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PubMed2006

Diagnosis and management of ST elevation myocardial infarction: a review of the recent literature and practice guidelines.

There is a large volume of literature available to guide the peri-infarct management of ST elevation myocardial infarction (STEMI). Most of this literature focuses on improving the availability and efficacy of reperfusion therapy. The purpose of this article is to review contemporary scientific evidence and guideline recommendations regarding the diagnosis and therapy of STEMI. Studies and epidemiological data were identified using Medline, the Cochrane Database, and an Internet search engine. Medline was searched for landmark and recent publications using the following key words: STEMI, guidelines, epidemiology, reperfusion, fibrinolytics, percutaneous coronary intervention (PCI), facilitated PCI, transfer, delay, clopidogrel, glycoprotein IIb/IIIa, low-molecular-weight heparin (LMWH), beta-blockers, nitrates, and angiotensin-converting enzyme (ACE) inhibitors. The data accessed indicate that urgent reperfusion with either fibrinolytics or percutaneous intervention should be considered for every patient having symptoms of myocardial infarction with ST segment elevation or a bundle branch block. The utility of combined mechanical and pharmacological reperfusion is currently under investigation. Ancillary treatments may utilize clopidogrel, glycoprotein IIb/IIIa inhibitors, or low molecular weight heparin, depending on the primary reperfusion strategy used. Comprehensive clinical practice guidelines incorporate much of the available contemporary evidence, and are important resources for the evidence-based management of STEMI.

Bundle-Branch Block↗

PubMed2006

Blast2GO goes grid: developing a grid-enabled prototype for functional genomics analysis.

The vast amount in complexity of data generated in Genomic Research implies that new dedicated and powerful computational tools need to be developed to meet their analysis requirements. Blast2GO (B2G) is a bioinformatics tool for Gene Ontology-based DNA or protein sequence annotation and function-based data mining. The application has been developed with the aim of affering an easy-to-use tool for functional genomics research. Typical B2G users are middle size genomics labs carrying out sequencing, ETS and microarray projects, handling datasets up to several thousand sequences. In the current version of B2G. The power and analytical potential of both annotation and function data-mining is somehow restricted to the computational power behind each particular installation. In order to be able to offer the possibility of an enhanced computational capacity within this bioinformatics application, a Grid component is being developed. A prototype has been conceived for the particular problem of speeding up the Blast searches to obtain fast results for large datasets. Many efforts have been done in the literature concerning the speeding up of Blast searches, but few of them deal with the use of large heterogeneous production Grid Infrastructures. These are the infrastructures that could reach the largest number of resources and the best load balancing for data access. The Grid Service under development will analyse requests based on the number of sequences, splitting them accordingly to the available resources. Lower-level computation will be performed through MPIBLAST. The software architecture is based on the WSRF standard.

Computational Biology↗

PubMed2006

Strategies for health information retrieval.

BACKGROUND: The amount of health data accessible on the Web is increasing and Internet has become a major source of health information. Many tools and search engines are available but medical information retrieval remains difficult for both the health professional and the patients. OBJECTIVE: In this paper we describe heuristics that aim at matching as much as possible queries with the content of the documents in the context of the CISMeF catalogue (Catalogue and Index of Health Resources in French) and its Doc'CISMeF search tool. The queries are represented by terms and the content of the documents is indexed by a terminology based on the MeSH thesaurus. RESULTS: Several operations are performed to match the terms of the terminology: natural language processing techniques on multi-words queries, phonemisation, spelling correction, plain text search with adjacency etc.. Each one is tested to evaluate its contribution in matching the terminology and the indexed documents. CONCLUSION: The implemented heuristics contribute significantly with good results in maximising as much as possible the recall of the Doc'CISMeF search tool.

France↗

PubMed1991

Fatal injuries at work in California.

We examined deaths due to injury on the job reported from three readily accessible data sources in California for a 1-year period. Of 682 deaths identified as of February 1990 as having occurred on the job in 1983, county coroners identified 607 (89.0%), workers' compensation records identified 294 (43.1%), and the California Occupational Safety and Health Administration investigated 141 (20.7%). Most fatal injuries at work resulted from events that are not covered by current California Occupational Safety and Health Administration standards: transportation vehicle accidents and homicides. Demographic patterns suggest that fatal injuries on the job are nonrandom events, which may be prevented by additions to existing standards or increased enforcement of workplace safety standards and by efforts to target groups at highest risk. Improved surveillance of fatal occupational injuries will require changes in existing reporting mechanisms, similar to those proposed by the US Bureau of Labor Statistics.

Accidents, Occupational↗

PubMed1991

The epidemiology of toxic stews.

'Toxic stews' is a term which refers to the innumerable manmade chemicals to which we are exposed today. Neither their composition nor their toxicity in humans and the environment is sufficiently understood. Little interest has been aroused thus far by synergisms between these substances. The sources of toxic stews are many and diverse: chemical products and associated impurities; industrial and household waste water; emissions from combustion, incineration and other industrial processes; exhaust fumes from traffic and power plants; etc. These negative aspects of modern life contribute to the development of chronic diseases such as cancer, allergies, and diseases of the respiratory tract and central nervous system. There are severe obstacles to, and deficiencies, in official monitoring of pollutants, including problems of data access, chemical analysis, and toxicological and epidemiological research. It is urgent that the role of the physician as guardian of human health be expanded to include a stronger emphasis on environmental protection as an important component of preventive medicine.

Animals↗

PubMed1990

[Useful results from the study of induced abortion in routine practice in gynecology departments].

The article presents the evaluation of the application of the results proceeding from 25 clinical-epidemiologic studies in the field of induced abortion (IA). They were performed with the aim of optimizing the whole procedure and the diminishing of early complications at the former Family Planning Institute and at the University Department of Obstetrics and Gynecology in Ljubljana in the period from 1968 to 1988. On the basis of the accessible data provided by official statistics and the results obtained by the aimed evaluation survey performed at all Slovenian gynecological departments and in some other Yugoslav health-care facilities, the following can be concluded: -the results obtained by the studies could be used more efficiently in routine work at gynecological departments, permanent evaluation of the complete IA procedure concerning the behavior of women and operators is a necessity, and--a periodical evaluation is needed after the results of new studies have been introduced. Beside all this, an agreement would be necessary regarding the doctrinary approach to the IA procedure on a certain territory with the same characteristics of women and the same conditions for work. Additional studies of new, nonsurgical methods of pregnancy interruption with new prostaglandin analogues and antiprogesterones are needed, and a more intensive dissemination of results in professional, as well as in popular press releases, should be provided for.

Abortion, Induced↗

PubMed1987

[New long-term patients--demographic and diagnostic peculiarities].

This paper presents results of a study which was done as part of an investigation on predictor variables for new long-stay patients. Using easily accessible data, e.g. age, sex, diagnosis, etc., 145 new long-stay patients of the Psychiatric Department of Berne University (PUK Bern) admitted from 1979 to 1982 were compared with all in-patients and 396 old long-stay patients of the same clinic, as well as with British and German case-register populations. A total of 3.1% of all admissions in this four-year-period received in-patient treatment for more than one year; this proportion is similar to those reported from British and German case-registers. Older patients tend to have more long stays in hospitalizations; only 25% in the PUK new long-stay population were aged 65 and over. The sex ratio men: women was 1:1, whereas there are twice as many women as men among new long-stay patients in Great Britain. Looking at marital status we found, as could be expected, only very few married people (15%), compared with 62% unmarried and 23% widowed or divorced. The diagnostic composition showed that organic brain syndromes, schizophrenia, personality disorders, and mental retardation were over-represented in the new long-stay population. The diagnostic comparison between new and old long-stay patients showed substantial differences which proved to be congruent with the results of other investigators.

Adult↗

PubMed1988

Sex research and sexual conduct in the era of AIDS.

The onset of the AIDS epidemic has made evident how scanty our knowledge is about sexuality, not only in the developing world where behavioral science resources are limited, but in the developed world as well. That the findings of the Kinsey group of nearly half a century ago remain relevant to current scientific discussion is an important measure of the lack of a well-developed and active research tradition in the area of sexuality. As a result of a lack of support for sex research, except in a number of very limited areas, when the epidemic began, there was a lack of baseline data, accessible and tested research techniques, and trained personnel. There is evidence that some of these problems are being addressed as new research initiatives are being undertaken both nationally and internationally that are relevant to both AIDS and sexuality. At the same time, a majority of this research has been driven by a concern for the disease and has not taken into account the larger role of sexuality in the life of individuals in specific cultures and societies. Much of the research that has been undertaken is examining sexuality from the perspective of AIDS rather than AIDS in the perspective of sexuality. Perhaps it is well to understand that long after the AIDS epidemic is history, sexuality will remain with us as a source of pleasure and difficulty.

Acquired Immunodeficiency Syndrome↗

PubMed1984

The early time course of calcium-binding protein induction by 1,25-dihydroxyvitamin D3 as determined by computer analysis of two-dimensional electrophoresis gels.

The time course of calcium-binding protein induction by 1,25-dihydroxyvitamin D3 was examined in embryonic chick duodena by single-label autoradiography. Duodena were excised from 19-day-old embryos, cultured for 24 h in defined medium, and exposed to 1,25-dihydroxyvitamin D3 at 1/2, 1, 1 1/2, 2, 2 1/2, 4, 6, and 20 h before the end of the culture period. Control duodena were identically handled but were not exposed to the hormone. All duodena were pulsed with [14C]leucine during the final 30 min of incubation. Cytosolic proteins, extracted from each radiolabeled tissue, were resolved by two-dimensional electrophoresis and autoradiographs were prepared from the resulting gels. Calcium-binding protein was detectable by autoradiography in duodena cultured with hormone for 1 h or more but not in the control duodena. The autoradiographs were converted to digital images by a scanning densitometer and entered into the Man-computer Interactive Data Access System. The total radioactivity incorporated into calcium-binding protein during the 30-min pulse was determined by computer analysis of the digitized autoradiographs, and the rate of calcium-binding protein biosynthesis was calculated. Duodena cultured with hormone for 1-20 h synthesized calcium-binding protein at rates of 129 +/- 17 to 8800 +/- 110 pg/mg of cytosolic protein/30 min. These rates demonstrate that calcium-binding protein is induced within the first hour of exposure to 1,25-dihydroxyvitamin D3, but in amounts too small to be detected by commonly used immunoassays.

Animals↗

PubMed1994

[The latest results of the advanced hypopharyngeal cancer surgery with immediate reconstruction using the free jejunal autograft].

In 21 patients with T3, T4 pharyngo-laryngeal cancer circumferential resection with immediate reconstruction using a free revascularized jejunal autograft was performed. In 13 cases the jejunal reconstruction was successful. In patients previously not irradiated the rate of success was 75% and in irradiated ones 37.5%. Five patients survived more than 5 years: one more than 7, two more than 6 and one more than 5. One patient with an unsuccessful jejunal graft and with subsequent skin reconstruction survived more than 6 years. The causes of failure were:-irreversible spasm of the arteries in 2 cases, skinking of the vessels resulting in flap necrosis in flap necrosis in 2 cases, -necrosis due to widespread atherosclerosis of the cervical arteries in 3 cases and of an unknown cause in 1 case. The cause of death was: widespread metastases in 12 cases, C.V.A. in 1 case, road traffic accident in 1 case, complications of the ileus in 1 case and carotid artery haemorrhage in 1 case. One of the successful patients was irradiated postoperatively, because the pathology report stated there was incomplete resection, and survived more than 6 years with no disturbance of swallowing. In general 10 patients died in the first year, 4 in the second, 1 in the third and 1 in the fourth--without any signs of recurrence. The five year survival of 24% in the presented group is relatively high in comparison with the generally accessible data for T3, T4 hypopharyngeal carcinoma treated by any of the usual methods.

Adult↗

PubMed1994

[A PACS system in clinical reality: the Trieste project].

The authors report on their experience gained during 5 years' use of a PACS Comm View (AT & T and Philips) in daily clinical practice. The system proved to be very effective in the preparation phase (retrieval of previous investigations), with major advantages over the conventional retrieval modality. The rate of unretrieved images is < 2% and their retrieval times are 10-210 seconds according to different archiving systems. The retrieval of previous images at the two workstations of our department took actually place 20 times a day--that is, much more than in past years. The reporting function was not implemented at the workstation due to its inherent limitations. Communicating the diagnoses (images and reports) to the hospital wards with PACS and RIS was highly appreciated by the referring physicians and a questionnaire distributed among them demonstrated that rapid data access: 1) avoids exam repetitions or unnecessary investigations (81.3% of answers); 2) avoids the request of previous medical records (80% of answers); 3) markedly shortens (two or more days) hospitalization time (100% of answers); 4) has a major impact on treatment choices (100% of answers) and 5) improves the efficiency of referring physicians (93.8% of answers). All the images acquired by the 5 connected modalities were entered in a juke-box with optical disks. Therefore, archive size is likely to reduce in the future. Slightly fewer films (about 14,000 USD/year) are now used.

Attitude to Computers↗

PubMed1993

[DKPM basic documentation. A uniform basic documentation for inpatient psychosomatic treatment and psychotherapy].

The Arbeitsgemeinschaft Basisdokumentation presents the DKPM-Basisdokumentation, which is conceptualized as a uniform modul of a documentation system for the routine-like use in the in-patient psychosomatic and psychotherapy. We outline possibilities of use, aspects of the data security and the data access as well as some practical presuppositions.

Documentation↗

PubMed1996

The Danish Twin Register.

BACKGROUND: Population based twin registers represent a valuable tool for genetic epidemiological research, since twin studies aim at separating the effect of genes and environment for complex traits. The Danish Twin Register's history, size, ascertainment and completeness of data, as well as data accessibility and availability are described. RESULTS: The Danish Twin Register comprises 14,051 twin pairs born 1870-1930, representing all twins surviving to age six years, and 20,888 twin pairs born 1953-1982, representing 75% of those born 1953-1967 and 95% of those born 1968-1982. The birth cohorts 1931-1952 og 1983-1993 are being ascertained at the moment. The register is available for research given certain conditions are fulfilled. CONCLUSION: This register will in a few years be the most comprehensive twin register in the world. It is a very valuable Danish research resource.

Child↗

PubMed1997

[Construction of an MRI reporting system using the Internet].

Out university hospital, includes a LAN (Local Area Network) and uses network services such as WWW(World Wide Web). We have constructed an MRI diagnostic reporting system on the Internet in which interactive date management was established on WWW by using CGI (Common Gateway Interface) software. Linking database information such as MRI reports with WWW browsers using by CGI provides easy data access to the database and offers hypertext and searching. This system suggests the possibility of creating a cheaper and more flexible network using Internet technology.

Computer Communication Networks↗

PubMed1998

[Traumatic stress in adult refugees: when ill-health is silent or speaks broken Swedish].

It is well established that a significant proportion of refugees in Sweden have had traumatic experiences prior to immigration, causing mental and psychosomatic disorders. The actual frequency is difficult to assess because of methodological problems. Of refugees resettled in Stockholm county in 1996, 13 per cent were immediately referred to specialised trauma centres, thus comprising half of all referrals. Moreover, it has to be borne in mind that underdiagnosis is common in clinical practice. In the article, the relevance of accessible data, the clinical picture and epidemiological issues are discussed with regard to the refugee population.

Adult↗

PubMedDate not supplied

Radiology information systems: evaluation and selection issues.

This article describes attributes of effective computer systems for radiology department management, such as the ability to minimize errors and data entry time while maximizing flexibility, data access and productivity. It also discusses implementation issues managers should be aware of in evaluating computer systems, including hardware platforms, input screens, output options and interfaces with other computer systems.

Computers↗

PubMed1986

State Data Centers: improving access to census information.

"The U.S. Bureau of the Census created the State Data Center program in 1978 to improve public access to census information. This article discusses the background, structure, and services of that program; the role of libraries in the program; and future directions in State Data Center/library relationships. The appendix lists contact person names, as well as addresses and telephone numbers for State Data Center lead agencies."

Americas↗

PubMed2006

Accessing health outcome data on high-cost medicines in Australia.

Data on health outcomes resulting from the use of medicines provide important evidence of cost-effectiveness. Currently, clinical information on individual patients, collected by Medicare Australia to assess eligibility for subsidised treatment with high-cost medicines, is inaccessible for research. Comprehensive data on drug use and health outcomes should be made accessible, with appropriate regulation, so that the effectiveness, utility and appropriateness of our systems of access to medicines can be independently analysed. In the interests of continuous improvement in medical care and optimal use of limited resources, we strongly advocate the enhancement of Medicare Australia databases and liberalisation of arrangements for access to administrative and clinical data.

Australia↗