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At least 1,711 records · Page 95Linked to original sources
PubMed2005

[Comparative study of three selective methods for nosocomial pneumonia surveillance in non-critical adult patients].

BACKGROUND AND OBJECTIVE: Among nosocomial infections, pneumonia is one of the most important ones due to the mortality, morbidity and the increase of costs that it causes. The implementation of a cost-effective surveillance system for these infections is a challenge for hospitals. The objective of this work was to evaluate three selective methods of surveillance for nosocomial pneumonias in non-critical adult patients. PATIENTS AND METHOD: A prospective surveillance of nosocomial pneumonias was carried out during 4 months in an university hospital of the Valencian Community, by means of three methods based on reports of chest x-ray, consumption of several antibiotics and health-care workers' liaison. Subsequently, possible cases were confirmed through revision of patient's charts, comparing each method with the reference one. RESULTS: Of 541 possible cases of pneumonia, 27 were confirmed. The cumulative incidence was 3.67 cases/1,000 admissions and the incidence density was 5.9 cases/10,000 patient-days. The method with the highest sensitivity was that dealing with the consumption of antibiotics (85.2%), followed by x-rays (70.4%). The method based on the personnel's liaison had 99.4% specificity, while that of x-rays was 75.5%. Negative predictive values were above 95% for the three methods. CONCLUSIONS: A surveillance system for nosocomial pneumonia based on reports of chest x-rays may be very efficient, providing the necessary information to program and to evaluate the prevention and control activities for these infections in the hospital.

Aged↗
PubMed2002

A note on the decomposition methods for support vector regression.

The dual formulation of support vector regression involves two closely related sets of variables. When the decomposition method is used, many existing approaches use pairs of indices from these two sets as the working set. Basically, they select a base set first and then expand it so all indices are pairs. This makes the implementation different from that for support vector classification. In addition, a larger optimization subproblem has to be solved in each iteration. We provide theoretical proofs and conduct experiments to show that using the base set as the working set leads to similar convergence (number of iterations). Therefore, by using a smaller working set while keeping a similar number of iterations, the program can be simpler and more efficient.

Journal Article↗
PubMedDate not supplied

Cramps and muscular pain: prevention with pycnogenol in normal subjects, venous patients, athletes, claudicants and in diabetic microangiopathy.

The aim of this study was to assess the preventive action of Pycnogenol (Horphag Research Ltd, UK) on cramps and muscular pain in different groups of subjects and patients. The study included a 5-week observation period (4 weeks treatment and one follow-up week after the suspension of treatment) to evaluate the efficacy of Pycnogenol after its withdrawal. Four 50 mg capsules (total dose 200 mg/day) were prescribed with suggestion to drink at least 1.5 liters of water every day. In the first part of the study 66 healthy subjects completed a 5-week follow-up period. The difference between number of cramps attacks recorded within the 2 weeks before inclusion and the number of episodes during the fourth (p <0.05) and fifth (p <0.05) week were statistically significant. In normal subjects the average number of episodes was reduced from 4.8 (1.2) events per week to 1.3 (1.1) at 4 weeks (p <0.05). In venous patients the decrease in events was from 6.3 (1.1) to 2.6 (0.4) per week (p <0.05). In athletes the number of episodes decreased from 8.6 (2) to 2.4 (0.5) (p <0.05). The decrease was still present at 5 weeks in the 3 groups, to levels significantly lower than inclusion values (p <0.05). In the second part of the study, patients with intermittent claudication and diabetic microangiopathy were evaluated and treated (4 weeks). The groups treated with Pycnogenol and the control, placebo groups were comparable. There was a significant decrease in the number of cramps episodes (p <0.05) and in the score concerning muscular pain (p <0.05) in claudicants and diabetics. No significant effects were observed in the placebo groups. In conclusion, cramps and muscular pain, common in these 2 types of patients, were decreased by the use of Pycnogenol. Globally, these results suggest that the use of Pycnogenol prevents cramps, muscular pain at rest, and pain after/during exercise in normals, in athletes prone to cramps, in patients with venous disease, in claudicants, and in diabetics with microangiopathy. The difference is statistically significant considering objective observations (cramps episodes) and evaluating more subjective aspects (score). This indicates that Pycnogenol is effective in reducing pain and cramps during retraining and rehabilitation increasing its efficiency. In starting any physical rehabilitation program, particularly in vascular subjects, the limitation in mobility associated with muscular pain and with cramps tends to be relevant, and controlling these symptoms is useful to speed up the retraining process.

Adult↗
PubMedDate not supplied

Colorectal cancer screening by fecal occult blood testing: results of a population-based experience.

AIMS AND BACKGROUND: The study evaluated the results of an experimental screening protocol for colorectal cancer by fecal occult blood testing in a municipality of the Province of Florence. METHODS: A total of 15,235 subjects aged 50-70 years were invited to perform a 1-day immunochemical fecal occult blood testing without any dietary restrictions. All eligible subjects were sent a personal invitation letter, followed by a postal reminder to non-responders. Subjects with a negative stool test were advised to repeat screening after 2 years. Subjects with a positive screening test were invited to undergo full colonoscopy or a combination of left colonoscopy and a double contrast barium enema. RESULTS: A total of 6,418 subjects performed the screening test, with an overall compliance of 42.1%. A total of 268 compliers had positive test results. The positivity rate was 4.2%. Detection rate for cancer and for adenomas was 5.1% and 11.6%, respectively. The positive predictive value was 14.3% for cancer and 32.5% for adenoma. A higher compliance was recorded in subjects born in the province of Florence or living in the centre of the town, in married subjects, and in women. The best results in compliance were associated with the direct distribution of fecal occult blood testing kits by general practitioners to their outpatients. CONCLUSIONS: The study provides useful information about the efficiency and feasibility of a screening program for colorectal cancer using fecal occult blood testing. Compliance results confirm the importance of GP involvement in oncological screening.

Aged↗
PubMedDate not supplied

Advances in hospital pharmacy computing.

These brief descriptions of hospital pharmacy computer applications only scratch the surface of the many different areas in which they have the potential of being used. As the pharmacy profession becomes more knowledgeable in the application of computers, these systems will be used to the fullest degree. The computer is a very important tool for the pharmacy. A whole new vision of hospital pharmacy can be seen in which pharmacy personnel must master existing systems and instigate a wide variety of new programs in order to create more efficient and wide-ranging services.

Clinical Pharmacy Information Systems↗
PubMed2005

ASPIC: a novel method to predict the exon-intron structure of a gene that is optimally compatible to a set of transcript sequences.

BACKGROUND: Currently available methods to predict splice sites are mainly based on the independent and progressive alignment of transcript data (mostly ESTs) to the genomic sequence. Apart from often being computationally expensive, this approach is vulnerable to several problems--hence the need to develop novel strategies. RESULTS: We propose a method, based on a novel multiple genome-EST alignment algorithm, for the detection of splice sites. To avoid limitations of splice sites prediction (mainly, over-predictions) due to independent single EST alignments to the genomic sequence our approach performs a multiple alignment of transcript data to the genomic sequence based on the combined analysis of all available data. We recast the problem of predicting constitutive and alternative splicing as an optimization problem, where the optimal multiple transcript alignment minimizes the number of exons and hence of splice site observations. We have implemented a splice site predictor based on this algorithm in the software tool ASPIC (Alternative Splicing PredICtion). It is distinguished from other methods based on BLAST-like tools by the incorporation of entirely new ad hoc procedures for accurate and computationally efficient transcript alignment and adopts dynamic programming for the refinement of intron boundaries. ASPIC also provides the minimal set of non-mergeable transcript isoforms compatible with the detected splicing events. The ASPIC web resource is dynamically interconnected with the Ensembl and Unigene databases and also implements an upload facility. CONCLUSION: Extensive bench marking shows that ASPIC outperforms other existing methods in the detection of novel splicing isoforms and in the minimization of over-predictions. ASPIC also requires a lower computation time for processing a single gene and an EST cluster. The ASPIC web resource is available at http://aspic.algo.disco.unimib.it/aspic-devel/.

Algorithms↗
PubMed2025

Nationwide carrier screening for congenital adrenal hyperplasia: integrated approach of CYP21A2 pathogenic variant genotyping and comprehensive large gene deletion analysis.

BACKGROUND: Congenital Adrenal Hyperplasia (CAH) due to 21-hydroxylase deficiency (21-OHD CAH) is an autosomal recessive disorder resulting from pathogenic variants in the CYP21A2 gene. The disorder exhibits variable clinical severity, with the classical form manifesting as salt-wasting crisis in neonates, while inducing ambiguous genitalia in females and precocious puberty in males through simple virilization. Identifying at-risk couples during the preconception stage holds significance for optimizing reproductive choices. METHODS: This study included 204 unrelated preconception individuals undergoing carrier screening. A robust molecular approach was devised for rapid detection of nine prevalent CYP21A2 pathogenic variants, utilizing Amplification-Refractory Mutation System (ARMS) PCR and mass spectrometry (MS) genotyping. Complementary quantitative real-time PCR (qPCR) and PCR-based Restriction Fragment Length Polymorphism (PCR-based RFLP) assays were employed for comprehensive gene deletion analysis. The concordance of pathogenic variant detection between ARMS-PCR and MS, as well as the consistency observed in molecular insights from qPCR and PCR-based RFLP, fortified the accuracy of our methodologies. RESULTS: Our combined method could detect common pathogenic variants and large gene deletions with high concordance between ARMS-PCR, MS genotyping, qPCR, and PCR-based RFLP assays. Remarkably, two carriers exhibited significant large-scale deletions, while another manifested a carrier state due to minor-scale gene conversion. The estimated carrier frequency in our cohort using these methods was approximately 1 in 65 individuals. CONCLUSIONS: The methods used for 21-OHD CAH carrier screening offer a reliable, swift, and cost-effective approach for detecting common pathogenic variants and large deletions. Despite some limitations, such as the inability to detect all rare mutations, the techniques provide a practical solution for carrier screening, with an estimated carrier frequency of 1 in 65 in our study population. These findings support the potential adoption of these methods in national carrier screening programs, offering a practical balance between efficiency and affordability.

Humans↗
PubMed2005

Flexible seasonal timing and migratory behavior: results from stonechat breeding programs.

Rigid schedules of long-distance migrants could be among candidate traits for adaptive migratory syndromes. This prediction was tested on stonechats, passerines that differ widely in migratory behavior and seasonal schedules. Stonechats in Europe are short-distance migrants and multiclutched, whereas African residents and Siberian long-distance migrants usually raise single broods. In captivity, all subspecies displayed endogenous cycles of reproductive development and molt. The subspecies differed in time afforded to life cycle stages. Under conducive aviary conditions, African stonechats were multibrooded, whereas Siberian stonechats did not add clutches. This difference in flexibility was exclusively related to the length of breeding windows. Stonechats also differed in premigratory preparations. Postjuvenile molt started early in Siberian stonechats, but in European and African stonechats, depended strongly on hatching date. In contrast, all subspecies shortened molt duration at the same rate when hatched from late broods. Plasticity of Zugunruhe timing was identical in Siberian and European subspecies and nearly compensated for hatching late. The stonechat data suggest a refined understanding of temporal plasticity in long-distance migrants. Overall, plasticity was not reduced, but was differently organized. Apparently rigid migrant schedules were related to short breeding cycles and inflexible molt onset. Short windows for breeding and juvenile development could provide safety measures for timely departure. Once molt was initiated, temporal plasticity of long-distance migrants matched that of less migratory conspecifics. In addition to adjusting endogenous programs, stonechats differed in implementing them in the field. Modifying the conditions under which programs are expressed may be an efficient way to enhance seasonal plasticity.

Africa↗
PubMed2004

Stem cell transplantation therapy: controversy over ethical issues and clinical relevance.

The possibility of regenerating tissues would provide an effective therapeutic tool for the treatment of many pathological conditions, including neurological diseases, spinal cord injuries, cardiopathies, diabetes, hematological illnesses and genetic disorders. While stem cells may have the potential of regenerating a variety of tissues, as indicated by a number of groundbreaking but preliminary reports, ethical issues and safety considerations seem to preclude the use of human embryonic stem cells in the clinical setting. Adult stem cells might circumvent the issues posed by embryonic stem cells, although the potential plasticity of adult stem cells is under scrutiny because of many conflicting and contradictory reports in the field of stem cell research. Indeed, many aspects of the biology of stem cells are still not known. In this respect, stem cell biologists have to address several pressing issues. A better understanding of stem cell biology would almost certainly allow for the establishment of efficient and reliable cell transplantation experimental programs in the clinic.

Cell Differentiation↗
PubMed2006

emb-4 is a conserved gene required for efficient germline-specific chromatin remodeling during Caenorhabditis elegans embryogenesis.

In C. elegans, germline blastomeres are initially kept transcriptionally quiescent by the maternally loaded CCCH zinc-finger protein PIE-1. PIE-1 disappears upon the birth of the primordial germ cells Z2 and Z3, yet these cells appear to remain quiescent. We have previously demonstrated that there is a chromatin-based repression that succeeds PIE-1 degradation. The chromatin in Z2/Z3 loses certain histone modifications, including histone H3 lysine 4 dimethylation (H3K4me2), a conserved marker for transcriptionally competent chromatin. We find that mutations in the maternal-effect gene emb-4 cause defects in both PIE-1 degradation and germline-specific chromatin remodeling. emb-4 encodes a highly conserved protein with orthologs in fly, mouse, and human and has a subtle role in Notch signaling. The embryonic phenotype of emb-4 is consistent with a defect in the efficient and timely activation of developmental programs, including germline chromatin remodeling. We also find that, as in early somatic blastomeres, the degradation of PIE-1 in Z2/Z3 is facilitated by zinc-finger-interacting protein ZIF-1, and in the absence of either zif-1 or emb-4, PIE-1 is abnormally retained in Z2/Z3.

Animals↗
PubMed2003

Re-establishment of a normal apoptotic process as a therapeutic approach in B-CLL.

Even though the capacity of B-CLL leukemic cells to proliferate has been underestimated until recently, the accumulation of tumor cells in patients mostly results from a defect in the apoptotic program. Several mechanisms can account for this deficient cell death pathway. These include overexpression of anti-apoptotic molecules such as members of the Bcl-2 family, which control the opening of the mitochondrial transition permeability pore, and of the IAP (inhibitors of apoptosis) family, which inhibit the activity of caspases. The latter is also suppressed by nitric oxide (NO) released through an inducible NO synthase present in the leukemic cells. The activity of the receptors with a death domain (Fas, TRAIL) is impaired, thus contributing to the resistance to spontaneous and/or drug-induced apoptosis. Interferons as well as several cytokines and angiogenic factors are also involved in the failure of programmed cell death, either by providing efficient signals for survival (BAFF) or by counteracting the apoptotic process. A better knowledge of the mechanisms of survival and escape from apoptosis of B-CLL cells has led to the proposal of new drugs that selectively interfere at the different steps of these cascades. Their study is complicated by the lack of suitable cell lines and pre-clinical models. Nevertheless, some of these chemotherapeutic agents appear to be promising, provided they are correctly targeted to the leukemic cells.

Animals↗
PubMedDate not supplied

Uncertainty analysis in QUAL2E model of Zayandeh-Rood River.

Water-quality modeling and prediction is a complicated task because of inherent randomness and uncertainties associated with various processes and variables throughout the stream environment and the lack of appropriate data. Hence, the results of mathematical models are always approximate, lying within an uncertainty. This paper describes and demonstrates the application of the U.S. Environmental Protection Agency's water-quality model, QUAL2E-UNCAS, to the Zayandeh-Rood River in Iran. First-order reliability analysis is used to examine the variability of predicted water-quality parameters of total dissolved solids, dissolved oxygen, and biochemical oxygen demand. This analysis also determines key sources of uncertainty affecting prediction of the water-quality parameters. The results show that reliability analysis can help water-quality modelers and planners to quantify the reliability of the water-quality predictions and to carry out more efficiently planned sampling and data collection programs to reduce model-prediction uncertainty.

Forecasting↗
PubMedDate not supplied

Organizing the present, looking to the future: an online knowledge repository to facilitate collaboration.

BACKGROUND: Comprehensive data available in the Canadian province of Manitoba since 1970 have aided study of the interaction between population health, health care utilization, and structural features of the health care system. Given a complex linked database and many ongoing projects, better organization of available epidemiological, institutional, and technical information was needed. OBJECTIVE: The Manitoba Centre for Health Policy and Evaluation wished to develop a knowledge repository to handle data, document research Methods, and facilitate both internal communication and collaboration with other sites. METHODS: This evolving knowledge repository consists of both public and internal (restricted access) pages on the World Wide Web (WWW). Information can be accessed using an indexed logical format or queried to allow entry at user-defined points. The main topics are: Concept Dictionary, Research Definitions, Meta-Index, and Glossary. The Concept Dictionary operationalizes concepts used in health research using administrative data, outlining the creation of complex variables. Research Definitions specify the codes for common surgical procedures, tests, and diagnoses. The Meta-Index organizes concepts and definitions according to the Medical Sub-Heading (MeSH) system developed by the National Library of Medicine. The Glossary facilitates navigation through the research terms and abbreviations in the knowledge repository. An Education Resources heading presents a web-based graduate course using substantial amounts of material in the Concept Dictionary, a lecture in the Epidemiology Supercourse, and material for Manitoba's Regional Health Authorities. Confidential information (including Data Dictionaries) is available on the Centre's internal website. RESULTS: Use of the public pages has increased dramatically since January 1998, with almost 6,000 page hits from 250 different hosts in May 1999. More recently, the number of page hits has averaged around 4,000 per month, while the number of unique hosts has climbed to around 400. CONCLUSIONS: This knowledge repository promotes standardization and increases efficiency by placing concepts and associated programming in the Centre's collective memory. Collaboration and project management are facilitated.

Databases as Topic↗
PubMed2005

Free text versus structured format: information transfer efficiency of radiology reports.

OBJECTIVE: We discuss the effect of radiology report format on the accuracy and speed with which reviewers can extract case-specific information. MATERIALS AND METHODS: A Web-based testing mechanism was used to present radiology reports to each of 16 senior medical students and record their answers to 10 multiple choice questions about specific medical content for each of 12 cases. Subjects were randomly assigned to view the reports in either free text or structured format. In addition to number of answers correct for each case, we recorded the time taken for each case and an efficiency score (correctly answered questions per minute). These three outcomes were tested for differences on report format using multifactorial analysis of variance. A postexperimental questionnaire and a mediated focus group elicited subject preference as to radiology report format. RESULTS: There were no significant differences in the three outcomes (score, time, and efficiency) between the free text and structured format conditions. The power of the experiment was sufficient to detect small differences in these outcomes by format. Subjects strongly and consistently expressed a preference for the structured version. CONCLUSION: We assert that free text and itemized (structured) forms of radiology reports are equally efficient and accurate for transmitting case-specific interpretative content to reviewers of the document.

Adult↗
PubMed1996

Computerised psychoeducation for patients with eating disorders.

OBJECTIVE: To assess a new computer-based method of health education for patients with bulimia and anorexia nervosa. METHOD: Fifty-four patients with DSM-III-R diagnosed eating disorders were allocated randomly to one of two groups, one receiving a computer-presented health education package called DIET, the other experiencing a placebo computer-based program. Each group contained 14 anorexia nervosa patients, four anorexic patients with bulimia and nine bulimic patients. Groups were equivalent in terms of the severity of their eating disorder as measured on the Eating Disorders inventory and their estimated premorbid intelligence according to the National Adult Reading Test. Both groups were assessed before and after intervention on a questionnaire measuring knowledge of eating disorders and a questionnaire measuring attitudes to eating-disordered behaviour. RESULTS: The DIET group members were significantly improved when compared to the placebo group in terms of both their knowledge and attitudes towards their disorder. The patients rated the DIET program as being both easy to use and helpful. CONCLUSION: The DIET program has been found to be a resource-efficient means of health education for patients with eating disorders. Further research is required to assess whether the program has therapeutic effects in terms of behavioural improvement.

Adolescent↗
PubMed1999

The PowerChecker: a visual basic program for ensuring data integrity.

Data entry and encoding errors can jeopardize the integrity of data sets generated in a variety of research settings. Despite researchers' pursuits of more accurate entry methods, data entry errors persist. Although techniques exist for identifying such errors, the PowerChecker program described here provides a more efficient method of data set validation. Rather than enter data twice and then manually search for the correct values when there are discrepancies between the two sets, with PowerChecker the user can correct entry errors as the data are entered the second time. In addition, the time-stamped record of changes to the original data set aids in meeting quality assurance requirements of the Good Clinical Practice standards.

Data Interpretation, Statistical↗
PubMed2005

[The effects of a self-management program on physical function and quality of life of patients with knee osteoarthritis].

PURPOSE: This study was to examine the effects of a Self-management program on physical function and quality of life of women with knee osteoarthritis. METHOD: The participants for this study, who had knee osteoarthritis, were recruited from an arthritis clinic, at a university hospital located in S city, Korea between February 16, 2004 and June 15, 2004. Seventeen subjects in the control group received no intervention and 18 subjects in for experimental group received an individual Self-management program. The self-management program consisted of dietary education and home-based exercise; walking and resistance exercise. The subjects performed this program 5 times per week during 8 weeks and recorded a diary for diet and exercise. In order to verify the effects of the Self-management program, physical function and Quality of life as a dependent variable were measured at three points in time: before, week 4 and week 8 after the interventions. RESULT: There were significant increases on physical function (F=5.08, p=.002) and significant interaction effects (F=7.42, p=.002) in the intervention group over the three measurement points in time. In addition, there were significant increases on quality of life (F=8.08, p=.002) and significant interaction effects (F=4.89, p=.016) in the intervention group over the three measurement points in time. CONCLUSION: This study revealed that a Self-management program can be used as an efficient nursing intervention for women with knee osteoarthritis.

Activities of Daily Living↗