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At least 613 records · Page 34Linked to original sources
PubMed2003

Influence of renal function on spontaneous dietary intake and on nutritional status of chronic renal insufficiency patients.

OBJECTIVE: To analyze the spontaneous food intake and the nutritional parameters of patients with different degrees of chronic renal insufficiency (CRI) at the onset of predialysis treatment. DESIGN: Cross-sectional. SETTING: Outpatient Clinic of the Nephrology Division of Federal University of São Paulo, Brazil. SUBJECTS: The analysis involved 487 (187 women and 300 men) patients with moderate to advanced CRI who were evaluated in the first visit to the clinic. RESULTS: Patients were divided according to creatinine clearance (CrCl) quartiles. CrCl in the first quartile was lower than 19.9 ml/min/1.73 m(2) and in the fourth one was higher than 43 ml/min/1.73 m(2). Energy intake was significantly (P<0.05) lower in the first quartile when compared with the fourth one while protein intake estimated by protein equivalent of nitrogen appearance (PNA) was significantly lower in the first, second and third quartiles in comparison with the fourth (P<0.05). Body mass index (BMI) and percentage of ideal body weight were significantly decreased in the three lowest levels of renal function. Standard per cent of triceps skinfold thickness was lower in the first quartile when compared with the fourth one. Compared with the fourth quartile, standard per cent of midarm muscle circumference (MAMC) was lower in the second and in the third quartile. CrCl correlated directly and significantly with PNA (r=0.30; P<0.01), energy intake (r=0.17; P<0.01), and MAMC (r=0.20; P<0.01). In a multiple linear regression analysis, controlling for energy and protein intake, CrCl correlated significantly and positively with BMI and MAMC. CONCLUSION: This study suggests that a spontaneous decrease in energy and protein intake as well as in anthropometric indices follows a decline in renal function in patients with no previous dietary intervention.

Creatinine↗
PubMed2000

Medication and medical service utilization for acne 1995-1998.

BACKGROUND: Acne occurs in most persons sometime during adolescence or early adulthood and is a frequent reason for visits to dermatologists and for prescription drug therapy. OBJECTIVE: The purpose of this study was to analyze changes in the utilization of physician services and medications for the treatment of acne. METHODS: An analysis was performed of data from two US federal surveys of outpatient physician services and prescribing for the years 1980 to 1997 and two commercial sources of drug prescription data for 1996 to 1998. From these data, I estimated visits for acne and drugs prescribed during these visits. RESULTS: Visits for women principally for acne are about 80% more frequent than those for men. Each year 5 million prescriptions for oral antibiotics and 1.4 million prescriptions for isotretinoin are dispensed for the treatment of acne. CONCLUSION: Substantial health care resources are devoted to the treatment of acne, with women particularly likely to continue to frequently utilize these services after 19 years of age.

Acne Vulgaris↗
PubMedDate not supplied

Case report: an investigation of chlortetracycline and oxytetracycline residues in suspect swine slaughtered in Manitoba, Canada, October 1987 to March 1988.

Tissue samples from 623 hogs suspected of having received antibiotic treatment were collected at federally-inspected abattoirs in Manitoba and submitted for analysis from October 1987 to March 1988. Initially, samples were screened by a multi-residue thin layer chromatography/bio-autography method, but, during the final two months of the investigation, analysis was restricted to a quantitative high performance liquid chromatography method for tetracycline antibiotics only. Sixteen animals (3%) were found with detectable tissue levels of chlortetracycline ranging from 0.10 to 1.38 ppm. One hundred thirty-eight animals (22%) were found with detectable tissue levels of oxytetracycline ranging from 0.05 to 2.07 ppm. Comparison of these levels with previously published values suggested that some producers were administering tetracyclines at therapeutic levels without observing the seven-day withdrawal period. The data generated by this study provided information for use by regulatory officials at Health and Welfare Canada in establishing specific tolerance levels for residues of the tetracycline antibiotics in animal tissue; previously, a zero tolerance had been in effect. During the study, only one hog had tetracycline residues in muscle which would have exceeded the current tolerance levels.

Abattoirs↗
PubMed1992

Independence of VNTR alleles defined as fixed bins.

An analysis is presented of data collected by the Federal Bureau of Investigation at six unlinked variable number of tandem repeats (VNTR) loci for the United States population. Databases have been constructed of VNTR profiles of Caucasians, Blacks and Hispanics from Florida, Texas and California. There was very little evidence for correlations between lengths for pairs of VNTR fragments, within or between loci. When the fragment lengths were amalgamated into discrete bins, there was also little evidence for disequilibrium over all genotypes, within or between loci, for the Caucasian database, although some disequilibrium was found for the Black and Hispanic databases. No disequilibrium was found for the Caucasian or Black databases when tests were confined to heterozygous individuals. In cases of global disequilibrium, local tests can be applied to specific genotypes. The results suggest that, at the bin level, frequencies of VNTR profiles can generally be estimated as the products of the frequencies of the constituent elements. This overcomes the problem of estimating population frequencies when any particular profile does not exist in the database. There is some evidence for different frequencies, at the individual bin level, between geographic samples within each of the Caucasian, Black and Hispanic databases, and considerable evidence for differences between the three databases. These differences are less evident for the frequencies of four-locus profiles.

Alleles↗
PubMedDate not supplied

Qualitative identification of doxacurium and its breakdown products in postmortem fluids by liquid chromatography-tandem mass spectrometry.

During a death investigation at the Office of the Cuyahoga County Coroner in Cleveland, OH, doxacurium became a drug of interest. The Coroner's Office enlisted the aid of the Federal Bureau of Investigation Laboratory for the doxacurium analysis. Following the request, a method for the extraction and qualitative analysis of the drug in biological fluids was developed. The procedure relies on a simple solid-phase extraction procedure followed by qualitative analysis with liquid chromatography-tandem mass spectrometry. During the development of the new analytical procedure, two breakdown products of doxacurium were detected. Structures for these breakdown products are proposed. This procedure was used to analyze heart blood, cerebrospinal fluid, and bile specimens from the decedent. Doxacurium and its breakdown products were identified in all three specimens.

Cerebrospinal Fluid↗
PubMed2005

Informed patient consent to participation in cluster randomized trials: an empirical exploration of trials in primary care.

Cluster randomized trials are increasingly common. Obtaining informed patient consent to participation in these trials raises practical challenges and ethical issues. The aims of this paper were to 1) develop a typology of interventions employed in cluster randomized trials in primary care; 2) assess whether the likelihood of seeking individual consent to participation varies by intervension type; 3) assess whether this likelihood has increased over time; 4) assess evidence for under reporting of consent procedures; 5) articulate reasons for not obtaining consent; and 6) make recommendations for future trial investigators. We collected data on trial interventions and consent procedures from reports of 152 recently published trials, and 47 unpublished trials. We develop a typology of interventions based on reasons for adopting a clustered design. We examine proportions seeking individual consent to participation among trials involving different types of intervention, in different periods, and among published and unpublished trials. Two-thirds of the trials had multifaceted interventions. Trials involving different types of intervention had different propensities to seek consent, largely because of practical obstacles to obtaining consent. Obtaining consent can compromise internal validity. More recent trials are no more likely to obtain consent than past trials. There was no evidence of under-reporting of consent procedures in publications. In conclusion, future trial investigators should consider both practical reasons and scientific arguments for not obtaining individual patient consent for all interventions in their trials. Where feasible, they should allow patients to opt out of the trial. Lay individuals should represent trial participants as part of the process of cluster consent to participation, and lay individuals could also be involved in considering ethical issues during trial planning. A more public debate may clarify the general acceptability of not obtaining consent in certain situations.

Biomedical Research↗
PubMed1997

Should health insurance cover IVF? Issues and options.

An emotional debate has attended the question of whether health insurance should cover the cost of in vitro fertilization (IVF) for infertile couples. Some private health plans have opted to cover IVF, although most have not. Ten states have mandated that it be included or offered as a standard benefit for private health insurance plans. This article analyzes several key issues in the debate: the impact of insurance coverage; the cost-effectiveness of IVF; valuing the benefit of IVF; and adoption as an alternative. It recommends policy action in several areas: more efficiently allocating resources for IVF (by giving priority to couples with better chances of success, and by making more extensive use of facilities with higher success rates); ensuring that clear and reliable information about the effectiveness of IVF is available; and leveling the playing field between IVF and adoption.

Adoption↗
PubMed2006

Heat-shock promoters: targets for evolution by P transposable elements in Drosophila.

Transposable elements are potent agents of genomic change during evolution, but require access to chromatin for insertion-and not all genes provide equivalent access. To test whether the regulatory features of heat-shock genes render their proximal promoters especially susceptible to the insertion of transposable elements in nature, we conducted an unbiased screen of the proximal promoters of 18 heat-shock genes in 48 natural populations of Drosophila. More than 200 distinctive transposable elements had inserted into these promoters; greater than 96% are P elements. By contrast, few or no P element insertions segregate in natural populations in a "negative control" set of proximal promoters lacking the distinctive regulatory features of heat-shock genes. P element transpositions into these same genes during laboratory mutagenesis recapitulate these findings. The natural P element insertions cluster in specific sites in the promoters, with up to eight populations exhibiting P element insertions at the same position; laboratory insertions are into similar sites. By contrast, a "positive control" set of promoters resembling heat-shock promoters in regulatory features harbors few P element insertions in nature, but many insertions after experimental transposition in the laboratory. We conclude that the distinctive regulatory features that typify heat-shock genes (in Drosophila) are especially prone to mutagenesis via P elements in nature. Thus in nature, P elements create significant and distinctive variation in heat-shock genes, upon which evolutionary processes may act.

Animals↗
PubMedDate not supplied

Medicaid coverage for the working uninsured: the role of state policy.

Low-income workers face the highest gap in health coverage; 37.3 percent were uninsured in 1999. Although employer-sponsored insurance covered many more low-income workers, state programs are very important to those without private insurance. We examined the wide variations across thirteen representative states in public insurance coverage of low-income workers to develop insights into the reasons for the variations and to suggest strategies for encouraging states to expand public insurance coverage. The analysis suggests that expanded and better-targeted federal assistance coupled with greater state flexibility would be needed to achieve this goal.

Adult↗
PubMedDate not supplied

[Popular wisdom: its existence in the university environment].

Nowadays, myths and superstitions are present in spite of scientific and technological developments, especially when trying to solve problems that escape human understanding. This study was aimed at determining the existence of superstitions and myths in the university community, investigating their origins, influences, adoption and credibility, correlating them with people's level of knowledge. It is a descriptive/analytical research conducted at Teaching Units in the Area of Health of the Federal University of Goiás. The technique of content analysis was utilized for data analysis. Two categories have been created: Personal Attitudes related to Superstitions and Influences and Destruction of Superstitions. It was found out that there is a clash between popular and scientific knowledge, either leading to the exclusion of popular wisdom, to its 'veiled' maintenance, or even to an alliance between the two types of knowledge.

Adolescent↗
PubMed2000

Tuberculosis in Russia.

Various aspects of tuberculosis in Russia, including epidemiology, means of prevention, diagnosis and treatment, have been widely discussed in the last few years in the medical literature and by the general media. A certain amount of controversy has been generated on some of these subjects. This review is an attempt to objectively analyze the true situation of tuberculosis in Russia, including the issues of control measures, as viewed by the public health authorities and by the majority of Russian tuberculosis specialists. The data presented and their analysis reflect the official position of the Russian Federation Ministry of Health. These views became a basis for the concept of the national anti-tuberculosis program to serve the needs of the population, which was approved by the Scientific Council of the Ministry of Health of Russia in February 2000.

Communicable Disease Control↗
PubMed1996

Keeping secrets.

Explore the source record for details and available documents.

Computers↗
PubMedDate not supplied

The Human Genome Project in the United States: a perspective on the commercial, ethical, legislative and health care issues.

The Human Genome Project represents a government supported effort to map and sequence the human genome. Governmental support for the Project should include increased emphasis on grants and contracts to industry. This is particularly true for small highly innovative biotechnology companies that can rapidly integrate and use technology as a base for product development. Private industry must be integrated as a partner into the Project, as it will be in Japan and Europe. There is a consensus in industry that the Genome Project is, at this stage at least, a science research project funded by government and not, at present, a commercial project. It is not seriously expected to have any substantial widespread commercial impact in the near future. The ultimate commercial benefits of the Human Genome Project, in terms of definable health care products, may not be realized until well into the next century. Yet, there are a few companies for which the Genome Project affords immediate commercial opportunities in certain niche areas. The Genome Project can be expected to have a significant impact upon medical knowledge and treatment. Though the Genome Project is just beginning, much of the type of medical knowledge expected to be gained from the Project is already present and even being exploited, albeit on a small scale. The application of genetic understanding to practical applications raises ethical, medical and legal issues central to the Genome Project. Unfortunately, emotion and sensationalism sometimes dominate and prevent a constructive discussion of ethical and social issues pertaining to genetics. To answer public concerns about human gene transfer experiments, the medical and biotechnology communities must constructively discuss the medical realities, the benefits to human health and the adequacy of the current governmental oversights. These presentations must be understandable by the lay public and must address their fears. Failure to assuage public fears and concerns, no matter how abstract or unrealistic they may be to the medical/scientific community, will lead to increased governmental controls and regulatory burdens.

Cost-Benefit Analysis↗