Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Data Files”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,513 records · Page 84Linked to original sources
PubMed2003

Cost-effectiveness of transfusion of platelet components prepared with pathogen inactivation treatment in the United States.

BACKGROUND: The Intercept Blood System (IBS) for platelets has been developed to reduce pathogen transmission risks during transfusions. OBJECTIVE: This study was a comprehensive economic analysis of the cost-effectiveness of using the IBS for single-donor apheresis platelets (AP) and random-donor pooled platelet concentrates (PC) versus AP and PC without the IBS in the United States in patient populations in which platelets are commonly transfused. METHODS: All data used in this analysis were summarized from existing published sources (primarily indexed in MEDLINE) and data on file at Baxter Healthcare Corporation (Chicago, Illinois) and Cerus Corporation (Concord, California). A literature-based decision-analytic model was developed to assess the economic costs and clinical outcomes associated with the use of AP and PC treated with the IBS for several conditions and procedures that account for a considerable proportion of the platelet usage in the United States: acute lymphocytic leukemia, non-Hodgkin's lymphoma, coronary artery bypass graft, and hip arthroplasty Risks of infection with HIV, hepatitis C virus (HCV), hepatitis B virus, human T-cell lymphotropic virus type 1, or bacterial agents were incorporated into the model. Possible benefits of reduction of the risk of emerging HCV like pathogens and elimination of the need for gamma irradiation were explored in sensitivity analyses. RESULTS: The incremental cost per quality-adjusted life-year gained by using AP + IBS versus untreated AP ranged from 1,308,833 dollars to 4,451,650 dollars (without bacterial testing) and 4,759,401 dollars to 22,968,066 dollars (with bacterial testing). Corresponding figures for PC + IBS versus untreated PC ranged from 457,586 dollars to 1,816,060 dollars. Inclusion of emerging HCV like virus and the elimination of the need for gamma irradiation improved the cost-effectiveness to a range of 177,695 dollars to 1,058,127 dollars for AP without bacterial testing, 176,572 dollars to 1,330,703 dollars for AP with bacterial testing, and 22,888 dollars to 153,564 dollars for PC. The model was most likely to be affected by mortality from bacterial contamination, IBS effect on platelet utilization, and the inclusion of potential benefits (ie, gamma irradiation and/or emergent HCV-like virus). The model was relatively insensitive to changes in the IBS price and viral transmission risks. CONCLUSIONS: The cost-effectiveness of pathogen inactivation via the IBS for platelets is comparable to that of other accepted blood safety interventions (eg, nucleic acid amplification technology). The IBS for platelets may be considered a desirable strategy to increase the safety of platelet transfusions and a potential insurance against the threat of emerging pathogens.

Bacterial Infections↗
PubMed2003

The cardiovascular effects of eplerenone, a selective aldosterone-receptor antagonist.

BACKGROUND: The role of the renin-angiotensin-aldosterone system in the pathophysiology and treatment of hypertension and heart failure has been extensively studied. Angiotensin-converting enzyme inhibitors and angiotensin II-receptor blockers have been shown to effectively reduce blood pressure, protect the kidney, and reduce morbidity and mortality in patients with heart failure. Therefore, there is increased interest in the effects of aldosterone and the use of aldosterone-receptor antagonists in the treatment of cardiovascular disease. Eplerenone is the first selective aldosterone-receptor antagonist approved for the treatment of hypertension and left ventricular (LV) dysfunction after acute myocardial infarction (AMI). OBJECTIVE: The goal of this article was to review the pharmacologic properties, clinical efficacy, and tolerability of eplerenone in the treatment of hypertension, LV dysfunction, and proteinuria. METHODS: Relevant English-language articles were identified through searches of MEDLINE (1966-May 2003), Current Contents, and International Pharmaceutical Abstracts (1970-May 2003) using the terms hypertension, heart failure, eplerenone, aldosterone, and aldosterone antagonist. Other pertinent publications were identified from the reference lists of the identified articles. Information was also obtained from abstracts presented at national meetings and data on file with the manufacturer. RESULTS: In clinical trials, eplerenone alone and in combination with renin-angiotensin blockade significantly reduced both systolic and diastolic blood pressure compared with placebo (P < 0.05 to P < 0.001). In EPHESUS (Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study), the addition eplerenone to optimal medical therapy reduced morbidity and mortality in patients with AMI and LV dysfunction, although the incidence of serious hyperkalemia was also significantly greater. In comparisons with spironolactone, eplerenone was associated with a lower incidence of gynecomastia and other sex hormone-related adverse effects. CONCLUSIONS: Either alone or in combination with other antihypertensive agents, eplerenone appears to be effective for the treatment of hypertension. Morbidity and mortality were reduced when eplerenone was added to standard therapy for LV dysfunction complicating AMI. The use of eplerenone for hypertension or heart failure may be limited in patients at risk for hyperkalemia.

Area Under Curve↗
PubMed1990

Price of dialysis, unit staffing, and length of dialysis treatments.

We analyzed the impact of the Medicare price for outpatient maintenance dialysis on the level and composition of staffing of dialysis units, and on the length (duration) of the average hemodialysis treatment for the period 1982 to 1987. With higher prices, dialysis units employ more total staff hours per patient per week (P less than 0.01) and use a higher proportion of registered nurses (RN) compared with other staff such as technicians and licensed practical nurses (LPN). Higher Medicare prices are also associated with longer average hemodialysis treatment duration for freestanding units (P less than 0.02), but there was no statistically significant association for hospital units. The impact of the Medicare price on both staffing and average treatment duration takes into account the calendar time trend, ie, 1987 versus 1982, which has a separate impact from the price effect. For example, to avoid the complication of technology changes over calendar time, we considered the impact of the price change at one point in time. Freestanding units that had a price cut of more than +15 in 1983, reported twice the reduction in the average dialysis treatment duration (-0.38 hours) compared with -0.20 hours (P = 0.01) for units that had a cut of less than +15. An analysis of the impact of average treatment duration on patient mortality provided some evidence that shorter treatment duration in freestanding units is associated with higher mortality. This result needs further analysis. There was no statistically significant relationship between the level of staffing in the dialysis unit or the percent of staff who were RNs and 3-year patient survival. The analysis in this report was based on 1,213 and 1,058 data forms filed with Medicare by freestanding and hospital units, respectively, for 1982 and 1987. In addition, we used a Cox proportional hazards model (multivariate) for the analysis of the 3-year patient survival for 14,807 new hemodialysis patients who started dialysis in 1984.

Fees and Charges↗
PubMed2004

[Information for the patient in hospitals: the implicit shared role among professionals].

OBJECTIVE: Perceived practices declared by physicians were assessed in order to determine the role of the different professionals in patient medical information, the communication methods and traceability practices used in patient files. Method Data were collected using an anonymous questionnaire sent by mail in April 2003 to the 794 physicians of the University Hospital of Nantes (France). RESULTS: The participation rate was of 38% (302 responses) and differed according to the medical categories: university professors (44%), young seniors (50%), hospital practitioners (43%) and practitioners under contract (21%). In outpatient departments, patient information was rarely shared between professionals: the senior practitioner only informed the patient in 80% of cases. In the case of hospitalisation, patient information concerned various health professionals: in general, senior practitioners, junior practitioners (50% of cases) and nursing staff (20 to 45%). Information for the patient was always oral, accompanied in 1/3 of cases by one or more documents. The traceability of the elements of information supplied to the patient was inadequate. CONCLUSION: This survey underlined the interest of the medical corps regarding information for the patient, and the important role played by junior practitioners and paramedical staff. Because they are all obviously implied in information supplied to the patient, quality improvement projects should target all the health professionals.

Adult↗
PubMedDate not supplied

Quality of care measurement in nursing home AIDS care: a pilot study.

A pilot study was conducted to identify which, if any, demographic or quality indicators differentiate HIV-positive patients from other long-term care patients. This study used the Minimum Data Set files for all New York state nursing homes submitted in 1997. Chi-square tests were used to assess difference in proportions of demographics and quality indicators between HIV-positive and HIV-negative patients. The HIV-positive patients tended to be between 40 and 59 years of age and male and were more likely to be Black or Hispanic. HIV-positive patients had a significantly higher prevalence of diagnosis or symptoms of depression without any treatment compared to HIV-negative patients. HIV-positive patients had significantly higher prevalence of weight loss, antipsychotic use, antianxiety/hypnotic use, and incontinence of bladder and bowel compared to HIV-negative patients. This study paves the way for the development of a more appropriate quality indicator system tailored to the AIDS population and allows facilities to make necessary improvements in the quality of care offered to this vulnerable population.

Adult↗
PubMed2000

Stereolithographic models of biopolymers.

Stereolithography (STL) has been used to make plastic models of the solvent accessible surfaces of biopolymers. Models have been made of proteins and proteins bound to DNA and RNA. The STL process uses a laser to photopolymerize a liquid resin. Using the ACES (accurate, clear, epoxy, solid) building technique, parts are made with minimum postcure shrinkage. Protein Data Bank files are converted to STL files that represent the surface topology of the biopolymer as a series of triangles and an index that describes their orientation. The models are useful in teaching biomolecular structure and the principle of docking. They are especially useful to the visually impaired.

Acetylcholinesterase↗
PubMed2001

Actuarial assessment of sex offender recidivism risk: a cross-validation of the RRASOR and the Static-99 in Sweden.

We cross-validated two actuarial risk assessment tools, the RRASOR (R. K. Hanson, 1997) and the Static-99 (R. K. Hanson & D. Thornton, 1999), in a retrospective follow-up (mean follow-up time = 3.69 years) of all sex offenders released from Swedish prisons during 1993-1997 (N = 1,400, all men, age > or =18 years). File-based data were collected by a researcher blind to the outcome (registered criminal recidivism), and individual risk factors as well as complete instrument characteristics were explored. Both the RRASOR and the Static-99 showed similar and moderate predictive accuracy for sexual reconvictions whereas the Static-99 exhibited a significantly higher accuracy for the prediction of any violent recidivism as compared to the RRASOR. Although particularly the Static-99 proved moderately robust as an actuarial measure of recidivism risk among sexual offenders in Sweden, both procedures may need further evaluation, for example, with sex offender subpopulations differing ethnically or with respect to offense characteristics. The usefulness of actuarial methods for the assessment of sex offender recidivism risk is discussed in the context of current practice.

Actuarial Analysis↗
PubMed2002

Women's knowledge and beliefs regarding breast cancer.

Approximately 20-30% of women delay for 12 weeks or more from self-discovery of a breast symptom to presentation to a health care provider, and such delay intervals are associated with poorer survival. Understanding the factors that influence patient delay is important for the development of an effective, targeted health intervention programme to shorten patient delay. The aim of the study was to elicit knowledge and beliefs about breast cancer among a sample of the general female population, and examine age and socio-economic variations in responses. Participants were randomly selected through the Postal Address File, and data were collected through the Office of National Statistics. Geographically distributed throughout the UK, 996 women participated in a short structured interview to elicit their knowledge of breast cancer risk, breast cancer symptoms, and their perceptions of the management and outcomes associated with breast cancer. Women had limited knowledge of their relative risk of developing breast cancer, of associated risk factors and of the diversity of potential breast cancer-related symptoms. Older women were particularly poor at identifying symptoms of breast cancer, risk factors associated with breast cancer and their personal risk of developing the disease. Poorer knowledge of symptoms and risks among older women may help to explain the strong association between older age and delay in help-seeking. If these findings are confirmed they suggest that any intervention programme should target older women in particular, given that advancing age is a risk factor for both developing breast cancer and for subsequent delayed presentation.

Adolescent↗
PubMed2000

Deaths in methadone maintenance treatment in New South Wales, Australia 1990-1995.

AIMS: To determine the number and causes of deaths in methadone maintenance treatment (MMT). DESIGN: Cross-sectional survey. SETTING: New South Wales (NSW), Australia. PARTICIPANTS: Two hundred and thirty-eight patients who died while registered in MMT from 1990 to 1995. MEASUREMENTS: Data on number and causes of death in MMT were obtained from data on file at the NSW Health Department, NSW Registry of Births, Deaths and Marriages, and NSW Department of Courts Administration. FINDINGS: The most common cause of death was drug-related (44%), followed by medical illness (24%). Fifty deaths (21%) occurred in the first week of MMT, 88% of which were drug-related. In 92% of these drug-related deaths, there was evidence of polydrug use. In all, 42% of all drug-related deaths occurred during the first week of MMT. Nearly half the cases of drug-related death (46%) in the first week were noted by the medical practitioner at assessment to have a history of polydrug abuse or dependence. Four (9%) drug-related cases were prescribed doses of methadone in excess of the-then current national methadone clinical guidelines. CONCLUSION: The first 7 days of MMT is a high-risk period. Inadequate clinical review of subjects' tolerance to methadone and/or subjects' use of other central nervous system (CNS) depressant drugs probably contributed to most of these cases' deaths during induction. The findings from this study reinforce the importance of a thorough drug and alcohol assessment of people seeking MMT, cautious prescribing of methadone, frequent clinical review of patients' tolerance to methadone during induction and education about the dangers of additional drug use during this period.

Adolescent↗
PubMed2001

Cytokine gene polymorphisms in psoriasis.

BACKGROUND: Cytokine production is under genetic control, and certain allelic variants of cytokine genes are associated with higher or lower cytokine production in vitro and in vivo. Psoriasis is associated with an overexpression in the involved skin of T-helper cell type 1 (Th1) cytokines, e.g. interferon (IFN) -gamma and tumour necrosis factor (TNF) alpha and relative underexpression of Th2 cytokines, e.g. interleukin (IL) -4 and IL-10. Objective We investigated the hypothesis that allelic variants of genes for a high production of Th1 cytokines or TNF-alpha, or conversely low production of Th2 cytokines might represent a risk factor for developing psoriasis. METHODS: Genotyping for IFN-gamma, IL-10, IL-4 and TNF-alpha was undertaken for 84 patients with psoriasis and compared with control data on file. RESULTS: Genotype frequencies showed no differences between patients and controls for IFN-gamma, TNF-alpha or IL-4. For IL-10, patients with late onset psoriasis (over 40 years) were more likely to be heterozygous at position - 1082 (P = 0.02), corresponding to intermediate production of IL-10 in vitro and in vivo. CONCLUSIONS: Psoriasis is not determined by a genotype consistent with high production of Th1 cytokines or low production of Th2 cytokines. Thus, the Th1 cytokine profile found in psoriatic plaques is most likely a consequence of local factors.

Adolescent↗
PubMed2001

Characteristics of adolescents with school refusal.

OBJECTIVE: To describe the characteristics of young people presenting with school refusal to a child and adolescent psychiatric unit and examine differences between those admitted for inpatient treatment and the rest. METHOD: One hundred and ninety-two adolescents who had been assessed or treated for school refusal between 1994 and 1998 at the Rivendell Unit, Sydney, Australia were identified. An instrument was developed and used to gather data from files. Diagnoses were made by the consensus of two of the investigators using DSM IV criteria from all sources of information. RESULTS: The commencement of school refusal generally occurred in the first 2 years of high school. School refusers had a high prevalence not only of anxiety, but also of mood and disruptive behaviour disorders. A family history of psychiatric illness was present in over half the sample. There were no differences between those subsequently admitted as inpatients and the rest in terms of symptom scores, family composition, family conflict, family separation or history of abuse. Those admitted for inpatient treatment were more likely to have a diagnosis of mood disorders and comorbid diagnoses and to have a maternal history of psychiatric illness. CONCLUSIONS: School refusal in adolescence can be a symptom of a variety of disorders, particularly anxiety and mood disorder. Treatment programs need to be geared to the range of diagnoses which occur in this patient group and to the various circumstances associated with the onset of the problem.

Adolescent↗
PubMed2003

Slowing of growth in height and weight on stimulants: a characteristic pattern.

OBJECTIVE: The aims of the present study were to describe the growth pattern of children starting stimulant medication and to analyse the changes over time in height, weight and height velocity in a cohort of treated patients. METHODS: Retrospective review of growth data from files of all newly treated patients with attention-deficit/hyperactivity disorder in one paediatric practice. Forty-four boys and seven girls were treated for 6-42 months with either dexam-phetamine (n = 32) or methylphenidate (n = 19). RESULTS: During the first 6 months on stimulant medication 44 children (86%) had a height velocity below the age-corrected mean and there was weight loss in 39 (76%). The height and weight standard deviation score (SDS) showed a progressive decline that was statistically significant after 6 and 18 months (P < 0.001, paired t-test). The height velocity was significantly attenuated for the first 30 months (P < 0.01), being lowest during the first 6 months. The mean height deficit during the first 2 years was approximately 1 cm/year. The change in weight SDS was 2.4 times the change in height SDS after 30 months on treatment with a significant correlation (Pearson's correlation coefficient r = 0.88, P < 0.001). CONCLUSIONS: Stimulant medication is associated with a decrease in height and weight SDS during the first 6-30 months with a characteristic pattern on the growth chart.

Adolescent↗
PubMed2002

Prenatal diagnosis and management of fetuses with liver hemangiomata.

OBJECTIVES: To study the relationship between prenatal appearance and perinatal outcome of fetuses with hepatic hemangiomata with special emphasis on criteria that may help to improve perinatal management. METHODS: In a tertiary referral center six fetuses with hepatic hemangiomata were evaluated by gray-scale, color, and pulsed wave Doppler ultrasound between 1994 and 2000. Fetal blood sampling was performed in four cases. All data (computerized files and video tapes) were analyzed retrospectively. RESULTS: Two fetuses showed very similar sonographic findings. They had an isolated large ('giant') round hepatic hemangioma (diameter 43 and 68 mm, respectively) supplied by one hepatic artery and drained by one hepatic vein, both of them showing high velocity and low pulsatility blood flow. Fetal blood count and coagulation parameters were normal in one case, whereas the other fetus showed a Kasabach-Merritt sequence with severe thrombocytopenia (10 platelets/nL) and mild disseminated intravascular coagulation. Intrauterine platelet transfusion was performed immediately prior to planned Cesarean delivery. Rapid platelet consumption continued postnatally, requiring several thrombocyte transfusions. Platelet counts stabilized only after tumor resection on the second day of life. One fetus with diffuse neonatal hemangiomatosis developed high-output cardiac failure with hydrops in addition to Kasabach-Merritt sequence (15 platelets/nL), and died following premature delivery. Three fetuses, however, showing an isolated small hyperechogenic hepatic hemangioma (5, 5, and 6 mm in diameter, respectively) did not develop any perinatal complications. CONCLUSION: Large fetal liver hemangiomata and diffuse hemangiomatosis may cause severe perinatal complications, particularly high-output cardiac failure and/or Kasabach-Merritt sequence with severe consumption of platelets and clotting factors and hemolytic anemia. Fetal blood sampling enables the prenatal detection of these potential complications, allowing critical modification of perinatal management such as intrauterine platelet transfusion, especially directly before delivery. In contrast, isolated small hyperreflexic hepatic hemangiomata do not appear to be associated with any of these fetal and postnatal sequelae.

Adult↗
PubMed2001

Hormone replacement therapy in postmenopausal women: utilization of health care resources by new users.

OBJECTIVE: To determine health care resource use by new postmenopausal users of hormone replacement therapy. METHOD: We used the Saskatchewan Health administrative databases, which include a health insurance registration file, a cancer registry, and files with data on outpatient prescription drugs, hospital services, and physician services. Our population included postmenopausal women aged 55 years and over with intact uteri taking hormone replacement therapy for long-term prevention benefits, and an equal number of postmenopausal women with intact uteri with no medical contraindications to hormone replacement therapy but who did not use the therapy during the study period. RESULTS: The population in our analysis included 2632 women with new episodes of hormone replacement therapy, all with at least 3 years of follow-up. Only 42% of new hormone replacement therapy users continuously took HRT during the first year after initiation of their first new episode; a third of these were full-year users in the second year. New users of hormone replacement therapy over a 6-year follow-up period had significantly higher rates of medical care contact for diagnoses of menopausal disorders in the first year of HRT compared with subsequent years. We also found slightly elevated numbers of visits to primary care physicians and obstetrician-gynecologists and slightly increased use of endometrial biopsies and dilation and curettage procedures in the first year of hormone replacement therapy, compared with subsequent years. CONCLUSION: New users of hormone replacement therapy had higher rates of medical care for menopausal disorders in their first year of therapy compared with rates in subsequent years. After discontinuing hormone replacement therapy, utilization of medical care decreased dramatically.

Antidepressive Agents↗
PubMed1995

Indexing the census: a by-product of the simulation of whole populations by means of SAS and SAR data.

"Amongst the new output formats adopted for the 1991 [U.K.] census were the Small Area and Local Base Statistics tables and the Samples of Anonymised Records. During an attempt to combine these data sources to estimate whole populations, a need was recognised for a computer algorithm to aggregate SAR data flexibly into LBS and SAS table look-alikes. This paper is a report on progress in the development of such an algorithm, including the concomitant development of a meta-database of census tables and variables required as an input to the algorithm. Out of this work a user-friendly, freely disseminable version of the census meta-database has been created, of interest to all census users."

Censuses↗
PubMed2002

Derived trail making test indices in a sample of heroin abusers: demographic effects.

Derived indices on the Trail Making test (TMT), a test often used for screening cognitive impairment, are examined in a sample of heroin abusers in drug abuse treatment programs. A mixed race sample of 1548 subjects was drawn from electronic files of data from the Drug Abuse Treatment Outcome Study (DATOS). The DATOS was a naturalistic, prospective cohort study that collected data from 1991-1993 in 96 programs in 11 cities in the United States. Data were analyzed to determine the effects of demographic variables on derived indices created by adding, subtracting, multiplying, and dividing parts A and B of the TMT in this large treatment sample of heroin abusers. The variables of sex, age, ethnicity, and education were strongly statistically significant for the total (A + B) and interaction (A x B/100) derived indices of the TMT. Similarly, the difference score (B - A) was significant for race/ethnicity and education, but the ratio score (B/A) was not significant for any demographic variable.

Adolescent↗