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Biomedical subjects

B Louie

Publications and source records attributed to B Louie.

11 recordsLinked to original sources
PubMed2001

Differences in the temporal trends of HIV seroincidence and seroprevalence among sexually transmitted disease clinic patients, 1989-1998: application of the serologic testing algorithm for recent HIV seroconversion.

The authors compared temporal trends in the prevalence and incidence of human immunodeficiency virus (HIV) infection based upon 34,866 specimens from patients who attended the San Francisco, California, municipal sexually transmitted disease clinic between 1989 and 1998. HIV infection data were collected during annual blinded HIV serologic surveys. Incidence was determined by applying a serologic testing algorithm for recent HIV seroconversion that uses both a sensitive and a less sensitive enzyme immunoassay to stored HIV positive sera. The HIV seroprevalence declined from 15.2% in 1989 to 7.2% in 1998 (odds ratio per year = 0.92, 95% confidence interval (CI): 0.91, 0.94). Among homosexual men, the HIV prevalence declined from 50.9% in 1989 to 19.9% in 1998 (odds ratio per year = 0.86, 95% CI: 0.85, 0.88). The pooled seroincidence was 1.6% and did not change significantly over time (odds ratio per year = 1.0, 95% CI: 0.98, 1.1). The pooled seroincidence among homosexual men was 6.6% per year and remained steady between 1989 and 1998 (odds ratio per year = 0.99, 95% CI: 0.92, 1.1). During a dramatic, 10-year decline in seroprevalence of HIV infection, the incidence of HIV infection remained remarkably stable.

Adult↗
PubMed2001

A high-resolution radiation hybrid map of the human genome draft sequence.

We have constructed a physical map of the human genome by using a panel of 90 whole-genome radiation hybrids (the TNG panel) in conjunction with 40,322 sequence-tagged sites (STSs) derived from random genomic sequences as well as expressed sequences. Of 36,678 STSs on the TNG radiation hybrid map, only 3604 (9.8%) were absent from the unassembled draft sequence of the human genome. Of 20,030 STSs ordered on the TNG map as well as the assembled human genome draft sequence and the Celera assembled human genome sequence, 36% of the STSs had a discrepant order between the working draft sequence and the Celera sequence. The TNG map order was identical to one of the two sequence orders in 60% of these discrepant cases.

Algorithms↗
PubMed2000

Low estimates of HIV seroconversions among clients of a drug treatment clinic in San Francisco, 1995 to 1998.

We estimated HIV incidence among injection drug users attending a drug treatment clinic in San Francisco from 1995 to 1998 using two methods. An anonymous sequential testing method identified no seroconversions among clients seen more than once during the period (one-sided upper 95% confidence limit 1.02 per 100 person-years). A sensitive/less sensitive immunoassay testing strategy detected no early infections (one-sided upper 95% confidence limit 1.90% per year). Methods were concordant and feasible in the setting. Although detection of no new HIV infections in this population of injection drug users (IDUs) is encouraging, epidemiologic studies among IDUs not in treatment are needed to monitor the HIV epidemic effectively.

Adult↗
PubMed1998

Donor site morbidity following vascularized fibular grafting.

We examined donor site morbidity in thirty-nine patients with avascular necrosis of the femoral head treated by curettage and transplantation of a free ipsilateral fibular graft. Utilising our donor site morbidity questionnaire, scar, functional loss, wound healing, complications, and pain were analysed. Subjective complaints and objective findings were evaluated and compared. Subjective complaints were common and included a sense of instability in 42% and a sense of weakness in 37%. However, objective findings were limited. No clinical instability could be elicited and only great toe flexion (29%) and extension (43%) were found to be mildly weak. Only one patient required reoperation for a donor site problem (2%). Eighty-nine percent were pain free at time of follow-up, and 93% felt the scar was good. Range of motion of the knee and ankle of the donor site leg was not different from the nonoperated leg. Donor site morbidity for avascular necrosis of the femoral head is low.

Adult↗
PubMed1996

From feedback to reciprocity. Developing a student-centered approach to course evaluation.

Reforms to medical education have refocused curricula on the need to produce primary care physicians through a problem-based, student-centered, community-oriented, and integrated approach to instruction. Course evaluations, originally designed for traditional lecture-based, teacher-centered curricula, provide inadequate input from students to support curriculum planning and change and to determine appropriate mixes of educational methods. At the University of Toronto Faculty of Medicine, a unique community-centered course, called "Health, Illness and the Community," developed a student-centered course evaluation to provide adequate student input to support curriculum planning and change. A 35-item evaluation was developed to obtain data to identify student concerns, student learning styles, and preferred community agency utilization. The results suggest that student-centered course evaluation can play a role in managing and identifying key relationships in integrated and systematic courses as well as establishing a method for continual improvement.

Curriculum↗
PubMed1995

Reducing surgical length of stay: quantifying the impact.

Length-of-stay (LOS) reduction is a strategy encouraged at all levels of health care to manage within a resource limited environment. However, few organizations have attempted to quantitatively understand the impact of reducing LOS. This study examines the relationship between reducing LOS and cost through a retrospective, medical records analysis of three surgical procedures (appendectomy, cholecystectomy and caesarean section) at an Ontario community hospital Department of Surgery. Hypotheses are presented and a methodology is described. The results are discussed with a focus on the factors that hospitals, administrators and physicians might consider in a LOS reduction program.

Adolescent↗
PubMed1993

Integrating technology assessment into the capital budgeting process.

Technology assessment can help hospitals rank the importance of capital requests by providing crucial information both about existing equipment and about new equipment that has been requested. Integrating technology assessment into the capital budgeting process is the best way for hospitals to determine what equipment should be purchased each year.

Budgets↗
PubMedDate not supplied

The evaluation and treatment of the febrile infant.

Over a period of 5 1/2 years 305 infants less than 60 days of age with temperatures greater than or equal to 100.4 degrees F (38.0 degrees C) were evaluated for sepsis. Of these 20.6% of the infants had significant diseases although only 3.6% had bacteremia. Neither the age of the child (above or below 30 days of age) nor the height of the fever helped to identify infants with bacteremia. A white blood cell count of greater than 15,000/mm3 was useful in identifying bacteremic infants over 30 days of age only. The differential white blood cell count was not helpful in distinguishing between bacteremic and nonbacteremic infants. The appearance of the infant was the most significant predictor (P less than 0.001) of bacteremia in this age group. Infants between 30 and 60 days of age who both appeared ill and had white blood cell counts greater than or equal to 15,000/mm3 had a 27.3% chance of having bacteremia.

Bacterial Infections↗
PubMedDate not supplied

Building a decision-support system.

To make decisions in today's dynamic health care environment, hospital managers rely on accurate and timely information--much of it compiled from hospital discharge data. For hospitals, the problem is not the lack of data but the inability to convert it to information useful to hospital management. This article describes how to build a cost-effective decision-support system that can transform HMRI (Hospital Medical Records Institute) data into a powerful management tool.

Canada↗