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At least 1,603 records · Page 89Linked to original sources
PubMed1998

Electrophysiology: a review of signal origins and applications to investigating glaucoma.

Because different electrophysiological responses can be isolated to different retinal and cortical cell types and levels, the proportion in which the different signals are reduced can reflect the primary areas of damage. The knowledge of electrophysiology component sources can thus be applied when examining ophthalmic disorders. The present review covers the proposed origins and the usefulness of the conventional electrophysiological responses. Their application to glaucoma is discussed, with particular reference to the pattern electroretinogram. In the second part of the current review, we present some recent developments that relate to the use of multifocal pseudorandomly stimulated recording. This technique enables a new approach to the electrical assessment of visual responses. Analysis for temporal non-linearities and spatial distribution of the response throughout the visual field can be implemented. This type of recording has the potential to provide a method of objective visual field assessment in glaucoma and other disorders of the visual system.

Animals↗
PubMed2003

Neurons with distinctive firing patterns, morphology and distribution in laminae V-VII of the neonatal rat lumbar spinal cord.

It is generally accepted that neurons in the ventral spinal grey matter, a substantial proportion of which can be regarded as constituents of the spinal motor apparatus, receive and integrate synaptic inputs arising from various peripheral, spinal and supraspinal sources. Thus, a profound knowledge concerning the integrative properties of interneurons in the spinal ventral grey matter appears to be essential for a fair understanding of operational principles of spinal motor neural assemblies. Using the whole cell patch clamp configuration in a correlative physiological and morphological experimental approach, here we demonstrate that the intrinsic membrane properties of neurons vary widely in laminae V-VII of the ventral grey matter of the neonatal rat lumbar spinal cord. Based on their firing patterns in response to depolarizing current steps, we have classified the recorded neurons into four categories: 'phasic', 'repetitive', 'single' and 'slow'. Neurons with firing properties characteristic of the 'phasic', 'repetitive' and 'single' cells have previously been reported also in the superficial and deep spinal dorsal horn, but this is the first account in the literature in which 'slow' neurons have been recovered and described in the spinal cord. The physiological heterogeneity in conjunction with the morphological correlation and distribution of neurons argues that different components of motor neural assemblies in the spinal ventral grey matter possess different signal processing characteristics.

Action Potentials↗
PubMed2000

Survey of nationally registered emergency medical services providers: pediatric education.

STUDY OBJECTIVE: To survey emergency medical services (EMS) providers on a national level to determine and describe their perspective regarding their initial and continuing education (CE) needs in pediatrics. METHODS: A 10-question survey was developed, pilot-tested, and sent to EMS providers as a part of their National Registry of Emergency Medical Technicians reregistration materials. RESULTS: Surveys were completed by 18,218 EMS providers, a response rate of 67%. During a typical month, 60% of emergency medical technician-paramedics (EMT-Ps), 84% of EMT-intermediates (EMT-Is), and 87% of basic EMTs (EMT-Bs) care for 0 to 3 pediatric patients. CE was identified by all provider levels as the main source of their pediatric knowledge and skills. A state or national mandate for required CE in pediatrics was supported by 76% of surveyed providers. More than 70% of all providers responded they were comfortable to some degree with their own ability and their EMS system's ability when confronted with a critical pediatric call. Cost, availability, and travel distance were identified by all levels as the primary barriers to obtaining pediatric CE. All levels identified infants as the age of greatest concern if the provider was called to manage a critical case. CONCLUSION: Surveyed practicing nationally registered EMS providers have infrequent contact with pediatric patients and have acquired most of their pediatric knowledge and skills from CE. In general, these providers are comfortable with their personal and their system's ability to care for children, but clearly support the need for required pediatric CE and identify the birth to 3-year age range as the priority for an educational focus. Cost, travel distance, and availability of pediatric CE are barriers that should be considered if pediatric CE is to be required of EMS providers.

Attitude of Health Personnel↗
PubMed2003

Interpretation systems for genotypic drug resistance of HIV-1.

Genotypic assays are widely used tools for determining human immunodeficiency virus type 1 (HIV-1) drug resistance and for guiding treatment changes in patients failing antiretroviral therapy. Several systems have been developed to interpret the complex influence of key amino acid substitutions of the enzymes targeted by therapy on the phenotypic susceptibility or clinical response to available antiretroviral agents. This overview identifies 21 systems giving an interpretation on how amino acid substitutions affect phenotypic drug susceptibility or clinical activity of anti-HIV-1 agents. There was substantial variability in the mechanisms underlying the interpretations, the nature of the systems, their intended use, the source type of their knowledge base, and their update and output. Most of the systems could be accessed for free on the internet, functioned as rule-based algorithms updated by experts and at least partially based on literature evidence, and offered an automated report through a software. Nevertheless, the rule base was not always clarified. An update of the rules and the clinical validation of the systems are presented to help in the critical evaluation of their possible use. Importantly, only 8 systems were intended for clinical use and 5 of these had at least partially undergone clinical validation.

Anti-HIV Agents↗
PubMed2000

Pediatric journals on the Internet.

UNLABELLED: The objective of this study was to evaluate the structure and contents of the websites of the major journals in general pediatrics. A comprehensive search of the Internet was carried out to identify all pediatric journals in English that are listed in the Scientific Citation Index. Websites of 11 journals in general pediatrics were found, and their Web pages were systematically compared. Two of the appraised websites provided free on-line access to the full journal text, seven had on-line abstracts, and all provided the table of contents. The contents and abstracts covered varying periods, mostly just a few years back. Most of the journals offered easy search and other navigational options, but only a few allowed electronic submission of manuscripts. CONCLUSION: We conclude that in the era of immense growth and dissemination of information, aimed either at medical professionals or their patients, general pediatrics journals are lagging behind. The pediatrician today remains dependent on hospital libraries and their limited and sometimes cumbersome capabilities. Only a few of the pediatric journal websites can serve as an efficient on-line source for updating the knowledge. Further developments in the future should allow for improved services.

Internet↗
PubMedDate not supplied

Lifestyle behavior counseling for women patients among a sample of California physicians.

BACKGROUND: Physical inactivity, poor diet, excessive alcohol consumption, and smoking are modifiable risk factors associated with development of chronic diseases. Although the prevalence of diseases associated with these detrimental lifestyle behaviors is high among women in the United States, they may not receive adequate counseling from physicians. METHODS: To predict physicians' lifestyle counseling practices, we assessed personal, professional, and health behavior characteristics from responses to a self-administered survey of breast cancer risk reduction practices. Subjects were California physicians identified through AMA Masterfile, in family practice, internal medicine, or obstetrics/gynecology, who were asked to report the percentages of women patients they counseled on physical activity, diet, alcohol, and smoking. RESULTS: Of 1647 eligible physicians, 822 (50.0%) responded. Fifty-six percent reported counseling at least 75% of patients about physical activity, 54.6% about diet, and 44.8% about alcohol. More than three quarters (78.7%) counseled at least 75% of patients about smoking. In logistic regression analyses, woman gender, family practice, and internal medicine specialties emerged as significant predictors of counseling for all lifestyle behaviors. Older age was associated with dietary and alcohol counseling. Race/ethnicity was associated only with smoking counseling, and country of medical school was associated with counseling for physical activity and smoking. Sources of new medical knowledge emerged as predictors for all types of counseling, whereas physicians' own level of physical activity only predicted counseling about physical activity. CONCLUSIONS: Physicians' personal, professional, practice, and health behavior characteristics were associated with reported lifestyle counseling of women patients. Results reveal important directions for future physician-based interventions to improve counseling.

Aged↗
PubMed1998

Over-the-counter emergency contraception: a feasible option.

BACKGROUND: The high number of unintended pregnancies and terminations in Britain indicates that women who could use emergency contraception do not. Knowledge of access to sources of emergency contraception is limited. Oral administration of combined oestrogen-progestogen is safe and does not require routine physical administration, and there are proposals to re-regulate this from a prescription-only medicine to a pharmacy medicine, available over the counter in community pharmacies under the supervision of a pharmacist. OBJECTIVES: We aimed to demonstrate that the availability of combined, oral oestrogen-progestogen under the supervision of the community pharmacist would be safe and effective. METHOD: Guidelines were developed by a multidisciplinary group incorporating pharmacists, GPs, a pharmacologist and a consultant in family planning. The guidelines were based on published evidence, where possible. CONCLUSION: Guidelines have been developed to accompany the provision of combined, oral oestrogen-progestogen which demonstrate that over-the-counter availability could be a safe and effective method of reducing the number of unwanted pregnancies in Britain.

Contraceptives, Oral↗
PubMed1998

The 1997 Garrod Lecture. The subtleties of antibiotic resistance.

Although the qualitative aspects of antibiotic resistance are increasingly well understood, our understanding of the quantitative aspects has always lagged. Deficiency of understanding or of investigation affects the methods used to characterize the phenotypes of organisms from clinical sources, delays acquisition of knowledge of the importance of quantitative diversity in patient management, and introduces error into epidemiological studies of the prevalence of resistance. This, in turn, gives rise to a devaluation of the work done in diagnostic laboratories in relation to the technology of sensitivity testing, to the interpretation of their results for clinicians, including those used in clinical trials, and to the statistical analyses of resistance trends used inter alia as a guide to empirical antibiotic therapy and to test the efficacy of methods of control. There is a need to bring about a shift of opinion of those who provide funds, in relation to the role of clinical microbiologists and infectious diseases clinicians in defining and solving these problems.

Anti-Bacterial Agents↗
PubMed2004

Het-PDB Navi.: a database for protein-small molecule interactions.

The genomes of more than 100 species have been sequenced, and the biological functions of encoded proteins are now actively being researched. Protein function is based on interactions between proteins and other molecules. One approach to assuming protein function based on genomic sequence is to predict interactions between an encoded protein and other molecules. As a data source for such predictions, knowledge regarding known protein-small molecule interactions needs to be compiled. We have, therefore, surveyed interactions between proteins and other molecules in Protein Data Bank (PDB), the protein three-dimensional (3D) structure database. Among 20,685 entries in PDB (April, 2003), 4,189 types of small molecules were found to interact with proteins. Biologically relevant small molecules most often found in PDB were metal ions, such as calcium, zinc, and magnesium. Sugars and nucleotides were the next most common. These molecules are known to act as cofactors for enzymes and/or stabilizers of proteins. In each case of interactions between a protein and small molecule, we found preferred amino acid residues at the interaction sites. These preferences can be the basis for predicting protein function from genomic sequence and protein 3D structures. The data pertaining to these small molecules were collected in a database named Het-PDB Navi., which is freely available at http://daisy.nagahama-i-bio.ac.jp/golab/hetpdbnavi.html and linked to the official PDB home page.

Adenosine Triphosphate↗
PubMed2003

The use of complementary and alternative medicine by asthma patients.

BACKGROUND: Use of complementary and alternative medicines (CAM) by asthmatic patients is increasing. Data on the prevalence of CAM use in asthma are limited, and the motivation for patients to seek CAM therapy is uncertain. AIM: To determine the prevalence and pattern of use of complementary therapies in adults treated for asthma in primary care in Singapore, and the demographic and clinical factors associated with their use. DESIGN: Cross-sectional study. SETTING: Five primary care clinics in Singapore. METHODS: Adult patients with asthma (n = 802) received a structured questionnaire interview and clinical assessment that included demographic and clinical variables (clinical status, patient's knowledge, self-care and healthcare-seeking behaviour, and spirometric measurements) and detailed information on CAM use in the past one year. RESULTS: CAM use in the past year was reported by 27.2%, including animal food products (12.3%), herbs (10.3%), herbal-based proprietary medicines (3.2%), and acupuncture or reflexology (1%). The use of CAM was significantly associated with Chinese ethnicity, longer disease duration, moderate and severe persistent asthma, FEV(1)/FVC < 80%, lack of positive response to treatment in the past year, higher patient knowledge score, and multiple sources of care providers. DISCUSSION: The use of CAM is highly prevalent in Asian patients treated for asthma in primary care, and is associated with cultural and clinical factors reflecting a need to improve care.

Adult↗
PubMed2004

A review of chronic lead intoxication: an unrecognized cause of chronic kidney disease.

Chronic lead nephropathy occurs as a result of years of lead exposure. This disease has been prevalent throughout human history. It is important that primary care providers and internists recognize this disorder because it can contribute to progressive loss of kidney function. Diagnosis is made by a thorough history in combination with physical examination. A history of lead intoxication often requires knowledge of the various sources of lead exposure. Laboratory tests, many previously known and some newly described, are available to further support this diagnosis. Therapy to reduce lead burden may be useful when employed early in the disease; new data sheds more light on which patients should be treated and when such patients should undergo chelation therapy. In particular, treatment with calcium EDTA chelation may benefit certain patients with chronic kidney disease by slowing the progression to end-stage renal disease.

Animals↗
PubMed1994

An EGS4 based mathematical phantom for radiation protection calculations using standard man.

This note describes an Electron Gamma Shower code (EGS4) Monte Carlo program for calculating radiation transport in adult males and females from internal or external electron and gamma sources which requires minimal knowledge of organ geometry. Calculations of the dose from planar gamma fields and from computerized tomography illustrate two applications of the package.

Adult↗
PubMed1999

A non-destructive method to determine the depth of radionuclides in materials in-situ.

A non-destructive method based on in-situ gamma spectroscopy is developed to determine the depth of radiological contamination in media. An innovative algorithm, Gamma Penetration Depth Unfolding Algorithm (GPDUA), uses point kernel techniques to predict the depth of contamination based on the results of the uncollided peak information from the in-situ gamma spectroscopy. The GPDUA is designed and verified through extensive Monte Carlo simulations and validated through laboratory experiments. This innovative tool promises to be "better, faster, safer, and cheaper" than the current practice in decontamination and decommissioning. The method requires the a priori knowledge of the contaminant source distribution. The applicable radiological contaminants of interest are any isotopes that emit two or more gamma rays per disintegration or isotopes that emit a single gamma ray but have gamma-emitting progeny in secular equilibrium with its parent (e.g., 60Co, 235U, and 137Cs to name a few). The predicted depths from the GPDUA algorithm using Monte Carlo N-Particle Transport Code simulations and laboratory experiments using 60Co have consistently produced predicted depths within 20% of the actual or known depth.

Gamma Rays↗
PubMedDate not supplied

Appropriateness of care: the case for changing the focus of "quality" measurement.

"Quality" of care has become one of the main foci of the American health care system during the last 20 years. As costs escalated in all areas of health care, the purchasers and consumers of health care have begun to demand accountability for the products they purchase. The initial focus of the system was "quality of care." When a number of research studies and reports highlighted the lack of basic safety in the American health care system, "safety" of health care was added to the discussion. It is the intent of this article to argue that quality of care is at this point in time not measurable, but that "appropriateness" of care is and can be measured based upon knowledge-based guidelines. With the option to use knowledge-based guidelines as sources for appropriateness indicators, the opportunity to add meaning to indicators and their meaning to the many stakeholders interested in this area cannot be ignored.

Delivery of Health Care↗
PubMed2001

Use of antimicrobials to prevent postoperative infection in patients with cataracts.

Despite the high frequency of cataract surgery, there are still no definitive studies on antibiotic prophylaxis against endophthalmitis after cataract surgery. Most surgeons follow an empiric approach. The results of several recent studies shed additional light on this complex topic. There is better knowledge of the usual source of the infection and the specific organisms incriminated. This review presents some principles of prophylactic treatment and selected literature that addresses the effectiveness of antisepsis, topical preoperative antibiotics, intracameral antibiotics, subconjunctival antibiotics, systemic antibiotics, and postoperative antibiotics. The worldwide problem of antibiotic resistance should temper our approach. Some organizational statements are reviewed, and personal recommendations are offered. Controversy still abounds.

Anti-Infective Agents↗
PubMed2005

Mineralization of soft-part anatomy and invading microbes in the horseshoe crab Mesolimulus from the Upper Jurassic Lagerstätte of Nusplingen, Germany.

A remarkable specimen of Mesolimulus from the Upper Jurassic (Kimmeridgian) of Nusplingen, Germany, preserves the musculature of the prosoma and associated microbes in three dimensions in calcium phosphate (apatite). The musculature of Mesolimulus conforms closely to that of modern horseshoe crabs. Associated with the muscles are patches of mineralized biofilm with spiral and coccoid forms. This discovery emphasizes the potential of soft-bodied fossils as a source for increasing our knowledge of the diversity of fossil microbes in particular settings.

Animals↗
PubMed2003

Inferring higher functional information for RIKEN mouse full-length cDNA clones with FACTS.

FACTS (Functional Association/Annotation of cDNA Clones from Text/Sequence Sources) is a semiautomated knowledge discovery and annotation system that integrates molecular function information derived from sequence analysis results (sequence inferred) with functional information extracted from text. Text-inferred information was extracted from keyword-based retrievals of MEDLINE abstracts and by matching of gene or protein names to OMIM, BIND, and DIP database entries. Using FACTS, we found that 47.5% of the 60,770 RIKEN mouse cDNA FANTOM2 clone annotations were informative for text searches. MEDLINE queries yielded molecular interaction-containing sentences for 23.1% of the clones. When disease MeSH and GO terms were matched with retrieved abstracts, 22.7% of clones were associated with potential diseases, and 32.5% with GO identifiers. A significant number (23.5%) of disease MeSH-associated clones were also found to have a hereditary disease association (OMIM Morbidmap). Inferred neoplastic and nervous system disease represented 49.6% and 36.0% of disease MeSH-associated clones, respectively. A comparison of sequence-based GO assignments with informative text-based GO assignments revealed that for 78.2% of clones, identical GO assignments were provided for that clone by either method, whereas for 21.8% of clones, the assignments differed. In contrast, for OMIM assignments, only 28.5% of clones had identical sequence-based and text-based OMIM assignments. Sequence, sentence, and term-based functional associations are included in the FACTS database (http://facts.gsc.riken.go.jp/), which permits results to be annotated and explored through web-accessible keyword and sequence search interfaces. The FACTS database will be a critical tool for investigating the functional complexity of the mouse transcriptome, cDNA-inferred interactome (molecular interactions), and pathome (pathologies).

Animals↗
PubMed1996

Comparison between the Health Belief Model and Subjective Expected Utility Theory: predicting incontinence prevention behaviour in post-partum women.

A small-scale study was undertaken to test the relative predictive power of the Health Belief Model and Subjective Expected Utility Theory for the uptake of a behaviour (pelvic floor exercises) to reduce post-partum urinary incontinence in primigravida females. A structured questionnaire was used to gather data relevant to both models from a sample antenatal and postnatal primigravida women. Questions examined the perceived probability of becoming incontinent, the perceived (dis)utility of incontinence, the perceived probability of pelvic floor exercises preventing future urinary incontinence, the costs and benefits of performing pelvic floor exercises and sources of information and knowledge about incontinence. Multiple regression analysis focused on whether or not respondents intended to perform pelvic floor exercises and the factors influencing their decisions. Aggregated data were analysed to compare the Health Belief Model and Subjective Expected Utility Theory directly.

Adult↗