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PubMed2005

Ice hockey injuries.

OBJECTIVE: This article reviews the distribution and determinants of injuries reported in the pediatric ice hockey literature, and suggests potential injury prevention strategies and directions for further research. DATA SOURCES: Thirteen electronic databases, the ISI Web of Science, and 'grey literature' databases were searched using a combination of Medical Subject Headings and text words to identify potentially relevant articles. The bibliographies of selected studies were searched to identify additional articles. Studies were selected for review based on predetermined inclusion and exclusion criteria. MAIN RESULTS: A comparison between studies on this topic area was difficult due to the variability in research designs, definition of injury, study populations, and measurements used to assess injury. The majority of injuries were sustained during games compared with practices. The two most commonly reported injuries were sprains/strains and contusions. Players competing at the Minor hockey, High School, and Junior levels of competition sustained most of their injuries to the upper extremity, head, and lower extremity, respectively. The primary mechanism of injury was body checking, followed by stick and puck contact. The frequency of catastrophic eye injuries has been significantly reduced with the world-wide mandation of full facial protection for all Minor hockey players. CONCLUSIONS: Specific hockey-related injury risk factors are poorly delineated and rarely studied among pediatric ice hockey players leaving large gaps in the knowledge of appropriate prevention strategies. Risk management strategies should be focused at avoiding unnecessary foreseeable risk, and controlling the risks inherent to the sport. Suggestions for injury prevention and future research are discussed.

Adolescent↗
PubMed1997

Myoclonus due to chlorambucil in two adults with lymphoma.

OBJECTIVE: To report myoclonus due to chlorambucil therapy in two adults with lymphoma, and to review the literature of chlorambucil neurotoxicity in adults. CASE SUMMARIES: Case 1: An 81-year-old man with lymphoma being treated with chlorambucil developed jerking movements and stiffness that persisted for 3 days and intensified at night. The dosage of chlorambucil was decreased with a subsequent decrease in symptomatology. Resolution of the myoclonus occurred with discontinuation of the chlorambucil. Rechallenge evoked a return of tremors the next day that later became constant and again resolved on discontinuation of chlorambucil. Case 2: A 75-year-old woman with lymphoma being treated with chlorambucil developed jerking movements in her limbs, particularly in her arms and right hip. The symptoms were so severe they prevented the patient from leaving her house. All symptoms resolved within 2-3 days after the cycle was completed and did not return. She was diagnosed as having had chlorambucil-induced myoclonus. DATA SOURCES: Searches were performed on MEDLINE, CancerLit, and Science Citation Index Review to identify reports and articles discussing chlorambucil-induced neurotoxicity, particularly myoclonus. DISCUSSION: Chlorambucil-induced myoclonus has been described in overdose situations and in the treatment of nephrotic syndrome in children. Three cases of reversible myoclonic activity associated with high-dose chlorambucil in adults have also been described. In each case, the myoclonus resolved following discontinuation of the drug. Only one other conclusive case of low-dose chlorambucil-induced myoclonus in an adult has been described. The two cases presented here are unique in that the myoclonus occurred in adults receiving low-dose chlorambucil who had no myoclonus before or after treatment with the drug. CONCLUSIONS: From the cases reviewed, it appears that chlorambucil may induce myoclonus in adults receiving therapeutic dosages of chlorambucil. The neurologic status of patients receiving chlorambucil should be followed closely during treatment. If myoclonus develops, drug-induced myoclonus should be considered, as well as discontinuation of the drug.

Aged↗
PubMed2006

Service utilization in community health centers in China: a comparison analysis with local hospitals.

BACKGROUND: Being an important part of China's Urban Health Care Reform System, Community Health Centers (CHCs) have been established throughout the entire country and are presently undergoing substantial reconstruction. However, the services being delivered by the CHCs are far from reaching their performance targets. In order to assess the role of the CHCs, we examined their performance in six cities located in regions of South-East China. The purpose of this investigation was to identify the utilization and the efficiency of community health resources that are able to provide basic medical and public health services. METHODS: The study was approved by Peking University Health Science Center Institutional Reviewing Board (NO: IRB00001052-T1). Data were collected from all the local health bureaux and processed using SPSS software. Methods of analysis mainly included: descriptive analysis, paired T-test and one-way ANOVA. RESULTS: The six main functions of the CHCs were not fully exploited and the surveys that were collected on their efficiency and utilization of resources indicate that they have a low level of performance and lack the trust of local communities. Furthermore, the CHCs seriously lack funding support and operate under difficult circumstances, and residents have less positive attitudes towards them. CONCLUSION: The community health service must be adjusted according to the requirements of urban medical and health reform, taking into account communities' health needs. More research is required on the living standards and health needs of residents living within the CHC's range, taking into consideration the users' needs in expanding the newly implemented service, and at the same time revising the old service system so as to make the development of CHCs realistic and capable of providing a better service to patients. Several suggestions are put forward for an attainable scheme for developing a community health service.

Adolescent↗
PubMed2005

Introducing article-processing charges and inviting "detailed methods sections" articles.

This editorial introduces the use of article-processing charges at Epidemiologic Perspectives & Innovations and reviews that advantages of publishing in an Open Access journal. In addition, it introduces a new type of article the journal hopes to publish, detailed reports of study design or data analysis methods that have been used in health science research. The new type of article is intended to supplement the woefully constrained methods sections in standard research report articles, providing information that better fulfills the goals of scientific publishing.

Journal Article↗
PubMed2025

Prevalence and associated risk factors of bacterial vaginosis among women of reproductive age living with, and without HIV in Lagos, Nigeria.

BACKGROUND: Bacterial vaginosis (BV) is a vaginal dysbiosis of public health significance in reproductive-aged women. BV is associated with an increased risk of pelvic inflammatory disease, cervicitis, HIV infection and other obstetric complications like premature rupture of membranes, preterm labour and post-partum endometritis. This study aimed to determine the prevalence and risk factors of BV among women of childbearing age living with, and without HIV in Nigeria. METHODS: This was a cross-sectional study conducted among non-pregnant women of childbearing age (18-49 years), living with and without HIV in Lagos, Nigeria. Participants were counselled and informed consent was obtained before vaginal swabs were collected. BV was defined using Amsel’s criteria, which uses 3 out of 4 diagnostic criteria to diagnose BV and Nugent scoring. Data analysis was done using Statistical Package for Social Sciences (SPSS) version 27.0. RESULTS: Two hundred and fifty-two (252) women of childbearing age including 198 (78.6%) living with HIV (WLHIV), and 54 (21.4%) without HIV were included in the study. The mean age was 41 ± 6 years with a range from 21 to 49 years. The overall prevalence rate of BV was 36.1%. Prevalence of BV was higher in WLHIV (37.9%) compared to those without HIV (29.6%) although this was not statistically significant (OR = 1.36; 95% CI: 0.67 – 2.79). Prevalence of BV among HIV-positive women with CD4 > 200 cells/mm3 was 36.9%, as against 54.5% for those whose CD4 was ≤ 200 cells/mm3 (OR = 1.40; 95% CI: 0.33–5.96). Having more than one sexual partner predisposed the women to BV (OR = 1.89; 95% CI: 1.01–3.53) while women who douche had a 1.7-fold increased risk of having BV than those who do not (OR = 1.65; 95% CI: 0.95- 2.88). CONCLUSION: The findings of this study indicate that women of reproductive age are equally susceptible to BV irrespective of their HIV status, with multiple sexual partners identified as a significant risk factor. These results underscore the need for targeted public health interventions aimed at reducing the prevalence of BV within this population, thereby reducing the risk of transmission of HIV and other sexually transmitted disease among this group.

Humans↗
PubMed2025

Association of MTHFD1 G1958A (rs2236225) gene polymorphism with the risk of congenital heart disease: a systematic review and meta-analysis.

BACKGROUND: We did this study to better clarify the correlations of methylenetetrahydrofolate dehydrogenase 1 (MTHFD1)-G1958A (rs2236225) gene polymorphism with the risk of congenital heart diseases (CHD) and its subgroups. METHODS: Relevant articles were searched in PubMed, Web of Science, Cochrane Library, Embase, CNKI, VIP database and Wanfang DATA until October 2023. We will use odds ratios (ORs) and 95% confidence intervals (CIs) to examine the potential associations of MTHFD1- G1958A gene polymorphism with CHD and its subgroups. RESULTS: We included a total of 9 eligible studies, encompassing 1917 children with CHD, 1863 healthy children, 1717 mothers of the children with CHD and 1666 mothers of healthy children. In our study, the meta-analysis of fetal group revealed no significant association between any of the five genetic models for the MTHFD1-G1958A polymorphism and the risk of CHD. Subgroup analysis showed that associations between the MTHFD1-G1958A polymorphism and Tetralogy of Fallot (TOF) risk in the homozygote model (AA vs. GG, OR = 2.82, 95%CI [1.16, 6.86], P = 0.02) and recessive model (AA vs. GG + GA, OR = 3.09, 95%CI [1.36, 7.03], P = 0.007). In addition, the MTHFD1-G1958A polymorphism was associated with the risk of CHD in racial subgroup, increasing the risk of CHD in Caucasians. In maternal analysis, 2 genetic models of MTHFD1-G1958A polymorphism increased the risk of CHD: the heterozygote model (GA vs. GG, OR = 1.22, 95%CI [1.04, 1.42], P = 0.01), and the dominance model (GA + AA vs. GG, OR = 1.17, 95%CI [1.01, 1.34], P = 0.03). CONCLUSIONS: The fetal MTHFD1-G1958A (rs2236225) gene polymorphism increase their risk of TOF. The maternal MTHFD1-G1958A polymorphism has a strong correlation with the risk of CHD, and there are racial differences in this correlation. Compared with GG genotype, the GA genotype increases the risk of CHD.

Humans↗
PubMed2004

The evolution of semantic systems.

Semantic or cultural systems are sets of concepts connected by meaningful relationships, and they exhibit properties similar to those of populations of biological organisms. Drawing upon ideas from evolutionary biology and methods from information technology, this article explores the potential for research and engineering on the evolution of semantic systems. Such work in cultural genetics requires two things: (1) a rigorous but evolving taxonomic system to categorize cultural artifacts, elements, and clusters, and (2) a set of hypotheses about the processes that cause evolutionary change. This article illustrates systematic approaches to cultural taxonomy with data on the popular ideology of the space program, science fiction motion pictures, nanotechnology books, and nanotechnology research grants. It offers hypotheses derived from evolutionary and population biology that might be useful in explaining cultural evolution.

Biological Evolution↗
PubMed2003

AAPS/RAPS/CAPRA collaborative program: exploring the challenges of drug regulation in a global environment: clinical concerns.

Globalization of the pharmaceutical industry has led to a need to harmonize the regulatory requirements governing the marketing of medicinal products. To minimize the barriers impeding global drug product registration, the International Conference on the Harmonization of Technical Requirements of Pharmaceuticals for Human Use (ICH) was established in 1990. The ICH has developed a series of guidelines that reflect agreements reached by participating nations on aspects of the chemistry and clinical technical sections that will fulfill the regulatory requirements of these various jurisdications. Nevertheless, there continue to be points of divergent perspectives and barriers that can impede the use of foreign clinical data. Given the importance of these issues, the Regulatory Science (RS) section of the American Association of Pharmaceutical Scientists (AAPS), in conjunction with the Regulatory Affairs Professional Society (RAPS) and the Canadian Association of Professional Regulatory Affairs (CAPRA) cosponsored a public forum on this topic. This manuscript provides a summary of the speaker presentations and audience discussions regarding the design of clinical trials and the extrapolation of results from these trials to support international drug registration.

Clinical Trials as Topic↗
PubMed2002

Girls' spatial abilities: charting the contributions of experiences and attitudes in different academic groups.

BACKGROUND: Gender-related differences in spatial abilities favouring males are well established but have also generated a great deal of controversy. Cross-cultural research, meta-analyses and training studies could show the influence of socio-cultural and experiential factors on spatial-test performance. However, little is known about how experiences and gender-role stereotypes mediate performance differences in this area. AIM: The relationship between specific experiences (spatial activities, computer experience), achievement-related attitudes, and spatial abilities, i.e., mental-rotation ability was investigated with males and females in different academic subgroups. SAMPLE: The sample comprised 112 female and 71 male undergraduates, majoring in arts, humanities and social sciences, sports, psychology and computational visualistics. METHODS: A redrawn version of the Vandenberg and Kuse Mental Rotations Test (MRT) was administered and the participants completed a questionnaire about their spatial activities, computer experience, self-ratings regarding everyday spatial abilities, and attitudes towards mathematics and physics. RESULTS: Mental Rotations Test performance was mainly affected by academic programme and gender, but the effect size of gender differences varied. It was largest with students majoring in arts, humanities and social sciences and smallest with those majoring in computational visualistics. Data analyses revealed statistically significant correlations with spatial activities and computer experience only for females. The relationship between test performance and scales of achievement-related self-concept also depended on gender. CONCLUSIONS: Compared to males, females' spatial abilities are extremely vulnerable to and thus modifiable through attitudinal and experiential factors. This has considerable consequences for intervention programmes that could help to overcome the gender gap in spatial abilities.

Adolescent↗
PubMed1997

Resource utilization among neonatologists in a university children's hospital.

OBJECTIVE: We studied factors affecting length of hospital stay and resulting hospital charges among patients managed by two separate groups of neonatologists in the same academic health science center. DESIGN: Retrospective analysis of clinical and financial data base information. METHODS: Neonatal intensive care was provided in the same acute care nursery in a large university children's hospital by: (1) neonatologists in a full-time academic division (group A) and (2) a group associated with a private managed care organization (group B). Clinical and financial parameters of all neonates admitted in fiscal year 1994 were compared for the two provider groups. Stepwise regression analysis was used to evaluate factors influencing hospital charges and length of hospital stay (LOS) and to adjust for differences in clinical variables between the two groups. RESULTS: Group A physicians provided care for 340 infants, while 137 were treated by those of group B. Group A included older patients, more outborns, more level III patients, more sepsis, more intermittent positive pressure ventilation, and more patent ductus arteriosus. The incidence of transient tachypnea of the newborn was higher among group B patients. Hospital charges were primarily determined by LOS, which was similar for the two groups. When the data were corrected for differences in risk and patient acuity, however, a significant relationship between physician group and LOS was demonstrated, with LOS being an average of 7.8 days shorter for group A. A net reduction of $3 114 969 in hospital charges might have been realized had group A physicians provided care for all study patients. CONCLUSIONS: Hospital charges were determined by LOS. In this setting, academic neonatologists produced shorter LOS and comparable clinical outcomes, despite caring for a population at greater risk. The reduction in LOS could have resulted in more than $3.1 million in annualized savings had the academic group provided care for all of the study patients.

Analysis of Variance↗
PubMed2000

How to fit a response time distribution.

Among the most valuable tools in behavioral science is statistically fitting mathematical models of cognition to data--response time distributions, in particular. However, techniques for fitting distributions very widely, and little is known about the efficacy of different techniques. In this article, we assess several fitting techniques by simulating six widely cited models of response time and using the fitting procedures to recover model parameters. The techniques include the maximization of likelihood and least squares fits of the theoretical distributions to different empirical estimates of the simulated distributions. A running example is used to illustrate the different estimation and fitting procedures. The simulation studies reveal that empirical density estimates are biased even for very large sample sizes. Some fitting techniques yield more accurate and less variable parameter estimates than do others. Methods that involve least squares fits to density estimates generally yield very poor parameter estimates.

Chi-Square Distribution↗
PubMedDate not supplied

Legal issues relevant to clinical laboratory education program admissions.

OBJECTIVE: To address the basic legal requirements for admissions, admissions standards, student and applicant records, and discrimination in admissions for clinical laboratory science (CLS) and clinical laboratory technician (CLT) educational programs. DATA SOURCES: Recent academic literature and legal precedents. STUDY SELECTION: Not applicable. DATA EXTRACTION: Not applicable. DATA SYNTHESIS: CLS and CLT educational programs typically practice selective admissions. Program directors and faculty need to be aware of the issues relating to student selection that may have legal implications. Admissions practices should be guided by three basic legal requirements: that the selection process not be arbitrary or capricious, that the program adhere to its published admissions standards and honor admissions decisions, and that the program not have admissions policies that discriminate on the basis of race, gender, age, disability, or citizenship. Specific guidelines are offered for applying these legal requirements to the admissions practices typically used by CLS and CLT programs, including published admission policies and standards, application forms, interviews, rating of noncognitive attributes, and communication with applicants. CONCLUSION: Admissions practices in CLS and CLT programs need to be guided by the three basic legal requirements.

Persons with Disabilities↗
PubMed1999

Lack of involvement of ataxia telangiectasia mutated (ATM) in regulation of nuclear factor-kappaB (NF-kappaB) in human diploid fibroblasts.

It has been suggested that the cellular response to exposure to ionizing radiation involves activation of the transcription factor nuclear factor-kappaB (NF-kappaB) and that this response is defective in cells from individuals with ataxia telangiectasia (AT). In one study, it was found that SV40 large T-transformed cells derived from a patient null for the AT mutated (ATM) gene exhibited constitutive activation of NF-kappaB and that in those cells, inhibition of NF-kappaB by expression of a modified form of IkappaBalpha led to correction of the radiosensitivity associated with the AT phenotype [M. Jung et al., Science (Washington DC), 268: 1691-1621, 1995]. From those data, it was suggested that NF-kappaB played a role in the AT phenotype. We show here that normal diploid cells derived from AT patients do not exhibit constitutive activation of NF-kappaB. Furthermore, we provide data that the transformation process associated with SV40 large T antigen expression in AT-/- cells leads to aberrant cellular responses. Our studies highlight the importance of using diploid, nontransformed AT-/- cells for in vitro studies relevant to the AT phenotype whenever possible.

Ataxia Telangiectasia↗
PubMed1994

Cardiopulmonary adaptation to weightlessness.

The lung is profoundly affected by gravity. The absence of gravity (microgravity) removes the mechanical stresses acting on the lung paranchyma itself, resulting in a reduction in the deformation of the lung due to its own weight, and consequently altering the distribution of fresh gas ventilation within the lung. There are also changes in the mechanical forces acting on the rib cage and abdomen, which alters the manner in which the lung expands. The other way in which microgravity affects the lung is through the removal of the gravitationally induced hydrostatic gradients in vascular pressures, both within the lung itself, and within the entire body. The abolition of a pressure gradient within the pulmonary circulation would be expected to result in a greater degree of uniformity of blood flow within the lung, while the removal of the hydrostatic gradient within the body should result in an increase in venous return and intra-thoracic blood volume, with attendant changes in cardiac output, stroke volume, and pulmonary diffusing capacity. During the 9 day flight of Spacelab Life Sciences-1 (SLS-1) we collected pulmonary function test data on the crew of the mission. We compared the results obtained in microgravity with those obtained on the ground in both the standing and supine positions, preflight and in the week immediately following the mission. A number of the tests in the package were aimed at studying the anticipated changes in cardiopulmonary function, and we report those in this communication.

Adaptation, Physiological↗
PubMed2002

Bone marrow examination. Indications and diagnostic value.

OBJECTIVE: To identify the main indications for bone marrow examination in a University hospital setup and the most common diagnoses encountered. To also identify the extent of correlation, if any, between the preliminary diagnosis and the result of the final bone marrow diagnosis. METHODS: The requests and reports of all bone marrow biopsies and aspirations carried out during a 12-year period from January 1988 through to December 1999, in King Fahd Hospital of the University, Al Khobar, Kingdom of Saudi Arabia were retrospectively reviewed. The information extracted included the main indications for performing this procedure, age groups involved, and the most common diagnoses encountered. A specially designed form was used for this purpose and the data was analyzed using the statistical package for social sciences. Randomly selected slides of the most common diagnoses were reviewed to concur with the diagnosis. RESULTS: There was a total of 1813 bone marrow biopsies or aspirations, or both, performed. The main indications for bone marrow examination in a descending order of frequency were the following: The diagnosis and management of acute leukemia 403 (22.2%), staging for lymphoma 276 (15.2%), evaluation of pancytopenia 215 (11.9%), thrombocytopenia 173 (9.5%), investigation of anemia 151 (8.3%), fever (pyrexia of unknown origin) 130 (7.2%), lymphadenopathy 120 (6.6%), and hepatosplenomegaly 80 (4.4%). The most common diagnoses encountered were: acute lymphoblastic leukemia 242 (13.3%), immune thrombocytopenia 123 (6.8%), acute myeloblastic leukemia 80 (4.4%), hypersplenism 79 (4.4%), chronic granulocytic leukemia 73 (4.0%), megaloblastic anemia 66 (3.6%), bone marrow positive for lymphomatous infiltration 63 (3.5%), chronic lymphocytic leukemia 40 (2.2%), and multiple myeloma 32 (1.8%). CONCLUSION: This study confirms that bone marrow examination is a very important investigation for establishing the diagnosis in many conditions, especially hematological neoplasms. The most common indication for this procedure in our hospital was to confirm and manage acute leukaemia and the most common diagnosis was acute lymphoblastic leukemia.

Adolescent↗
PubMed2003

[The national GTH haemophilia registry as database within the scope of the German human genome project].

The Committee of Haemophilia of the GTH has established a central registry for all German centers treating patients with haemophilia. The intention was to establish a suitable system for collecting and analyzing epidemiological data relevant to bleeding disorders. The registry provides the database within the scope of the German Human-Genome-Project. The set goal is the complete molecular characterization of the genetic mutations on chromosome X of haemophilia A patients in Germany and subsequent correlation with the phenotype. An electronic network is applied for communication. A Java-application was developed for online electronic data acquirement by the participating centers. Offline data entry and sending encrypted data carriers is possible, too. A high level of security is assured by personalized access. Data are anonymized and scrambled by secure encoding. The concept was confirmed by the official data security offices. A considerable improvement for the epidemiological sciences and a better basis on therapy for patients with bleeding disorders is expected. Furthermore the registry is available for other scientific projects.

Chromosomes, Human, X↗
PubMed2002

Compliance and blood pressure control in women with hypertension.

Compliance with treatment is a fundamental prerequisite for therapeutic benefit. The aim of this study is to determine the level of knowledge of hypertension, compliance with recommended antihypertensive therapy, and current blood pressure status in women with hypertension attending a Type V health centre. A pre-tested questionnaire with 37 in-depth items was administered to 30 (37.5%) women, selected by quota sampling, from a population of 80 women with hypertension, on four consecutive regular clinic days in May/June 2001. Weights and the mean of two blood pressure measurements were recorded. Data were analysed using Statistical Package for the Social Sciences (SPSS) version 7.5. The median age and weight of the respondents was 57 years (range 36-85 years) and 80.3 kg (range 66.8-150 kg). Median duration of hypertension was five years. Fifty per cent of the sample were diabetic. The longer the patient had been hypertensive, the greater the compliance with medication (p < 0.05). Twenty per cent of non-diabetics were controlled to blood pressure < or = 140/90 mmHg and 13% of the diabetics were controlled to blood pressure < or = 135/85 mmHg. Twenty per cent reported ill effects from medication; 60% used "folk remedies" such as garlic. Only 27% of patients were fully compliant with medication. Sixty per cent did no exercise, 73% did less than one hour of exercise per week. Diabetics took more exercise than non-diabetics (Z = -2.1, p < 0.05) and were more compliant with medication than non-diabetics (Z = -2.3, p < 0.05). All respondents included salt in their diets and consumed fruits and vegetables only "sometimes". One third believed that hypertension could be "cured". The overall median knowledge score and median compliance score were 50% (range 16.7%-100%) and 31% (range 13%-60%) respectively. This group had inadequate knowledge of hypertension, poor compliance with recommended antihypertensive therapy (JNCVI) and limited BP control. Counselling of these patients in the areas of medication, diet, exercise and weight control is recommended. Further research, using randomized samples, to inform interventions to improve the knowledge, compliance and self-care management of patients with hypertension is indicated.

Adult↗
PubMed1992

When weaning from mechanical ventilation fails.

OBJECTIVE: To describe the etiologies and indicators of weaning failure and to provide a framework for planning interventions to facilitate weaning of long-term ventilation patients. DATA SOURCE: A Medline search of human studies in English on weaning from mechanical ventilation. ARTICLE SELECTION: Articles were selected if they pertained to the assessment and management of weaning failure. Both research and review articles were included. DATA EXTRACTION: All pertinent articles were described, along with their limitations. DATA SYNTHESIS: Weaning from mechanical ventilation is an emerging science. Caring for patients who are difficult to wean requires expert clinical decision making so patients do not feel defeated and have the best chances for success. Combining the limited research on weaning intervention with clinical expertise helps to build a scientific basis for care and can assist clinicians in tailoring interventions to specific problems that precipitate weaning failure. CONCLUSION: A scientific approach to care may promote weaning in difficult cases and provide directions for future research into the etiologies of weaning failure.

Attitude to Health↗