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PubMed1988

Direct sequencing of amplified genomic fragments documents N-ras point mutations in myeloid leukemia.

A number of different techniques have been utilized to document point mutations in ras oncogenes in leukemic cells, but these approaches are either labor intensive, require relatively large numbers of leukemic cells or provide sequence data for only a limited number of codons. Here we describe a technique for documenting N-ras point mutations that involves the direct sequencing of N-ras genomic fragments that have been amplified in vitro utilizing the polymerase chain reaction (PCR). This technique permits the rapid analysis of a relatively large number of samples. Moreover this approach requires relatively small numbers of cells and provides direct nucleotide sequence information of multiple N-ras codons at a single reading.

Base Sequence↗

PubMed1988

[High-contrast radiographs for field control and field documentation in radiotherapy with high-energy photons].

In ambitious radiotherapy with individually shaped irradiation fields, high-contrast field radiography is necessary for fine adjustment, control and field documentation. If intensification foils made of materials with medium or high atomic numbers such as copper, iron and lead are used, the film lying between the foils is mainly darkened by the secondary electrons released from the material of the front foil. Within the range of 1 MeV to 15 MeV, high-contrast radiographs are produced by means of copper or steel foils which are clearly superior to lead foils. Steel foils are to be preferred to copper foils because of their rigidity and the firmness of the polished surface. Usual X-ray diagnosis films with steep graduation can be used as film material for field control radiography performed in double exposure technique. A new insensitive film not applied hitherto in X-ray diagnosis allows to prepare field documentation images of high quality which are exposed during the whole irradiation time. This is also important for perpetuation of evidence.

Humans↗

PubMed1988

[Importance of the initial examination after a rape in considering the criminal penalty and indemnification of the victim in a civil suit. Review of the documents from one Court of Assizes over 11 years].

The gynaecologist-obstetrician may be the medical witness who has to give evidence about the extent of the initial trauma after the presumption of a sexual assault on a victim who comes to consult him, or as an expert witness. The certificate that he gives at the time of the first consultation is an essential document for the examining magistrates who have to decide whether there has been an offence. It is also a very great help to support the brief for the lawyers in a civil action taken by the victim, who is claiming damages as compensation for physical or psychological damage resulting from the sexual abuse. The authors reported it useful to look through 64 case documents that were considered in 11 years. They studied the differences in the penalties that were awarded for criminal offences and the sums of money for indemnity that were awarded in civil cases. These were before the new law concerning rape was passed on the 23rd December 1980, and after this law had been applied. It tends to improve the position for the victim in civil cases and increases the sentences that can be passed for aggravated rape (as on a minor by an adult, or in particular somebody who has a position of responsibility to the child). The authors point out especially how important it is to take note of sexual precocity and to have a detailed account of the first investigations carried out after the sexual assault. These can be used to make the sentences differ and to make it possible to increase and widen the awards given to compensate the victims. As far as civil action is concerned, as there is usually a fixed scale for every regional Court of Assizes according to a definite formula, it is advisable according to the authors that the initial expert assessment presented by the magistrates should establish in its conclusions the details of the indemnity to be considered by professional judges of the Assize juries. They should take particular notice of added injuries that are not physical and are often not considered, such as pain and suffering, loss of pleasure and the aesthetic, the sexual, the obstetrical and the moral as well as the juvenile points of view. In certain cases ad full medical assessment presented before the end of the case will help the professional judges of the jury of Assizes who have to give judgment in a civil action by giving them information that will support the true interests of the victim.

Expert Testimony↗

PubMed1987

A computerized quantitative food frequency analysis for the clinical setting: use in documentation and counseling.

Documentation of nutrition counseling effectiveness is essential to reinforce its value in an era of escalating health care costs. Counseling effectiveness can be determined definitively only if dietary assessment is made both before and after intervention. Unfortunately, methods currently available have drawbacks that limit feasibility of routine use. A directly computer-readable Quantitative Food Frequency Analysis method, which eliminates the need for manual data entry, has been developed and instituted at the University of Southern California School of Medicine, Los Angeles, for outpatient counseling. A 1-hour interview, focusing upon "usual" intake, is conducted using pictorial menus for food items. Feedback is available to the patient and health care team immediately. The data base is derived from the National Heart, Lung, and Blood Institute Food Table; the intake of 61 nutrients, including 23 fatty acids, is computed. The computer printout consists of four components: a summary; an alert for foods high in fat, cholesterol, sucrose, alcohol, and/or sodium; a listing of all foods consumed by frequency, accompanied by their nutrient contribution to daily intake; and a bar graph relating current nutrient intake to recommended levels. This document serves as a counseling tool and can support claims for third-party payment.

Computers↗

PubMed1979

[Documentation of arrhythmias - the value of long-term ECG monitoring].

Computer-supported long-term ECG-analysis, must be considered as complementary to other methods of documentation concerning arrhythmias. With the introduction of computers in the last several years, exact quantification and qualification of arrhythmias, over long monitoring periods, has become possible. With this method diverse forms of documentation and data presentation enhance its value of information and increase plausibility. Major indications for long-term ECG-monitoring of ambulatory patients are detection of occult arrhythmias, evaluation of subjective symptoms such as dizziness or syncope, recognition of pacemaker dysfunctions, selection of patients with coronary heart disease at high risk and evaluation as well as control of the efficacy of antiarrhythmic therapy.

Arrhythmias, Cardiac↗

PubMed1986

Detailed, controlled, and documented self-experimentation in dermatology.

Because the skin is easily available, the combination of frequent periods of critical observation, the dermatologist's clinical experience, and carefully controlled documentation of these observations allow for self-experimentation in dermatologic disorders on the part of clinicians. The practical value of such self-experimentation has been shown over many years, especially by the use of skin surface microscopy at moderate magnification to examine various lesions; to document sensitization experiments with nickel, Japanese lacquer, and nitrogen mustard; to examine prolonged use of topical fungicides for the treatment of onychomycoses; and to contribute to extensive and continuing experiments in laser medicine.

Cryosurgery↗

PubMed1985

[Documentation in the polyclinic-internal medicine care process].

In five full-time and part-time specialists for internal medicine, respectively, of the district outpatient department the quality of the documentation of the ambulatory care has been tested. The documentations proved to be sufficient. Obviously this or that specialist sometimes keeps away from establishing a tentative diagnosis in the primary consultation. But the making of a preliminary diagnosis involves to do with a limited but sufficient examination programme.

Ambulatory Care↗

PubMed1979

[Results in the documentation for pregnancy surveillance].

Some results from the pregnancy surveillance booklet documentation are discussed in this paper. These results were gained on the basis of data from a representative random sample taken in Rheinland-Pfalz in 1977. Unfortunately, the risk factors section in the pregnancy surveillance booklet does not receive sufficient medical documentation. Apparently, its structure is too complex and its second part is not on the proper place. Contrary to the risk factor check list, which has been answered poorly, the entry of the observations on the course of the pregnancy obviously has carried out regularly. Only half of the pregnant women take advantage of at least 10 preventive medial examinations. Frequency of these examinations and date of the first medical examination in pregnancy depend on social conditions. In case of unfavourable general conditions pregnant women go less often, and later, to the prenatal examinations and the state of health of the new-born child depends on the "social strata" factor. Seen especially from the viewpoint of a greater centralization in obstetrics, the measures taken in prenatal care should be decentralized and varied and should include a revision of the pregnancy surveillance booklet.

Child Health Services↗

PubMed1983

[Medico-psychological base and trend documentation in a residential facility for rehabilitation of the handicapped].

The article presents the system for medical-psychological base and trend documentation developed between 1977 and 1980 at Rotenburger Anstalten der Inneren Mission (Home Mission). A practicable system from the user angle, it is operated on a mediumsized data processing unit. Being a pure dialogue system with programme generators, it is easy to handle and flexible in its possible applications, several of which are illustrated by examples from the rehabilitative field. As the various characteristics used can easily be attributed with other contents, and as the data base can moreover be expanded, the documentation system could also be used by comparable facilities that have the necessary electronic data processing equipment at their disposal.

Computers↗

PubMed1983

[EDP (electronic data processing)-oriented special documentation in neurology--extension to a computer epicrisis].

The contribution describes a final neurological documentation system for in-patients that permits the computerized print-out of an epicrisis. The computer automatically summarizes the elementary findings and presents them as a number of important neurological syndromes. The structure of the documentation and the experience gained in the course of many years of routine application are described. The system has proved to be basically sound under the conditions existing at a university hospital and a specialized hospital for psychiatry and neurology and has proved applicable for a large proportion of the patients without major restrictions.

Aftercare↗

PubMed1978

Performance documentation: how to confirm a resident's progress.

Family medicine faculty members are accountable for the quality of training and the level of proficiency that residents attain. Determination of board certification and hospital privileges is dependent on technical and affective skills as well as cognitive testing. Self-evaluation and self-education behaviors will result from placing the responsibility for documentation of satisfactory performance with the resident. "Performance documentation" is defined as those parts of an evaluation system combining a cumulative record of patient care experiences with proficiency ratings indicating performance at or above the criteria specified in a program's behavioral objectives.

Education, Medical, Continuing↗

PubMed1984

Requirements for documentation of clinical effects of antibiotics.

Documentation of clinical and microbiological efficacy and safety of antibiotics require well designed studies involving large number of patients. In principal, all studies should be comparative and the comparative agent(s) should be well documented in the literature. If possible, the studies should also be blind but if satisfactory blinding cannot be guaranteed, open studies will have to be performed, especially if injectible antibiotics are studied. The size of the trial, in terms of number of patients evaluable for clinical and especially for microbiological efficacy, must be sufficient either to prove significant differences between the regimens studied or to demonstrate equality with a reasonable type II error. Since the end-points used for efficacy and safety are not normally continuous, the patient materials must often be of a size which can only be achieved by multiple independent trials or multicentre trials. Thus, such studies are recommended.

Anti-Bacterial Agents↗

PubMed1980

[Obligation to document front tooth injuries in adolescents for forensic purposes].

Following trauma to the anterior teeth during adolescence, exact clinical and roentgenologic records of the findings as well as documentation of the direct and indirect consequences of the trauma are required for forensic, evaluatory, and insurance reasons. Regular control examinations over a period of several years are necessary, since secondary damage may only be demonstrable after a periof of one year or even longer. The use of a uniform medical examination form was recommended to improve and compare documentation of the consequences of injuries to the anterior teeth.

Adolescent↗

PubMed1977

[Medical check-up concerning cancer of the prostate. 1st report of experiences, results and documentation of findings].

It is reported on 1,790 medical check-ups concerning cancer of the prostate gland. We found 8 carcinomata = 4.47%. Apart from this 16 adenomata to be operated with adequate disturbances of the micturition were established. The documentation of the findings of medical check-ups by means of a reference on the basis of perforated cards is described and it is referred to the necessity of a systematic documentation of findings.

Adult↗

PubMed1982

[Rational EDP-basic documentation in the surgical clinic].

The establishment of a clinical basis documentation has approved because of the co-operation with the service-computer-centre of the clinical administration by linking the administrative and clinical data of the patients. The most essential data like diagnosis, operation, complication, operating surgeon as well as the eventual case of death will be registered in a protocol by the ward physician. These data will be registered by a documentary assistant according to the international keys. The evaluation of the data is done by a SPSS-program. The present results demonstrate that this kind of computer assisted clinical documentation has been successful.

Adolescent↗

PubMed1982

[A simple light and dark field set-up for documentation purposes in brain research].

An illumination method adopted from metallography was improved to give bilateral oblique epiillumination that can be used on any standard transmitted-light microscope. Series evaluation and documentation possible for autoradiograms exceeding 0,5 cm2 in area are the advantages over the known photographic documentation procedures that are highly time and material consuming. Combination with transmitted-light bright-field illumination permits the simultaneous representation of silver grain distribution and its precise topographic coordination into stained tissue structures (negative enlargement 2:1 to 200:1). When the combination illumination technique is used, neurons impregnated according to Golgi's method are represented with improved "subjective" depth of focus compared to the brightfield transmitted-light procedure, while appearing more graphic. Moreover, dendritic spines are visible that are not seen in the bright-field transmitted-light mode.

Animals↗

PubMed1981

[Problems of photographic documentation in plastic surgery].

A basic aim of photographic documentation of clinical cases is to compare these cases with each other. Some examples illustrate possible misinterpretations due to inadequate or variable photographic conditions. To assess postoperative results is possible only in exact comparative photography. Depending upon specific problems, the required conditions are variable. Nevertheless, some general rules can be formulated. They should be applied in a photographic documentation of clinical cases.

Female↗

PubMedDate not supplied

Orofacial trauma management. Patient assessment and documentation.

New technologies and treatments for managing children with orofacial trauma are constantly updated and available to the practitioner through current literature. What often fails to be appreciated, however, is that orofacial injury is a subset of head trauma and may have systemic emergent considerations that supersede the oral conditions being addressed. The complexity of a thorough assessment of the child from both medical and dental standpoints requires a systematic approach, which in turn can be guided by an appropriate document for inclusion in the chart. Further, such a document will serve as an important record should future civil litigation ensure from the traumatic incident.

Child↗