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At least 109 records · Page 6Linked to original sources

PubMed1997

Cardiovascular morbidity and mortality among hypertensive patients in general practice: the evaluation of long-term systematic management.

OBJECTIVE: To evaluate systematic management of hypertensive patients with regard to cardiovascular morbidity and mortality. DESIGN: In a matched cohort study (1978-1993) the number of cardiovascular events among hypertensive patients under continuous systematic management in four general practices was compared with those occurring among hypertensive patients from eight "usual care" general practices. SUBJECTS: The source population consisted of employees of a major electronic company in Eindhoven with hypertension as determined at an occupational health examination. The index group (n = 120) consisted of employees who were participating in the systematic management program in four practices. A reference group of 120 patients was selected from hypertensive employees who were registered in eight "usual care" practices by matching for age, gender, fasting blood glucose, and frequency of occupational health examinations. The total cohort consisted primarily of males (78%), whose ages ranged from 50 to 65 years. MAIN OUTCOME MEASURES: Risk difference (RD) per 1000 patient years regarding left ventricular hypertrophy, heart failure, angina pectoris, myocardial infarction, transient ischaemic attack, stroke, peripheral arterial disease, nephropathy, retinopathy, cardiac death, death due to stroke, and non-cardiovascular death was determined. In addition to morbidity and mortality, systematic hypertension management was evaluated with regard to cardiovascular risk factors throughout a period of maximally 12 successive years (1978-1989). Morbidity and mortality data were derived from general practice records and archives; data on risk factors were assessed at bi-annual occupational health examinations. RESULTS: The total follow-up duration amounted to 2628 patient years. The mean follow-up duration in the index group was 10.8, in the reference group 11.1 years. As compared to the "usual care" reference group, the index group showed less left ventricular hypertrophy (RD 8.2, 95% CI 1.4-15.0), less angina pectoris (RD 9.7, 95% CI 2.0-17.4) and less peripheral arterial disease (RD 3.7, 95% CI 0.5-7.1). The difference in mean decrease in blood pressure during follow-up was 11.3 mmHg systolic and 5.9 mmHg diastolic in favour of the index group. No significant differences between the index and the reference groups were found with regard to the changes in other risk factors. CONCLUSION: In our study systematic management of hypertensive patients aged 50 to 65 in general practice was associated with a statistically significant, and clinically relevant decrease in cardiovascular morbidity and blood pressure. Although causality cannot be determined from this non-randomized cohort study, the findings do support the view that systematic management of hypertensive patients in general practice is valuable.

Cardiovascular Diseases↗

PubMed2003

Physiologic data acquisition system and database for the study of disease dynamics in the intensive care unit.

OBJECTIVE: To describe a real-time, continuous physiologic data acquisition system for the study of disease dynamics in the intensive care unit. DESIGN: Descriptive report. SETTING: A 16-bed pediatric intensive care unit in a tertiary care children's hospital. PATIENTS: A total of 170 critically ill or injured pediatric patients. INTERVENTIONS: None. MAIN OUTCOME MEASURES: None. RESULTS: We describe a computerized data acquisition and analysis system for the study of critical illness and injury from the perspective of complex dynamic systems. Both parametric (1 Hz) and waveform (125-500 Hz) signals are recorded and analyzed. Waveform data include electrocardiogram, respiration, systemic arterial pressure (invasive and noninvasive), central venous pressure, pulmonary arterial pressure, left and right atrial pressures, intracranial pressure, body temperature, and oxygen saturation. Details of the system components are explained and examples are given from the resultant physiologic database of signal processing algorithms and signal analyses using linear and nonlinear metrics. CONCLUSIONS: We have successfully developed a real-time, continuous physiologic data acquisition system that can capture, store, and archive data from pediatric intensive care unit patients for subsequent time series analysis of dynamic changes in physiologic state. The physiologic signal database generated from this system is available for analysis of dynamic changes caused by critical illness and injury.

Algorithms↗

PubMedDate not supplied

Evolution of neuronetworks.

Since the 1970s, the care of critically ill neurologic and neurosurgical patients has emerged as a developing subspecialty. Management of these patients involves an enormous amount of data generation and analysis. Review of the history of neuroepidemiology and neurocritical care demonstrates the inevitability of their present unwiedly burden of information. Compelling advantages of computerization in direct patient care include aid in data acquisition, analysis and remote access. Infrastructure and resources used to collect data on individual patients may be augmented to archive data in clinical databases. Several investigators have initiated information management projects including automation of beside clinical documentation, development of systems for remote access to information and patient registries to study the natural history and outcome of specific neurological conditions. These are steps toward the development of integrated systems to aid in patient monitoring, data management, continuous quality improvement and the generation of hypotheses for further clinical investigation. Improvements in information management technology will allow increased efficiency in an era where information generation continues to increase exponentially.

Critical Care↗

PubMed1991

Frequency analysis instrumentation for sinus wall and baroreceptor responses.

Blood pressure regulation involves feedback signals from baroreceptors detecting wall strain of arterial sinuses. A research goal is identification of wall viscoelastic properties and associations between elements and baroreceptors. This report presents development of computer-based procedures for control of pressure inputs and recording responses of an in situ carotid sinus. Features include a hydraulic system to generate swept-frequency sinusoidal pressure inputs (0.2 to 200 Hz); measurements of: (i) sinus wall area and vectors of strain using a fiber optic sensor system, (ii) intrasinus pressure using solid state probes, (iii) baroreceptor fiber activity using a unipolar electrode and (iv) algorithms for data archival, frequency domain analysis and transfer function determinations. Data analysis will focus on estimates of wall properties of elasticity (K), viscosity (C), natural frequency (omega w), damping ratio (zeta w), reactive mass (Mw) and relationships to similar properties at tissue-baroreceptor junctions. Computer-based procedures are exemplified with data detailing mechanical properties of the hydraulic system; which is an important prerequisite to analysis of sinus viscoelastic properties.

Animals↗

PubMed2001

Ontologies of developmental anatomy: their current and future roles.

A central problem in current biology is elucidating the molecular networks that drive developmental change and physiological function. Such knowledge is needed partly to understand these networks, partly to be able to manipulate them, and partly to understand and help treat those human congenital abnormalities that arise as a result of mutation. Thus far, bioinformatics technology has been of limited use in this enterprise, mainly because its core focus has been on sequence technology and data archiving. For bioinformatics to be of use in this next tier of investigations, genetic and protein data need to be both archived and searchable by tissue since this is the level at which these networks operate. The resulting databases in turn require ontologies of developmental anatomy that can provide the formal infrastructure for handling gene expression, microarray and other tissue-based data. Here, the progress in making such ontologies, particularly for the developing mouse, is reported and the uses to which they are and will be put, together with the resources and tools currently available for investigating molecular networks and the genetic basis of congenital abnormalities, are considered.

Anatomy↗

PubMed1992

Elastofibroma: MR and CT appearance with radiologic-pathologic correlation.

OBJECTIVE: The purpose of our study was to determine the MR and CT appearances of elastofibroma and correlate the imaging features with the underlying pathologic findings. MATERIALS AND METHODS: We reviewed retrospectively the MR and CT findings in five cases of elastofibroma. All patients had a soft-tissue mass; one patient also complained of pain. The mean age of the patients was 71 years (range, 63-79 years). Four lesions occurred in the subscapular region, and one occurred in the thigh. In addition, we reviewed and compared the demographic data of 72 histologically proved cases for which we had archival data. RESULTS: Three of four lesions evaluated with spin-echo MR imaging were approximately isointense with skeletal muscle and contained areas with a signal intensity similar to that of fat; these corresponded to areas of dense collagen and interspersed fat, respectively. In the fourth case, the MR appearance was nonspecific. In one case, MR imaging with gadopentetate dimeglumine showed areas with and without enhancement. Three of four lesions evaluated with CT had variable margins, with tissue attenuation similar to that of the adjacent soft tissue as well as scattered areas of decreased attenuation, suggesting fat within the lesion. In one case, the lesion was well defined and relatively homogeneous with an attenuation less than that of skeletal muscle. CONCLUSION: The MR and CT features of elastofibroma are different from those of most other soft-tissue tumors, reflecting entrapped fat within a predominantly fibrous mass. Although these features are not pathognomonic, their presence in a subscapular lesion in an older patient suggests a presumptive diagnosis of elastofibroma.

Adult↗

PubMed1999

A uniform database of rehabilitation as a basis for evaluating the outcome quality.

To make it possible to benefit from patient data recorded in rehabilitation clinics, with regard to outcome quality and scientific investigation, the Rehabilitation Research Centre at the University of Ulm has created a rehabilitation register, a database based on ORACLE, into which the relevant patient data is transferred, having been made anonymous via an SQL archiving program. The archived data includes the clinical parameters, the running text of the discharge report, and the doctor's and patient's assessment of the rehabilitation outcome. It can be automatically searched for structured data, according to every conceivable criterion and in every conceivable combination, also in combination with a text search in the running text of the admission and discharge reports and the rehabilitation outcome. With the aid of the rehabilitation register and thanks to the possibilities of EDP (Electronic Data Processing), in future it will be possible to make much more differentiated comments on the rehabilitation outcome than would be the case if the search were restricted to structured data alone. This is essential in order to be able constantly to improve outcome quality and to verify the economic benefit of rehabilitation medicine.

Databases as Topic↗

PubMed2006

A gradient of radioactive contamination in Dolon village near the SNTS and comparison of computed dose values with instrumental estimates for the 29 August, 1949 nuclear test.

Spatial distributions of soil contamination by 137Cs (89 sampling points) and 239+240Pu (76 points) near and within Dolon village were analyzed. An essential exponential decrease of contamination was found in Dolon village: the distance of a half reduction in contamination is about 0.87-1.25 km (in a northwest-southeast direction from the supposed centerline of the radioactive trace). This fact is in agreement with the available exposure rate measurements near Dolon (September 1949 archive data): on the basis of a few measurements the pattern of the trace was estimated to comprise a narrow 2 km corridor of maximum exposure rate. To compare computed external doses in air with local dose estimates by retrospective luminescence dosimetry (RLD) the gradient of radioactive soil contamination within the village was accounted for. The computed dose associated with the central axis of the trace was found to be equal to 2260 mGy (calculations based on archive exposure rate data). Local doses near the RLD sampling points (southeast of the village) were calculated to be in the range 466-780 mGy (averaged value: 645+/-70 mGy), which is comparable with RLD data (averaged value 460+/-92 mGy with range 380-618 mGy). A comparison of the computed mean dose in the settlement with dose estimates by ESR tooth enamel dosimetry makes it possible to estimate the "upper level" of the "shielding and behavior" factor in dose reduction for inhabitants of Dolon village which was found to be 0.28+/-0.068.

Body Burden↗

PubMed2004

The study designed by a committee: design of the Multisite Violence Prevention Project.

This article describes the research design of the Multisite Violence Prevention Project (MVPP), organized and funded by the National Center for Injury Prevention and Control (NCIPC) at the Centers for Disease Control and Prevention (CDC). CDC's objectives, refined in the course of collaboration among investigators, were to evaluate the efficacy of universal and targeted interventions designed to produce change at the school level. The project's design was developed collaboratively, and is a 2 x 2 cluster-randomized true experimental design in which schools within four separate sites were assigned randomly to four conditions: (1) no-intervention control group, (2) universal intervention, (3) targeted intervention, and (4) combined universal and targeted interventions. A total of 37 schools are participating in this study with 8-12 schools per site. The impact of the interventions on two successive cohorts of sixth-grade students will be assessed based on multiple waves of data from multiple sources of information, including teachers, students, parents, and archival data. The nesting of students within teachers, families, schools and sites created a number of challenges for designing and implementing the study. The final design represents both resolution and compromise on a number of creative tensions existing in large-scale prevention trials, including tensions between cost and statistical power, and between internal and external validity. Strengths and limitations of the final design are discussed.

Adolescent↗

PubMedDate not supplied

Methodology-dependent variation in documentation of outcome predictors in out-of-hospital cardiac arrest.

OBJECTIVE: To identify variation in outcome predictor documentation in out-of-hospital cardiac arrest associated with two different methods of data collection: concurrent questioning of personnel following a resuscitation attempt and archival report review. METHODS: All patients > or = 18 years old who had out-of-hospital cardiac arrests, verified using the New York City 911 telephone system, between October 1, 1990, and April 1, 1991, were eligible for inclusion. The authors reviewed the first 200 cases of presumed primary cardiac arrest involving a resuscitation attempt among 3,243 consecutive ambulance call reports for cardiac arrest occurring during the study period. This archival data set was compared with data for the same 200 cases gathered through direct interview of field personnel by trained paramedics. The two data sets had been compiled independently by different individuals, using the same data collection instrument, which conformed to the Utstein template. RESULTS: Comparison of the data obtained from ambulance records with the data obtained from interviews of prehospital personnel revealed several areas of variance. Of note was a significantly lower proportion of bystander-witnessed ventricular fibrillation (VF) in the data set gathered from written reports (7% vs 18%; 95% CI for the difference 4-18%; p = 0.001). CONCLUSION: differences in methods of collection of out-of-hospital cardiac arrest data are associated with a more than twofold variation in the reported incidences of witnessed cardiac arrests manifesting as VF. Methodology-dependent variation in this important "denominator" may produce substantially different estimates of survival within the same cohort of patients.

Adult↗

PubMed1997

Tele-education: the virtual medical laboratory.

The virtual medical laboratory (VML) was conceived to provide an Internet-accessible resource, offering access for clinicians and scientists to an invaluable data archive at the institute of Laryngology and Otology, London. The Institute is home to the largest collection of temporal bone, laryngeal, skull and sinus sections in Europe. The skull and sinus collections include an extensive section consisting of animal material. These were contributions from zoos around the world. Over the last 50 years, samples have been carefully sectioned and stained by specialized technicians to produce histology slices of most regions of the head and neck. The aim of the project is to create a virtual medical laboratory, which will provide access to archived histological material as well as computerized tomography and magnetic resonance data. Central to this aim is the reconstruction of the internal anatomy of the temporal bone from two-dimensional histology slices, to create three-dimensional views that can be used for anatomical simulation and surgical training in otolaryngology. State-of-the-art three-dimensional reconstruction and rendering technology allows us to develop such a model. Computer-generated simulation could be made available to all hospitals in which otolaryngology is practised, via digital communication networks. We aim to develop core technology in our own specialty that is applicable to other fields of higher education, which have not been exposed to such modern teaching modalities. This has the potential to become an invaluable teaching resource for anatomists, surgeons and other scientists.

Computer Communication Networks↗

PubMed2005

Common conventions for interchange and archiving of three-dimensional electron microscopy information in structural biology.

Three-dimensional electron microscopy (3DEM) has made significant contributions to structural biology. To accomplish this feat, many image-processing software packages were developed by various laboratories. The independent development of methods naturally implied the adoption of dissimilar conventions-penalizing users who want to take advantage of the wealth of algorithms from different packages. In addition, a public repository of 3DEM research results, the EM Data Bank, is now established. In an era where information exchange is important, standardizing conventions is a necessity. The 3DEM field requires a consistent set of conventions. We propose a set of common conventions named the "3DEM Image Conventions." They are designed as a standardized approach to image interpretation and presentation. In this regard, the conventions serve as a first step on which to build data-exchange solutions among existing software packages and as a vehicle for homogenous data representation in data archives, such as the EM Data Bank.

Algorithms↗

PubMed2002

A computerized version of EBIS evaluation chart and its opportunities in the rehabilitation program of TBI patients.

The need of rehabilitation programs for severely traumatic brain injured (TBI) patients is great and is growing, but these programs are long, costly and it would be very useful if we could demonstrate and quantify the benefits of our approaches. We think that scarcity of literature in this field is a consequence of the well known and real difficulty in this kind of investigations (too many variability factors, groups of population not homogeneous, ethical problems for double blind studies and so on). It is our opinion that EBIS Protocol could be a very useful instrument for the evaluation of rehabilitation programs benefits, provided that the protocol is used regularly for a long time after the acute phase and in many different TBI centres: in this way it would be possible to compare and to elaborate data concerning a large number of patients. This instrument could also become an opportunity for a continuous and more coordinated collaboration between rehabilitation centres of different countries. We think that this target is realistic only if we dispose of a commonly accepted computerized version of EBIS Protocol with a data exchange via Internet. Since 1996 we have been using a computerized version of the EBIS protocol for data archivation and follow up of TBI patients treated in our centre. The data bank concerns actually n. 341 TBI patients. Objective of the present research is the presentation of a computerized version of EBIS protocol. This program is freely available and it could contribute to a more common use of this evaluation tool. We thank particularly Prof. Truelle and Prof. Brooks who gave us the permission for the use of EBIS document.

Brain Injuries↗

PubMed1985

Correlates of language development in language-disordered children.

This study organized a large data archive gathered over 8 years on 718 children with language disorders. Descriptive data categorized by demographic/background, physical/development, social/personality, and language/academic characteristics were analyzed to provide a broad description of this group of children. Sets of descriptor variables in five domains were identified from program records and were used to predict language performance at program entry and relative language improvement over 2-3 years. Age was the strongest predictor for all analyses. In general, the primary research factors in the study (53 variables representing IQ, language history, socioeconomic status, physical/neurological, and social-emotional background) failed to account very well for either language performance at program entry or for relative language gain. In prediction of pretest language performance, IQ and physical factors played the strongest role. The two factors contributing significantly to prediction of relative gain were IQ (although surprisingly weakly) and social-emotional status. Characteristics of those children who progressed most while in the program were identified.

Adolescent↗

PubMed1998

Nurse and patient reactions to a developmental home telecare system.

Pilot studies have suggested that telemedicine is a satisfactory means of delivering nursing services into the home. A home telecare programme in Kansas provided nursing services to homes in four towns in Kansas. The present study examined patients' and nurses' perceptions of a variety of issues related to home telecare. Data-collection methods included in-depth interviews, observation and analyses of archival data from patient records. Patients suffered an average of 4.6 concurrent illnesses. On the whole, patients perceived the system as a valuable resource that offered great potential, although many saw no immediate health benefits for themselves. Nurses were enthusiastic about the prospect of practising in this way, although they did have strong opinions about what types of nurses, patients and illnesses were suited to telemedicine.

Adult↗

PubMed1994

If there is gold in the labeling index hills, are we digging in the right place?

Surrogate endpoint biomarkers (SEBs) are a necessary tool for cancer chemoprevention studies. However, the efficiency gain from using an SEB is purchased at a price. SEBs need to go through a developmental process, in which their behavior is understood in detail, before they can be used broadly in chemoprevention work. Examples of problems that need to be overcome are presented for labeling indices of cell proliferation. Since literature-based meta-analyses are not feasible for SEBs, a data archive is proposed in order to strengthen the development phase by pooling data across studies.

Anticarcinogenic Agents↗

PubMed2002

Non-curated distributed databases for experimental data and models in neuroscience.

Neuroscience is generating vast amounts of highly diverse data which is of potential interest to researchers beyond the laboratories in which it is collected. In particular, quantitative neuroanatomical data is relevant to a wide variety of areas, including studies of development, aging, pathology and in biophysically oriented computational modelling. Moreover, the relatively discrete and well-defined nature of the data make it an ideal application for developing systems designed to facilitate data archiving, sharing and reuse. At present, the only widely used forms of dissemination are figures and tables in published papers which suffer from inaccessibility and the loss of machine readability. They may also present only an averaged or otherwise selected subset of the available data. Numerous database projects are in progress to address these shortcomings. They employ a variety of architectures and philosophies, each with its own merits and disadvantages. One axis on which they may be distinguished is the degree of top-down control, or curation, involved in data entry. Here we consider one extreme of this scale in which there is no curation, minimal standardization and a wide degree of freedom in the form of records used to document data. Such a scheme has advantages in the ease of database creation and in the equitable assignment of perceived intellectual property by keeping the control of data in the hands of the experts who collected it. It does, however, require a more sophisticated infrastructure than conventional databases since the software must be capable of organizing diverse and differently documented data sets in an effective way. Several components of a software system to provide this infrastructure are now in place. Examples are presented, showing how these tools can be used to archive and publish neuronal morphology data, and how they can give an integrated view of data stored at many different sites.

Animals↗

PubMed2003

Radioactive contamination of bottom sediments in the upper reaches of the Techa river: analysis of the data obtained in 1950 and 1951.

A stationary sorption model has been developed for re-evaluating and analysing archive data from 1950-1951 on the radioactive contamination of Techa river bottom sediments close to the site of liquid radioactive waste discharge. In general, good agreement was obtained between calculations and measurements, which substantiates further the assumptions and conclusions in two preceding articles, on the radionuclide composition of discharged liquid radioactive waste. Estimates on the effective liquid radioactive waste discharges given here are significantly different from those deduced in the 1950s, i.e. in summer 1950 and October 1951. The results are discussed in relation to the Techa River Dosimetry System 2000 (TRDS-2000) that has recently been presented to serve as a means for estimating doses to the Techa river residents. Parameter values describing the exponential decrease of bottom sediment contamination along the river due to short-lived radionuclides, such as (106)Ru, and (144)Ce, agree reasonably with those used in TRDS-2000. However, for other radionuclides, such as (95)Zr, (95)Nb, (91)Y, (90)Sr and (137)Cs, substantial differences are found. It is demonstrated that water flow rate, width of the river, and surface area of bottom sediments are important parameters which were not adequately taken into account in TRDS-2000. Also, the stirring-up of contaminated bottom sediments and their subsequent transport by the water flow are seen to be an important mechanism that governs the radionuclide transport downstream. This mechanism was not included in the TRDS-2000 model. It is concluded that the sorption model used in TRDS-2000 for the reconstruction of radioactive contamination of water and bottom sediments of the Techa river in 1949-1951, is subject to considerable errors. While the present paper is focussed on details of the dosimetric modelling, the implications for the Techa river dosimetry are major. They will be further elucidated in a forthcoming paper.

Adsorption↗