PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Continuous Evolution”

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 937 records · Page 52Linked to original sources

Sequelae of the initial attack of acute rheumatic fever in children from north India. A prospective 5-year follow-up study.

We determined the outcome of acute rheumatic fever in 85 children from North India who had received regular antistreptococcal prophylaxis after their first attack. By the end of the 5-year follow-up, 33 patients had rheumatic heart disease. Mitral insufficiency, the most common valvular lesion, appeared in 91% of the patients, whereas mitral stenosis developed in only 18%. Initial carditis, congestive heart failure, cardiomegaly or moderate-to-severe mitral insufficiency significantly increased the risk of rheumatic heart disease (p less than 0.001). The recurrence rate of acute rheumatic fever in children who received continuous prophylaxis was 0.006 per patient-year. Most recurrence (92%) mimicked the first attack and produced further cardiac damage in five patients with carditis and in one patient with chorea. Cardiac status during the first attack of rheumatic fever and the continuity of prophylaxis were the major determinants of outcome. Statistical comparisons disclosed that with continuous prophylaxis, the prevalence rate, evolution and clinical spectrum of the sequelae of acute rheumatic fever in children from India do not differ significantly from those in the West.

Child↗

A history of the Pathological Division of the Bureau of Animal Industry, United States Department of Agriculture, between 1891-1921.

As part of a continuing historical study of the evolution of the discipline of veterinary pathology in North America, this paper relates the role played by the Pathological Division of the Bureau of Animal Industry (BAI), formerly a unit of the United States Department of Agriculture. The work of this division of the BAI during its first three decades is examined with respect to its leadership, activities and attainments, and these are compared with similar activities in veterinary colleges and state experiment stations in the United States and in foreign veterinary colleges and research establishments. The Pathological Division devoted a good deal of its efforts to the production of biologic prophylactic products, with resounding success in controlling blackleg and other diseases. Its other activities were in laboratory diagnostic work and in research into animal diseases. The picture that emerges in those spheres is of an organizational unit that despite its name, made little use of the approaches and methods of pathology, but rather availed itself of the tools of microbiology whether or not these were appropriate. In so doing, it lagged considerably behind the comparable institutions both in the United States and abroad.

Agriculture↗

Infection control: its evolution to the current standard precautions.

BACKGROUND: The use of appropriate infection control precautions to protect against transmission of bloodborne and other occupational microbial pathogens has become a routine component of health care provision. Evolution and revision of recommendations continues to be based on updated scientific information, as well as documented and inferred clinical applications of new knowledge. In addition, surveillance of occupational risks in medical treatment settings often has served as a basis for subsequent disease prevention recommendations for dental care. TYPES OF STUDIES REVIEWED: Guidelines designed to protect dental professionals and their patients have focused on bloodborne pathogens since the first published American Dental Association recommendations in the 1970s. Subsequent statements developed by the Centers for Disease Control and Prevention, the ADA and other organizations during the past 30 years also have addressed prevention of other infections, transmitted by either direct or indirect contact with a variety of potentially infectious body fluids. RESULTS: Review of the major features of these recommendations provides an appropriate framework to consider current guideline revisions. The success of long-standing universal precautions, or UP, against bloodborne infection has been augmented with the incorporation of body substance isolation, or BSI, practices into the infection control protocol designated "standard precautions." Combination of the major tenets of UP with the BSI systems routinely employed in acute care facilities affords all health care professionals the means of preventing a spectrum of bloodborne, respiratory, contact and other potential exposures during provision of patient care. CLINICAL IMPLICATIONS: As infection control recommendations for dentistry are updated this year, they undoubtedly will include guidelines expanding previous UP to provide expanded protection for dental professionals in the multiple types of nonacute treatment settings in which routine treatment is provided.

American Dental Association↗

[Clinical spectrum of prenatal tetralogy of Fallot].

The aim of this study of 44 cases of tetralogy of Fallot was to assess the echocardiographic aspects and the prognosis with respect to associated abnormalities and the potential evolution in utero. Group I, tetralogy of Fallot with other abnormalities (N = 27: 2 valvular agenesis, 26.5 5.3 weeks), had genetic anomalies in 18 of the foetus (10 trisomies including 5 trisomy 21, 5 structural abnormalities including 2 micro-deletions 22q11 in the two cases of valvular agenesis, and one deletion of chromosome 8p23.1, 3 mendelian syndromes) and other abnormalities in 9 cases. Hypoplasia of the pulmonary artery was present in 60% of cases with a non-dilated aorta in 72%, infundibular hypertrophy in 33% and 2 evolutions to pulmonary atresia. Aspect of "isolated" ventricular septal defect were observed in 20% of cases. Survival was 10%. In Group II, tetralogy of Fallot was isolated (N = 17, including 2 pulmonary valve agenesis, 31 +/- 6 weeks) (p < 0.01 versus Group I). Pulmonary artery hypoplasia was observed in 50% of cases with dilatation of the aorta and infundibular hypertrophy in all and in one a postnatal progression towards pulmonary atresia. A correlation between growth of the pulmonary artery and gestational age was found in 5 foetus out of 9 studied sequentially (p between 0.03 and 0.007) and between age at first surgery and size of the pulmonary artery (r = 0.80, p = 0.001). Survival was 84%. The risk of malformation (61%) and the prenatal potential evolution of this disease justifies continuous follow-up of all cases of tetralogy of Fallot, high resolution karyotyping and postnatal evaluation in a specialized centre.

Abnormalities, Multiple↗

The "patholog" of the genes expression profile, a new tool in defining, evaluating, and classifying genetic diseases.

The paper introduces the pre-Hilbert space of standard gene expression (SSGE) based on the normal variability in gene profiles, as revealed by the "spotting" microarray technique. In this space, every point represents a possible gene profile and every continuous curve a possible genetic evolution. The gene "patholog" is defined as the Euclidean distance separating the representative point of the gene profile from the unit, 0-centered hyperball. It is the most general quantification of the alteration in digital genes expression, suitable to define, evaluate, and classify the genetic diseases. Our mathematical model and the afferent computer package allow the researcher to identify the patterns of various genetic afflictions in the SSGE. A publicly available database will be opened where every interested experimentalist could introduce his/her results and process them according to our procedure.

Gene Expression↗

Managing quality and reducing risks in ambulatory surgery.

This article reviews the evolution of quality assurance and continuous quality improvement (QA/CQI) in ambulatory surgery centers. As an example, The QA/CQI Plan of the Gumenick Ambulatory Care Center is examined in detail.

Ambulatory Surgical Procedures↗

The "dual degree". Does it change the scope of practice for oral and maxillofacial surgery?

The scope of practice for OMS is not, nor should it ever be, an issue of single or dual degree but must be related to the surgeon being trained to competence in the procedures performed. Future evolution will be based on continual advancements in the specialty and related areas as well as the development of new techniques. While the medical education may improve a core fund of general knowledge, the surgical residency and/or fellowship is the determinant of surgical competence and scope of practice.

Clinical Competence↗

Prolonged intermittent renal replacement therapy in the intensive care unit.

OBJECTIVE: To present a review on the use of prolonged intermittent renal replacement therapy in the intensive care patient. DATA SOURCES: Articles and abstracts reporting the use of renal replacement therapy. SUMMARY OF REVIEW: Standard intermittent haemodialysis (IHD) has significant shortcomings in the treatment of the acute renal failure (ARF) of critical illness. These shortcomings include haemodynamic instability, the need to remove excess fluid over a short period of time, the episodic nature of small solute control, the limited ability to achieve middle molecular weight solute control and the episodic nature of acid-base control. Over the last 20 years, these limitations have stimulated the evolution and increased application of continuous renal replacement therapy (CRRT) which provides major biochemical, biological and physiological advantages compared with IHD, although it remains unclear as to whether such advantages translate into a survival advantage. However, CRRT is technically demanding, requires supervision 24 hr per day and is often associated with the need for continuous anticoagulation, which, in some patients, might be undesirable. In some institutions, CRRT changes the nurse to patient ratio from 1:2 to 1:1, an alteration which has cost implications and might affect resource availability for other patients. Accordingly, techniques which prolong the duration of intermittent therapy and avoid the need for 24 hr treatment may offer "best value" in the management of ARF in the intensive care unit (ICU). These techniques will be referred to as prolonged intermittent renal replacement therapies (PIRRT) in this article. They are characterised by several fundamental principles: 1. Use of a modified or standard dialysis machines, 2. Use of diffusion, convection or any combination of the two, 3. Application of a decreased intensity of solute removal compared with IHD, 4. Extended duration of treatment beyond the typical 3 or 4 hr of standard IHD (hence the term prolonged) but not beyond an 8-12 hr period (hence the term intermittent) and 5. Use of "on-line" generation of dialysate or replacement fluid from tap water. CONCLUSIONS: Information is now being obtained on the efficacy and safety of PIRRT in the ICU. Several units in Australia have started applying this technology to patient care. It is now important that critical care physicians and nurses become familiar with its principles and practice.

Journal Article↗

[Lipoprotein (a) [Lp(a)] and ischemic cardiopathy: correlation between radial immunodiffusion (RID) and radioimmunoassay methods (RIA)].

The anomalous lipemic values are considered as a risk factor in coronarial pathology. We are separately studying different lipemic factors, Lp(a) in the present paper. May be our 38 clinical cases are still a too small number to demonstrate any correlation between Lp(a) haematic content and arterial pathology, and we will continue this study in the evolution of the pathology, eventually until the infarctus. For the moment, we established the significance of correlation between two methods in two laboratories of ours (in Pavia, Italy, and in Lisboa, Portugal). Correlation is more than 0.9. Assays were done on the same air mailed samples.

Coronary Disease↗

Magnetic resonance imaging of degenerative disk disease of the spine.

MRI has undergone an incredibly rapid evolution, and technical advances are continually occurring. MRI allows for high resolution imaging that can clearly demonstrate a variety of degenerative processes of the spine. High-resolution MRI that gives detailed anatomic information, coupled with the use of MR contrast agents, promises to change our diagnostic approach significantly for degenerative disk disease of the spine.

Humans↗

Heterochrony in the development of vestigial and functional deciduous incisors in rabbits (Oryctolagus cuniculus L.).

Foetal and postnatal development of vestigial and functional deciduous incisors was reexamined using routine serial histological sections of maxillae and mandibles at daily intervals from day 16 postconception to postnatal day 15. It was found that the development of the maxillary and mandibular vestigial incisor teeth was more rapid than that of the functional incisors and that, of the functional incisors, the maxillary posterior deciduous incisors were the slowest to develop. It appeared from this study that a basic morphogenetic requirement for unfolding structure, ie, developmental timing, was not critical in generating hypsodont or brachydont teeth. A proposition has been made that originally juvenile stages of odontogenesis represent a continuously growing system, which during evolution has successively become typical for adult descendants.

Animals↗

[Mineralization of refuse from medical consulting rooms and municipal refuse in a model landfill].

Refuse originated from consulting rooms of medical doctors of five different specializations were disposed of for more than six months in a model landfill. Another variants of the same experiment consisted of a mixture, made from refuse as above with municipal refuse (1:10), and of municipal refuse alone. Using estimation of either CO2 and NH3 evolution before and after disposal, continuous temperature measurement, organic matter and moisture contents, the mineralization process in the disposed refuse was followed. In model landfill which was kept under aerobic conditions the results indicated a low rate of mineralization in refuse from medical consulting rooms. The mixture containing municipal refuse and refuse from medical consulting rooms showed mineralization rate similar to that of municipal refuse alone. If the model landfills were kept nearly anaerobic almost no mineralization occurred in all kind of refuse disposed of.

Animals↗

RNA virus quasispecies: significance for viral disease and epidemiology.

The experimental evidence available for animal and plant RNA viruses, as well as other RNA genetic elements (viroids, satellites, retroelements, etc.), reinforces the view that many different types of genetic alterations may occur during RNA genome replication. This is fundamentally because of infidelity of genome replication and large population sizes. Homologous and heterologous recombination, as well as gene reassortments occur frequently during replication of retroviruses and most riboviruses, especially those that use enzymes with limited processivity. Following the generation of variant genomes, selection, which is dependent on environmental parameters in ways that are poorly understood, sorts out those genome fits enough to generate viable quasispecies. Chance events can also be destabilizing, as illustrated by recent results on fitness loss and other phenotypic changes accompanying bottleneck transmission. Variation, selection, and random sampling of genomes occur continuously and unavoidably during virus evolution. Evolution of RNA viruses is largely unpredictable because of the stochastic nature of mutation and recombination events, as well as the subtle effects of chance transmission events and host/environmental factors. Among environmental factors, alterations resulting from human intervention (deforestation, agricultural activities, global climatic changes, etc.) may alter dispersal patterns and provide new adaptive possibilities to viral quasispecies. Current understanding of RNA virus evolution suggests several strategies to control and diagnose viral diseases. The new generation of chemically defined vaccines and diagnostic reagents (monoclonal antibodies, peptide antigens, oligonucleotides for polymerase chain reaction amplification, etc.) may be adequate to prevent disease and detect some or even most of the circulating quasispecies of any given RNA pathogen. However, the dynamics of viral quasispecies mandate careful consideration of those reagents to be incorporated into diagnostic kits. Broadening diagnosis without jeopardizing specificity of detection will be challenging. There is a finite probability (impossible to quantify at present) that a defined vaccine may promote selection of escape mutants or a particular diagnostic kit may fail to detect a viral pathogen. Of particular concern are the potential long-term effects of weak selective pressures that may initially go unnoticed. Variant viruses resulting from evolutionary pressure imposed by vaccines or drugs may insidiously and gradually replace previous quasispecies. The great potential for variation and phenotypic diversity of some important RNA virus pathogens (human immunodeficiency virus, the hepatitis viruses, the newly recognized human hantaviruses, etc.) has become clear. Prevention and therapy should rely on multicomponent vaccines and antiviral agents to address the complexity of RNA quasispecies mutant spectra.(ABSTRACT TRUNCATED AT 400 WORDS)

Biological Evolution↗

Contracted visiting hours in the coronary care unit. A patient-centered quality improvement project.

As critical care technology advances, the need to provide patient-centered care becomes increasingly critical. Grandstrom states that patients and families want "more." They have greater expectations and demand greater knowledge and involvement, vis-à-vis the hospital experience. Rather than indicating a desire to observe procedures or equipment, these expectations reveal a more personal and human need--the desire of patients and families to maintain contact and interact with one another. Allowing patients and families control over visiting times in a critical care setting is the first step in giving families and patients what they need. The use of contracted visiting hours allows families and patients to maintain some control over their lifestyles during a crisis. This project is still in progress. The evolution of the perfect contract continues. The outcome of increased flexibility and control of visiting times for families has been embraced and supported by the staff. It is believed that implementation of flexible visiting hours has increased the staff's awareness of the patient and family as consumers. In today's competitive health care environment, Artinian proposes that "strengthening relationships with families may make the critical difference related to patients' and families' choices about whether a health-care setting meets their needs." By implementing flexible visiting hours these relationships are enhanced and consumer satisfaction is influenced. Also, the institutional goal of patient-centered care, and ultimately quality patient care, is promoted.

Academic Medical Centers↗

Gastric emptying of radionuclide-labeled solid meal in beagle dogs using a scintigraphic method.

A scintigraphic method for in vivo radiotracers measurement is described to investigate the gastrointestinal emptying rate in beagle dogs. The proposed method has been applied to study the effect of a pharmacological compound in enhancing stomach emptying and involves the following steps: 1) 131I-labeled anion exchange resin grains preparation, as solid food markers to be ingested by the dogs; 2) continuous recording of gastric emptying evolution over a period of 5 h with fast data-gathering instrumentation employing small size and light-weight CsI scintillation detectors coupled to a photodiode, equipped with a lead shield and collimator; 3) comparison of results obtained with drugs to previous standard emptying curves. The purpose of this study was to evaluate the prokinetic activity of a recent synthesized compound (BIMU 1).

Animals↗

Glaucoma medications, glaucoma therapy, and the evolving paradigm.

BACKGROUND: Therapy for the glaucomas is dynamic, with changes evolving as new medications or modalities are discovered. In comparing the method(s) of treating open-angle glaucoma today, as compared to treatment in the 1980s, clear differences emerge. While topical beta-blockers remain the mainstay for treatment of open-angle glaucoma, other medications and modalities have recently become available that supplement their use. Topical carbonic anhydrase inhibitors (CAIs), introduced in 1995, have become an important addition to the glaucoma armamentarium. They are more useful than their oral counterparts, since they cause fewer systemic side effects, with similar efficacy. Brimonidine, a topical alpha2-adrenergic agonist, and latanoprost, a topical prostaglandin, have become important additions to the glaucoma regimen because of their ability to reduce the intraocular pressure (i.o.p.) with an improved therapeutic index, as compared to older medications. Finally, argon laser trabeculoplasty (ALT) appears to be a safe technique and useful in reduction of IOP. CONCLUSION: The scheme for how the anti-glaucoma medications and modalities are used for the therapy of open-angle glaucoma will change over time. The evolution will occur as we continue to learn more about the drugs presently being used.

Adrenergic beta-Antagonists↗

The complexities of viral genome analysis: the primate lentiviruses.

Analysis of sequence information from RNA-based replication systems continues to challenge the computational molecular biology community. Recent sequence data from the study of primate lentiviruses indicate that extreme sequence heterogeneity, recombination, and cross-species transmissions are all observed in HIV evolution. These types of events will continue to make the development of effective anti-retroviral therapies difficult.

Animals↗

Bateson's two Toronto addresses, 1921: 2. Evolutionary faith.

William Bateson's plenary address to the American Association for the Advancement of Science meeting in Toronto in 1921 was titled "Evolutionary Faith and Modern Doubts." In it he expressed his deep-seated skepticism about the causes of evolution (and in particular, his dissatisfaction with Darwinian natural selection) while reaffirming his belief in the reality of evolution itself. The address led to controversy at both the scientific and popular levels. Scientific criticism centered on Bateson's rejection of natural selection; popular controversy, as evidenced by contemporary newspaper clippings, was very widespread, not least because religious fundamentalists misrepresented Bateson in their campaign against evolution. I draw attention to the forgotten case of F.E. Dean, a superintendent of schools at Fort Sumner, New Mexico, who in 1922 was forced to resign his post for merely challenging a resolution of the local school board banning the teaching of evolution in schools. Dean deserves to be remembered, along with John T. Scopes, as an early hero of the continuing fight for the right to teach evolution in U.S. schools.

Biological Evolution↗