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At least 199 records · Page 11Linked to original sources

Potential years of life lost: what is the denominator?

OBJECTIVE: To suggest an appropriate denominator for use with the statistic "potential years of life lost", in order to facilitate valid comparisons between health authorities. DESIGN: Analysis of OPCS population and mortality data for the period 1987-91. SETTING: Data for Wales were analysed to provide comparisons between the nine district health authorities. SUBJECTS: There were 46,139 males and 30,258 females--that is, all deaths of Welsh residents, aged under 75 years, during the period 1987-91. MAIN RESULTS: The use of age sensitive denominators with the potential years of life lost statistic alters the rank position of Welsh district health authorities. CONCLUSION: It is suggested that potential years of life lost should be expressed as a rate per 100,000 potential years of life in public health common data sets, and elsewhere, to facilitate valid comparisons between health authorities.

Adolescent↗

A model for integration and continuous development of standards for tumour documentation using relational database techniques and extensible markup language.

In oncology various international and national standards exist for different aspects of a disease. These standards, maintained by different organisations, have multiple relationships with each other. A common data dictionary like UMLS would facilitate the reorganisation of such relationships when a new version of a standard is published. While the modelling of relationships usually is restricted to types having a relevant frequency, there are often relationships which are expressed in texts like definitions or explanations. Such texts are a very important supplement for the acceptance and the safe use of coding systems, but often are neglected when implementing coding systems in computerised systems, because they are costly to implement. This paper discusses potentials when integrating various sources in a common, database based dictionary enhanced by XML (Extensible Markup Language) techniques.

Databases as Topic↗

[Computerized data storage of antibiograms obtained by various methods (automatic reading by 2 different systems or manual processing by the disk method) and retrieval of antibiograms and cytobacteriological data using microcomputers].

This software is composed of different programmes. It works on Apple IIe computers. It enables to capture all the data information concerning bacteriological tests to store them and to edit either personnel reports or global lists made out according to different criteria and to study them under both the statistical or the epidemiological aspects. The results of the antibiotic sensitivity test are notified either by an automatic reader (ABAC or API system) when carried out in a liquid environment or by an original computerized device (compass or enlarger) when manually carried out by the disc method. The informations are directly transmitted to the computer. It's possible to make up a common data file that can be exploited as a whole.

Bacteriological Techniques↗

TmaDB: a repository for tissue microarray data.

BACKGROUND: Tissue microarray (TMA) technology has been developed to facilitate large, genome-scale molecular pathology studies. This technique provides a high-throughput method for analyzing a large cohort of clinical specimens in a single experiment thereby permitting the parallel analysis of molecular alterations (at the DNA, RNA, or protein level) in thousands of tissue specimens. As a vast quantity of data can be generated in a single TMA experiment a systematic approach is required for the storage and analysis of such data. DESCRIPTION: To analyse TMA output a relational database (known as TmaDB) has been developed to collate all aspects of information relating to TMAs. These data include the TMA construction protocol, experimental protocol and results from the various immunocytological and histochemical staining experiments including the scanned images for each of the TMA cores. Furthermore the database contains pathological information associated with each of the specimens on the TMA slide, the location of the various TMAs and the individual specimen blocks (from which cores were taken) in the laboratory and their current status i.e. if they can be sectioned into further slides or if they are exhausted. TmaDB has been designed to incorporate and extend many of the published common data elements and the XML format for TMA experiments and is therefore compatible with the TMA data exchange specifications developed by the Association for Pathology Informatics community. Finally the design of the database is made flexible such that TMA experiments from several types of cancer can be stored in a single database, which incorporates the national minimum data set required for pathology reports supported by the Royal College of Pathologists (UK). CONCLUSION: TmaDB will provide a comprehensive repository for TMA data such that a large number of results from the numerous immunostaining experiments can be efficiently compared for each of the TMA cores. This will allow a systematic, large-scale comparison of tumour samples to facilitate the identification of gene products of clinical importance such as therapeutic or prognostic markers. In addition this work will contribute to the establishment of a standard for reporting TMA data analogous to MIAME in the description of microarray data.

Data Interpretation, Statistical↗

IMGT, the international ImMunoGeneTics database: a new design for immunogenetics data access.

IMGT, the international ImMunoGeneTics database is an integrated database specializing in Immunoglobulins (Ig), T-cell receptors (TcR) and MHC molecules of all vertebrate species, created by Marie-Paule Lefranc, University of Montpellier, CNRS, Montpellier, France (Nucleic Acids Research, Database issue, Vol 26, January 1998). IMGT includes three databases: LIGM-DB (for Ig and TcR), MHC/HLA-DB and IMGT/PRIMER-DB (an Ig, TcR and MHC-related primer database), the last two in development. IMGT comprises expertly annotated sequences and alignment tables. LIGM-DB contains more than 24.000 Immunoglobulin and T cell Receptor sequences from 81 different species. MHC/HLA-DB contains class I and class II Human Leucocyte Antigen alignment tables. An IMGT tool, DNAPLOT, developed for Ig, TcR and MHC sequence analysis, is also available. IMGT goals are to establish a common data access to all immunogenetics data, including nucleotide and protein sequences, oligonucleotide primers, gene maps and other genetic data of Ig, TcR and MHC molecules, from all species, and to provide a graphical user friendly data access. IMGT has important implications in medical research (repertoire in autoimmune diseases, AIDS, leukemias, lymphomas), therapeutical approaches (antibody engineering), genome diversity and genome evolution studies. In this paper, we describe our approach for the data modelisation, the automation of the annotation procedure and control of data quality in LIGM-DB database. IMGT is freely available on the CNUSC WWW server at Montpellier: http://imgt.cnusc.fr: 8104 (contact: Denys.Chaume@cnusc.fr) and on the EBI servers: http://www.ebi.ac.uk/imgt (contact: malik@ebi.ac.uk) and ftp.ebi.ac.uk/pub/databases/imgt. LIGM-DB users are encouraged to report errors or suggestions to giudi@ligm.crbm.cnrs-mop.fr. IMGT initiator and coordinator: Marie-Paule Lefranc, lefranc@ligm.crbm.cnrs-mop.fr. (fax: +33(0)467040231).

Amino Acid Sequence↗

Stressors in five client populations: Neuman systems model-based literature review.

AIM: This paper reports a literature review identifying and categorizing client system stressors in Neuman systems model-based studies. BACKGROUND: To date, literature reviews related to the Neuman systems model have focused broadly on all concepts of the model. The concept of stressors has been selected by the Neuman Systems Model Research Institute as the focus for an initial collaborative research project. METHOD: Cooper's five-stage integrative review method was used: problem formulation, data collection, data evaluation, analysis and interpretation, and dissemination. The Neuman systems model research literature from 1983 to February 2005 was searched using Fawcett's Neuman systems model bibliography and a follow-up review of the CINAHL database using the keywords 'Neuman systems model' and 'stressors'. A total of 87 studies published as journal articles or book chapters between 1983 and 2005 were reviewed; 13 of the 87 studies met the definition of 'stressor studies'. FINDINGS: Stressors were identified in five client populations: caregivers, cancer survivors, ICU patients in intensive care units, care receivers, and parents whose children were undergoing day surgery. The most common data collection method was the interview, and investigator-developed interview guides were most often used. Evidence of categorization of intra-, inter- and extra-personal stressors was present. The following overall stressors were identified: burden of responsibility (caregivers); awareness of vulnerability (cancer survivors); being overwhelmed (patients in intensive care units); loss of control (parents); and frustration with role changes (care receivers). CONCLUSIONS: These data could form the basis for nursing practice as well as future research within a collaborative environment. Given the existing body of knowledge concerning Neuman system model-derived middle range theory concepts in the caregiver population, the middle-range theory of caregiver role strain could be tested empirically.

Caregivers↗

Retrospective analysis of acute inhalation toxicity studies: comparison of actual concentrations by filter and cascade impactor analyses.

Determination of acute inhalation toxicity is usually the initial step in the assessment and evaluation of the toxic characteristic of a substance that may be inhaled. Commonly, data from this bioassays may serve as a basis for classification and labeling and may also be used for the derivation of Emergency Response Guidance Levels. The focus of this analysis is on the comparative measurement of actual total mass concentrations in inhalation chambers obtained from independent filter (or alternative) analyses and cascade impactor analyses and whether the similarity/disparity of concentration measurements found by different equipment and sampling strategies could serve as robust criterion for the identification of inconclusive measurements. Potential artifacts leading to erroneous concentrations include anisokinetic sampling errors, obstructions of filters, errors related to the calculation/measurement of the sampled volume of atmospheres, wall losses or evaporation. The outcome of this analysis supports the conclusion that the mass concentrations obtained by the commonly performed cascade impactor analysis provide an important adjunct to the established procedures. In summary, the similarity of mass concentrations obtained independently by cascade impactor and filter analyses, i.e., sampling equipment with different aspiration efficiencies and collection media, improve the judgment whether the results from atmosphere characterization are 'conclusive' or 'inconclusive.'

Administration, Inhalation↗

Selecting the right statistical model for analysis of insect count data by using information theoretic measures.

Researchers and regulatory agencies often make statistical inferences from insect count data using modelling approaches that assume homogeneous variance. Such models do not allow for formal appraisal of variability which in its different forms is the subject of interest in ecology. Therefore, the objectives of this paper were to (i) compare models suitable for handling variance heterogeneity and (ii) select optimal models to ensure valid statistical inferences from insect count data. The log-normal, standard Poisson, Poisson corrected for overdispersion, zero-inflated Poisson, the negative binomial distribution and zero-inflated negative binomial models were compared using six count datasets on foliage-dwelling insects and five families of soil-dwelling insects. Akaike's and Schwarz Bayesian information criteria were used for comparing the various models. Over 50% of the counts were zeros even in locally abundant species such as Ootheca bennigseni Weise, Mesoplatys ochroptera Stål and Diaecoderus spp. The Poisson model after correction for overdispersion and the standard negative binomial distribution model provided better description of the probability distribution of seven out of the 11 insects than the log-normal, standard Poisson, zero-inflated Poisson or zero-inflated negative binomial models. It is concluded that excess zeros and variance heterogeneity are common data phenomena in insect counts. If not properly modelled, these properties can invalidate the normal distribution assumptions resulting in biased estimation of ecological effects and jeopardizing the integrity of the scientific inferences. Therefore, it is recommended that statistical models appropriate for handling these data properties be selected using objective criteria to ensure efficient statistical inference.

Animals↗

[Is clinical diagnosis of deep venous thrombosis really unreliable?].

The clinical diagnosis of deep venous thrombosis (DVT) is traditionally regarded as lacking of sensitivity and specificity. As we were not fully convinced by this statement, we assessed the value of two associated clinical signs in outpatients, namely the flapping of the calf and the modified Lowemberg's sign. The examiner has first put forth a diagnosis based on the data of history and/or the presence of clinical signs specific for another kind of disease. Then an objective test of the diagnosis was carried out with a duplex scanner performed by an expert. DVT was observed in 39 subjects out of 102 (38.2%) who where all referred by general practitioners (GP), which confirms the poor diagnostic value of clinics at GP level. Associated positiveness of these two signs yielded 87.2% sensitivity and 88.8% specificity with a positive predictive value of 82.9% and a negative predictive value of 91.8%. The addition of an overall clinical assessment later improved results to 87.2% sensitivity and 96.8% specificity, a positive predictive value of 94.4% and a negative predictive value of 92.4%. In this study, the performance of clinics, if assessed by an angiologist qualified for the diagnosis of DVT, proved to be better than in the common data of the literature. Clinical data, if perfect, should be included in the diagnostic management of DVT.

Adolescent↗

Food-drug interactions in the summary of product characteristics of proprietary medicinal products.

BACKGROUND: Food-drug interactions can produce negative effects in the safety and efficacy of drug therapy, as well as in the nutritional status of the patient. However, the data commonly provided to the prescriber about possible nutrient-pharmacological compound interactions and the recommendations for their prevention are often scarce. The summary of product characteristics (SmPC) of a proprietary medicinal product, as authorised by the health authorities in Europe, is usually the main source of information for the health professional. Therefore, the SmPC can be a useful tool to prevent or reduce food-drug interactions and, as a consequence, improve the therapeutical approach. OBJECTIVE: The aim of this study was to assess the information about food-drug interactions with potential clinical relevance as it is described in the SmPCs of the authorised medicinal products in a European Union country (Spain). METHODS: A bibliographical search of food-drug interactions, including nutrients and alcohol, was carried out. The adequate information to be included in the SmPC was defined in accordance with the European Recommendations in this field. The SmPCs of the medicinal products containing selected active substances were examined with emphasis on food-drug interactions. RESULTS: It was found that, frequently, the information concerning food-drug interactions as is mentioned in the SmPC of the authorised medicinal products in Spain does not fulfil the current recommendations, both in quantity and quality. Indeed, the available data reveal that the food-drug information is only mentioned in 72.7% of all SmPC where it should be and it was only found in the specific section for interactions in 36.0% of all cases. The description and agreement with recommendations for each SmPC item ranged between 4.2% and 36.0% and between 31.8% and 49.0%, respectively. Some related factors, such as the clinical relevance of the interaction, the existence of an authorised SmPC and the registration procedure followed, influence the information characteristics concerning food-drug interactions. CONCLUSION: The SmPC is a suboptimal source of information for food-drug interactions.

Beverages↗

Cerebral protection devices for use during carotid artery angioplasty with stenting: a health technology assessment.

OBJECTIVES: This study sought to examine the safety, efficacy, and economic implications of the use of cerebral protection devices during carotid artery angioplasty and stenting (CAS) in high-risk patients with severe carotid artery disease (CAD). METHODS: A comprehensive search for peer- and non-peer-reviewed studies that compared carotid endarterectomy (CEA) or CAS without cerebral protection to CAS with cerebral protection and appeared in the English language literature between January 1990 and January 2005 was completed. Information from studies identified was extracted using a common data abstraction form and then critically appraised against published quality assessment criteria. RESULTS: Of the eight studies found, six provided information on technical or procedural success rates, with values ranging from 95.6 percent to 100 percent. Three of the four studies comparing groups of patients who received CAS with cerebral protection with those who received only CAS reported a non-statistically significantly higher 30-day incidence of death and stroke (major or minor) in the latter group. None of the three studies comparing CAS with cerebral protection to CEA demonstrated a statistically significant difference in the 30-day incidence of death, major stroke, or myocardial infarction between treatment groups. No economic analyses were found. CONCLUSIONS: In high-risk patients with severe CAD, the evidence suggests that CAS with cerebral protection may offer a safe and efficacious alternative to CEA, reducing the risk of embolic peri-procedural complications associated with CAS to acceptable levels.

Angioplasty↗

Methodological variations in estimating apparent progressive visual field loss in clinical trials of glaucoma treatment.

OBJECTIVES: To compare methods to estimate the incidence of visual field progression used by 3 large randomized trials of glaucoma treatment by applying these methods to a common data set of annually obtained visual field measurements of patients with glaucoma followed up for an average of 6 years. METHODS: The methods used by the Advanced Glaucoma Intervention Study (AGIS), the Collaborative Initial Glaucoma Treatment Study (CIGTS), and the Early Manifest Glaucoma Treatment study (EMGT) were applied to 67 eyes of 56 patients with glaucoma enrolled in a 10-year natural history study of glaucoma using Program 30-2 of the Humphrey Field Analyzer (Humphrey Instruments, San Leandro, Calif). The incidence of apparent visual field progression was estimated for each method. Extent of agreement between the methods was calculated, and time to apparent progression was compared. RESULTS: The proportion of patients progressing was 11%, 22%, and 23% with AGIS, CIGTS, and EMGT methods, respectively. Clinical assessment identified 23% of patients who progressed, but only half of these were also identified by CIGTS or EMGT methods. The CIGTS and the EMGT had comparable incidence rates, but only half of those identified by 1 method were also identified by the other. CONCLUSIONS: The EMGT and CIGTS methods produced rates of apparent progression that were twice those of the AGIS method. Although EMGT, CIGTS, and clinical assessment rates were comparable, they did not identify the same patients as having had field progression.

Disease Progression↗

Intraobserver and interobserver variation in the histopathological assessment of liver allograft rejection. The Liver Transplantation Database (LTD) Investigators.

A study to determine the reproducibility of histopathological findings and diagnoses of rejection was carried out on a series of 42 liver allograft needle biopsy specimens by five pathologists practicing at four liver transplant centers. Pathologists from each of the four centers read each slide independently on two different occasions and were asked to assess 12 histopathological features and render a diagnosis. For all histological variables, the intrarater agreement was higher than the interrater agreement. Moderate to excellent agreement occurred among the pathologists about all histological variables thought to be important in establishing the diagnosis of acute rejection (i.e., portal tract inflammation, subendothelial inflammation and bile duct damage). Other variables such as lobular disarray, bile duct proliferation and particularly arteritis, however, were only fairly or poorly reproducible. Surprisingly, the diagnosis of acute rejection was more reproducible than the individual histopathological findings that were thought to be the basis for the diagnosis. The agreement for the diagnosis of chronic rejection, however, varied according to observer. We noted that relatively inexperienced observers within this group had some difficulties agreeing with more experienced observers in establishing a diagnosis of chronic rejection. These findings demonstrate that the histopathological diagnosis of acute cellular liver allograft rejection is highly reproducible within a group of experienced pathologists and that this diagnosis can be pooled in a common data base with confidence.

Biopsy, Needle↗

Medical computing in the 1980s. Operating system and programming language issues.

Operating systems and programming languages differ widely in their suitability for particular applications. The diversity of medical computing needs demands a diversity of solutions. Compounding this diversity if the decentralization caused by evolution of local computing systems for local needs. Relevant current trends in computing include increased emphasis on decentralization, growing capabilities for interconnection of diverse systems, and development of common data base and file server capabilities. In addition, standardization and hardware in dependence of operating systems, as well as programming languages and development of programmerless systems, continue to widen application opportunities.

Computers↗

[Prevention and therapy of acute radiation-related morbidity of the skin and mucosa. II, Recommendations of the literature].

BACKGROUND: In a German multicenter questionnaire, answered by 89 departments, we had examined the strategies to prevent or to treat the acute morbidity of the skin and mucosa associated to radiation therapy. In this work, the recommendations from the literature are compared to the results of the questionnaire. METHODS: An extensive research on common data information systems (Medline, Cancerlit, DIMDI and others) was performed. The criteria included the organ related morbidity and therapeutic strategies for its reduction. The obtained data were compared to the results from the questionnaire. RESULTS: The study data found by the research often demonstrate small patient numbers and little convincing results. However, as in the questionnaire, the joint principle seems to be the reduction of acute inflammatory tissue reaction by evasion of bacterial and mycotic overgrowth and reduction of exo- and endogenous toxins. CONCLUSIONS: Further studies with more convincing results are required.

Animals↗

Network system: the integrated picture archiving and communication system with the hospital information system.

We describe the outline of Hokkaido University picture archiving and communication system (HU-PACS) and its network functions. HU-PACS processes 0.5 Gbytes of images daily through 10 acquisition devices. Functional integration of hospital information system (HIS) and PACS has been implemented. The HU-PACS can access common data base with HIS. Multi-image data-base systems provide fast throughput of image retrieval. The system is composed of 4 modules: (1) 2 image data-base systems (IDS), (2) 1 image management system (IMS), (3) image display terminals (IDT), and (4) 8 image acquisition nodes interfaced to 10 modalities and 1 film scanner. These 4 modules are connected by branch and loop type local area networks (LAN). HU-PACS has functions other than basic PACS functions. Images in optical disk library (ODL) are loaded onto magnetic disks (MD) in advance according to patient booking information, the images expected to be viewed are transferred to the local storage automatically, and the desired images can be pre-downloaded into local storage by instruction through HIS terminals.

Computer Communication Networks↗

Regional distribution of mutations of the ATP7B gene in patients with Wilson disease: impact on genetic testing.

Wilson disease is an autosomal recessive inherited disorder of copper metabolism. The Wilson disease gene codes for a copper transporting P-type ATPase (ATP7B). Molecular genetic analysis reveals at least 300 distinct mutations. While most reported mutations occur in single families, a few are more common. The most common mutation in patients from Central, Eastern, and Northern Europe is the point mutation H1069Q (exon 14). About 50-80% of Wilson disease (WD) patients from these countries carry at least one allele with this mutation with an allele frequency ranging between 30 and 70%. Other common mutations in Central and Eastern Europe are located on exon 8 (2299insC, G710S), exon 15 (3400delC) and exon 13 (R969Q). The allele frequency of these mutations is lower than 10%. In Mediterranean countries there is a wide range of mutations, the frequency of each of them varies considerably from country to country. In Sardinia, a unique deletion in the 5' UTR (-441/-427 del) is very frequent. In mainland Spain the missense mutation M645R in exon 6 is particularly common. Data from non-European countries are scarce. Most data from Asia are from Far Eastern areas (China, South Korea and Japan) where the R778L missense mutation in exon 8 is found with an allele frequency of 14-49%. In summary, given the constant improvement of analytic tools genetic testing will become an integral part for the diagnosis of WD. Knowledge of the differences in the worldwide distribution of particular mutations will help to design shortcuts for genetic diagnosis of WD.

Adenosine Triphosphatases↗