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PubMed2006

Role of human beta-defensins in HIV infection.

Mechanisms of resistance to HIV-1 infection in the human oral cavity are incompletely understood. While salivary components have been implicated in protection, there is growing evidence that human beta-defensins (hBDs), originating in oral epithelial cells, may be playing an important role in the prevention of HIV infection. New antiviral, chemotactic, and immunosurveillance properties are being attributed to hBDs, which are small cationic antimicrobial innate response molecules expressed in mucosal epithelium. Inducible hBDs are always expressed in normal oral epithelium, a property not shared by other mucosal barriers. Data reviewed in this paper demonstrate that: (1) HIV-1 X4 and R5 phenotypes induce hBD-2 and -3 mRNA in normal human oral epithelial cells; (2) hBD-2 and -3 inhibit HIV-1 infection by both viral strains, with greater activity against X4 viruses; and (3) this inhibition is due to a direct interaction with virions and through modulation of the CXCR4 co-receptor. These properties may be exploited as strategies for mucosal protection against HIV-1 transmission.

Animals↗
PubMed2004

A common founder mutation in FANCA underlies the world's highest prevalence of Fanconi anemia in Gypsy families from Spain.

Fanconi anemia (FA) is a genetic disease characterized by bone marrow failure and cancer predisposition. Here we have identified Spanish Gypsies as the ethnic group with the world's highest prevalence of FA (carrier frequency of 1/64-1/70). DNA sequencing of the FANCA gene in 8 unrelated Spanish Gypsy FA families after retroviral subtyping revealed a homozygous FANCA mutation (295C>T) leading to FANCA truncation and FA pathway disruption. This mutation appeared specific for Spanish Gypsies as it is not found in other Gypsy patients with FA from Hungary, Germany, Slovakia, and Ireland. Haplotype analysis showed that Spanish Gypsy patients all share the same haplotype. Our data thus suggest that the high incidence of FA among Spanish Gypsies is due to an ancestral founder mutation in FANCA that originated in Spain less than 600 years ago. The high carrier frequency makes the Spanish Gypsies a population model to study FA heterozygote mutations in cancer.

Codon, Nonsense↗
PubMed2002

GPR99, a new G protein-coupled receptor with homology to a new subgroup of nucleotide receptors.

BACKGROUND: Based on sequence similarity, the superfamily of G protein-coupled receptors (GPRs) can be subdivided into several subfamilies, the members of which often share similar ligands. The sequence data provided by the human genome project allows us to identify new GPRs by in silico homology screening, and to predict their ligands. RESULTS: By searching the human genomic database with known nucleotide receptors we discovered the gene for GPR99, a new orphan GPR. The mRNA of GPR99 was found in kidney and placenta. Phylogenetic analysis groups GPR99 into the P2Y subfamily of GPRs. Based on the phylogenetic tree we propose a new classification of P2Y nucleotide receptors into two subgroups predicting a nucleotide ligand for GPR99. By assaying known nucleotide ligands on heterologously expressed GPR99, we could not identify specifically activating substances, indicating that either they are not agonists of GPR99 or that GPR99 was not expressed at the cell surface. Analysis of the chromosomal localization of all genes of the P2Y subfamily revealed that all members of subgroup "a" are encoded by less than 370 kb on chromosome 3q24, and that the genes of subgroup "b" are clustered on one hand to chromosome 11q13.5 and on the other on chromosome 3q24-25.1 close to the subgroup "a" position. Therefore, the P2Y subfamily is a striking example for local gene amplification. CONCLUSIONS: We identified a new orphan receptor, GPR99, with homology to the family of G protein-coupled nucleotide receptors. Phylogenetic analysis separates this family into different subgroups predicting a nucleotide ligand for GPR99.

Journal Article↗
PubMed2004

An increasing number of qualitative research papers in oncology and palliative care: does it mean a thorough development of the methodology of research?

BACKGROUND: In the second half of the nineties, a scientific debate about the usefulness of qualitative research in medicine began in the main medical journals as well as the amount of "qualitative" papers published on peer reviewed journals has noticeably increased during these last years. Nevertheless the label of qualitative methodology has been assigned to an heterogeneous collection of studies. Some of them show a complete awareness of the specificity of this kind of research, while others are still largely influenced by the quantitative paradigm prevailing in the medical field. The concern with the rigour and credibility of qualitative methods has lead to the development of a number of checklist for assessing qualitative research. The purposes of this review were to describe the quality of the development of qualitative research in the medical field, focusing on oncology and palliative care, and to discuss the applicability of a descriptive checklist. METHODS: A review was conducted on Medline and PsycINFO databases. On the basis of their abstract, papers found have been classified considering: publication year, kind of journal, paper type, data gathering method, sample size and declared methodological approach. A sub sample of the previous papers was than selected and their methodological characteristics were evaluated based on a descriptive checklist. RESULTS: 351 abstracts and 26 full papers were analysed. An increase over time in the number of qualitative studies is evident. While most of the papers before 1999 were published on nursing journals (43%), afterwards also medical journals were largely represented. Psychological journals increased from 7% to 12%. The 22% of studies used a sample size lower than 15 and the 15% did not specify the sample size in the abstract. The methodological approach was also often not specified and the percentage increased in the second time period (from 73% to 80%). Grounded theory was the most employed methodological approach while phenomenology shows a decrease. Interview remains the most used data gathering method in both periods, even if it shows a 10% reductions, while focus group and multiple methods application both increase to 12%. The use of the descriptive checklist on the full text of the 26 papers shows that all the items present a larger percentage of satisfaction after 1 January 1999 than it was for the paper published before 1999. There seems to be two different types of quality criteria: specific and unspecific. The first ones mainly refer to qualitative paradigm (such as the relationship with the subject of research or evidence about how subjects perceived the research) and they are often not satisfied. In contrast unspecific criteria (such as the connection to an existing body of knowledge or systematic data gathering) which are mainly shared with the quantitative paradigm are more frequently satisfied. CONCLUSIONS: In oncology and palliative care the publication of qualitative studies increased during the nineties, reaching its peak in around 2000. The use of descriptive checklists even if it was not easy to apply, allows researchers to get a deeper insight into methodological facets that a global judgement may leave out.

Bibliometrics↗
PubMed2004

Peer support groups in multiple sclerosis: current effectiveness and future directions.

Peer support programs have become a common method of providing support for patients with chronic illness. Utilizing peers as resources has been proposed as an effective means for coping with a stressful life experience and for gaining support from others who share a common factor, although data are somewhat mixed on the efficacy of peer support. The aim of the present study was to evaluate the effectiveness of eight weeks of a standard form of peer support in improving quality of life and reducing depressive symptoms in 44 patients with multiple sclerosis (MS). One person from each of six groups participated in a training course in order to learn basic principles of peer support. Eight weekly sessions were held and patients completed self-administered questionnaires pre- and post-treatment assessing quality of life and depression. Results showed that support groups do not provide consistent improvement in quality of life or depression in patients with MS and suggest that patients who have better mental health functioning could be at risk for deterioration in support groups.

Depression↗
PubMed2005

Network basics for telemedicine.

Early telemedicine networks employed dedicated telecommunications circuits (e.g. leased digital lines) in which the sender and receiver were connected by a private circuit. More recently, the Internet has become widely available for general use, including telemedicine. The Internet was engineered to permit network paths to be shared by all users, so data transmission is fundamentally different from traditional, circuit-switched networks. Early telemedicine applications demonstrated the feasibility of Internet Protocol transmission. The basic performance criteria to use in evaluating newer digital communications technologies that carry both voice and data are: (1) bandwidth; (2) packet loss; (3) end-to-end delay; (4) jitter; (5) privacy and security. Network engineering involves performance trade-offs between the hardware, architecture, security and the budget available. A telemedicine application may be running over a network whose design is entirely under the user's control, or the application may employ some part of the Internet whose design is unknown to the user. If an application is not running to satisfaction, then a network engineer should be consulted.

Confidentiality↗
PubMed2006

Neural basis of embodiment: distinct contributions of temporoparietal junction and extrastriate body area.

Embodiment, the sense of being localized within one's physical body, is a fundamental aspect of the self. Recently, researchers have started to show that self and body processing require distinct brain mechanisms, suggesting two posterior brain regions as key loci: the temporoparietal junction (TPJ), which is involved in self processing and multisensory integration of body-related information; and the extrastriate body area (EBA), which responds selectively to human bodies and body parts. Here we used evoked potential mapping and a distributed linear inverse solution to show that activations in EBA and TPJ code differentially for embodiment and self location, because the location and timing of brain activation depended on whether mental imagery is performed with mentally embodied (EBA) or disembodied (TPJ) self location. In a second experiment, we showed that only EBA activation, related to embodied self location, but not TPJ activation, related to disembodied self location, was modified by the subjects' body position during task performance (supine or sitting). This suggests that embodied self location and actual body location share neural mechanisms. Collectively, these data show that distributed brain activity at the EBA and TPJ as well as their timing are crucial for the coding of the self as embodied and as spatially situated within the human body.

Adult↗
PubMed2000

Baby CareLink: using the internet and telemedicine to improve care for high-risk infants.

OBJECTIVE: To evaluate an Internet-based telemedicine program designed to reduce the costs of care, to provide enhanced medical, informational, and emotional support to families of very low birth weight (VLBW) infants during and after their neonatal intensive care unit (NICU) stay. BACKGROUND: Baby CareLink is a multifaceted telemedicine program that incorporates videoconferencing and World Wide Web (WWW) technologies to enhance interactions between families, staff, and community providers. The videoconferencing module allows virtual visits and distance learning from a family's home during an infant's hospitalization as well as virtual house calls and remote monitoring after discharge. Baby CareLink's WWW site contains information on issues that confront these families. In addition, its security architecture allows efficient and confidential sharing of patient-based data and communications among authorized hospital and community users. DESIGN/METHODS: A randomized trial of Baby CareLink was conducted in a cohort of VLBW infants born between November 1997 and April 1999. Eligible infants were randomized within 10 days of birth. Families of intervention group infants were given access to the Baby CareLink telemedicine application. A multimedia computer with WWW browser and videoconferencing equipment was installed in their home within 3 weeks of birth. The control group received care as usually practiced in this NICU. Quality of care was assessed using a standardized family satisfaction survey administered after discharge. In addition, the effect of Baby CareLink on hospital length of stay as well as family visitation and interactions with infant and staff were measured. RESULTS: Of the 176 VLBW infants admitted during the study period, 30 control and 26 study patients were enrolled. The groups were similar in patient and family characteristics as well as rates of inpatient morbidity. The CareLink group reported higher overall quality of care. Families in the CareLink group reported significantly fewer problems with the overall quality of care received by their family (mean problem score: 3% vs 13%). In addition, CareLink families also reported greater satisfaction with the unit's physical environment and visitation policies (mean problem score: 13% vs 50%). The frequency of family visits, telephone calls to the NICU, and holding of the infant did not differ between groups. The duration of hospitalization until ultimate discharge home was similar in the 2 groups (68.5 +/- 28.3 vs 70.6 +/- 35.6 days). Among infants born weighing <1000 g (n = 31) there was a tendency toward shorter lengths of stay (77.4 +/- 26.2 vs 93.1 +/- 35.6 days). All infants in the CareLink group were discharged directly to home whereas 6/30 (20%) of control infants were transferred to community hospitals before ultimate discharge home. CONCLUSIONS: CareLink significantly improves family satisfaction with inpatient VLBW care and definitively lowers costs associated with hospital to hospital transfer. Our data suggest the use of telemedicine and the Internet support the educational and emotional needs of families facilitating earlier discharge to home of VLBW infants. We believe that further extension of the Baby CareLink model to the postdischarge period will significantly improve the coordination and efficiency of care.

Aftercare↗
PubMed2006

Impact of parasite sympatry on the geographic mosaic of coevolution.

Slave-making ants are specialized social parasites that steal the young from colonies of their host species to augment their slave supply. The degree of parasite-host specialization has been shown to shape the trajectory along which parasites and hosts coevolve and is a prime contributor to the geographic mosaic of coevolution. However, virtually nothing is known about extrinsic influences on parasite-host dynamics, although the simple addition of a competing slave-maker may significantly alter selection pressures. Here we report the effect of two sympatric slave-makers on a single host. We measured temporal and spatial changes in colonies of the primary host Temnothorax curvispinosus that had been placed in field enclosures along with a single colony of either one or both species of the North American slave-making ants Protomognathus americanus and Temnothorax duloticus. Each slave-maker species alone had a negative impact on its hosts, although one slave-maker species more frequently decimated its host assemblage and then went extinct. Nevertheless, the combined effect in mixed-parasite enclosures was, surprisingly, greatly attenuated. Virulent slave-maker growth and prudent slave-maker decay in these shared enclosures, together with field data showing an inverse proportional relationship between the two slave-makers in natural populations, suggest that their checkered distribution is a consequence of direct asymmetrical antagonism between parasites. Thus, our results imply a tripartite coevolutionary arms race, whereby intraguild interactions among social parasites strongly affect the realized selection pressures on hosts and contribute to the geographic mosaic of coevolution.

Animals↗
PubMedDate not supplied

What is Health Level 7?

HL7 is a huge undertaking and continues to grow. We talked about certain main themes of the spec that I've found interesting and thought you might too. You can always find additional information-especially from the HL7 website itself at www.hl7.org or www.altisinc.com/ IE/hl7.html. The main thing to remember is that HL7 is a specification for describing, formatting, encoding, and sharing of clinical and administrative data in healthcare. An easy way to remember that is that the 7 in HL7 refers to the Application layer in the OSI model. The next time someone talks about their HL7 software or application, you'll know that they really mean their HL7 compliant software or application. Then be sure to ask them how many composites are in their OBX segments!

Communication↗
PubMed2004

Relationships among international body condition scoring systems.

Scoring body condition and assessing changes in the body condition of dairy cattle have become strategic tools in both farm management and research. Consequently, body condition score (BCS) is being researched extensively throughout the world. However, international sharing, comparing, and use of data generated are limited because different BCS systems exist. In the United States and Ireland a 5-point BCS system is used for dairy cows, whereas Australia and New Zealand use 8- and 10-point scales, respectively. The New Zealand 10-point scale was compared with the scoring systems in the United States, Ireland, and Australia by trained assessors. Cows were assessed visually in the United States and Australia, and in Ireland, cows were assessed by palpating key areas of the cow's body (n = 154, 110, and 120, respectively). Data were analyzed by regression. Significant positive linear relationships were found between the New Zealand 10-point scale and the other scoring systems: US 5-point scale, r(2) = 0.54; Irish 5-point scale, r(2) = 0.72; and Australian 8-point scale, r(2) = 0.61. Those relationships must be interpreted cautiously because respective BCS within a given country were by just one experienced evaluator in each country in comparison to a separate evaluator scoring all cows in all counties using the New Zealand 10-point scale. Also, few very thin or very fat cows limit evaluation across extremes of BCS. However, differences between systems were not accurately predicted by simple mathematical calculations. The relationship may be closer for New Zealand and Ireland (r(2) = 0.72) because both of those scoring systems include palpation of individual body parts, whereas visual evaluation is done in Australia and the United States. The current study is the first to examine relationships among differing BCS systems. These results may be useful for comparing/extrapolating research findings from different countries.

Adipose Tissue↗
PubMed1994

Interface gateways: defining the solutions.

In summary, an interface gateway is able to quickly create and support relationships. In the healthcare environment of the 1990s, organization executives will be faced with an exponential increase in the number of provider, payor and employer alliances, affiliations and acquisitions. One of the recurring requirements in this scenario is the need to share information. Most of the data standards in existence today do not address the vast interface requirements of these organizations. However, the capabilities, flexibility and capacity of interface gateways can allow these relationships to be created and supported in a fraction of the time that conventional methods require.

Computer Communication Networks↗
PubMed1994

Vital links for today and tomorrow. With one stage of MIS development complete, an integrated delivery network looks to the future.

Over the past four years, Provenant Health Partners (PHP), Denver, has been developing and implementing a management information system to meet the organization's current needs. The system consists of the following information networks: Internal management; Electronic claims processing; Purchasing; Physician communications; Clinic communications; Physician practices; Other hospitals,offnaged health. In the past, PHP used the system primarily for traditional management and control purposes. Recently, however, the organization has extended the use of its data outputs to include internal and external marketing purposes as well. Clinical, service, and management quality data are now tracked and shared with internal and external constituents. PHP is also working to develop a health information system for the future. Such a system will include all the components of the current management information system, but will also facilitate effective health management of populations enrolled in the organization's integrated delivery network.

Colorado↗
PubMed1981

Automated DRG systems: unanswered questions.

Health care facilities seeking to prepare for a DRG-based or a similar case mix system may consider a range of options: microcomputers, shared computer services, a generalized data base management system.

Computers↗
PubMed1999

Linkage of a composite inhibitory phenotype to a chromosome 22q locus in eight Utah families.

Eight Utah multigenerational families, each with three to six cases of schizophrenia, were phenotyped with two specific measures of inhibitory neurophysiological functioning, P50 auditory sensory gating (P50), and antisaccade ocular motor performance (AS). A genomewide linkage analysis was performed to screen for loci underlying a qualitative phenotype combining the P50 and AS measures. For this composite inhibitory phenotype, the strongest evidence for linkage was to the D22s315 marker on chromosome 22q (lod score = 3.55, theta = 0) under an autosomal dominant model. Simulation analyses indicate that this 3.55 lod score is unlikely to represent a false positive result. Lod scores were 2.0 or greater for markers flanking D22s315. A nonparametric linkage (NPL) analysis of the chromosome 22 data showed evidence for allele sharing over the broad region surrounding D22s315 with a maximum NPL score of 3.83 (p = .002) for all pedigrees combined.

Acoustic Stimulation↗
PubMed1999

Formation of medical and hospital groups.

The first impression of most physicians and hospitals when dealing with managed care companies (MCOs) is that the size or "bigness" of the MCO is a major factor in the success of the MCO in negotiating contracts. This is only true to a degree. Physicians and hospitals have developed a tendency to make an unqualified bolt to also be "big", to put themselves on a more equal negotiating footing with MCOs. They should consider first the circumstances associated with organizational growth that lead to an effective outcome versus those that lead to failure. Effective outcomes happen because local market share can be controlled; management data systems that work are in place; and senior management has depth as well as maturity.

California↗
PubMed2001

Adhesive tape analysis: establishing the evidential value of specific techniques.

This study investigated the evidential value of specific methods of analysis for packaging tapes and clear adhesive tapes available in Australia. Fifty-eight adhesive tapes were analyzed using a wide range of optical, physical, and chemical techniques. The results were collated for the purpose of creating an Australian database of adhesive tapes, which would be of assistance in criminal investigation. Each technique was evaluated for its discriminating power, both for comparative purposes and for the identification of adhesive tapes by comparing unknown samples with the database. The combined discriminating power of the techniques applied is very high. It is possible to individually identify the source of an unknown adhesive tape sample in many instances by searching the database. It is also possible to form an opinion on the significance of a failure-to-discriminate result in comparative casework. Further work is still needed to expand and update the database, as well as compiling data on the relative market share of various products.

Journal Article↗
PubMed2001

[DNA-array analysis of the expression profile of apoptosis gene regulators in malignant lymphoma].

Microarray technology has recently led to the identification of molecular prognostic subgroups in non Hodgkin's lymphomas. In order to determine the usefulness of ready-made macroarrays as routine diagnosis tools in haemato-pathology, we have analysed lymph node biopsies using a cDNA macroarray containing genes involved in apoptosis, including caspases. Nine biopsy specimens were analysed on total frozen tissues: 4 samples of B-cell follicular lymphoma (FL), two of B-cell diffuse large cell lymphoma (DLCL), and three of non-neoplastic lymph nodes from benign lymphadenitis. Eight cell populations were sorted from fresh tissues: malignant B-cells from 2 FL cases and 2 DLCL cases, reactive B-cells from 1 benign lymph nodes, reactive T-cells from 1 benign lymph node, virgin (mantle zone) B-cells and germinal center (GC) B-cells from benign tonsils. Immunohistochemistry (IHC) on paraffin sections was performed for localization of caspases 2, 3, 4, 7, 8, and 9. In the clustered array data, sorted cells from samples sharing common histological lesions grouped together, whereas the array/histology correlation was less satisfactory for tissues. The expression profiles of both array and IHC methods were correlated for most caspases and samples. Variations in array profiles of sorted cell populations can be statistically associated with specific histological features, suggesting a possible diagnostic application of ready-made "Apoptosis macroarrays" in haematopathology.

Apoptosis↗