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At least 397 records · Page 22Linked to original sources
PubMed2004

Patterns of agent interaction scenarios as use case maps.

A use case map (UCM) presents, in general, an abstract description of a complex system and, as such, is a good candidate for representing scenarios of autonomous agents interacting with other autonomous agents. The "gang of four" design patterns are intended for object-oriented software development but at least eight of the patterns illustrate structure, or architecture, that is appropriate for interacting agents, independent of software development. This study presents these particular patterns in the form of UCMs to describe abstract scenarios of agent interaction. Seven of the patterns attempt to balance the decentralized nature of interacting agents with an organized structure that makes for better, cleaner interactions. An example performance analysis is provided for one of the patterns, illustrating the benefit of an early abstraction of complex agent behavior. The original contribution here is a UCM presentation of the causal paths in agent behavior as suggested by software design patterns.

Algorithms↗
PubMed1983

Treatment of airways obstruction.

This review of the treatment of airways obstruction attempts to demonstrate that treatment needs to be guided by an understanding of pathophysiology and pathogenesis as well as a knowledge of the natural history of the diseases underlying airways obstruction and their causes. This enables effective health education and prevention to be applied where appropriate and treatment itself to be directed in an intelligent and logical manner.

Adrenal Cortex Hormones↗
PubMed1996

Role of pharmacokinetic-pharmacodynamic principles in rational and cost-effective drug development.

An important goal of drug development is to define dose and concentration-response relationships for new drugs and biologics. Such critical information from controlled clinical trials can provide primary evidence of efficacy and safety and an informative database for devising dosing instructions for clinical use. This article describes applications of pharmacologic principles [pharmacokinetic-pharmacodynamic (PK-PD)] and modeling methods for drugs in which the evaluation process is guided by and/or identifies significant PK and/or PD variability in drug response. In the case of the recently registered immunosuppressive agent, tacrolimus, preclinical PK-PD in model systems can be used to rationally design safe and effective immunomodulatory dosing regimens for phase 1 clinical studies. Furthermore, a study design based on concentration control guided by a novel artificial intelligence modeling system (AIMS) can be efficiently applied to conduct randomized clinical trials in auto-immunity and to implement cost-effective therapeutic drug monitoring of tacrolimus and cyclosporine in clinical transplantation. In the case of a cardioselective beta-adrenergic blocking agent, betaxolol, marketed for essential hypertension, population PD modeling can be shown to be a more efficient method for estimating dose response compared with standard statistical tests. Using a sigmoid Emax PD model, only a fraction (40 of 300) of the randomized patients was needed to demonstrate dose response. Therefore, two methods, i.e., PD modeling of dose response and AIMS-guided dosing, can achieve significant cost benefits for drug developers, patient care, and the health care system.

Artificial Intelligence↗
PubMed2004

Long-term, open-label study of risperidone in children with severe disruptive behaviors and below-average IQ.

OBJECTIVE: This study determined the long-term safety and effectiveness of risperidone in treating severe disruptive behavior in children with subaverage intelligence. METHOD: This 48-week, open-label extension included 107 children ages 5-12 years with severe disruptive behavior disorders (according to DSM-IV criteria and a score of > or = 24 on the conduct problem subscale of the Nisonger Child Behavior Rating Form) and subaverage intelligence (IQ 36-84) who completed at least 2 weeks of a randomized, double-blind, placebo-controlled study of risperidone. All patients received 0.02-0.06 mg/kg/day of oral risperidone; the purpose was to accumulate long-term safety data. Scores on the Nisonger Child Behavior Rating Form were also obtained. RESULTS: The mean risperidone dose was 1.5 mg/day. The most common adverse events reported were somnolence (33%), headache (33%), rhinitis (28%), and weight gain (21%). Somnolence was usually mild and transient. The mean weight increase was 5.5 kg; half was attributable to developmentally expected growth. Transient and asymptomatic increases in prolactin levels were observed. There were no significant changes in Extrapyramidal Symptom Rating Scale scores and no cases of tardive dyskinesia. No clinically relevant changes in ECGs or vital signs were noted. Risperidone was associated with rapid, significant improvement on the conduct problem subscale score of the Nisonger Child Behavior Rating Form in patients previously treated with placebo; improvement was maintained during long-term treatment and in patients previously given risperidone. CONCLUSIONS: Long-term risperidone appears to be generally safe, well tolerated, and effective for treating severely disruptive behaviors in children with subaverage intelligence.

Antipsychotic Agents↗
PubMedDate not supplied

Neuropsychologic sequelae in the long-term survivors of childhood acute lymphoblastic leukemia.

The neurotoxicity of either systemic chemotherapy or central nervous system prophylaxis was studied in 19 children treated for acute lymphoblastic leukemia (ALL). They had completed ALL therapy at least a year before and survived more than 5 years after diagnosis. The duration between age at diagnosis and age at investigation was 8.6 +/- 2.7 years (5-15 years). Neuropsychologic tests, cranial magnetic resonance imaging (MRI), and evoked potentials (EP) were studied. Seventeen healthy siblings were taken as a control group. Emotional evaluation was done using the childhood depression inventory and Beck depression inventory. Cognitive functions were evaluated using Wechsler's Intelligence Scale for Children-Revised (WISC-R) or the Wechsler's Adult Intelligence Scale-Revised (WAIS-R) tests, which were adapted to Turkish children. Performance and total IQ scores (94.0 +/- 16.8 and 92.2 +/- 16.5) were significantly low as compared to the control group (112.1 +/- 18.9 and 105.4 +/- 14.2) (p = .007 and p = .02). Abnormal MRI findings were found in 33.3% (6/18). Three out of 18 patients (16.6%) had abnormal auditory while 5 out of 17 patients (29.5%) displayed abnormal visual EPs. Abnormal findings in MRI, cognitive examination, and electrophysiologic testing were not associated with age at diagnosis, radiotherapy doses, intermediate/high-dose systemic methotrexate administration or central nervous system involvement. But more patients must be studied to demonstrate discrete outcomes of neurotoxicity in long-term survivors of childhood leukemia.

Adolescent↗
PubMed2002

[Telemedicine: chances and risks].

PROBLEM: Due to the rapid progress in the fields of information technology and data networks, telemedicine applications are growing in number. Besides curative telemedicine, the electronic exchange of medical data and the integration of health information systems between health care providers is gaining importance. Through the improved accessibility of electronic patient record information, considerable risks arise. METHODS: A project for the interconnection of medical picture archiving and communication systems (PACS) between several hospitals is presented and the possibilities for further developing such networking systems utilizing new software technologies for transparent data access between different locations (GRID) and for decision support (software agents) are considered. RESULTS: The availability of the electronic patient record via the data network and the perspective of semi intelligent software systems automatically preparing the data bears great potential for a boost in treatment quality and efficiency. Systems for unique electronic patient identification and for secure digital signature are a prerequisite, but per se not enough to ensure the protection of data against illegitimate access. CONCLUSION: Despite quality and efficiency benefits, challenges in the protection of sensible data and in the change of the physicians role result.

Artificial Intelligence↗
PubMed1996

Nonsteroidal antiinflammatory drug use and cognitive function in the elderly: inconclusive results from a population-based cohort study.

As part of the cohort Paquid, we studied the relationship between the use of NSAID, incidence of dementia, and evolution of cognitive functions. Dementia was diagnosed by DSM-III criteria and cognitive functions was assessed through the Mini-Mental Status Examination (MMSE). During 2 years of follow-up, the incidence rate of dementia was 3.84% among 53 NSAID users as compared with 3.77% in 1199 nonusers (OR, 0.98; 95% CI, 0.23-4.16). Using a cutoff of -3 points for the MMSE score and taking into account age and educational status in a logistic regression model, NSAID use was related to an unfavourable variation of the MMSE score (OR, 2.84; 95% CI, 0.99-8.1).

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2004

Are the cognitive effects of atypical antipsychotics influenced by their affinity to 5HT-2A receptors?

It is well documented that atypical antipsychotics have an influence on cognitive function in patients with schizophrenia, although the neurochemical basis for this effect is not well understood. One suggestion is that the effects are exerted through action on 5HT-2A receptors, which leads to changes in the level of dopamine in the prefrontal cortex. The following study explored this hypothesis by comparing the cognitive effects of the atypical antipsychotics which have a high affinity for 5HT-2A receptors, with those that have little or no affinity to these receptors. Forty-four patients with a DSM-IV diagnosis of schizophrenia were recruited within 6 weeks of starting one of the atypical antipsychotics: clozapine, olanzapine, risperidone, quetiapine, or amisulpride. The patients were divided into two groups according to the 5HT-2A affinity of the individual medications (high 5HT-2A affinity--clozapine, olanzapine, risperidone vs. low 5HT-2A affinity--quetiapine, amisulpride). Patients were tested on a broad range of neuropsychological measures after 9 months and 18 months of treatment. The high 5HT-2A affinity group showed a decrement in performance on tests of visual recognition memory and planning ability. In contrast, the low-5HT-2A affinity group showed improvements on these measures in addition to others. The 5HT-2A affinity of the atypical antipsychotics is an important determinant of their cognitive effects.

Adult↗
PubMed1990

Cognitive disturbances in neuroleptic therapy.

Eighteen patients (7 men, 11 women) from one of the centres taking part in a multicentre comparative study of remoxipride and haloperidol in the treatment of acute schizophrenia were investigated separately to study the effect of the two neuroleptic drugs on cognitive abilities. The tests of cognitive ability that were used are standard in West Germany. The results of this study indicate that there could be differences between remoxipride and haloperidol regarding their effects on cognitive abilities--the patients who had been treated for four weeks with remoxipride showed a greater "mental fitness".

Adult↗
PubMed2004

Psychomotor slowing in hepatitis C and HIV infection.

BACKGROUND: Both HIV and hepatitis C virus (HCV) may enter the central nervous system and cause cognitive and/or motor dysfunction. There are limited data on cognition and no data on motor performance in HIV/HCV-coinfected patients. OBJECTIVE: To provide data on cognition and motor performance in HIV/HCV infected patients. METHODS: We compared 43 HIV-seropositive but HCV-seronegative patients, 43 HIV/HCV-coinfected patients, and 44 HIV-negative but HCV-positive patients, all of whom went through neuropsychologic testing and electrophysiologic assessment of basal ganglia-mediated motor function. RESULTS: No significant differences could be found among the groups with regard to premorbid verbal and actual nonverbal intelligence, attention, and memory; the HIV dementia scale; and all somatic and most psychiatric complaints. Affective disorders were less frequent in HIV-negative but HCV-positive patients. This group also scored lower for depression. For all 3 groups, significant pathologic slowing of most rapid alternating movements (right hand) compared with those of HIV/HCV-negative controls as well as significantly prolonged contraction times (both hands) could be diagnosed. Simple reaction times were significantly prolonged only in HIV/HCV-coinfected patients. CONCLUSIONS: Although clinically asymptomatic, both HIV-positive and HCV-positive patients may show affective disturbances and significant psychomotor slowing. A potential predictive value for the further course of infection, which is well established in HIV-positive patients, remains to be investigated in HCV-positive or HIV/HCV-coinfected patients.

Adult↗
PubMedDate not supplied

Thyroid function and intellectual development of children of mothers taking methimazole during pregnancy.

There is some debate regarding the safety of methimazole (MMI) therapy during pregnancy. It is not known whether MMI therapy in mothers during pregnancy is safe for their children or if it causes alterations in thyroid function and intellectual development during childhood. Twenty-three children, whose mothers were hyperthyroid during pregnancy and treated with MMI 5-20 mg were studied from age 3-11 yr. Thyroid function and liver function tests, urinary iodine, anti-thyroid antibodies, intelligence quotient (IQ), verbal and functional components of Wechsler test were performed on 23 children of thyrotoxic mothers and 30 controls. In all children T3, T4, RT3U and TSH concentrations were normal. Mean T3, T4 and TSH values were 147 ng/dl, 9.7 microg/dl and 1.2 mU/l, respectively. Height, weight, thyroid function, and thyroid antibodies did not differ from controls. None of the children had T4 below 6 microg/dl or TSH>3.0 mU/l. Liver enzymes and serum albumin were normal in both groups. Mann-Whitney test showed no difference in verbal and performance IQ and their components between children of thyrotoxic mothers and controls. Total IQ of cases and controls was 117 +/- 11 and 113 +/- 14, respectively. No deleterious effect occurred in thyroid function and physical and intellectual development of children whose mothers were treated during pregnancy with doses of MMI up to 20 mg daily.

Alanine Transaminase↗
PubMed1979

Bedside maneuvers in the diagnosis of heart disease.

Numerous other pathologic conditions are encountered. The relatively few maneuvers and drugs presented here were chosen as the ones most commonly used in daily practice. Cardiac auscultation is just one aspect of the cardiovascular examination; equal attention should be paid to determination of jugular venous pressure, jugular venous wave form, carotid upstroke characteristics, and to observation and palpation of the precordium. Finally, if the examiner keeps in mind the hemodynamic changes induced by the various maneuvers and pharmacologic agents while auscultating the heart, and if he understands the pathophysiology of the commonly encountered cardiac lesions, he should be able to diagnose heart disease and to evaluate more intelligently various murmurs and heart sounds without necessitating the use of expensive invasive or noninvasive procedures.

Adolescent↗