambulatory visits before hospitalization for an ACS condition than did those in the most affluent neighborhoods. Many conditions showed a gradient in rate of hospitalization even after controlling for the number of ambulatory care visits. CONCLUSIONS: In the Canadian universal health care plan, the poor have reasonable access to ambulatory care for ACS conditions. Ambulatory care may be more effective in preventing hospitalizations among relatively affluent individuals than among the less well off.

Adolescent↗
PubMed1990

Computerized literature reference system: use of an optical scanner and optical character recognition software.

A computerized reference system for radiology journal articles was developed by using an IBM-compatible personal computer with a hand-held optical scanner and optical character recognition software. This allows direct entry of scanned text from printed material into word processing or data-base files. Additionally, line diagrams and photographs of radiographs can be incorporated into these files. A text search and retrieval software program enables rapid searching for keywords in scanned documents. The hand scanner and software programs are commercially available, relatively inexpensive, and easily used. This permits construction of a personalized radiology literature file of readily accessible text and images requiring minimal typing or keystroke entry.

Electronic Data Processing↗
PubMedDate not supplied

Community orientation, strategic flexibility, and financial performance in hospitals.

The objective of this study was to examine how community orientation and strategic flexibility affect accounting measures of financial performance in acute care hospitals. This cross-sectional study used organizational data from the American Hospital Association, environmental data from the Area Resource File, and financial data from the Healthcare Cost Report Information System. We tested our hypotheses on 1,779 hospitals using OLS regression models that controlled for organizational and environmental factors that might affect financial performance. The community orientation of a hospital had a negative impact on its short-term financial performance. However, the strategic flexibility of a hospital with regard to structure and resources was significantly and positively associated with hospital performance. Our findings are important to healthcare managers. Specifically, although a community orientation is thought to be essential for improving the health of populations, the healthcare market may lack clarity concerning the wants and needs of patients and payers to such a degree that this orientation does not result in improved short-term financial performance. In contrast, when a hospital maintains flexibility in its resource allocations and organizational structure, it can meet changing needs and uncertainties and thereby enhance financial performance.

Community-Institutional Relations↗
PubMed1989

[Use of the automated management system "Manpower" for solving the problems of ambulatory care and improving working conditions of workers and employees at large industrial plants].

In order to raise efficacy of dispensarization activities and to improve labour conditions of workers and employees of large industrial enterprises it is proposed to develop an automated system of medical data processing through attaching additional files with the data on periodic medical check-ups and workers' morbidity rates to the operating automated management system "Manpower". This system has been developed and introduced at the Chimikent Phosphorus Production Association and it has demonstrated high profitability when solving a number of public health problems.

Adult↗
PubMed1999

A uniform format for ocular imaging devices.

PURPOSE: To develop a uniform file format of ocular imaging data, including, but not limited to, ultrasound biomicroscopy, optical coherence tomography, and nerve fiber analyzer, capable of being transmitted via Internet or intranet for collaborative research and telemedicine use. METHOD: File filters were developed as dynamic link libraries (DLLs). These can read the original raw data format of each ocular imaging device. A data file format was also designed to describe these raw data uniformly in three different types of compression: noncompressed, run length compression, and differential pulse code modulation (DPCM). These three file formats were then tested in the following aspects: file size, speed of reading, and speed of writing. RESULTS: Run length compression failed to compress raw data, while DPCM compressed raw data successfully (< or =35.5%). The speed of reading and writing files was slowest in DPCM. However, the actual time of reading and writing was fast enough (<0.6 s) for daily work regardless of file compression methods. CONCLUSION: The format designed has robust potential to be the standard file format for transmission of any ocular imaging raw data.

Data Display↗
PubMed1984

A data base system for pediatric intensive care.

A data base system has been designed at the pediatric intensive care unit of St. Görans Hospital in Stockholm. Information on all cases treated during 1982 was retrieved, including information from another file containing data on inpatient stays in the county of Stockholm. Thus an automatic follow-up study was made and the results of intensive care were expressed as mortality occurring at the intensive care unit (ICU), mortality up to 180 days after discharge, average length of stay in the ICU and average number of bed days as inpatients from discharge from the ICU up to 180 days later. Altogether, 705 ICU days of 626 patients were retrieved. Mortality in the ICU was 8.6% and increased to 12.5% 180 days after discharge from the ICU. The average period of hospitalization after discharge from the ICU was 19 days. Cases diagnosed as IRDS were studied specifically and the mortality was 53% in cases with birth weights less than 1500 g and 13% in cases with birth weights of 1500 g or more. High mortality and long hospitalization after discharge from the ICU was seen in cases with neurological complications. All information was retrieved interactively from a display terminal at the department. This could be done at any hour of the day.

Adolescent↗
PubMed1992

Computer assisted data collection for stereology: rationale and description of point counting stereology (PCS) software.

The paper describes microcomputer software for point counting stereology. Stereology includes a collection of statistical methods that quantify the images of light and transmission electron microscopy. The methods use test grids placed over images to collect raw data, which includes counts of points, intersections, transections, and profiles. In turn, the counts are included in stereological equations that give estimates of compartmental volumes, surfaces, lengths, or numbers. These parameters describe the composition of a structure in three-dimensional space. The PCS (point counting stereology) System Software III serves as a data collection, storage, and management tool. Users set up point counting protocols without programming, enter data by pressing predefined function (MS-DOS) or alphabetic keys (UNIX), store data in files, select files for analysis, and calculate results as stereological densities. The latest version of the PCS software includes a new user interface and is designed as a research "front end" that can feed data either into the calculation tools of a stereology tutorial (Bolender, 1992, this issue) or into the analysis routines of quantitative morphology databases (Bolender and Bluhm, 1992).

Animals↗
PubMed1996

Angiotensin II receptor antagonists: the prototype losartan.

OBJECTIVE: To describe a new class of antihypertensive agents, the angiotensin II receptor antagonists, with emphasis on the prototype losartan. Pharmacokinetic data and clinical trials are reviewed, as well as adverse reactions, drug interactions, and dosing guidelines. DATA SOURCES: A MEDLINE search of English-language literature published from 1966 through 1995 was performed. In addition, Merck and Co. provided bibliographic data on file for losartan. STUDY SELECTION: Emphasis was placed on clinical and pharmacokinetic studies in humans. Controlled, double-blind studies were evaluated to assess the efficacy and adverse effect profile of losartan. DATA SYNTHESIS: Losartan is a nonpeptide, competitive antagonist of the type I angiotensin II receptor. In comparative clinical trials, losartan appears to have antihypertensive efficacy similar to that of the angiotensin-converting enzyme (ACE) inhibitors. Losartan is well tolerated, with an adverse effect profile similar to that of placebo and a reduced incidence of cough versus that with ACE inhibitors. A combination product consisting of losartan 50 mg and hydrochlorothiazide 12.5 mg has also received approval for the treatment of hypertension. The combination product is not indicated for initial therapy, but is recommended for patients who do not respond adequately to losartan monotherapy. The angiotensin II receptor antagonists are also being investigated for beneficial effects in patients with ventricular hypertrophy, renal disease, and heart failure. CONCLUSIONS: Losartan, the first angiotensin II receptor antagonist to receive approval for use in the US, appears to be an effective new antihypertensive agent with an adverse effect profile similar to that of placebo. Losartan may be an alternative for patients who cannot tolerate ACE inhibitors. However, the effect of losartan on mortality remains to be evaluated. The role of the angiotensin II receptor antagonists in areas such as ventricular hypertrophy, renal function, and heart failure has yet to be determined.

Angiotensin II↗
PubMed2005

Seasonal variation in undiagnosed HIV infection on the general medicine and trauma services of two urban hospitals.

OBJECTIVE: To examine the seroprevalence of undiagnosed HIV and variation by season among patients admitted to the general internal medicine (GIM) and trauma services of two urban hospitals. DESIGN: A cross-sectional blinded HIV-1 seroprevalence survey. SETTING: A 725-bed academic medical center's hospital and an affiliated 324-bed tertiary care hospital. PARTICIPANTS: Residual serological specimens were obtained for unique patients aged 17 to 65 to study services in summer (June 16 to September 4, 2001) and fall to winter (November 1, 2001 to January 8, 2002). METHODS: Hospital files provided data on demographics, service type, and discharge clinical categories (fall-winter group only). HIV ELISA (enzyme-linked immunosorbent assay) tests with confirmatory Western blot were linked to subjects' de-identified files. We excluded 34 subjects with known HIV. Of the remaining unique admissions in summer (n=604) and fall-winter (n=978), 60% and 55% were tested, respectively. Predictors of undiagnosed HIV infection were examined using multivariate analysis. RESULTS: The summer cohort (n=362) had significantly lower unadjusted seroprevalence of undiagnosed HIV infection (1.4%; 95% confidence interval [CI], 0.4% to 3.2%) than the fall-winter cohort (n=539; 3.7%; 95% CI, 2.3% to 5.7%; P=.04). Overall, undiagnosed HIV was somewhat less likely in women (adjusted odds ratio [AOR], 0.45; 95% CI, 0.19 to 1.07) but more likely in black patients (AOR, 3.46; 95% CI, 0.70 to 17.06). In the fall-winter cohort, undiagnosed HIV was more likely for discharges with the following clinical categories versus those with a cardiac condition: dermatologic/breast (AOR, 14.90; 95% CI, 1.20 to 184.77), renal/urological (AOR, 22.43; 95% CI, 2.12 to 236.75), or infectious (AOR, 31.08; 95% CI, 2.40 to 402.98). CONCLUSIONS: The higher seroprevalence of undiagnosed HIV in the fall-winter admissions to GIM and trauma services supports especially targeting HIV testing in these months.

Adolescent↗
PubMed1989

Xanthogranuloma: report on clinical and histologic findings in 64 patients.

Although xanthogranulomas are frequently encountered by pediatricians and dermatologists, data on the course of this tumor are restricted to several series with limited follow-up. We report on our experience with 64 patients whom we were able to identify from the surgical files. Our data support the currently held view that xanthogranulomas are generally benign, self-limited lesions. They may persist or continue to erupt for years, however, particularly in individuals who develop the first lesion after age 20 years.

Adolescent↗
PubMed1999

The Regenstrief Medical Record System: a quarter century experience.

Entrusted with the records for more than 1.5 million patients, the Regenstrief Medical Record System (RMRS) has evolved into a fast and comprehensive data repository used extensively at three hospitals on the Indiana University Medical Center campus and more than 30 Indianapolis clinics. The RMRS routinely captures laboratory results, narrative reports, orders, medications, radiology reports, registration information, nursing assessments, vital signs, EKGs and other clinical data. In this paper, we describe the RMRS data model, file structures and architecture, as well as recent necessary changes to these as we coordinate a collaborative effort among all major Indianapolis hospital systems, improving patient care by capturing city-wide laboratory and encounter data. We believe that our success represents persistent efforts to build interfaces directly to multiple independent instruments and other data collection systems, using medical standards such as HL7, LOINC, and DICOM. Inpatient and outpatient order entry systems, instruments for visit notes and on-line questionnaires that replace hardcopy forms, and intelligent use of coded data entry supplement the RMRS. Physicians happily enter orders, problems, allergies, visit notes, and discharge summaries into our locally developed Gopher order entry system, as we provide them with convenient output forms, choice lists, defaults, templates, reminders, drug interaction information, charge information, and on-line articles and textbooks. To prepare for the future, we have begun wrapping our system in Web browser technology, testing voice dictation and understanding, and employing wireless technology.

Computer Terminals↗
PubMed2000

Miglitol: assessment of its role in the treatment of patients with diabetes mellitus.

OBJECTIVE: To evaluate miglitol, a new oral alpha-glucosidase inhibitor, and discuss its pharmacology, therapeutics, pharmacokinetics, dosing guidelines, adverse effects, drug interactions, and clinical efficacy. DATA SOURCES: A MEDLINE English-language only database search using the keywords miglitol, glyset, and Bay m 1099 (1985 to December 1999), was completed to identify relevant articles including reviews, recent studies, and abstracts; American Diabetes Association 1999 Annual Meeting abstracts; Pharmacia & Upjohn data on file and product information. STUDY SELECTION: The clinical trials that were selected to be reviewed in detail were randomized, double-blind studies with at least 100 patients in the intention-to-treat group. DATA EXTRACTION: All articles and abstracts were reviewed along with the product labeling from Pharmacia & Upjohn. DATA SYNTHESIS: Miglitol is an alpha-glucosidase inhibitor that exerts its effect through the delayed absorption of complex carbohydrates in the small intestine, resulting in a decrease in postprandial glucose concentrations that are directly correlated with the dietary carbohydrate content. Both small, short-term trials and large, clinical trials show a decrease in postprandial glucose concentrations and a modest decrease in glycosylated hemoglobin of approximately 0.5-1.0% as a result of miglitol's action. The adverse effects of miglitol are mild and transitory and include flatulence, diarrhea, and abdominal pain. The incidence of gastrointestinal problems may be reduced with a small initial dose, which is slowly titrated as tolerated. CONCLUSIONS: Miglitol is an effective and safe treatment option in patients with type 2 diabetes mellitus who are inadequately controlled with diet or oral sulfonylurea therapy. Miglitol is a good choice of therapy in Hispanic, African-American, and elderly patients, or any patients in whom hypoglycemia, weight gain, or lactic acidosis are risks. No published studies comparing miglitol with acarbose have been published, but there appears to be no major clinical or financial advantages to using one agent over the other.

1-Deoxynojirimycin↗