Trends in the utilization and wastage of coagulation factor concentrates: the application of a regional tracking programme.

The Commission of Inquiry on the Blood System in Canada ('Krever Commission', 1997) recommended an active programme of surveillance for all blood products. To describe trends in the utilization of coagulation factor concentrates using a comprehensive factor tracking programme. Between 2001 and 2004 in the region of Southern Ontario, we prospectively tracked all coagulation factor concentrates that were distributed from the national blood supplier, issued by hospitals for inpatient use or for home infusions, infused at hospital facilities or at home and wasted.

Using state lead poisoning surveillance system data to assess false positive results of capillary testing.

Objective: The purpose of this study was to determine the false positive percentage of capillary blood lead screening in a statewide surveillance system and to explore potential predictors of false positive results.

Methods: Data were all blood lead tests of 0-5 year old children in Maine during 2002-2003. We determined the proportion of children with elevated (>/=10 microg/dL) capillary test results who received a venous confirmatory test, and calculated the percentage of false positive tests, defined as a capillary test of >/=10 microg/dL with a confirmatory venous test of <10 microg/dL.

Randomized effectiveness study of four therapeutic strategies for TMJ closed lock.

For individuals with temporomandibular joint (TMJ) disc displacement without reduction with limited mouth opening (closed lock), interventions vary from minimal treatment to surgery. In a single-blind trial, 106 individuals with TMJ closed lock were randomized among medical management, rehabilitation, arthroscopic surgery with post-operative rehabilitation, or arthroplasty with post-operative rehabilitation. Evaluations at baseline, 3, 6, 12, 18, 24, and 60 months used the Craniomandibular Index (CMI) and Symptom Severity Index (SSI) for jaw function and TMJ pain respectively.

Gata6 is an important regulator of mouse pancreas development.

Gata4, Gata5, and Gata6 represent a subfamily of zinc-finger transcriptional regulators that are important in the development and differentiation of numerous tissues, including many endodermally-derived organs. We demonstrate that Gata4 and Gata6 have overlapping expression patterns in the early pancreatic epithelium. Later, Gata4 becomes restricted to exocrine tissue and Gata6 becomes restricted to a subset of endocrine cells.

Successful use of posaconazole in a pediatric case of fungal necrotizing fasciitis.

Objective: To report a pediatric case of posttraumatic fungal fasciitis treated successfully with a combination including posaconazole.

Design: Case report.

Setting: Pediatric critical care unit at Antwerp University Hospital.

Gene expression in the LNCaP human prostate cancer progression model: progression associated expression in vitro corresponds to expression changes associated with prostate cancer progression in vivo.

Identification of the genes involved in prostate cancer (PCa) progression to a virulent and androgen-independent (AI) form is a major focus in the field. cDNA microarray was used to compare the gene expression profile of the indolent, androgen sensitive (AS) LNCaP PCa cell line to the aggressively metastatic, AI C4-2. Thirty-eight unique sequences from a 6388 cDNA array were found differentially expressed (> or =2-fold, 95% CI).

Mathematical simulation of the diel O, S, and C biogeochemistry of a hypersaline microbial mat.

The creation of a mathematical simulation model of photosynthetic microbial mats is important to our understanding of key biogeochemical cycles that may have altered the atmospheres and lithospheres of early Earth. A model is presented here as a tool to integrate empirical results from research on hypersaline mats from Baja California Sur (BCS), Mexico into a computational system that can be used to simulate biospheric inputs of trace gases to the atmosphere. The first version of our model, presented here, calculates fluxes and cycling of O(2), sulfide, and dissolved inorganic carbon (DIC) via abiotic components and via four major microbial guilds: cyanobacteria (CYA), sulfate reducing bacteria (SRB), purple sulfur bacteria (PSB) and colorless sulfur bacteria (CSB).

Hydroxyethyl starch 130/0.4 versus modified fluid gelatin for volume expansion in cardiac surgery patients: the effects on perioperative bleeding and transfusion needs.

In this prospective, randomized, open controlled study we compared the effects on net red blood cell loss of 6% hydroxyethyl starch 130/0.4 (HES: n = 64) and 3% modified fluid gelatin (GEL: n = 68) administered for intravascular volume management in patients undergoing coronary surgery. Blood losses were calculated from determination of circulating blood volume and measurement of preoperative and postoperative hematocrit.

Fomepizole as a therapeutic strategy in paediatric methanol poisoning. A case report and review of the literature.

Unlabelled: Methanol poisoning is not frequently observed in children; however, without treatment, serious intoxication can be complicated by visual impairment, coma, metabolic acidosis, respiratory and circulatory insufficiency and death. Treatment in a paediatric intensive care is therefore compulsory. Methanol is metabolised in the liver by alcohol dehydrogenase to the toxic metabolites formaldehyde and formic acid.

Influence of direct referrals on time to diagnosis after an abnormal breast screening result.

This study examined the influence of a direct referral process implemented by a population-based provincial breast screening program on the time from screening to first procedure, first procedure to diagnosis, and screening to diagnosis following an abnormal breast screening result. The direct referral process shifted the responsibility for the coordination of diagnostic follow-up procedures from the family physician to the screening program. Three cohorts of women were included: a control cohort (screened prior to the initiation of a direct referral process, n = 1347), a usual care cohort (screened after the initiation of a direct referral process but for whom permission to refer was denied by the family physician, n = 1225), and a direct referral cohort (screened after the initiation of the direct referral process and for whom permission to refer was given by the family physician, n = 1232).

"Brain drain" of health professionals: from rhetoric to responsible action.

The question of the "brain drain" of health professionals has re-emerged since last exposed in 1970s. This paper is based on exploratory studies in Ghana, South Africa and the UK, a literature review and subsequent tracking of contemporary events. It reviews what is currently known about professional migration in the health sector and its impact on health services in poorer countries.

The University of California at Los Angeles Post-traumatic Stress Disorder Reaction Index.

Over the past decade, the University of California at Los Angeles Post-traumatic Stress Disorder Reaction Index has been one of the most widely used instruments for the assessment of traumatized children and adolescents. This paper reviews its development and modifications that have been made as the diagnostic criteria for post-traumatic stress disorder have evolved. The paper also provides a description of standard methods of administration, procedures for scoring, and psychometric properties.

Diet and behavior in at-risk children: evaluation of an early intervention program.

This study describes outcomes for children enrolled in the Prevention-Oriented System for Child Health Project, an early intervention program aimed at improving health and developmental status in at-risk families. Through a series of home visits by public health nurses, 60 families received lessons on nutrition- and health-related topics determined by the child and family's needs. On two occasions, some 8 months apart, the children were evaluated using the Developmental Assessment of Young Children, and their energy intake over the previous day was recorded.

Chondrocyte response to growth factors is modulated by p38 mitogen-activated protein kinase inhibition.

Inhibitors of p38 mitogen-activated protein kinase (MAPK) diminish inflammatory arthritis in experimental animals. This may be effected by diminishing the production of inflammatory mediators, but this kinase is also part of the IL-1 signal pathway in articular chondrocytes. We determined the effect of p38 MAPK inhibition on proliferative and synthetic responses of lapine chondrocytes, cartilage, and synovial fibroblasts under basal and IL-1-activated conditions.

GoFigure: automated Gene Ontology annotation.

Summary: We have developed a web tool to predict Gene Ontology (GO) terms. The tool accepts an input DNA or protein sequence, and uses BLAST to identify homologous sequences in GO annotated databases. A graph is returned to the user via email.

Effect of topiramate on glucocorticoid receptor mediated action.

This study examined the effects of topiramate (TPM) on glucocorticoid receptors (GRs) in mononuclear leukocytes of nine men and four women with chronic and recurring post-traumatic stress disorder (PTSD) and a group of comparison subjects (nine men, four women). A measure of 60 ml of blood was withdrawn by venipuncture at 0800 and mononuclear leukocytes were isolated. The cells were incubated with a series of concentrations of dexamethasone (DEX) without or with 50 micromol/l of TPM to evaluate the effects of DEX to inhibit lysozyme activity and the effect of TPM on it.

Divisions and diversity: the complexities of medical refuge in Britain, 1933-1948.

The experiences of medical refugees who came to the United Kingdom from Nazi Germany and occupied Europe in the 1930s and 1940s reflect the general characteristics of the British response to the refugee crisis. This article analyzes the role of the British medical establishment and its interplay with the government and refugee aid organizations. Processes of decision making and changes of policy are revealed, drawing on the files of the "Aliens Committee" at the archive of the British Medical Association, on the private collection of Yvonne Kapp, former administrative head of the Medical Department of the Central Office for Refugees, and on the medical subseries of the archive of the Society for the Protection of Science and Learning.

Splitter imperfections in annular split-flow thin separation channels: experimental study of nonspecific crossover.

The separation performance of a split-flow thin (SPLITT) separation device depends on uniformity of channel thickness and the precise placement of the flow splitters at fixed distances between the channel walls. The observation of nonspecific crossover, that is, the transport of sample materials across the channel thickness without the influence of an applied field, has routinely been taken to indicate the presence of irregularities in splitter shape or placement. Computational fluid dynamics software may be used to predict the influence of splitter imperfections on nonspecific crossover, where it is assumed that sample transport is by convection alone.

Basilar artery thrombosis in a trauma patient. Case report and review of the literature.

Thrombotic disease of the vertebrobasilar circulation is associated with a poor prognosis. It may occur in trauma patients, especially those with neck injuries and even several months after the initial insult. We report on the case of a young polytrauma patient, victim of a traffic accident, with associated cervical and thoracic spinal injuries resulting in paraplegia.

Nitric oxide inhibition of IGF-1 stimulated proteoglycan synthesis: role of cGMP.

Insulin-like growth factor (IGF-1) is critical for normal development and maintenance of cartilage, however arthritic cartilage responds poorly to IGF-1; part of this insensitivity is mediated by nitric oxide (NO). These studies test if cGMP is responsible for NO dependent insensitivity to IGF-1 in chondrocytes in situ in organ culture and in monolayer culture. Lapine cartilage and chondrocytes in monolayer culture and cartilage from osteoarthritic human knees were used.

A double-screening method to identify reliable candidate non-synonymous SNPs from chicken EST data.

Discovery of non-synonymous single nucleotide polymorphisms (nsSNP), which cause amino acid substitutions, is important because they are more likely to alter protein function than synonymous SNPs (sSNP) or those SNPs that do not result in amino acid changes. By changing the coding sequences, nsSNP may play a role in heritable differences between individual organisms. In the chicken and many other vertebrates, the main obstacle for identifying nsSNP is that there is insufficient protein and mRNA sequence information for self-species referencing and thus, determination of the correct reading frame for expressed sequence tags (ESTs) is difficult.

Contribution of clinical breast examination to mammography screening in the early detection of breast cancer.

Objectives: As the benefit of clinical breast examination (CBE) over that of screening mammography alone in reducing breast cancer mortality is uncertain, it is informative to monitor its contribution to interim measures of effectiveness of a screening programme. Here, the contribution of CBE to screening mammography in the early detection of breast cancer was evaluated.

Setting: Four Canadian organised breast cancer screening programmes.

Cardiac complications after noncardiac thoracic surgery: an evidence-based current review.

Despite advances in perioperative management, thoracic surgery remains a high-risk procedure for many patients. A systematic review of cardiac complications after thoracic surgery is presented. Most reviews about noncardiac thoracic surgery discuss postoperative analgesic regimens and pulmonary complications.