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At least 1,747 records · Page 97Linked to original sources
PubMed1985

Microtome: histopathology day book based on a microcomputer system.

The development of a histopathology day book based on a microcomputer is described. The system has the capacity to search on file records for details of previous specimens from current patients. It also possesses a SNOP/SNOMED input and search system that can aggregate data for analytical and other purposes. The system is relatively inexpensive and is user friendly. It has been developed within and is exclusively devoted to the requirements of a histopathology department and is designed to permit expansion to a multiuser system.

Computers↗
PubMed2000

Survey of symptoms, respiratory function, and immunology and their relation to glutaraldehyde and other occupational exposures among endoscopy nursing staff.

OBJECTIVES: To find the nature and incidence of symptoms experienced by a large sample of hospital endoscopy nurses. To find whether nurses in endoscopy units develop asthma under current working conditions in endoscopy units. To obtain analytically reliable data on exposure concentrations of glutaraldehyde (GA) vapour in endoscopy units, and to relate them to individual hygiene and work practices. To characterise any exposure-response relations between airborne GA and the occurrence of work related symptoms (WRSs). Due to the growing concern about the perceived increase in WRSs among workers regularly exposed to biocides, all of whom work within a complex multiexposure environment, a cross sectional study was designed. METHODS: Current endoscopy nurses (n=348) from 59 endoscopy units within the United Kingdom and ex-employees (who had left their job for health reasons (n=18) were surveyed. Symptom questionnaires, end of session spirometry, peak flow diaries, skin prick tests (SPTs) to latex and common aeroallergens, and measurements of total immunoglobulin E (IgE) and IgE specific to GA and latex were performed. Exposure measurements included personal airborne biocide sampling for peak (during biocide changeover) and background (endoscopy room, excluding biocide changeover) concentrations. RESULTS: All 18 ex-employees and 91.4% of the current nurses were primarily exposed to GA, the rest were exposed to a succinaldehyde-formaldehyde (SF) composite. Work related contact dermatitis was reported by 44% of current workers exposed to GA, 56.7% of those exposed to SF composite, and 44.4% of ex-employees. The prevalence of WRSs of the eyes, nose, and lower respiratory tract in current workers exposed to GA was 13.5%, 19.8%, and 8.5% respectively and 50%, 61.1%, and 66.6% in the ex-employees. The mean percentage predicted forced expired volume in 1 second (ppFEV(1)) for ex-employees (93.82, 95% confidence interval (95% CI) 88.53 to 99.11) was significantly lower (p<0.01) than that of current workers exposed to GA (104.08, 95% CI 102.35 to 105.73). Occupational peak flow diaries completed by current workers with WRSs of the lower respiratory tract showed no evidence of bronchial asthma (<15% variation). Six per cent of the population had positive latex SPTs. Positive indications of one GA specific IgE and 4.1% latex specific IgE occurred. There was no conformity between the latex specific IgE and positive SPTs. Positive SPTs to latex were associated with WRSs of dermatitis and ocular WRSs, but no other WRSs. Exposures were above the current maximum exposure limit (MEL) of 0.2 mg/m(3) (0.05 ppm) in eight of the units investigated. A significant relation existed between peak GA concentrations and work related chronic bronchitis and nasal symptoms (after adjustment for types of local ventilation) but not to other WRSs. Peak GA concentrations were significantly higher in units that used both negative pressure room and decontaminating unit ventilation. CONCLUSION: This study documents a significant level of symptoms reported in the absence of objective evidence of the physiological changes associated with asthma. Ex-employees and current workers with WRSs warrant further study to elucidate the cause and mechanisms for their symptoms. Ventilation systems used for the extraction of aldehydes from the work area may be less effective than expected and due to poor design may even contribute to high peak exposures.

Air Pollutants, Occupational↗
PubMed2003

Systematic reviews of the effectiveness of quality improvement strategies and programmes.

Systematic reviews provide the best evidence on the effectiveness of healthcare interventions including quality improvement strategies. The methods of systematic review of individual patient randomised trials of healthcare interventions are well developed. We discuss methodological and practice issues that need to be considered when undertaking systematic reviews of quality improvement strategies including developing a review protocol, identifying and screening evidence sources, quality assessment and data abstraction, analytical methods, reporting systematic reviews, and appraising systematic reviews. This paper builds on our experiences within the Cochrane Effective Practice and Organisation of Care (EPOC) review group.

Canada↗
PubMed1983

Reconstruction of preverbal experiences.

Only a few analysts (Deutsch, 1947, 1952; Braatøy, 1954) have systematically tried to investigate how nonverbal behavior may be derived from events and experiences from the preverbal phase of development. Their approaches to the analysis of such behavior differ. Extracts of an analysis are used to illustrate basic technical and theoretical questions with regard to the possibility of making use of nonverbal material to reconstruct preverbal experiences. It is inferred that the analyst's visual observations of the patient's nonverbal behavior may be a cue to significant events and trauma from the preverbal period. Besides, the specific visual imagery of the patient that, in this case, emerged just after the appearance of nonverbal behavior, may be a valuable source of data for analytic reconstruction.

Child, Preschool↗
PubMed2002

Cost-benefit analysis of a new health insurance card and electronic prescription in Germany.

A new (electronic) health insurance card for Germans could eliminate errors in documenting exemption from charges. Electronic prescribing, if introduced nationally, would lead to improved medication-related information and the availability of structural and control data. An analytical model for Germany has shown that DM1 billion would be saved from improved prescription information simply in terms of the number of avoided hospital stays now paid for by the health-care system. However, the distribution of costs and benefits among the participants in health-care would be very uneven. For example, doctors would have the largest investment and operating costs, but would enjoy only marginal savings (less than 2% of investment).

Cost-Benefit Analysis↗
PubMed2004

Rationale for a non-inferiority clinical trial design focused on subpopulations.

Although double-blind, placebo-controlled clinical trials are utilized extensively to characterize the efficacy and safety of new treatment options, the characteristics of the trial participants often do not reflect those of the wider patient population. In most cases, one or more patient subgroups (whether defined by race, ethnicity, co-morbidity, concomitant medication, age, or gender) will be under-represented. Understanding treatment responses in these subpopulations is a vital component of the overall therapeutic profile of a medication. Several different approaches to subgroup analyses within a single trial have been described. In addition, meta-analytic and data pooling approaches utilize results from multiple clinical trials of similar design to increase the number of patients within a targeted subgroup. If the results from exploratory analyses are suggestive of a clinically relevant difference in treatment response for a particular subgroup, then implementation of a prospectively designed clinical trial may be warranted. In this commentary, we discuss the design and results of various studies that include subgroup analyses. In addition, we describe a novel study design with a non-inferiority subpopulation analysis (NISA) that may provide new insights with respect to subgroup analyses. The NISA study design relies on characterization of the dominant group of patients recruited to date in placebo-controlled trials. In the NISA study, the group of patients with those same characteristics is referred to as the Core group. The other key features of the NISA design include non-inferiority analyses comparing subgroups to the Core group and study conditions closely aligned with routine clinical practice (heterogeneous study population and open-label drug administration without placebo). Limitations of the NISA design include the requirement of previously conducted placebo-controlled trials, the inability to compare treatment response to placebo, and that NISA has yet to be validated in practice. We also describe the implementation of the NISA study design in two ongoing clinical trials. After completion of these two studies, the practical value of the NISA design can be more thoroughly evaluated.

Clinical Trials as Topic↗
PubMed2004

An application of conditional logistic regression and multifactor dimensionality reduction for detecting gene-gene interactions on risk of myocardial infarction: the importance of model validation.

BACKGROUND: To examine interactions among the angiotensin converting enzyme (ACE) insertion/deletion, plasminogen activator inhibitor-1 (PAI-1) 4G/5G, and tissue plasminogen activator (t-PA) insertion/deletion gene polymorphisms on risk of myocardial infarction using data from 343 matched case-control pairs from the Physicians Health Study. We examined the data using both conditional logistic regression and the multifactor dimensionality reduction (MDR) method. One advantage of the MDR method is that it provides an internal prediction error for validation. We summarize our use of this internal prediction error for model validation. RESULTS: The overall results for the two methods were consistent, with both suggesting an interaction between the ACE I/D and PAI-1 4G/5G polymorphisms. However, using ten-fold cross validation, the 46% prediction error for the final MDR model was not significantly lower than that expected by chance. CONCLUSIONS: The significant interaction initially observed does not validate and may represent a type I error. As data-driven analytic methods continue to be developed and used to examine complex genetic interactions, it will become increasingly important to stress model validation in order to ensure that significant effects represent true relationships rather than chance findings.

Gene Expression Regulation↗
PubMed2002

Organochlorine pollutants [corrected] in California sea lions revisited.

BACKGROUND: Dichlorodiphenyltrichloroethane (DDT) and polychlorinated biphenyls (PCBs) are ubiquitous environmental contaminants that have been banned in most countries, but considerable amounts continue to cycle the ecosphere. Top trophic level predators, like sea birds and marine mammals, bioaccumulate these lipophilic compounds, reflecting their presence in the environment. RESULTS: We measured concentrations of tDDT (p,p' - DDT + p,p' - DDD + p,p' - DDE) and PCBs in the blubber of dead California sea lions stranded along the California coast. tDDT and PCB concentrations were 150 +/- 257 ug/g lipid weight (mean +/- SD) and 44 +/- 78 ug/g lipid weight, respectively. There were no differences in tDDT or PCB concentrations between animal categories varying in sex or age. There was a trend towards a decrease in tDDT and PCB concentrations from northern to southern California. The lipid content of the blubber was negatively correlated with levels of tDDT and PCBs. tDDT concentrations were approximately 3 times higher than PCB concentrations. CONCLUSIONS: tDDT levels in the blubber of California sea lions decreased by over one order of magnitude from 1970 to 2000. PCB level changes over time were unclear owing to a paucity of data and analytical differences over the years. Current levels of these pollutants in California sea lions are among the highest among marine mammals and exceed those reported to cause immunotoxicity or endocrine disruption.

Adipose Tissue↗
PubMed2026

Machine learning-based clinical prediction model and multi-omics integration for assessing pancreatic cancer risk in new-onset diabetes.

BACKGROUND: Given that pancreatic cancer (PC) is typically diagnosed at an advanced stage but is often preceded by new-onset diabetes mellitus (NODM), providing a window for early detection, we sought to develop and validate an interpretable machine-learning model integrated with multi-omics profiling to identify early biomarkers of NODM-associated PC. METHODS: In a population-based cohort, individuals with NODM-associated PC and NODM without PC were identified and randomly divided (70:30) into training and validation sets after feature selection. Eight machine learning (ML) classifiers were compared using fivefold cross-validation, and model performance was evaluated in terms of discrimination, calibration, and decision curve&#x2013;based clinical utility. We evaluated interpretability using the Shapley additive explanations (SHAP) analyses. Mechanistically, Olink proteomic profiling and metabolomics were analyzed through clinical classifications and model-defined risk strata. RESULTS: Categorical boosting achieved the best performance in the independent validation set (AUROC&#x2009;=&#x2009;0.844). The NODM cohort was stratified into high- (n&#x2009;=&#x2009;2,362) and low-risk (n&#x2009;=&#x2009;5,030) groups, and internal validation together with SHAP analyses demonstrated consistent model performance and identified clinically interpretable predictors. Proteomic and metabolomic analyses under clinical and risk-based grouping identified 39 overlapping differentially expressed proteins and 145 overlapping metabolites with enriched across 11 shared KEGG pathways. Cross-platform validation highlighted PLTP, CRTAC1, and ITGAV as serum biomarkers with a strong potential for early NODM-PC detection. CONCLUSIONS: We developed an interpretable ML framework centered on NODM enables practical risk stratification for early PC detection by multi-omics and provides a pathway of ML-based triage followed by biomarker confirmation for earlier detection and diagnosis.

Humans↗
PubMed1998

Stepping backward to improve assessment of PCB congener toxicities.

Polychlorinated biphenyls (PCBs) are ubiquitous global contaminants that have been intensively investigated for three decades. They are broad-acting toxicants occurring in complex mixtures and accurate risk assessment has proven to be elusive. Focusing on a limited set of end points and emphasizing a fixed set of congeners have led to more streamlined data sets that are meant to expedite hazard characterization and risk assessment for the most potent congeners--aryl hydrocarbon receptor (AhR) agonists. Unfortunately, this has made it impossible to confirm or deny significant contributions from the more prevalent components of the mixtures. PCBs may be only coincidentally present, rather than causal, in some diseases. Still, attempts to determine associations with incomplete residue data may lead to erroneous conclusions and make accurate risk assessment even more elusive. Responses not mediated through the AhR are presented and emphasize large data gaps. Dissimilar analytical reports emphasize that selection of analytes is not consistent. Collectively, these data confirm that AhR-focused objectives unintentionally created the impression that nonplanar PCBs have little if any potential for hazards to humans and wildlife. Near steady-state exposure of healthy adults are probably of minor consequence except for emerging correlations with non-Hodgkin's lymphoma; however, pulses of exposure to more labile mixtures may contribute to developmental effects without leaving a residue record. More broadly based criteria are suggested and harmonization of data collection and presentation are desirable. A more comprehensive list of PCB congeners is proposed that would provide more adequate data upon which to base associations with adverse outcomes.

Animals↗
PubMed1987

Diffuse interstitial pulmonary disease from the perspective of the clinician.

Diffuse interstitial pulmonary disease encompasses a large number of diverse entities having in common the diffuse infiltration of alveolar walls by inflammatory or malignant cells, connective tissue, or fluid that impairs transfer of oxygen to blood. Pertinent clues to the diagnosis may be obtained by careful analysis of history, physical examination, chest roentgenogram, pulmonary function, and other laboratory data. This analytic process is referred to as the "algorithmic synthesis." This synthesis can guide the clinician in the selection of tissue sampling techniques most likely to confirm the diagnosis.

Algorithms↗
PubMed2001

Teratogenicity testing of BI 58 EC (38% dimethoate) in chicken embryos with special respect to degradation of the active ingredient.

The insecticide formulation BI 58 EC was tested for teratogenicity in chicken embryos, with particular reference to degradation of the active ingredient (dimethoate) after the treatment of embryonated eggs. The pesticide was diluted in water to a concentration level of 0.8%, and the emulsion was injected into the air space in a volume of 0.1 ml/egg, or hen's eggs were treated by the immersion technique. Residues of dimethoate were measured in the samples on days, 13, 15 and 19 of the incubation of chicken embryos, and morphological examinations were performed simultaneously. Analytical chemistry data indicated a slower degradation of dimethoate in embryos after the immersion of eggs, and cyllosis was remarkable in this group among the sporadic developmental anomalies. The liver tissues of both treated groups exhibited severe fatty infiltration.

Abnormalities, Drug-Induced↗
PubMed1999

Degradation of some pesticides in avian embryos.

On day 9 or 12 of the hatching period different pesticides (parathion, methyl-parathion, carbendazim, 2,4-D-amine Na, phosmethylane) were applied in ecotoxicological trials. The formulations were either injected into the air space of pheasant, quail or hen eggs or hen eggs were treated by the immersion technique. The residues of pesticides were measured in samples on days 13, 14 and 16 of incubation of chicken and pheasant embryos, while the Japanese quail embryos were analysed on days 10-14 of incubation. Analytical chemistry data showed a varying degradation rate of the compounds in avian embryos of the same species. The residues directly affect the embryos, disturbing their normal development and causing pathophysiological and morphological changes.

2,4-Dichlorophenoxyacetic Acid↗
PubMed2004

Metabonomics and its role in drug development and disease diagnosis.

This article describes the new approach known as metabonomics, a combination of data-rich analytical chemistry and chemometrics for profiling metabolism in complex systems. Two main analytical approaches have been used, namely nuclear magnetic resonance spectroscopy and mass spectrometry, however, most literature on mammalian systems pertains to nuclear magnetic resonance spectroscopy. The technologies are reviewed in relation to other -omics, and how these methods can be applied to drug safety assessment, characterization of genetically modified animal models of disease, diagnosis of human disease and drug therapy monitoring is demonstrated.

Animals↗
PubMedDate not supplied

[Reflection on the significance of the family health theme in the teaching of nursing graduate studies].

This study is about the insertion and performance of the recently graduated nurses in the Family Health Program (FHP). Its aims are: to analyze the contributions of the educational process for the nursing practice in the FHP; to verify if nursing professionals feel secure about their capacity to work FHP after going through the nursing course with its specific curriculum; to discuss the difficulties faced by these professionals in this program. This is a qualitative, descriptive and analytical research. Data was obtained through semistructured interviews with 15 nursing professionals graduated since 1997. Through data analysis two categories were identified: the first was the professional qualification of first aid nursing professionals, the second was difficulties and satisfaction of these professionals as participating in the FHP. Results showed that there is a need for a better approach regarding family health in the undergraduate courses.

Brazil↗
PubMed2005

[Therapeutic relationship and teaching of mental health and psychiatric nursing: trends in the state of São Paulo].

This study presents a panorama of the insertion of the thematic of therapeutic relationship and therapeutic communication in undergraduate courses in Nursing in the public universities of the State of São Paulo. This is a qualitative and descriptive-analytical research. Data was collected through a questionnaire applied on professors of the area of Psychiatric Nursing and Mental Health from 8 schools and grouped according to the institution, the disciplines, the program and the objectives of the practical activities and practical fields. It was verified that most schools include the therapeutic relationship in their teaching approach, which makes possible the rescue of Nursing as a profession that is concerned with the human being in his/her complexity, in which the know-how is directed to the respect of the patients' limitations, potentialities, needs and interpersonal relations.

Brazil↗