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PubMed2005

Short report: Rapid DNA extraction from archive blood spots on filter paper for genotyping of Plasmodium falciparum.

The practical advantages of sampling and storing blood on filter paper for analyses of human and pathogen genes highlight the need for reliable, sensitive, and cost-effective DNA extraction methods. We describe a new Tris-EDTA (TE) buffer-based method for extraction of DNA from blood dried on filter paper. The method was evaluated against the commonly used methanol and Chelex methods, regarding polymerase chain reaction detection of Plasmodium falciparum parasites from samples stored for 1-2 years. The sensitivity of detection was dependent on the parasite density and type of filter paper. For 3MM Whatman filter paper, the sensitivity was 100%, 73%, and 93% for the TE, methanol, and Chelex methods, respectively. For the longer stored 903 Schleicher & Schuell filter paper, the sensitivity was 93%, 73%, and 0%, respectively. This rapid, simple, and inexpensive extraction method generated superior results from archived specimens compared with the two standard methods and may represent a useful tool in molecular epidemiologic studies.

Animals↗

PubMed2005

Computer-administered bath ankylosing spondylitis and Quebec Scale outcome questionnaires for low back pain: agreement with traditional paper format.

OBJECTIVE: To measure the agreement between computer and paper-administered versions of Bath ankylosing spondylitis (AS) questionnaires and the Quebec Scale for low back pain (LBP). METHODS: Fifty patients with LBP completed the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Functional Index (BASFI), Global Score (BAS-G), and the Quebec Scale. Outcome measures were administered both in traditional paper format and by computerized touch-screen system. The order of completion was randomly assigned to each participant. The length of time required to complete each set of questionnaires was recorded and a "washout" period of at least 40 minutes was ensured between completion of the first and second set of outcome measures. RESULTS: There was no statistically significant difference in completion time between the 2 methods of administration. A small systematic difference between computer and paper-administered versions was observed in the Quebec Scale and in the BAS-G results. However, there was a high degree of agreement between paper and computer-administered versions of the Quebec Scale, the BASDAI, BASFI, and BAS-G. Out of the 50 subjects, 84% indicated a preference for the computer-administered method. CONCLUSION: The Bath AS questionnaires and the Quebec Scale can be reliably administered by a computerized touch-screen system. Given the ease of data integration and analysis supported by computer-administered versions of these outcome measures, their excellent reliability, and their popularity among study participants, the computerized versions of the BASDAI, BASFI, BAS-G, and Quebec Scale seem preferable to the traditional paper format.

Adult↗

PubMed2005

Pneumocystis jiroveci in HIV/AIDS patients: detection by FTA filter paper together with PCR in noninvasive induced sputum specimens.

OBJECTIVES: To detect P. jiroveci (previously named P. carinii) by PCR using FTA filter paper to extract the DNA, from noninvasive induced sputum samples of HIV/AIDS patients. MATERIAL AND METHOD: Fifty two HIV/AIDS patients suspected of Pneumocystis jiroveci pneumonia (PJP) in King Chulalongkorn Memorial Hospital were recruited. Both cytological method and PCR with FTA filter paper technique were performed to detect P jiroveci from each specimen. RESULTS: The detectability rate of P. jiroveci infection was 21%. The PCR with FTA filter paper method was 4 folds much more sensitive than Giemsa staining technique. P. jiroveci was detected in 18% of the HIV/AIDS patients in spite of receiving standard PJP prophylaxis. CONCLUSION: Detection of P. jiroveci by using FTA filter paper together with PCR in induced sputum samples could detect more cases of P. jiroveci infection than by using cytological method. DNA extraction using the FTA filter paper was more rapid and convenient than other extraction methods. The causes of failure of PJP prophylaxis should be evaluated.

AIDS-Related Opportunistic Infections↗

PubMed1989

[Effects of articulating paper on mandibular paths in lateral and protrusive excursions].

Mandibular movements in 7 normal dentulous subjects during lateral and protrusive excursions were studied to investigate the effects of the clinical use of articulating paper on mandibular paths. Mandibular movements with or without the intraoral articulating paper (thickness: 35 microns) were detected as the lower incisal point displacement and were recorded three-dimensionally with the Selspot system. The date displayed on the X-Y chart recorder on the selected plane were analyzed quantitatively. 1. The paths of the mandible differed between the outward (from the intercuspal position) and the return (backward to the intercuspal position) movements. In lateral excursions the return path tended to be antero-inferior to the outward path, whereas in protrusive excursions the former tended to be dextro-inferior to the latter. 2. In lateral excursions the return path tended to be less stable than the outward path. In protrusive excursions no significant difference was found between the two paths. 3. In lateral excursions, 21-34% of the movements performed using the articulating paper deviated from the normal paths made without using the paper, and in the case of protrusive excursions, deviation was found in 21-50%. At or near the intercuspal position, the return path showed a greater deviation than the outward path. Near the edge-to-edge position, however, the relationship between these two path was reversed. 4. It is suggested that, when the articulating paper is used, the directions of the movement should be taken into account and sufficient care should be paid in occlusal adjustment because the range of functional movement may be overestimated.

Dental Occlusion↗

PubMed1986

Collection of blood on filter paper for measurement of glycated hemoglobin by affinity chromatography.

We present data on a filter-paper collection and assay method for measurement of glycated hemoglobin (gHb). Onto filter paper dipped into a solution of glucose oxidase (EC 1.1.3.4) and allowed to dry, approximately 20 microL of capillary blood was spotted. For analysis, we eluted the dried blood spot from the paper by soaking in water for 1 h, then measured the gHb in the eluate by affinity chromatography. Because the gHb significantly increased from day 1 to day 14 of storage, it was necessary to standardize the day of elution from the paper. We found a high correlation between gHb measured from samples stored for 14 days on treated paper and gHb measured by affinity chromatography from frozen whole blood or hemolysates (r = 0.96). This method is convenient, requiring small amounts of blood and little sample handling and assay time, and may be particularly useful in certain situations such as large-scale screening for diabetes.

Blood Specimen Collection↗

PubMed1979

ASHP Midyear Clinical Meeting papers: 1967--1978.

Trends in the types of topics of papers presented at the American Society of Hospital Pharmacists' Midyear Clinical Meetings from 1967 to 1978 are reviewed. A total of 1,210 abstracts of papers presented at the 12 meetings were reviewed. Twenty-three subject categories were identified. Papers were subdivided into four different study types--review, case report, report, and study. Topics such as general hospital pharmacy, management and administration, and drug distribution were emphasized more during the early years of the meeting. Papers on role evaluation, adverse drug reactions and drug use review were presented more frequently in the early 1970s. Therapeutics and general clinical pharmacy were topics consistently emphasized. Case reports increased from 0% in 1967, to 2% in 1972, to 6% in 1978. Review papers decreased from 72% in 1967, to 11% in 1972, to 3% in 1978. Studies increased from 4% in 1967, to 28% in 1972, to 43% in 1978. Concentration on increasing the number of studies presented at the meeting will advance hospital pharmacy and thus improve patient care.

Congresses as Topic↗

PubMed1995

The production and reception of scientific papers in the academic-industrial complex: the clinical evaluation of a new medicine.

The production and reception of scientific papers in the academic-industrial complex have been neglected in sociology. In this article the social processes which influence the nature of the scientific paper in that complex are explored in depth by taking a number of controversial medical papers as case studies. The empirical evidence is collected and discussed in the light of sociological theories of normative ethos, paradigm development, reward-induced conformity and social interests in science. It is concluded that within the medical-industrial complex conformity to industrial interests can be a major criterion in defining the kind of reception given to a scientific paper and the professional autonomy of the authors in the paper's production, rather than an ethos of scientific scepticism or commitment to paradigmatic conventions. This is seen to have implications for the production of scientific knowledge - implications that might be in conflict with the public interest. Consequently, the desirability of current British Government proposals to intensify its policy of making science more responsive to the needs of industry may have significant drawbacks, hitherto unacknowledged in official circles, and in need of more extensive sociological investigation.

Clinical Trials as Topic↗

PubMed1993

Application of statistical methods in the papers published in the East African Medical Journal (EAMJ) since 1923.

The subject Statistics was hardly known in the research world at the time the EAMJ was being started in 1923. It was at this time, scientists working in their field of specialization were busy developing statistical methods with the aim of solving problems affecting them in their research work. Using a random sample of some of the papers published by the EAMJ, this paper evaluates the usage of statistical methods since 1923. Usage was very low before 1965, but started picking-up with a rising trend since then but still not impressive. Scientists should strive to apply statistical methods correctly in their research work. EAMJ should lay more emphasis on statistical refereeing as a policy to raise the quality of published papers in the Journal. If statisticians were not available, which often may be the case, scientists should be encouraged to show their work to other research colleagues working in similar areas, before sending the paper to the EAMJ. By adopting this approach, it is possible that the quality of papers will go up and the usage of statistical methods will increase.

Bias↗

PubMed1994

The contributions of authors to multiauthored biomedical research papers.

OBJECTIVE: To determine the contributions of each author to multiauthored biomedical research papers. DESIGN: Mailed, self-administered survey. PARTICIPANTS: A total of 184 first authors from a consecutive sample of 200 papers with four or more authors published in 10 leading biomedical journals. MAIN OUTCOME MEASURES: First authors' ratings of which authors had made substantial contributions to the following: initial conception of the study, design of the study, provision of needed resources, collection of data, analysis and interpretation of data, and writing the first draft of the paper or revising drafts for important intellectual content. RESULTS: The contributions of nonfirst authors varied greatly within and among papers. Even second and last authors--though they generally contributed more than other nonfirst authors--were markedly inconsistent in the extent and pattern of their contributions. Time spent on the research differed among authors by orders of magnitude. An appreciable number of authors made few or no substantial contributions to the research. CONCLUSIONS: The nature and extent of contributions of nonfirst authors to biomedical research reported in multiauthored papers cannot reliably be discerned (or discounted) by authorship or order of authors. The two core purposes of scientific authorship--to confer credit and denote responsibility for research--are not adequately being met by these authorship practices.

Authorship↗

PubMed1995

An analysis of the paper-based health record: information content and its implications for electronic patient records.

An analysis of paper-based charting was carried out at Sunnybrook Health Sciences Center as a prelude to developing a strategic plan to implement an electronic patient record. A relational model of the Sunnybrook paper chart was developed, describing each of its forms in terms of specific data fields. Three hundred and forty nine different forms are in current use at Sunnybrook, containing 64 types of data fields such as Patient Demographics, Vital Signs, and Doctor's Orders. The extent of data field duplication at the level of hospital forms was significant. A Patient Demographics field was present on all forms and on all pages of a patient's chart, as would be expected. Twenty seven other fields were duplicated on more than ten different forms, including Working Diagnosis which was present on 110 forms, History of Past Illness on 42 forms, and History of Present Illness on 32 forms. Current Medications were recorded on 32 forms and Allergy fields were present on 29 separate forms. Only five data fields of the total 64 were present on only one form. The duplication of data fields within complete patient charts was then examined to confirm that data field duplication was occurring within the actual healthcare delivery process. Using the relational model of the charting system, 143 acute care in-patient encounters were abstracted into the database. The charts were selected randomly from each of the hospital inpatient services. The numbers and types of forms within each chart were recorded, amounting to 18,654 physical pages and using 165 of the different forms. The average in-patient encounter within the model was 130.4 pages long, with a minimum of 27 pages, a maximum of 559 pages, and containing on average 25.8 different forms. The duplication of data fields within actual charts followed a pattern similar to the duplication found on the forms. Initial diagnosis was present on an average of 20.4 pages within the charts, with a minimum of 2 pages and a maximum of 152 pages containing this data field. Other frequently occurring data fields included History of Past Illness present on an average of 12.2 pages per chart, History of present illness on 10.2 pages per chart, and allergies on an average of 9.1 pages per chart. The results obtained through the examination of Sunnybrook charts should be generalizable to most paper-based systems. This study did not measure the workload associated with duplicating chart data. however, the magnitude of the duplication seen in this study leaves little doubt that significant amounts of time could be saved with appropriate modification of health care delivery processes. Multiple copies of the same data field within a database are referred to as aliases of each other. This study demonstrates that hospital charts contain many copies of the same information, such as medication lists, allergies etc. Due to manual replication of data fields, there is no mechanism to ensure that each copy of a data element within a chart actually contains the same information. This aliasing of data through manual duplication compromises the integrity of data within paper-based charts. Decisions and therapy based upon contradictory or inaccurate data are likely to lead to inefficient or erroneous care delivery; this has significant implications for hospital liability and quality of patient care. A growing recognition of the costs and risks of data replication within paper-based charting systems is driving the healthcare industry toward Electronic Patient Record systems. Better quality patient care data, provided by computerized records, is likely to be necessary but not sufficient to improving the efficiency and effectiveness of the healthcare system. Intelligent application of this information will be essential.

Medical Records↗

PubMed1996

CDR Review's editorial process: a survey of papers published in 1995.

Readers and authors of scientific material need and deserve to know how journal editors select and prepare papers for publication. Editors need to keep track of their procedures to avoid delay and ensure that there is always material to publish. This paper presents data on the time taken for the 48 papers published in the Communicable Disease Report Review in 1995 to be processed. The mean time from receipt to publication was five months. All papers were sent out to at least one referee and most to two. This paper describes the editorial process and suggests the adoption of blinded peer review.

England↗

PubMed1997

Chart recorder paper minder.

Many paper based chart recorders still suffer from paper uptake systems for the collection of chart record that operate inefficiently or haphazardly. An efficient low cost paper minder using 1.2 mm diameter stainless steel wire for the Siemens-Elema AB Mingograph 7, has been developed. This wire pivots from the end of the chart viewing table and provides an effective force to redirect paper into the standard collecting basket over the entire range of paper speeds.

Medical Records↗

PubMed1998

[Biomedical papers written by Chilean authors published in international journals in 1997. A review of MEDLINE].

BACKGROUND: Many Chilean biomedical investigators publish the results of their research in international journals, not easily accessible to fellow physicians of the country. AIM: To assess the amount and quality of papers published by Chilean authors in international journals. DATA SOURCE AND METHODS: Using MEDLINE databases from January to August, 1997, all papers in which Chile appeared in the field "AD" (Address of author) were selected. Papers with a clear relationship to human medicine were identified. RESULTS: During the study period, 390 papers with authors residing in Chile appeared in MEDLINE. Of these, 188 (48%) were published in Chile and the rest was published abroad. Thirty manuscripts had a greater relationship to clinical medicine and the authors of nine of them were invited to submit a translation of their abstract into Spanish to have them reproduced in the present article. CONCLUSIONS: A significant proportion of biomedical research papers originated in Chile is published abroad with the consequent lack of diffusion among non-specialized readers from their own country.

Bibliometrics↗

PubMed1961

Effect of paper on the performance assay in the control of antibiotic sensitivity discs.

Antibiotic discs were prepared, using several several batches of papers meeting Food and Drug Administration specifications. The analysis of 1,152 zones of inhibition produced showed no performance differences among these batches. Other discs were prepared using papers of different grades. These produced large differences in performance. It is obvious, therefore, that the use of a specified disc paper is necessary for standardizing the performances of the products of various manufacturers and that reproducible results can be attained with the grade of paper specified.

Anti-Bacterial Agents↗

PubMed1996

Health effects of working in pulp and paper mills: malignant diseases.

This paper reviews the available literature regarding the work environment in pulp and paper mills and the risk for malignant diseases. An increased risk for lung cancer among pulp and paper mill workers has been reported. Most studies are inconclusive with regard to considerations of etiologic agents. However, maintenance workers seem to be at an increased risk for lung cancer, as well as for malignant mesothelioma, indicating that this occupational group was (is) exposed to asbestos. Workers exposed to chlorine compounds also seem to run an increased risk for lung cancer. An increased risk for malignant lymphomas among pulp mill workers is a constant finding. The increased risk is observed both among sulfite and sulfate workers, indicating a common exposure. Such an exposure could be wood dust, terpenes, or preservatives present in the wood. An increased risk for leukemias has been found in many studies carried out on pulp and paper workers, but the studies do not permit any conclusions about etiologic factors. In some studies an increased risk for stomach cancer has been found. However, the socioeconomic status of the workers is strongly related to stomach cancer, and factors, such as dietary habits, have not been taken into account in any of the reviewed studies. Hence, no further conclusions can be drawn regarding etiologic agents.

Air Pollutants, Occupational↗

PubMed1997

Sensitization and exposure to methylisothiazolinones (Kathon) in the pulp and paper industry--a report of two cases.

Two cases of contact allergy to methylisothiazolinones from slimicides used in pulp and paper mills are described. The first patient worked as a batcher in a paper mill, and he was in charge of pumping slimicides containing methylisothiazolinones. During pumping, the liquid often overflowed, and his clothes were wet daily with slimicides. After 3 months of work, he began to suffer from dermatitis, which improved when he was away from work. A clinical investigation confirmed the dermatitis diagnosis and a positive skin patch test to Kathon CG was found. The second patient worked as an agent for a firm marketing slimicides containing methylisothiazolinones. One of his tasks was to pump slimicides into the mills, and during such operations his clothes often got wet from slimicides. After some years of work, he began to suffer from erythema and dermatitis after contact with the slimicides. A skin patch test showed a strongly positive reaction to Kathon CG. These case reports draw the attention to the fact that employees in the pulp and paper industry handling slimicides are exposed to extraordinarily high concentrations of methylisothiazolinones and run a substantial risk of being sensitized. The report also stresses the need for improved handling routines of those strong sensitizers in the paper mills.

Anti-Infective Agents↗

PubMed1999

Cancer incidence among women in the Norwegian pulp and paper industry.

BACKGROUND: The aim of the present study was to investigate cancer risk among women working in the Norwegian pulp and paper industry. The cohort included a total of 4,247 workers employed for at least one year between 1920 and 1993 (108,095 person-years), 85% of them as paper or administration workers. METHODS: The follow-up period for cancer was from 1953-1993. No data of exposure measurements were available. The analyses were based on comparisons of standard incidence ratios. The expected numbers of cancer cases were calculated using the five-year age-specific incidence rates for the entire female population. RESULTS: During the follow-up period, 380 new cases of cancer were observed vs. 322 expected (SIR = 1.2, 95% CI = 1.07-1.30). An excess risk of ovarian cancer was found (SIR = 1.5, 95% CI = 1.07-2.09). The SIR was highest among those younger than 55 years, and mostly among those working in paper departments. Short-term workers showed increased risk of lung and bladder cancer. CONCLUSIONS: Based on results from the present study, the increased risk of ovarian cancer is difficult to interpret, since existing knowledge of its etiology is limited. However, these women might have been exposed to various work-related agents such as talc, microbes, and different types of paper dust.

Adult↗

PubMed2003

Testicular cancer among Swedish pulp and paper workers.

BACKGROUND: The incidence of testicular cancer has increased in recent decades. The aims of the present study were to elucidate whether Swedish paper and pulp mill workers had an increased incidence of testicular cancer, and to investigate whether certain occupational groups within the pulp and paper mill workforce were at increased risk. METHODS: The study was based on the Swedish Cancer Environment Register, which links the incidence of cancer for the period 1971-1990 with 1960 and 1970 National Census data on specific industries and occupations for all employed subjects in Sweden. RESULTS: Among maintenance workers employed both in 1960 and in 1970 in paper mills there was an increased risk for testicular cancer (standardized incidence ratio (SIR) 7.4, 95% confidence intervals (CI) 1.5-22), especially for seminomas (SIR 10.1, 95% CI 2.1-29). Maintenance workers were also at increased risk when analyzing workers employed in 1960, 1970, or both years. CONCLUSIONS: This study indicates an increased risk for testicular cancer, especially seminomas, among maintenance workers, but not among process workers, in Swedish paper mills.

Cohort Studies↗