SEARCH · PubMed Health

Results for “Clinical Distribution”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources

PubMed1995

Prevalence, geographical distribution and clinical manifestations of onchocerciasis on the Island of Bioko (Equatorial Guinea).

A survey for the prevalence, geographical distribution and clinical manifestations of onchocerciasis was conducted on the Island of Bioko (formerly Fernando Póo), Equatorial Guinea, between 1987-89. The whole population (1799 inhabitants) of thirteen villages distributed around the island was surveyed. Identification data, physical examination and Snellen "E" test for visual acuity were performed. Skin snips were taken from both iliac crests and right scapula and calf. Differential diagnosis between Onchocerca volvulus and Mansonella streptocerca was carried out in both fresh and Giemsa stained preparations. The overall prevalence (+ skin snips) and mean microfilarial density were 75.2% (range 51.9% to 87.1%) and 32.2 mf/snip respectively. Skin snips showed a higher microfilarial density from iliac crests. The following clinical manifestations were found: 560 (31.2%) with nodules; 518 (28.8%) with dermatitis, pigmentation changes and cutaneous atrophy; 753 (41.9%) with lymphoadenopathy and lymphoedema. Blindness due to different causes was registered in 13 cases (0.8%). The results showed that onchocerciasis is hyperendemic and widespread over the island. It is estimated that almost the whole population (62,000) is at risk of infection.

Adolescent↗

PubMed1988

Adjustments of distributive and clinical pharmacy services to financial constraints.

The effects of hospital budget constraints on a pharmacy department's ability to provide distributive and clinical services are described, and the development and use of workload-monitoring systems to match resources with demand is discussed. In 1980, the pharmacy department at Grace Hospital, a 402-bed community hospital in Detroit, Michigan, began quantifying workload by using five drug distribution indicators. After the pharmacy began providing clinical services in 1981, workload elements were measured in a pilot program for ASHP's Hospital Pharmacy Management Information System. Hospitalwide staff reductions occurred in 1985, eliminating most clinical pharmacy services. From 1985 to 1986, drug costs increased more than expected; also, turnaround time for medication orders increased. In 1986, 1.4 full-time-equivalent positions were added, and the pharmacy instituted use of decentralized carts and a pharmacist on the patient-care units to provide first doses. The hospital's management engineering department had selected patient days as the single indicator for pharmacy workload, but pharmacy used the ASHP Pharma Trend monitoring system to present data that convinced management engineering that patient days was an inadequate indicator of pharmacy workload. Also, drug costs decreased after the drug distribution changes and the reinstitution of patient drug therapy monitoring. Pharmacy managers need workload monitoring systems that are responsive to changes and include departmental expense information; these systems should be able to interrelate to hospital cost-accounting systems.

Cost Control↗

PubMed1990

[Studies on respiratory infections in primary care clinic (III). Distribution of bacteria isolated from patients with respiratory infections visiting 21 private clinics in the Tohoku District of Japan].

The bacteriology of the isolates from the throat swab and the sputum respectively of 2,539 patients with respiratory infections visiting 21 private clinics in Tohoku district of Japan during the period from January to April in 1989 was documented. Of the 2,539 patients, 1,694 had an acute upper respiratory infection, 609 had acute bronchitis, 46 had acute pneumonia, 84 had acute exacerbation of chronic respiratory infections and 106 had respiratory infections without diagnosis registered. 1887 (74.3%) strains of potential pathogens were recovered from 1507 (59.4%) of the 2539 cases. The rate of recovery of potential pathogens was very high in patients of the younger age. These patients had elevated body-temperature. There were statistically significant differences in recovery rate when classified by diagnosis, prefecture and the period of investigation. Of the 1,887 strains, 996 (52.8%) were gram-positive and 891 (47.2%) were gram-negative bacteria. The rate of recovery of gram-negative bacteria was high in patients who were less than 10 years old and more than 51 years old, in patients with pneumonia and chronic respiratory infections, and in patients with fever. Of the 1,887 strains, those which exceeded 100 were Staphylococcus aureus (481 strains), Haemophilus influenzae (340 strains), Streptococcus pneumoniae (329 strains), Streptococcus pyogenes (117 strains) and Acinetobacter spp. (100 strains). Species other than those mentioned above had less than 100 strains. In this group there were 39 strains of Branhamella catarrhalis, 32 strains of Escherichia coli, 97 strains of Klebsiella spp., 40 strains of Enterobacter spp., 25 strains of Serratia spp., 12 strains of Pseudomonas aeruginosa and 43 strains of Pseudomonas putida. There was a remarkable difference in recovery rate of each species when classified by diagnosis, age class, prefecture and the period of investigation, respectively. The above results indicated that gram-positive bacteria are more frequent than gram-negative bacteria, that enterobacteriaceae and glucose-non-fermentative gram-negative bacteria are only rarely found in primary care clinics, and that the bacteriology in primary care clinic is different from that of medical school-affiliated hospitals.

Adolescent↗

PubMed1995

The distribution and clinical significance of sleep time misperceptions among insomniacs.

It is well recognized that sleep time misperceptions are common among insomniacs, but little is known about the distribution and clinical significance of these subjective distortions. The current investigation was conducted to examine the distribution of sleep time misperceptions among a large (n = 173), diverse group of insomniacs and to determine if such misperceptions might relate to the patients' clinical characteristics. Consistent with previous studies, our subjects, as a group, produced sleep estimates that were significantly (p < 0.0001) lower than polysomnographically determined sleep times. However, patients' sleep time perceptions were widely distributed across a broad continuum, which ranged between gross underestimates and remarkable overestimates of actual sleep times. Results also showed that subgroups, formed on the basis of presenting complaints and diagnostic criteria (i.e. International Classification of Sleep Disorders nosology), differed in regard to the magnitude and direction of their sleep distortions. Moreover, these differences appeared consistent with the types of objective sleep disturbances these subgroups commonly experience. Hence, the tendency to underestimate actual sleep time is not a generic attribute of all insomniacs. Furthermore, it appears that the accuracy and nature of sleep time perceptions may relate to the type of sleep pathology underlying insomniacs' presenting complaints.

Adult↗

PubMed2005

[Oblique incidence of electron beams--comparisons between calculated and measured dose distributions].

Clinical applications of high-energy electron beams, for example for the irradiation of internal mammary lymph nodes, can lead to oblique incidence of the beams. It is well known that oblique incidence of electron beams can alter the depth dose distribution as well as the specific dose per monitor unit. The dose per monitor unit is the absorbed dose in a point of interest of a beam, which is reached with a specific dose monitor value (DIN 6814-8). Dose distribution and dose per monitor unit at oblique incidence were measured with a small-volume thimble chamber in a water phantom, and compared to both normal incidence and calculations of the Helax TMS 6.1 treatment planning system. At 4 MeV and 60 degrees, the maximum measured dose per monitor unit at oblique incidence was decreased up to 11%, whereas at 18 MeV and 60 degrees this was increased up to 15% compared to normal incidence. Comparisons of measured and calculated dose distributions showed that the predicted dose at shallow depths is usually higher than the measured one, whereas it is smaller at depths beyond the depth of maximum dose. On the basis of the results of these comparisons, normalization depths and correction factors for the dose monitor value were suggested to correct the calculations of the dose per monitor unit.

Breast↗

PubMed2001

[Long-term observations on type distribution of clinical isolated of beta-hemolytic streptococci in Sapporo. I. T-type distribution of group A hemolytic streptococci during the thirty one-year period between 1969 and 1999].

During the thirty one-year period between 1969 and 1999, a total of 6,876 strains of group A streptococci isolated in Sapporo City General Hospital were classified by T-agglutination method. This research consisted of 5,866 strains of scarlet fever-patients (scarlet fever-strains), 450 of child-patients (child-strains), 141 of adult-patients (adult-strains) and 409 strains of the indistinct. The results were summarized as follows: 1. Total of 6,866 strains were classified to sixteen kinds of T-types such as T12 (44.1%), T4 (21.7%), T1 (9.2%), T6 (4.4%), T3 (2.8%), T22 (2.1%), T18 (1.9%), T28 (1.6%) & others. This pattern of type distribution, three prevailing types of T12/T4/T1, have been reported in other areas generally. But original increase of isolation rates of strains of some T-types as T6, for example, also appeared in Sapporo. 2. Long-term observations demonstrated that the isolation rates of individual T-type, especially T4 or T1, had been forming a small epidemic-wave having a 4 to 8 year-interval and these of type T3 or type T6 on the other hand were repeating sudden prevalence every several years. 3. The isolation rates of type T12 or type T4 in scarlet fever-strains, were significantly higher than in child-strains or adult-strains. It was shown that Type T1 was distributed widely irrespective of patient-group and age-group. It was also characteristic to be distributed to many T-types in adult-strains.

Adult↗

PubMed2001

Hepatitis C virus genotypes: distribution and clinical significance in patients with cirrhosis type C seen at tertiary referral centres in Europe.

The aim of this study was to evaluate the distribution and clinical significance of hepatitis C virus (HCV) genotypes in European patients with compensated cirrhosis due to hepatitis C (Child class A) seen at tertiary referral centres. HCV genotypes were determined by genotype-specific primer PCR in 255 stored serum samples obtained from cirrhotics followed for a median period of 7 years. Inclusion criteria were biopsy-proven cirrhosis, absence of complications of cirrhosis and exclusion of all other potential causes of chronic liver disease. The proportion of patients with types 1b, 2, 3a, 1a, 4 and 5 were 69%, 19%, 6%, 5%, 0.5% and 0.5%, respectively. Kaplan-Meier 5-year risk of hepatocellular carcinoma (HCC) was 6% and 4% for patients infected by type 1b and non-1b, respectively (P=0.8); the corresponding figures for decompensation were 18% and 7% (P=0.0009) and for event-free survival were 79% and 89% (P=0.09), respectively. After adjustment for baseline clinical and serological features, HCV type 1b did not increase the risk for HCC [adjusted relative risk=1.0 (95% confidence interval=0.47-2.34)], whereas it increased the risk for decompensation by a factor of 3 (1.2-7.4) and decreased event-free survival by a factor of 1.7 (0.9-3.10). In conclusion, type 1b and, to a lesser extent, type 2, are the most common HCV genotypes in European patients with cirrhosis. HCV type 1b is not associated with a greater risk for HCC, but increases the risk for decompensation by threefold in patients with cirrhosis.

Adult↗

PubMed2000

Tissue distribution and clinical monitoring of the novel macrolide immunosuppressant SDZ-RAD and its metabolites in monkey lung transplant recipients: interaction with cyclosporine.

We report the tissue distribution and clinical monitoring of the novel macrolide immunosuppressant SDZ-RAD ¿40-O-(2-hydroxyethyl)-rapamycin and its metabolites in monkey lung transplant recipients as well as its interaction with cyclosporine as the Neoral formulation. After left unilateral lung transplantation, cynomolgus monkeys received by oral administration either 1) 1.5 mg/kg/day SDZ-RAD (n = 4); 2) 100 mg/kg/day cyclosporine (n = 4); 3) 0.3 mg/kg/day SDZ-RAD + 100 mg/kg/day cyclosporine (n = 6); 4) 1.5 mg/kg/day SDZ-RAD + 50 mg/kg/day cyclosporine (n = 5); or 5) SDZ-RAD and cyclosporine doses adjusted according to trough blood concentration measurements (n = 6). At the end of the observation period (usually 29 days after transplantation), and 24 h after the last doses, tissue samples were collected and analyzed with HPLC/mass spectrometry. Gall bladder, pancreas, the transplant lung, cerebellum, kidneys, and spleen had the highest SDZ-RAD concentrations. Coadministration of cyclosporine increased SDZ-RAD concentrations in most tissues as well as tissue-to-blood distribution coefficients. In contrast, SDZ-RAD had only a small effect on cyclosporine blood and tissue concentrations. Rejection in lung grafts in monkeys treated with either of the cyclosporine/SDZ-RAD combinations was significantly less than in the monotherapy groups (P <.002). Histological rejection scores were inversely correlated with SDZ-RAD concentrations in blood (r = -0. 68; P <.001; n = 24), lymph nodes (P = -0.58; P <.003; n = 24), thymus (r = -0.63; P <.001; n = 23) and transplant lung tissue (r = -0.58; P <.003; n = 24). We conclude that, in addition to the synergistic pharmacodynamic interaction, a pharmacokinetic interaction resulting in higher SDZ-RAD tissue concentrations contributed to the significantly better immunosuppressive efficacy when both drugs were combined compared with monotherapy.

Animals↗

PubMed1993

Distribution of clinical mastitis among quarters of the bovine udder.

Clinical mastitis episodes occurring from 1962 through 1991 in the Louisiana State University Dairy Research Herd were studied to determine the distribution of clinical mastitis among quarters of the udder. Data were detailed records of all mastitis episodes that occurred during 1630 Holstein lactations. Incidence of episodes, categorized according to which quarters within a cow were clinical for a given case, were compared with mathematical expectations based upon the assumption that quarters were independent. Results indicated that quarters within a cow were more alike with respect to clinical mastitis than would be expected if quarters were independent. More episodes occurred in which either no quarters or all four quarters were clinical. Deviation of observed frequencies from expectation could have resulted from generalized cow differences, such as cow milk yield, immune competency, mammary type characteristics, and general health. Front quarters had less clinical mastitis than rear quarters when all episodes were considered. No difference was observed in incidence between front and rear quarters when only first episodes in first lactations were considered. No difference was observed between incidence in left and right quarters. Diagonal pairs occurred less often than expected and at about half the frequency of other pairs. Dependence between quarters should be taken into consideration when experiments are designed and analyzed.

Animals↗

PubMed2002

Challenges in image acquisition and distribution for clinical image service.

We have developed a centralized application for acquiring images from multiple picture archiving and communication systems (PACS) and distributing images to a clinical image web server and other repositories. Our flexible strategy addresses a number of administrative challenges associated with delivering images into clinical, research, and test environments. DICOM images flow from PACSs and modalities to a UNIX-based "distributor" application, which relays them to one or more destinations. Image volume and transmission times were collected and analyzed. Three distributors receive an average of 34 gigabytes of image data per day. Images are sent concurrently to two web-based image servers, one used clinically by physicians and one used for testing. Transmission of certain classes of studies is prioritized for key physician groups. Delivery to research systems is also supported. Acquiring images from multi-vendor PACS for distribution to a web server for clinical image viewing is a challenging task. Centralizing the acquisition and distribution process reduces both the administrative effort and the impact on clinical operations associated with maintaining dynamic clinical, testing, and research environments.

Computer Communication Networks↗

PubMed2002

[Distribution of clinically significant small cancer of the prostate in radical prostatectomy specimens].

BACKGROUND: In patients with prostate cancel, radical prostatectomy specimen frequently exhibits non-organ confined disease. We should detect clinically significant small cancer to cure the patients, because tumor volume is one of factors with respect to progression of prostate cancer. The distribution of clinically significant small cancer foci of the prostate was studied to determine an adequate sampling portion in needle biopsy using the maps of radical prostatectomy specimens. MATERIALS AND METHODS: Thirty-seven cases with less than 1.5 cc tumor volume in the main cancer focus who underwent radical prostatectomy were pathologically evaluated using step-sectioned specimens. RESULTS: Seventy three clinically significant cancer foci with less than 1.5 cc tumor volume were recognized. Forty six of 73 foci (63.0%) existed only in the lateral aspect of the prostate compared to 14 foci (19.2%) only in the mid-lobe aspect. The remaining 13 foci (17.8%) existed in both aspects. Moreover, 53 of 73 foci (72.6%) were detected in lateral aspect of the middle and apex of the prostate. CONCLUSION: Systematic biopsy including sampling of lateral aspect in the apex and middle portion of the prostate may improve the detection of clinically significant cancer with small tumor volume.

Biopsy↗

PubMed1989

Report of a survey conducted by the Consultant Orthodontists Group. The nature and distribution of clinical assistant posts in orthodontics in the United Kingdom in 1987.

This paper describes and discusses the results of a survey, conducted by the Consultant Orthodontists Group in the United Kingdom in 1987, which examined the nature and distribution of clinical assistant posts, and consultants' attitudes to the concept of appointing orthodontic auxiliaries. This survey demonstrated a large regional variation in the number of clinical assistant posts and in the number of 'specialist practitioners' and community orthodontists. More than 90% of consultants teach their clinical assistants how to use removable appliances, headgear and simple fixed appliances. More than 70% of consultants also teach their clinical assistants how to use multi-bracketed techniques and functional appliances. Ninety-one per cent of consultants would give their support to developing regional training schemes for clinical assistants in orthodontics. Eighty-eight per cent of consultant orthodontists favoured the appointment of orthodontic auxiliaries to carry out intra-oral work, and 75% believed that they already had a member of staff capable of doing these duties with some further training.

Attitude of Health Personnel↗

PubMed2005

[Distribution and clinical significance of hepatitis B virus (HBV) genotypes and subtypes in HBV-infected patients].

OBJECTIVE: To study hepatitis B virus (HBV) genotype and subtype distribution and its clinical significance in HBV-infected patients. METHODS: We used type/subtype-specific primers and PCR to detect HBV genotype and subtype of 445 HBV-infected patients from Beijing, Changchun, Hanchuan Shenzhen, Qingyuan and Nanjing, including 7 acute hepatitis (AH), 36 asymptomatic HBV carriers (ASC), 352 chronic hepatitis (CH), 28 liver cirrhosis (LC), and 22 hepatocellular carcinoma (HCC) cases. Genotyping results were confirmed by PCR product sequencing. RESULTS: Among 445 HBV-infected patients, the proportions of genotype B, C, and B/C were 32.6% (145/445), 53.7% (239/445), and 13.7% (61/445), respectively. In genotype C, 13 (5.4%) were subtype C1, 135 (56.5%) were subtype C2, and the remaining 91 (38.1%) were neither C1 nor C2. In genotype B, 100 (69.0%) were subtype Ba, 25 (17.2%) subtype Bj, and the other 20 (13.8%) were neither Ba nor Bj. In genotype B/C, 15 (24.6%) were Ba/C2, 8 (13.1%) Bj/C2, 6 (9.8%) Ba/C1, 3 (4.9%) Bj/C1, 11 (18.0%) Ba/neither C1 nor C2, 7 (11.5%) Bj/neither C1 nor C2, and 6 (9.8%) neither Ba nor Bj/neither C1 nor C2, 2 (3.3%) neither Ba nor Bj/C1, 3 (4.9%) neither Ba nor Bj/C2. The HBV genotype and subtype distribution we found exhibited significant differences in the various clinical types of HBV infection tested, and showed that genotype C was predominant among patients with liver cirrhosis (78.6%) and hepatocellular carcinoma (86.4%) while genotype B was predominant in asymptomatic carriers (72.2%). In addition, genotype and subtype distribution showed no significant differences between male and female patients, but genotype and subtype distribution showed significant differences in patients positive or negative with HBeAg. CONCLUSION: Subtypes Ba and C2 are predominant in patients with hepatitis B from these 6 cities, and genotype C may be associated with the development of liver cirrhosis and hepatocellular carcinoma.

Genotype↗

PubMed1989

[Serotyping of beta hemolytic streptococci and their distribution in clinical specimens].

In the present study 300 beta hemolytic streptococci isolated from various clinical specimens have been serogrouped and their distribution in body sites have been discussed. Beta hemolytic streptococci have been recovered from 10.6% of throat cultures, 8.7% of urine cultures, 7% of other cultures. Group A streptococci have been mostly isolated from throat cultures with a percentage of 71.9 whereas the mostly isolated serogroup from urinary specimens was Group D (73.7%). Group B streptococci have been isolated in 21.1% and 22.7% ratios from urinary tract and other specimens, respectively.

Bacteriuria↗

PubMed2004

Multivariate distributions of clinical covariates at the time of cancer detection.

Many screening trials conducted in the past have generated a wealth of interesting data. These data represent an invaluable source of information for furthering our knowledge about the natural history of the disease. The traditional approach to modeling cancer screening tends to describe the process of tumor development in only one dimension, that is, the time natural history. A broader methodological idea is to construct a stochastic model of cancer development and detection that yields the multivariate distribution of observable variables at the time of diagnosis. By focusing on such multivariate observations, rather than just on the age of patients at diagnosis, this idea seeks to invoke an additional source of information (available only at the time of detection) in order to improve an estimation of unobservable quantitative parameters of cancer latency. In this article, we discuss modeling techniques that make the above-mentioned problems approachable. A special focus is placed on analytical tools for deriving joint distributions of clinical covariates at the time of cancer detection under an arbitrary screening protocol. In addition, some future research avenues and public health implications of the proposed approach are discussed.

Aged↗

PubMed2001

[The standing of clinical research in Germany - distribution of experimental versus clinical research in anaesthesia].

OBJECTIVE: Clinical research has been proposed to be less active and less attractive in Germany. The distribution of clinical versus experimental research of German university departments of anesthesiology was analysed. METHODS: With the help of Medline all articles published from all German university anesthesiology departments in German and English in 1998 and 1999 were analysed and specified with regard to the following subtypes: experimental research, clinical research, miscellaneous (reviews, questionnaires). RESULTS: 369 articles in German and 545 articles in English language were specified. From the German publications 129 articles were derived from clinical research (35 % of all papers), 29 papers were from experimental research (8 % of all papers), and 211 papers were miscellaneous articles (57 % of all papers). From the publications in English language, 291 papers were from clinical research (53 % of all articles), 195 were from experimental research (36 % of all articles), and 59 papers were miscellaneous articles (11 % of all articles). CONCLUSION: Clinical research was published more often in German, whereas experimental studies were published more often in English. Some anesthesia departments prefer to focus their research efforts mainly on experimental research. It is tempting to speculate whether concentration on experimental research is beneficial for research in the field of anesthesia in Germany.

Anesthesia↗

PubMed2005

The global distribution of clinical episodes of Plasmodium falciparum malaria.

Interest in mapping the global distribution of malaria is motivated by a need to define populations at risk for appropriate resource allocation and to provide a robust framework for evaluating its global economic impact. Comparison of older and more recent malaria maps shows how the disease has been geographically restricted, but it remains entrenched in poor areas of the world with climates suitable for transmission. Here we provide an empirical approach to estimating the number of clinical events caused by Plasmodium falciparum worldwide, by using a combination of epidemiological, geographical and demographic data. We estimate that there were 515 (range 300-660) million episodes of clinical P. falciparum malaria in 2002. These global estimates are up to 50% higher than those reported by the World Health Organization (WHO) and 200% higher for areas outside Africa, reflecting the WHO's reliance upon passive national reporting for these countries. Without an informed understanding of the cartography of malaria risk, the global extent of clinical disease caused by P. falciparum will continue to be underestimated.

Africa↗

PubMed2004

MLC leaf width impact on the clinical dose distribution: a Monte Carlo approach.

PURPOSE: The influence of the multileaf collimator (MLC) leaf width on the dose distribution in patients treated with conformal radiotherapy and intensity-modulated radiotherapy has been analyzed. This study was based on the Monte Carlo simulation with the beams generated by a linac with the double-focused MLC. MATERIALS AND METHODS: The transmission through the leaves and the exact shape of the penumbra regions are difficult to model by treatment planning system algorithms. An accurate assessment of the dose variations due to the leaf width change can be achieved by means of Monte Carlo simulation. The BEAM/EGS4 code was used at the Hospital of the Virgen Macarena to model a Siemens PRIMUS linac, featuring an MLC with a leaf width projecting 1 cm at the isocenter. Based on this real model, a virtual head was designed while allowing for a variation of the leaf width projection. Both the real linac and the virtual linac, with leaves projecting 0.5 cm, were used to obtain the dose distributions for several treatments. A few disease sites, including the prostate, head and neck, and endometrium, were selected for the design of the conformal and intensity-modulated radiotherapy treatments with a forward planning algorithm sensitive to the different shapes of the volumes of interest. Isodose curves, differential matrix, gamma function, and the dose-volume histograms (DVHs) corresponding to both MLC models were obtained for all cases. The tumor control probability and the normal tissue complication probability were derived for those cases studied featuring the greatest differences between results for both MLCs. RESULTS: The impact on the DVHs of changing leaf width projections at the isocenter from 1.0 cm to 0.5 cm was low. Radiobiologic models showed slightly better tumor control probability/normal tissue complication probability values using the virtual MLC with a leaf width projecting 0.5 cm at isocenter in those cases presenting greater differences in the DVHs. CONCLUSIONS: The impact on the clinical dose distribution due to the MLC leaf width change is low based on the design and conditions used in this study.

Abdominal Neoplasms↗