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PubMed2002

The impact of the maternal experience with a jaundiced newborn on the breastfeeding relationship.

OBJECTIVE: To examine the process by which mothers' experiences with neonatal jaundice affect breastfeeding. STUDY DESIGN: We used ethnographic interviews with grounded theory methodology. Audiotaped data were transcribed and analyzed for themes using ATLAS/ti qualitative data analysis software (Scientific Software Development, Berlin, Germany). POPULATION: We studied a total of 47 Spanish- and English-speaking breastfeeding mothers of otherwise healthy infants diagnosed with neonatal jaundice. OUTCOME MEASURED: Our outcomes were the qualitative descriptions of maternal experiences with neonatal jaundice. RESULTS: Interactions with medical professionals emerged as the most important factor mediating the impact of neonatal jaundice on breastfeeding. Breastfeeding orders and the level of encouragement from medical professionals toward breastfeeding had the strongest effect on feeding decisions. Maternal reaction to and understanding of information from their physicians also played an important role. Guilt was common, as many mothers felt they had caused the jaundice by breastfeeding. CONCLUSIONS: By providing accurate information and encouragement to breastfeed, medical professionals have great impact on whether a mother continues breastfeeding after her experience with neonatal jaundice. Health care providers must be aware of how mothers receive and interpret information related to jaundice to minimize maternal reactions, such as guilt, that have a negative impact on breastfeeding.

Adolescent↗

PubMedDate not supplied

EMGLAB: objective outcome measures in neurophysiological testing.

The aim of this work was to objectively measure and quantify the results of various neurophysiological tests and indirectly provide objective outcome measures for neurological therapy and rehabilitation. We have studied the silence of Electromyographic (EMG) activity after evoking motor potentials with magnetic cortical stimulation. Since different criteria were previously used to determine the level where the silence of muscle activity ends, an objective computer aided method was developed. This analysis was further developed to include objective testing of surface EMG, long latency reflexes, reciprocal inhibition of the H-reflex, H-reflex recovery curve and decrement testing. Responses were recorded at different sampling frequencies, depending on the application, time window, filter settings, etc. The developed software proved to be a fast and objective tool, able to standardize the determination of different neurophysiological tests, and as such a valuable tool facilitating multi-center studies and diminishing human bias. The software reduced the study time with each patient. Until date we have used the software with the Medtronic, Medelec and BTS EMG instruments.

Diagnosis, Computer-Assisted↗

PubMed2002

[Computer program for diagnosis, monitoring, and prophylaxis of cardiovascular diseases].

Cardiovascular diseases remain the main cause of death among adult population; their incidence can be reduced only using an effective system of primary and secondary prevention. The aim of our study was to develop software for automated recognition of cardiovascular risk factors, prognosis, and evaluation of dyslipoproteinemia phenotypes in lipid centers. Prognostic indexes, lipidogram values are estimated, and the program detects the risk factors (overweight, poor physical training, irrational nutrition, tobacco smoking, etc.) and predicts the summary risk of coronary disease. Neuronal network was used for evaluating the types of dyslipoproteinemias and for cardiovascular prognosis. The input vectors were lipid and lipoprotein concentrations. Output neurons were diagnostic signs of dislipoproteinemia phenotypes or cardiovascular prognosis.

Adult↗

PubMed2002

Use of anodic stripping voltammetry in predicting toxicity of copper in river water.

The labile concentration and toxicity of Cu as influenced by alkalinity and different concentrations of ethylenediaminetetraacetic acid (EDTA) and naturally derived fulvic acid (FA) were determined by bioassays carried out in the culture media for Daphnia magna (D. magna). The labile concentration of Cu was obtained by differential pulse anodic stripping voltammetry with a double-acidification method (DAM-DPASV). Changes in water alkalinity did not affect the labile concentration of Cu, but increase in alkalinity did reduce the mortality of D. magna. In the presence of EDTA and FA, both labile concentration of Cu and mortality were reduced. By excluding Cu-carbonate complexes from the labile concentration, a bioavailable concentration of Cu ([Cu*]) was obtained and was used to predict the acute toxicity of Cu on D. magna. For natural waters, the labile concentration of Cu was measured by DAM-DPASV, and [Cu*] was calculated using MINTEQ A2 software (developed by the U.S. Environmental Protection Agency) based on the anion composition of waters. This procedure was tested for waters and sediment elutriates sampled from the Le An River (Jiangxi Province, China) that were severely polluted by the discharges from a copper mine. The results showed that [Cu*] was a good indicator for Cu toxicity and could be used under field conditions.

Animals↗

PubMed2002

Correlation of three-dimensional tumor volumetry with cervical cancer prognostic parameters.

OBJECTIVE: Estimation of tumor size by a single diameter is used in the current Federal International Gynecology Oncology (FIGO) cervical cancer staging system. However, the role of three-dimensional volumetry is rarely mentioned. In this study, three kinds of tumor volume estimations were performed and the relationship of these volume estimations among associated cervical cancer prognostic parameters were evaluated. METHODS: Thirty patients with newly diagnosed cervical cancer at Taipei Veterans General Hospital were enrolled in the study. Final pathology and associated parametric information was obtained by chart review. The original magnetic resonance (MR) image was reappraised by an experienced radiologist and the tumor volume was estimated using either three axial measurements or the longest axial measurement. The corresponding three-dimensional (3-D) volume was calculated by the integration of lesion areas in different images using volumetric software developed by engineers at National Central University, Taiwan. All data were analyzed separately for correlation with clinical staging, histological differentiation, pelvic lymph node metastasis and survival status. RESULTS: A statistically significant difference in tumor volume estimates was found between 3-D-integration and one-dimensional estimates among tumors with lymph nodes metastasis, cell differentiation and parametrial involvement. CONCLUSION: This study found that the parameters of lymph node metastasis, parametrial involvement and tumor differentiation are volume-dependent. 3D-tumor volumetry showed superior discrimination of these parameters compared to current single diameter evaluation suggesting its potential as a rapid method for initial prediction of prognostic factors in cervical cancer.

Adult↗

PubMed1999

Virtual colonography: techniques and current clinical applications.

The advent of volumetric helical computed tomography (CT), coupled with the almost universal use of oral and intravenous contrast agents, has resulted in CT becoming the diagnostic and therapeutic cornerstone for alimentary tract disease. Recent technical advances, further enhanced by innovative software developments, now permit multiplanar and endoluminal projections of the entire abdomen, and have resulted in the development of novel diagnostic applications in the abdomen.

Journal Article↗

PubMed2002

An overview on predicting the subcellular location of a protein.

The present paper overviews the issue on predicting the subcellular location of a protein. Five measures of extracting information from the global sequence based on the Bayes discriminant algorithm are reviewed. 1) The auto-correlation functions of amino acid indices along the sequence; 2) The quasi-sequence-order approach; 3) the pseudo-amino acid composition; 4) the unified attribute vector in Hilbert space, 5) Zp parameters extracted from the Zp curve. The actual performance of the predictive accuracy is closely related to the degree of similarity between the training and testing sets or to the average degree of pairwise similarity in dataset in a cross-validated study. Many scholars considered that the current higher predictive accuracy still cannot ensure that some available algorithms are effective in practice prediction for the higher pairwise sequence identity of the datasets, but some of them declared that construction of the dataset used for developing software should base on the reality determined by the Mother Nature that some subcellular locations really contain only a minor number of proteins of which some even have a high percentage of sequence similarity. Owing to the complexity of the problem itself, some very sophisticated and special programs are needed for both constructing dataset and improving the prediction. Anyhow finding the target information in mature protein sequence and properly cooperating it with sorting signals in prediction may further improve the overall predictive accuracy and make the prediction into practice.

Algorithms↗

PubMed2003

Patient-specific, 3-dimensional dosimetry in non-Hodgkin's lymphoma patients treated with 131I-anti-B1 antibody: assessment of tumor dose-response.

UNLABELLED: A comprehensive, SPECT-based, patient-specific 3-dimensional (3D) dosimetry analysis has been performed using 3D-ID, a previously developed software package. The role of the total-body tumor burden, individual lesion size, tumor absorbed dose, and the spatial distribution of the absorbed dose on response and on the time course of tumor shrinkage has been examined in patients with lymphoma treated by radioimmunotherapy. METHODS: Data from 15 patients participating in a phase II study of (131)I-labeled anti-B1 antibody (tositumomab) were used. Patients were administered a tracer dose of (131)I for imaging and pharmacokinetics. Dose estimates from the tracer studies were used to prescribe the therapeutic administration such that the whole-body absorbed dose did not exceed 75 cGy. All patients received a fixed mass amount of antibody for both the tracer and the therapeutic administrations. SPECT and planar imaging were performed 3-4 d after the therapeutic administration. CT or MRI scans were available on all patients. Total tumor burden was assessed by drawing contours around all lymphoma lesions identified on whole-body CT or MRI. Mean absorbed doses were estimated for selected, index lesions by conventional dosimetry and also by 3D SPECT-based dosimetry. Using a patient-specific dosimetry package, 3D-ID, dose-volume histograms were also generated to assess the spatial distribution of absorbed dose. This approach made it possible to obtain estimates of the minimum and maximum absorbed doses for individual tumors in addition to the mean. RESULTS: Mean absorbed dose estimates obtained by patient-specific SPECT-based dosimetry using 3D-ID were within 2%-5% of estimates obtained by conventional dosimetry. None of the absorbed dose parameters (mean, minimum, maximum, uniformity) were found to have a significant correlation with tumor response. The total-body tumor burden did not impact on overall response or toxicity. CONCLUSION: This analysis represents the first full reported implementation of a patient-specific 3D dosimetry package. The absence of a dose-response relationship for tumors is surprising and suggests that absorbed dose is not the sole determinant of tumor response in these patients. The absence of a correlation between the total-body tumor burden and overall response or toxicity suggests that tailoring the milligram amount of administered antibody to patient tumor burden is not likely to improve response or reduce toxicity.

Antibodies, Monoclonal↗

PubMed2003

Murine S factors for liver, spleen, and kidney.

UNLABELLED: Preclinical evaluation of new radiopharmaceuticals is performed in animal systems before testing is started in humans. These studies, often performed in murine or other rodent models, are important in understanding the relationship between absorbed dose and response, which can be translated to preclinical results for humans. In performing such calculations, either electrons are assumed to deposit all of their energy locally or idealized models of mouse anatomy are used to determine absorbed fractions. Photon contributions are generally considered negligible. To improve the accuracy of such absorbed dose calculations, mouse-specific S factors for (131)I, (153)Sm, (32)P, (188)Re, and (90)Y have been generated, and the photon and electron portions have been tabulated separately. Absorbed fractions for 5 monoenergetic electrons, ranging in energy from 0.5 to 2 MeV, are also provided. METHODS: Female athymic mouse MR images were obtained on a 4.7-T MRI device. Fifteen T1-weighted, 1.5-mm-thick slices (0.5-mm gap) were collected. Using a previously developed software package, 3-dimensional Internal Dosimetry (3D-ID), organ contours were drawn to obtain a 3-dimensional representation of liver, kidneys, and spleen. Using a point-kernel convolution, the mean absorbed dose to each organ from the individual contributions of each source organ were calculated. S factor equivalent values were obtained by assuming a uniform distribution of radioactivity in each organ. Results were validated by comparing 3D-ID generated electron S factors for different-sized spheres with published data. Depending on matrix size, sphere size, and radionuclide, 1% (256(2) matrix) to 18% (64(2) matrix) agreement was obtained. RESULTS: S factor values were calculated for liver, spleen, and right and left kidneys. Cross-organ electron-absorbed fractions of up to 0.33 were obtained (e.g., (90)Y right kidney to liver). Comparisons between S factor values and values obtained assuming complete absorption of electron energy yielded differences of more than 190% ((90)Y spleen self-dose). CONCLUSION: The effect of cross-organ and self-absorbed dose is dependent on emission energy and organ geometry and should be considered in murine dose estimates. The approach used to generate these S factors is applicable to other animal systems and also to nonuniform activity distributions that may be obtained by small-animal SPECT or PET imaging or by quantitative autoradiography.

Animals↗

PubMed2003

Pharmacokinetics and Biodistribution of (86)Y-Trastuzumab for (90)Y dosimetry in an ovarian carcinoma model: correlative MicroPET and MRI.

UNLABELLED: Preclinical biodistribution and pharmacokinetics of investigational radiopharmaceuticals are typically obtained by longitudinal animal studies. These have required the sacrifice of multiple animals at each time point. Advances in small-animal imaging have made it possible to evaluate the biodistribution of radiopharmaceuticals across time in individual animals, in vivo. MicroPET and MRI-based preclinical biodistribution and localization data were obtained and used to assess the therapeutic potential of (90)Y-trastuzumab monoclonal antibody (mAb) (anti-HER2/neu) against ovarian carcinoma. METHODS: Female nude mice were inoculated intraperitoneally with 5.10(6) ovarian carcinoma cells (SKOV3). Fourteen days after inoculation, 12-18 MBq (86)Y-labeled trastuzumab mAb was injected intraperitoneally. Tumor-free mice, injected with (86)Y-trastuzumab, and tumor-bearing mice injected with labeled, irrelevant mAb or (86)Y-trastuzumab + 100-fold excess unlabeled trastuzumab were used as controls. Eight microPET studies per animal were collected over 72 h. Standard and background images were collected for calibration. MicroPET images were registered with MR images acquired on a 1.5-T whole-body MR scanner. For selected time points, 4.7-T small-animal MR images were also obtained. Images were analyzed and registered using software developed in-house. At completion of imaging, suspected tumor lesions were dissected for histopathologic confirmation. Blood, excised normal organs, and tumor nodules were measured by gamma-counting. Tissue uptake was expressed relative to the blood concentration (percentage of injected activity per gram of tissue [%IA/g]/%IA/g blood). (86)Y-Trastuzumab pharmacokinetics were used to perform (90)Y-trastuzumab dosimetry. RESULTS: Intraperitoneal injection of mAb led to rapid blood-pool uptake (5-9 h) followed by tumor localization (26-32 h), as confirmed by registered MR images. Tumor uptake was greatest for (86)Y-trastuzumab (7 +/- 1); excess unlabeled trastuzumab yielded a 70% reduction. Tumor uptake for the irrelevant mAb was 0.4 +/- 0.1. The concentration in normal organs relative to blood ranged from 0 to 1.4 across all studies, with maximum uptake in spleen. The absorbed dose to the kidneys was 0.31 Gy/MBq (90)Y-trastuzumab. The liver received 0.48 Gy/MBq, and the spleen received 0.56 Gy/MBq. Absorbed dose to tumors varied from 0.10 Gy/MBq for radius = 0.1 mm to 3.7 Gy/MBq for radius = 5 mm. CONCLUSION: For all injected compounds, the relative microPET image intensity of the tumor matched the subsequently determined (86)Y uptake. Coregistration with MR images confirmed the position of (86)Y uptake relative to various organs. Radiolabeled trastuzumab mAb was shown to localize to sites of disease with minimal normal organ uptake. Dosimetry calculations showed a strong dependence on tumor size. These results demonstrate the usefulness of combined microPET and MRI for the evaluation of novel therapeutics.

Animals↗

PubMed1992

[Electrocardiography in pediatrics. 2: Recommendations for a newly introduced recording and evaluation procedure].

ECG recordings were made by means of a modified NELSON-lead system in a total of 100 children aged between 2 weeks and 59 months. Software developed by ourselves served for on-line calculations of the dipole moment D which is graphically represented by vector loops in three projection planes, horizontal, frontal and sagittal. In addition, the maximum spatial vector Dmax and the mean vector A are calculated by the program. The examination of one child including positioning of 20 electrodes and production of a hard-copy of the results takes no longer than 15 minutes. The children were unsedated and awake when the ECGs were recorded. The results show the continuously growing dipole moment and its gradually changing direction from the right posterior or left anterior to the left posterior quadrant in parallel with the growth of the body and the heart, respectively. The smallest vector magnitudes and smallest vector loops of the dipole moment are measured in the youngest infants (0-2 months) while very high voltages in conventional ECGs of infants are regularly seen, predominantly in the precordial region. Two examples of pathological NELSON-ECGs are reported. One case is a boy aged 4 years 10 months with aortic supravalvular stenosis, the other one is a girl aged 4 years 3 months with pulmonic valve stenosis. These cases demonstrate the excellent suitability of this noninvasive method as a diagnostic tool for pediatric cardiology.

Child↗

PubMed2003

IOM cites core functions to improve EHR systems.

Key elements must address quality, efficiency, and feasibility. Committee piggybacks on ongoing study for faster results. Common industry standard for software developers being created.

Medical Records Systems, Computerized↗

PubMed2003

From DRG databases to an epidemiological observatory for colorectal cancer in a French small area oncology network.

Following a request from the local health authority, we have organised the permanent linkage of DRG/MBDS databases from different tertiary care hospitals from Saint-Etienne urban area. To made anonymous the MBDS, we used the asymmetric hashing and encrypting software developed and registered by the University hospital of Dijon. In each hospital, the selection of acute care stay MBDS is performed on the presence of at least one malignant tumour ICD code. The output is an anonymous but personal 20,000 patients register. We are presenting the method to estimate the incidence of colorectal cancer (CRC) cured between 1996 and 2000 from DRG databases of four hospitals and checking the validity against the figures coming from a cancer registry. Among the 1953 CRC patients observed, 156 patients have followed a CRC surgical excising in 1999. The DRG activity of the 4 observatory hospitals is 33.5% of the total hospital activity for people of the area recorded by the 1999 regional DRG PMSI data bases. The estimation of the incidence is 465 for 1999, the estimation of the same incidence by applying the incidence rate by sex and age from the Isère cancer register to the population of the Loire area, is 504. The under estimation is 7.7% with the observatory method. It is rather difficult to check an estimation by another estimation but in France the evaluation of oncology care strategies is impeded by the lack of cancer registries. The conclusion of this study is a good feasibility and acceptability of the linking procedure when used with a clear healthcare goal. The use of DRG data bases within an oncology network by linking the mandatory MBDS data bases gives the opportunity to share some clinical data between healthcare professionals.

Colorectal Neoplasms↗

PubMed1992

The homogenization of the Metathesaurus schema and distribution format.

The third version of the UMLS Metathesaurus, Meta-1.2, to be released in October 1992, will have a simpler schema and simpler distribution formats than the first two versions, Meta-1.0 and Meta-1.1 released in October 1990 and 1991, respectively. For one thing, it will have only a single kind of entry (Concept), rather than three (Concept, Related, and Synonym). Further, the Relational Format, will consist of four logical relations, or tables, instead of the nearly three score different tables used to represent the same kind of information in Meta-1.1. These four tables will contain, respectively, (1) the names of each concept, (2) the relationships between concepts, (3) attributes of the concepts, and (4) a word-based index into the concept names. We argue that the new schema and formats provide a better conceptual model of the Metathesaurus, and represent the information contained there more uniformly. Even though these changes are incremental and evolutionary, both users and software developers should find the Meta-1.2 significantly easier to understand, and the information contained in it significantly easier to use.

Information Storage and Retrieval↗

PubMed1992

Electronic imaging of the human body.

The Human Engineering Division of the Armstrong Laboratory (USAF); the Mallinckrodt Institute of Radiology; the Washington University School of Medicine; and the Lister-Hill National Center for Biomedical Communication, National Library of Medicine are sponsoring a working group on electronic imaging of the human body. Electronic imaging of the surface of the human body has been pursued and developed by a number of disciplines including radiology, forensics, surgery, engineering, medical education, and anthropometry. The applications range from reconstructive surgery to computer-aided design (CAD) of protective equipment. Although these areas appear unrelated, they have a great deal of commonality. All the organizations working in this area are faced with the challenges of collecting, reducing, and formatting the data in an efficient and standard manner; storing this data in a computerized database to make it readily accessible; and developing software applications that can visualize, manipulate, and analyze the data. This working group is being established to encourage effective use of the resources of all the various groups and disciplines involved in electronic imaging of the human body surface by providing a forum for discussing progress and challenges with these types of data.

Computer Simulation↗

PubMed2004

Treatment of intrabony pockets with Emdogain: results at 36 months.

This study reports the results obtained 36 months after treating deep periodontal defects with amelogenins. Results at 12 months have already been published. Sixteen of 21 patients completed the 3-year recall program. This study confirms after 3 years the results obtained at 1 year: Probing pocket depth decreased from 7.87 +/- 2.03 mm to 2.93 +/- 2.19 mm; recession increased from 2.20 +/- 1.42 mm to 2.93 +/- 1.87 mm; and attachment level decreased from 10.07 +/- 2.28 to 5.87 +/- 2.59 mm. No statistically significant difference was found between the data collected at 12 and 36 months. The standardized radiographs, digitized and analyzed with purpose-developed software, did not show any appreciable increase in bone volume, but only improved mineralization of the preexisting bone after 3 years using Emdogain without grafts.

Absorptiometry, Photon↗

PubMed2004

A new set of bioinformatics tools for genome projects.

A new tool called System for Automated Bacterial Integrated Annotation--SABIA (SABIA being a very well-known bird in Brazil) was developed for the assembly and annotation of bacterial genomes. This system performs automatic tasks of assembly analysis, ORFs identification/analysis, and extragenic region analyses. Genome assembly and contig automatic annotation data are also available in the same working environment. The system integrates several public domains and newly developed software programs capable of dealing with several types of databases, and it is portable to other operational systems. These programs interact with most of the well-known biological database/softwares, such as Glimmer, Genemark, the BLAST family programs, InterPro, COG, Kegg, PSORT, GO, tRNAScan and RBSFinder, and can also be used to identify metabolic pathways.

Brazil↗

PubMedDate not supplied

[The meaning of vegetation classification for modern ecology].

Eco-floristic classification (Brawn-Blanquet system) is useful since in similar manner it can establish ecological units of different level (syntaxons) that have high indicative value. Syntaxons can be used as markers of terrestrial ecosystems of different range. Although this system was proposed by analogy with plant taxonomy it reflects vegetation continuum. The application of this approach is based on certain standards and supported by developed software. The elements of arbitrariness in Brawn-Blanquet method are constrained by rules of strict recommendations. The method is considered as necessary in studies of biodiversity in protected areas.

Ecology↗