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At least 1,621 records · Page 90Linked to original sources
PubMed2005

[Sub-standard factors in primary obstetric care].

OBJECTIVE: Investigating the frequency and nature of sub-standard care factors in non-complicated pregnancies in primary obstetric care. DESIGN: Retrospective investigation of medical files. METHOD: Data concerning obstetric care in 3 midwifery practices in the Delft area (Pijnacker, Nootdorp, Den Hoorn and Schipluiden), the Netherlands, from 1989-1999 were gathered from the primary National Obstetrics Register. Of the 8362 pregnancy records, 72 were selected at random. Using a checklist containing criteria based on the Obstetrics Indication List, the Cochrane Pregnancy and Childbirth Database, and from an expert panel, the records were analysed for the frequency of occurrence of sub-standard factors in perinatal care. RESULTS: Of the 72 pregnancy records, only 1 was found to contain no sub-standard factors. On average 1.7 sub-standard factors were seen with a maximum of 7. Most frequently found were: too few check-ups during the first trimester (39%), no testing for proteinuria at the first visit (26%) and no administration of prophylactic vitamin K1 (43%). Less frequently found sub-standard care factors were: no ultrasound despite indication (11%), no referral to secondary care in the event of foetal distress (6%), no consultation with secondary care in the event of hypertension (3%), or in the case of membranes ruptured for more than 24 hours (1%). Frequently the circumstances surrounding the departure from the main checklist criteria were found to justify the action. CONCLUSION: Sub-standard care factors were demonstrated in many of the pregnancies investigated. A limited number of these factors gave reason to question whether guidelines for good quality perinatal care are being properly applied.

Adult↗
PubMed2006

Insurance coverage and subsequent utilization of complementary and alternative medicine providers.

BACKGROUND: Since 1996, Washington State law has required that private health insurance cover licensed complementary and alternative medicine (CAM) providers. OBJECTIVE: To evaluate how insured people used CAM providers and what role this played in healthcare utilization and expenditures. STUDY DESIGN: Cross-sectional analysis of insurance enrollees from western Washington in 2002. METHODS: Analysis of insurance demographic data, claims files, benefit information, diagnoses, CAM and conventional provider utilization, and healthcare expenditures for 3 large health insurance companies. RESULTS: Among more than 600,000 enrollees, 13.7% made CAM claims. This included 1.3% of enrollees with claims for acupuncture, 1.6% for naturopathy, 2.4% for massage, and 10.9% for chiropractic. Patients enrolled in preferred provider organizations and point-of-service products were notably more likely to use CAM than those with health maintenance organization coverage. The use of CAM was greater among women and among persons 31 to 50 years of age. The use of chiropractic was more frequent in less populous counties. The CAM provider visits usually focused on musculoskeletal complaints except for naturopathic physicians, who treated a broader array of problems. The median per-visit expenditures were 39.00 dollars for CAM care and 74.40 dollars for conventional outpatient care. The total expenditures per enrollee were 2589 dollars, of which 75 dollars(2.9%) was spent on CAM. CONCLUSIONS: The number of people using CAM insurance benefits was substantial; the effect on insurance expenditures was modest. Because the long-term trajectory of CAM cost under third-party payment is unknown, utilization of these services should be followed.

Adolescent↗
PubMed2005

Comparison of single-agent androgen suppression for advanced prostate cancer.

Gonadotropin-releasing hormone (GnRH) agonists are the agents of choice for achieving androgen suppression in men with advanced prostate cancer. The GnRH agonists that have been developed and marketed for prostate cancer are leuprolide, goserelin, triptorelin, and histrelin. So far, there have been few randomized studies directly comparing these single-agent therapies; however, the literature and the data on file with the Food and Drug Administration suggest that triptorelin may be more reliable than leuprolide in maintaining castration levels of serum testosterone. The clinical significance of this benefit remains to be proven.

Journal Article↗
PubMed2006

[Prevention of vascular ulcers and diabetic foot. Non-randomized open clinical evaluation on the effectiveness of "Mepentol Leche"].

INTRODUCTION: Vascular ulcers and diabetic foot ulcers present a health serious problem which affects a large number of patients, creating a major challenge for health professionals. Hyper-oxygenated fatty acid dressings have proven to be effective thanks to their favorable action on the skin in three ways: increasing the microcirculation of the blood, promoting the renovation of the epidermic cells, and notably increasing cutaneous hydration. OBJECTIVE: Evaluate the effectiveness of Mepentol Leche, an emulsion based on Hyper-oxygenated fatty acids, Aloe barbadensis and Mimosa tenuiflora, used to treat the skin and alleviate symptoms in patients who suffer from vascular ulcers and diabetic foot ulcers. METHODS: Clinical evaluation carried out between June 2004 and December 2005. 195 patients were studied. The parameters for inclusion in this study were 32.82% for venous pathology 35.90% for skin care, 26.67% due to arterial pathology, and 4.62% for a lymphatic pathology. These patients were evaluated over a one month period and each had a follow-up by means of a data collection file. The guideline to apply this product was twice a day and always over integral skin. The effectiveness of this product has been established based on these epigraphs: symptoms of itching, smarting and pain, and skin conditions: color, dryness, edema, maceration, rashes, and desquamation. RESULTS: Not one patient developed new lesions in healthy skin protected by Mepentol Leche. Symptoms linked to this pathology saw improvements in these percents: itching 96%, smarting 93%, and pain 96%, and skin conditions: color 100%, edema 90%, maceration 96%, rashes 92%, and desquamation 100%. Health professionals' evaluation of this product has been highly favorable in regards to ease of use, tolerance, absorption, and ease of application. CONCLUSIONS: This study showed the benefits in applying this product systematically to alleviate the symptoms prior to the appearance of ulcers, thus avoiding skin dryness and reducing itching, smarting, pain and eczema while returning normal color to the skin.

Diabetic Foot↗
PubMedDate not supplied

Geographical and temporal trends of childhood leukemia in relation to the nuclear plant in the Negev, Israel, 1960-1985.

Gardner et al. (Br Med J 1990; 300: 423-429) reported a high relative risk for childhood leukemia among children, aged 0-24 years at time of diagnosis, born to fathers employed at the Sellafield nuclear plant in the U.K. As a result we looked for spatial and temporal trends of childhood and young adult leukemia in the Negev, where a nuclear plant has been in operation since 1960. We divided the Negev into an Eastern part where plant employees are likely to live, and a Western part where this is quite unlikely. Reported leukemia cases were provided by the Israel Cancer Registry for the age group 0-24, and for the period 1960-1985. We checked this file against data obtained from the hospitals in the area. We added 6 more cases in the Eastern Negev, none in the Western Negev, and none of the reported cases was discarded. There was a total of 192 cases, of which 52% were acute lymphatic leukemia. Jewish and Bedouin children were studied separately. Among Jewish children the average annual incidence rate for the Eastern Negev was 2.76/100,000, the Western Negev 3.51. Over time the leukemia rates were consistently higher in the Western Negev among children aged 0-9 years, which holds especially for acute lymphatic leukemia. There was a sudden increase among girls born during the period 1970-1979 in the northern part of the Western Negev, which was not noticed among boys. No excess cases were found in the small towns around the plant.

Adolescent↗
PubMed1991

Molecular cloning, induction and taxonomic distribution of caffeoyl-CoA 3-O-methyltransferase, an enzyme involved in disease resistance.

Trans-Caffeoyl-CoA 3-O-methyltransferase is involved in the reinforcement of the plant cell wall under conditions that trigger the disease resistance response (Pakusch, A.-E., Kneusel, R.E., and Matern, U. (1989) Arch. Biochem. Biophys. 271, 488-494). Partial amino acid sequences of the enzyme from cultured parsley cells that had been treated with a crude elicitor were identified (Pakusch, A.-E., Matern, U., and Schiltz, E. (1991) Plant Physiol. 95, 137-143), and corresponding degenerated oligonucleotides of 29- and 30-nucleotide length were synthesized. Northern hybridizations with these probes revealed one specific RNA band, and the amount of this RNA appeared to be transiently induced upon elicitation of the cells. De novo enzyme synthesis was confirmed by Western blotting experiments using a specific antiserum. The time course of induction closely followed the pattern observed for phenylalanine ammonia-lyase and suggested the operational coordination of the methyltransferase with the general phenylpropanoid pathway in vivo. Full size cDNA of 1.258 kilobases was isolated in lambda gt11, sequenced and found to contain a remarkably long 5'-untranslated leader sequence followed by an open reading frame that codes for a 241-residue polypeptide representing the 27-kDa subunit of the native, dimeric parsley enzyme. Almost no homology was found to protein sequences filed in data banks. Southern hybridization with genomic DNA suggested that only one or two copies of the respective gene(s) are present in the parsley genome. Caffeoyl-CoA-specific methyltransferase activity was demonstrated in taxonomically widely diverse plants such as Dianthus caryophyllus (Caryophyllaceae), Carthamus tinctorius (Asteraceae) or Daucus carota, and Ammi majus (Apiaceae) where it is commonly induced by elicitor treatment. In Northern blots with RNA from Ammi or Daucus, parsley cDNA hybridized specifically to one band comparable in size to the parsley RNA, whereas Dianthus and Carthamus appear to code for slightly larger RNAs (roughly 1.45 and 1.3 kilobases, respectively). Slot-blot hybridizations revealed in all instances the rapid and transient increase of mRNA levels in response to elicitation. This emphasizes the integral role of the enzyme in disease resistance expression in plants far beyond parsley and also illustrates a new physiological context for the induction of 4-coumarate:CoA ligase.

Amino Acid Sequence↗
PubMed1991

Weapon-carrying among high school students--United States, 1990.

From 1980 through 1989, more than 11,000 persons died in the United States as a result of homicides committed by high school-aged youth using firearms, cutting instruments, or blunt objects (Federal Bureau of Investigation, Uniform Crime Reports, Supplementary Homicide Report Files, unpublished data, 1980-1989). Firearm-related homicides accounted for more than 65% of these fatalities. Immediate access to a potentially lethal weapon, especially a firearm, may increase the likelihood that a lethal event would result from a violent altercation. This article presents the prevalence and incidence of self-reported weapon-carrying among high school students in grades 9-12 in the United States during 1990.

Adolescent↗
PubMed1987

[Computerized processing, using a Macintosh, of ambulatory arterial pressure measurements collected on a Spacelabs monitor].

UNLABELLED: The use of the Spacelabs blood pressure recorder has given rise to processing programs running on Apple II and IBM PC computers. The authors have written in M.S. BASIC (2.1) a program who take advantage of graphic abilities and easy manipulation on Macintosh. The software was designed to perform three tasks: Communicating between Macintosh and Spacelabs station using serial interface (RS 232) without requesting specific interface card. Editing a report on two pages: The first is the listing of 96 measurements (one by 15 minutes). The second provides: patient identification, height, weight, diagnosis. Graphic representation of measurements Systolic and diastolic blood pressure (BP) repartition histogram for 24 hours, day and night. Standard deviation and mean of pressure and heart rate (HR) for those periods. A third optionally gives hourly chronogram and diagrams for cumulated BP and HR. Creating a file: 550 records can be stored on a 800 K floppy disk. The file handles: data for each patient (excepted identification). Random access and revision of each parameter is possible. SYNTHESIS: comparative reports for group patients and patient by patient analysing data with appropriate statistical test (ANOVA and correlation) are done.

Blood Pressure Determination↗
PubMed1988

[Numeration of patients from anonymous data: a method established with the epidemiological data of public health of Paris].

Anonymity in the registration of medical information for computerized data, which is imposed by French legislation, complicates the processing and utilization of epidemiological data at Paris's Public Hospitals ("Assistance Publique de Paris"). The number of patients may only be counted by linkage of anonymous data from files containing information on hospital stays. Some characteristics of this procedure are described. An original method for refusing the procedure giving anormalous results, based on probability calculation, is developed and applied to one example.

Adult↗
PubMed1987

Trends in elderly mortality in the Nordic countries.

This study describes the development of elderly mortality in the Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden) during this century. Long-term trends in total mortality are examined on the basis of life table statistics. More recent trends (from the 1950s onwards) are described by means of annual mortality rates according to a rough classification of causes of death. The series of vital statistics have been utilized as the data source for the long-term trends, and the original data for annual trends have been obtained from the mortality data bank files of the WHO. Marked improvements were observed in survival at advanced ages in the Nordic countries. However, the development has not been stable as in recent decades the elderly mortality rate has fluctuated, roughly comparable to the fluctuations in mortality among the younger age groups. The fact that the rate of recent improvement has been greatest in Finland where there, traditionally, is a high mortality level, and low in Norway and Sweden, where mortality levels are low, is in accordance with the idea of approaching a certain biological lower limit to mortality. However, certain characteristics seem to suggest that further advances are possible. Marked improvements have taken place recently in Iceland even though its mortality level at the end of the 1960s was already low. In addition, a large proportion of the differences in mortality rates between the Nordic countries may be due to external factors related to living conditions or life-style. Recent trends in mortality from several causes of death may also be primarily linked to such factors. Further research focusing particularly on a more detailed classification of causes of death and sociodemographic differentials within the national elderly populations is suggested.

Aged↗
PubMed1986

The use of bacillary tuberculosis information system central files for special-purpose data search.

The automated information system for surveillance of bacillary tuberculosis (ISBT) was put into operation in 1981, with the objective to record, store and process all mycobacterial positivity data reported by the network of specialized mycobacteriological laboratories in the Czech socialist republic. Here are described the newly developed data processing programs which allow it to carry out some special-purpose searches for the stored epidemiological data important for surveillance of tuberculosis. Further improvement of the national system of tuberculosis surveillance is believed to lie in the future compatibility of the two computerized systems operating at present in Czechoslovakia, i.e. ISBT and the Register of Tuberculosis.

Czechoslovakia↗
PubMed1978

The "healthy worker effect"--fact or artifact?

Workers in five chemical plants with diverse characteristics were studied by attempting to locate all white male employees who worked at least 12 months over a 25 to 30 year period. Former employees were contacted directly, rather than using questionnaires or Social Security Administration files. The data were analyzed by comparing observed mortality to expected mortality based on age-sex-race specific death rates in the U.S. population. The results indicate that the mortality experience of the chemical workers studied is essentially that of the general population. It is suggested that the "healthy worker effect" may be due to methods frequently employed in searching for death claims which understate the true experience of the employee group studied, or if present, does not affect mortality rates for neoplastic or cardiovascular disease.

Cardiovascular Diseases↗
PubMed1980

[Diagnostic significance of the equine electrocardiogram (author's transl)].

The anatomical and electrophysiological basis of the electrocardiogram are described. Attention is drawn to the fact that the technique of recording has not been standardized and to the failure to file the data obtained on an international scale. Today the ECG is only useful in recording arrhythmias, the clinical significance of which is estimated empirically.

Animals↗
PubMed1993

Childhood blindness: a new form for recording causes of visual loss in children.

The new standardized form for recording the causes of visual loss in children is accompanied by coding instructions and by a database for statistical analysis. The aim is to record the causes of childhood visual loss, with an emphasis on preventable and treatable causes, so that appropriate control measures can be planned. With this standardized methodology, it will be possible to monitor the changing patterns of childhood blindness over a period of time in response to changes in health care services, specific interventions, and socioeconomic development.

Abstracting and Indexing↗