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PubMed2003

[Ultrastructural observation of rat thymus tissue with coronavirus infection].

OBJECTIVE: To investigate the ultrastructure of rat thymus tissues with rat coronavirus (RCV) infection for clarifying the mechanism responsible for the morphological changes of the cells infected by RCV. METHODS: Routine electron microscopy was performed for observing RCV-infected rat thymus tissues. RESULTS: Following RCV infection, endoplasmic reticulum (ER) pools of different dimensions were observed in the cytoplasm of the thymic epithelial reticular cells, merging subsequently with each other into larger ER lakes filled with particles of mature RCV, or viral inclusion bodies. After germination on the ER membrane, the viruses entered the matrix of the ER lake to mature and were eventually excreted to the extracellular space. The RCV particles were spherical in shape with a diameter of 100-130 nm and two distinct membranes, the outer one being the envelope and the inner one the nuclear capsid to enclose the viroplasm. Between the envelop and nuclear capsid was a electron-lucent middle layer comprising one to two thin membranous structures. Large quantity of short spike-like projections starting from the nucleus capsid penetrated the middle layer and the envelop to reach the glycoprotein coat and formed a corona-like structure. Mature RCV particles were distributed around the ER pools, cytoplasm, and intercellular space, and the RCVs in the endosome/lysosome were devoid of the envelop and nuclear capsid. CONCLUSION: The ER lakes are involved in the maturation of the viruses, and the envelop and nuclear capsid of the virus entering the cells from extracellular space are removed and degraded in the endosome/lysosome. Replications of virus occurs in plasma of the thymic epithelial reticular cells, and no RCV can be detected in the thymocytes.

Animals↗

PubMed2003

[Standards, Options and Recommendations for the management of invasive cervical cancer patients (non metastastic)].

CONTEXT: The "Standards, Options and Recommendations" (SOR) project, started in 1993, is a collaboration between the Federation of French Cancer Centers (FNCLCC), the 20 French cancer centers and specialists from French public university and general hospitals and private clinics. Its main objective is the development of clinical practice guidelines to improve the quality of health care and outcome for cancer patients. The methodology is based on literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. OBJECTIVES: To develop, according to the definitions of the Standards, Options and Recommendations, clinical practice guidelines for the management of invasive cervical cancer patients. Methods : Data were identified by searching Medline and the personal reference lists of members of the expert groups, then submitted for review to independent reviewers. RESULTS: This is a synthesis of the Standards, Options and Recommendations elaborated by a working group of experts. Pretherapeutic assessment, classification, diagnosis, therapeutic modalities (surgery, radiotherapy, radiochemotherapy, chemotherapy), therapeutic strategies by disease stage and follow-up are covered. Algorithms for the management of patients are also included.

Algorithms↗

PubMed2003

[Probing of the target molecules of Rho-kinase and its function in neuronal cells].

Genome project terminated and post-genome project started, one of which aim is to understand the function and its regulation mechanism(s) of the molecules in living cells. Protein phosphorylation is one of the most common reactions responsive to extracellular stimulants. It is well understood about the involvement of Rho/Rho-kinase and Cdc42/p21-activated kinase (PAK) in the functions of muscle and non-muscle cells, but in neuronal cells little or poorly is understood. This is due to poor evidences about the target molecules of Rho-kinase and PAK and its functions in neuronal cells. We have revealed using a phosphorylation site-specific antibody that PAK targets synapsin Ia at Ser603 in vitro and in neuronal cells in culture, which is recognized as CaMKII site. This is reasonable, because the 600RQAS603 around Ser603 is also consensus motif for the phosphorylation of PAK and Rho-kinase besides CaMKII. Like this, we have tried to define the target molecules of Rho-kinase in neuronal cells. In this symposium, I would present that both Rho-kinase and PAK target MARCKS at Ser159 in vitro and in neuronal cells stimulated with LPA and bradykinin, respectively. Moreover, we would address the role of phosphorylation of MARCKS at Ser159 in neuronal functions.

Animals↗

PubMed1992

Sogn and Fjordane county community-based injury prevention: evaluation design.

The Sogn and Fjordane Injury Prevention Programme is a community-based research and demonstration project located in the Sogn and Fjordane county (S&F county) in Western Norway. The aim of the project is: (i) to further effective intervention; (ii) to be cost-effective; (iii) to provide information about local community based injury intervention. Liaison groups on injury prevention will be organised in 24 communities participating in the project. Starting 1 April 1993 they will be supplied with local specific injury rates obtained from the all-injury registration of the National Injury Surveillance System. The intervention design includes feedback of three types of information: (1) home and traffic injury rates; (2) sports, occupational, school, and outdoor injury rates; (3) both (1) + (2). The liaison groups will be asked to concentrate their activities only on the information-related injury areas. The hypothesis is that the results will be information-related. The intervention protocol will last for two years, until 1 April 1995. Evaluation will be based on a hypothetical causal intervention model. The model includes three groups of independent influences, two groups of mediator attributes, and desired end-result. A variety of data sources will be used including national and local data sources, two cross-sectional surveys on awareness, knowledge, behaviour and attitudes, interviews, observations, and self-reports from individuals. A mixed-model ANOVA will be used to test the main information-related effects. A combination of multivariate analytical methods will be used to test the hypothesised causal intervention model.

Accident Prevention↗

PubMed2003

Maternal and child health project in Nigeria.

Maternal deaths in developing countries are rooted in womens powerlessness and their unequal access to employment, finance, education, basic health care, and other resources. Nigeria is Africa's most populous country, and it is an oil producing country, but Nigeria has one of the worst maternal mortality rates in Africa. These deaths were linked to deficiencies in access to health care including poor quality of health services, socio-cultural factors, and access issues related to the poor status of women. To address these problems, a participatory approach was used to bring Christian women from various denominations in Eastern Nigeria together. With technical assistance from a research unit in a university in Eastern Nigeria, the women were able to implement a Safe Motherhood project starting from needs assessment to program evaluation. Lessons learned from this program approach are discussed.

Adolescent↗

PubMed2004

Medical abortion: the Tunisian experience.

This paper reports the Tunisian experience of medical abortion. The project started in 1998 with a small introductory study at the obstetric and gynaecology department of a university hospital and was later extended step by step to other family planning and public health centres that provided abortion services. The study was first conducted on 264 women using the modified regimen of 200mg mifepristone, followed 48 hours later by 400 microg misoprostol in women seeking pregnancy of maximum 56 days of amenorrhoea. This gave a success rate of 91.1%. Results from further studies in other locations showed increasing success rates of 94.4% and 95.6%, with high acceptability and satisfaction among users and providers The registration and effective introduction of medical abortion was quite rapid. Following successful conduct of the pilot study, intervention programmes were designed and implemented to improve the capacity of providers in providing safe medical abortion.

Abortifacient Agents, Nonsteroidal↗

PubMed2004

Survey a launching pad for wide-ranging improvement.

Frontline employees were solicited for recommendations for improvement opportunities. Several teams were formed, with coaches and team leaders receiving training before starting projects. Project outlines and successes are shared through a database on the hospital intranet.

Data Collection↗

PubMedDate not supplied

[Periconceptional supplementation with folic acid for the primary prevention of congenital malformations].

Most international trials support the recommendation that all women planning or at risk of pregnancy take a daily multivitamin supplement containing folic acid, beginning one month before conception and continuing through the first trimester for primary prevention of neural tube defects and other congenital malformations. Recently an intervention project started also in Italy, in order to support and maintain the periconceptional supplementation and to evaluate the efficacy of a national preventive campaign on parents' behaviour.

Adult↗

PubMed2005

[Standards, Options and Recommendations for the management of ductal carcinoma in situ of the breast (DCIS): update 2004].

The " Standards, Options and Recommendations " (SOR) project, started in 1993, is a collaboration between the Federation of French Cancer Centres (FNCLCC), the 20 French cancer centres, and specialists from French public universities, general hospitals and private clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and the outcome of cancer patients. The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. Objectives : To update the Standards, Options and Recommendations clinical practice guidelines for the management of ductal carcinoma in situ of the breast (DCIS). Methods : The working group identified the questions requiring up-dating from the previous guideline. Medline(r) and Embase(r) were searched using specific search strategies from year 1996 to year 2003. In addition several Internet sites were searched in October 2002. Results : Clinical guidelines have been defined for the management of diagnosis, treatment, follow-up, and treatment of recurrence of DCIS. The issue of hormone replacement therapy has also been addressed in the context of DCIS.

Breast Neoplasms↗

PubMed2005

[Clinical Practice Guidelines 2004. Standards, Options and Recommendations for the management of patient with adenocarcinoma of the stomach: radiotherapy (therapeutic evaluation)].

CONTEXT: The "Standards, Options and Recommendations" (SOR) project, started in 1993, is a collaboration between the Federation of French Cancer Centers (FNCLCC), the 20 French regional cancer centers, and specialists from French Public Universities, General Hospitals and Private Clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and the outcome of cancer patients. OBJECTIVES: To elaborate clinical practice guidelines for patients with stomach adenocarcinoma. These recommendations cover the diagnosis, treatment and follow-up of these tumors. METHODS: The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. The Standards, Options and Recommendations are thus based on the best available evidence and expert agreement. RESULTS: This guidelines presents the synthesis of the data concerning the evaluation of the therapeutic ones. The main questions concern the type of gastrectomy to realize (Total Gastrectomy or gastrectomy subtotal), the extent of the lymphadenectomy (D2, D3 versus D1, D3, D2 versus D4) and the role of postoperative chemotherapy and adjuvant concomitant chemoradiotherapy.

Adenocarcinoma↗

PubMed1992

Rural neonatal care: Dahanu experience.

The Rural Neonatal Care Project, started by the Government of Maharashtra in the Ganjad Primary Health Centre, Dahanu block in Maharashtra, had the TBA as the sheet anchor for delivery of neonatal care. Maintenance of "warm chain" and resuscitation of an asphyxiated baby were recognized as the most important interventions besides detection of a very low birth weight/preterm baby and safe transportation of such a baby. Foot length measurement from foot print was used as a surrogate to birth weight as an indicator for referral. Neonatal and perinatal mortality rates dropped appreciably over 3 years and the antenatal registration went up by 30%. The cost of this programme is affordable and the programme itself was acceptable to the community and the TBAs because of its simplicity.

Humans↗

PubMed2005

[Full version of the 2005 Standards, Options and Recommendations for the management of procedure-related pain (lumbar puncture, bone marrow aspiration or biopsy, blood sampling) in adult patients with cancer].

The << Standards, Options and Recommendations >> (SOR) project, started in 1993, is a collaboration between the Federation of French Cancer Centres (FNCLCC), the 20 French cancer centres, and specialists from French public universities, general hospitals and private clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and the outcome of cancer patients. The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. Objectives : To establish the Standards, Options and Recommendations clinical practice guidelines for the management of procedure related pain (lumbar puncture, bone marrow aspiration or biopsy, blood sampling) in adult oncology patients. To define, on the basis of the critical appraisal of the best available evidence and expert agreement, the clinical situations in which a pain preventive strategy should be implemented. Methods. Medline(R) was searched using specific search strategies from January 1966 to August 2003. Literature monitoring was performed to identify controlled clinical trials published between August 2003 to September 2004. In addition several Internet sites were searched in July 2003. Results. A total of 12 references, corresponding to 10 randomised clinical trials, were identified. Clinical guidelines have been defined for each invasive procedure.

Adult↗

PubMed2005

Design of a Multi Dimensional Database for the Archimed DataWarehouse.

The Archimed data warehouse project started in 1993 at the Geneva University Hospital. It has progressively integrated seven data marts (or domains of activity) archiving medical data such as Admission/Discharge/Transfer (ADT) data, laboratory results, radiology exams, diagnoses, and procedure codes. The objective of the Archimed data warehouse is to facilitate the access to an integrated and coherent view of patient medical in order to support analytical activities such as medical statistics, clinical studies, retrieval of similar cases and data mining processes. This paper discusses three principal design aspects relative to the conception of the database of the data warehouse: 1) the granularity of the database, which refers to the level of detail or summarization of data, 2) the database model and architecture, describing how data will be presented to end users and how new data is integrated, 3) the life cycle of the database, in order to ensure long term scalability of the environment. Both, the organization of patient medical data using a standardized elementary fact representation and the use of the multi dimensional model have proved to be powerful design tools to integrate data coming from the multiple heterogeneous database systems part of the transactional Hospital Information System (HIS). Concurrently, the building of the data warehouse in an incremental way has helped to control the evolution of the data content. These three design aspects bring clarity and performance regarding data access. They also provide long term scalability to the system and resilience to further changes that may occur in source systems feeding the data warehouse.

Databases, Factual↗

PubMed2005

[Standards and Options for the use of radiation therapy in the management of patients with osteosarcoma. Update 2004].

CONTEXT: The A "Standards, Options and Recommendations A" (SOR) project, started in 1993, is a collaboration between the Federation of French Cancer Centres (FNCLCC), the 20 French regional cancer centres, and specialists from French public universities, general hospitals and private clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and the outcome of cancer patients. The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. OBJECTIVE: To update the SOR recommendations for the use of radiation therapy in the management of patients with osteosarcoma. This work was performed in collaboration with the French society against cancers in children and adolescent (SFCE). METHODS: Data have been identified by literature search using MedlineA (from January 1992 to October 2003). In addition several Internet sites were searched in October 2003. RESULTS: The 3 mains standards are: 1) local and exclusive curative irradiation is not indicated as primary treatment for osteosarcoma or for local and operable recurrence, except for lesion in inaccessible sites or if the patient refuses surgery; 2) local and prophylactic adjuvant irradiation is not indicated for the treatment of osteosarcoma after chemotherapy (neoadjuvant and/or adjuvant) and complete macro or microscopic surgery, except for nonoperable R1 or R2 surgical resection and 3) whole-lung prophylactic irradiation is not indicated in non-metastatic osteosarcoma. Systemic metabolic radiotherapy for pain treatment, using samarium-153 ethylene diamine tetramethylene phosphonic acid (Sm-153-EDTMP) can be offered to patients with painful metastatic osteosarcoma or in case of recurrent bone sites inaccessible to local therapies (surgery, external irradiation).

Bone Neoplasms↗

PubMed1992

The Glostrup Population Studies, 1964-1992.

The Glostrup Population Studies, 1964-92, comprise descriptive and analytical, clinical epidemiological studies. Since 1964, different birth cohorts have been examined. More than 20,000 persons, randomly selected from the background population of 300,000 inhabitants (Copenhagen County), have been invited to participate. The project started in 1964 with a survey of the 1914 population on risk factors for coronary heart disease. As the 1914 population has been followed and new cohorts added, a time-sequential design, suited for studies of aging, has been constructed. The staff has been kept in the unit for up to 28 years. Doctoral candidates in medical science and Ph.D candidates have defended their analyses of Glostrup data in several fields and continue to belong to the group of representatives, supporting the board of leaders. The head of Medical Department C serves as chairman, thus maintaining a close connection with clinical medicine.

Adult↗

PubMed2006

[Standards, options and recommendations for the management of procedure-related pain (lumbar puncture, bone marrow aspiration or biopsy, blood sampling) in children patients with cancer (summary report)].

CONTEXT: The Standards, Options and Recommendations (SOR) project, started in 1993, is a collaboration between the Federation of French Cancer Centres (FNCLCC), the 20 French cancer centres, and specialists from French public universities, general hospitals and private clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and the outcome of cancer patients. The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. OBJECTIVES: To establish the Standards, Options and Recommendations clinical practice guidelines for the management of procedure related pain (lumbar puncture, bone marrow aspiration or biopsy, blood sampling) in children oncology patients. To define, on the basis of the critical appraisal of the best available evidence and expert agreement, the clinical situations in which a pain preventive strategy should be implemented. METHODS: MEDLINE was searched using specific search strategies from January 1966 to August 2004. Literature monitoring was performed to identify controlled clinical trials published in 2005. RESULTS: A total of 57 references were identified. Clinical guidelines have been defined for each invasive procedure.

Biopsy↗

PubMed1987

[Results of the integration of psychiatric services in general hospitals. Testimony after ten years of absence.].

The author traces the evolution of psychiatrie services in Montréal and the province of Québec up until 1977. Following this summary, the author describes what has been undertaken in the area of mental health since that year. He also recounts his observations in the course of visits made in the fall of 1986 to certain hospital centers catering to short term patients (centres hospitaliers de courte durée), at the request of the Harnois Committee. Among his findings, he points out that the projects started at the onset of the Bédard and Castonguay reforms have been implemented, if not in spirit by the book, and that the integration of the entire psychiatric services of the C.H.C.D. is about to be completed.

English Abstract↗

PubMed2006

[Environmental protection techniques used in the federal state of Baden-Württemberg in Germany].

Within the framework of the programme "Partnership for Sustainable Development" The Ministry of Environment of the German Federal State of Baden-Württemberg has come up with a project "Study Visit--Environmental Protection Techniques". It was intended as a three-week study visit for environmental protection experts from Central and Eastern European Countries (CEEC) to learn about the environmental protection techniques used in this federal state. Visits were paid to companies producing, applying or installing plants based on the state-of-the-art environmental protection techniques. The project started in 2005 and will last five years. The first visit to Baden-Württemberg was scheduled for 25 September-14 October 2005 for 12 experts from 12 countries: Bulgaria, Croatia, Cyprus, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Slovakia and Ukraine.

Conservation of Natural Resources↗