Deriving modified Rankin scores from medical case-records.

Background And Purpose: Modified Rankin score (mRS) is traditionally graded using a face-to-face or telephone interview. Certain stroke assessment scales can be derived from a review of a patient's case-record alone. We hypothesized that mRS could be successfully derived from the narrative within patient case-records.

Pneumococcal conjugate vaccine: review of cost-effectiveness studies in Australia, North America and Europe.

The pneumococcal conjugate vaccine (PCV) is the first vaccine proven to be effective in reducing the incidence of invasive pneumococcal disease, pneumonia and acute otitis media in children, and has been recommended for universal use in children in a number of high-income countries. The high cost of the vaccine relative to previous vaccines has generated interest in assessing its cost-effectiveness and numerous cost-effectiveness analyses of PCV have been performed in Australia, North America and Europe. The primary objectives of this review are to enhance the ability to make direct comparisons between these analyses, to aid in the identification and interpretation of methodological differences and to summarize the findings.

Epidemiological and clinical profile of irritable bowel syndrome in India: report of the Indian Society of Gastroenterology Task Force.

Aims: To study the profile of irritable bowel syndrome (IBS), and the frequency of such symptoms among the general population, in India.

Methods: In this prospective, multi-center study, data were obtained from 2785 patients with chronic lower gastrointestinal symptoms (complainants) with no alarm feature and negative investigations for organic causes visiting physicians at 30 centers, and from 4500 community subjects (non-complainants), using separate questionnaires.

Results: Most complainants were middle-aged (mean age 39.

Efficacy and tolerability of pegylated interferon alpha 2b and ribavirin in chronic hepatitis C--a report from eastern India.

Aim: To study the efficacy and tolerability of pegylated interferon alpha 2b and ribavirin therapy in a cohort of chronic hepatitis C patients.

Methods: In a prospective, open label, uncontrolled trial pegylated interferon alpha 2b (Viraferon Peg) 1.5 microgram/ kg subcutaneously weekly plus daily ribavirin 800mg for 24 weeks in genotypes 2 & 3 and 1000mg for 48 weeks in genotypes 1 and 4 was administered to 16 patients of chronic hepatitis C.

Interline Transfer CCD Camera for Gated Broadband Coherent Anti-Stokes Raman-Scattering Measurements.

Use of an interline transfer CCD camera for the acquisition of broadband coherent anti-Stokes Raman-scattering (CARS) spectra is demonstrated. The interline transfer CCD has alternating columns of imaging and storage pixels that allow one to acquire two successive images by shifting the first image in the storage pixels and immediately acquiring the second image. We have used this dual-image mode for gated CARS measurements by acquiring a CARS spectral image and shifting it rapidly from the imaging pixel columns to the storage pixel columns.

Community and patient values for preventing herpes zoster.

Objectives: The US Advisory Committee on Immunization Practices has recently recommended a new vaccine against herpes zoster (shingles) for routine use in adults aged > or =60 years. However, estimates of the cost effectiveness of this vaccine vary widely, in part because of gaps in the data on the value of preventing herpes zoster. Our aims were to (i) generate comprehensive information on the value of preventing a range of outcomes of herpes zoster; (ii) compare these values among community members and patients with shingles and post-herpetic neuralgia (PHN); and (iii) identify clinical and demographic characteristics that explain the variation in these values.

Decreasing scoring errors on Wechsler Scale Vocabulary, Comprehension, and Similarities subtests: a preliminary study.

Studies of graduate students learning to administer the Wechsler scales have generally shown that training is not associated with the development of scoring proficiency. Many studies report on the reduction of aggregated administration and scoring errors, a strategy that does not highlight the reduction of errors on subtests identified as most prone to error. This study evaluated the development of scoring proficiency specifically on the Wechsler (WISC-IV and WAIS-III) Vocabulary, Comprehension, and Similarities subtests during training by comparing a set of 'early test administrations' to 'later test administrations.

Case-control study of antibiotic use and subsequent Clostridium difficile-associated diarrhea in hospitalized patients.

Objective: To determine which antibiotics increase or decrease the risk of Clostridium difficile-associated diarrhea (CDAD).

Design: Retrospective case-control study.

Setting: Nonprofit, integrated healthcare delivery system in Northern California.

OH sensor based on ultraviolet, continuous-wave absorption spectroscopy utilizing a frequency-quadrupled, fiber-amplified external-cavity diode laser.

The development of an all-solid-state cw laser system for optical absorption measurements of the OH radical in the UV spectral range is described. The tunable output of a 1064-nm external-cavity diode laser is amplified by use of a Nd:doped, double-clad fiber amplifier. The amplified near-IR radiation is frequency doubled by a periodically poled lithium niobate crystal and then quadrupled in a beta-barium borate crystal.

2-Methoxyestradiol modulates beta-catenin in prostate cancer cells: a possible mediator of 2-methoxyestradiol-induced inhibition of cell growth.

2-Methoxyestradiol (2-ME(2)) is a novel anticancer agent because of its ability to potentiate apoptotic cell death and inhibit cancer cell growth and angiogenesis. The modes of action of this agent, however, have not yet been fully elucidated. In our study, we have investigated whether 2-ME2 is able to modulate beta-catenin signaling in prostate cancer cells, which is one of the major players in cell-cell adhesion, proliferation, apoptosis and carcinogenesis.

Studies on binary and ternary amphiphile combinations of tetradecyltrimethylammonium bromide (C14TAB), tetradecyltriphenylphosphonium bromide (C14TPB), and tetradecylpyridinium bromide (C14PB). A critical analysis of their interfacial and bulk behaviors.

Mixed surfactants play a promising role in surface chemical applications. In this study, interfacial and bulk behaviors of binary and ternary combinations of tetradecyltrimethylammonium bromide (C(14)TAB), tetradecyltriphenylphosphonium bromide (C(14)TPB), and tetradecylpyridinium bromide (C(14)PB) have been examined in detail using the methods of tensiometry, conductometry, fluorimetry, and microcalorimetry. The state of micellar aggregation, amphiphile composition in the micelle, extent of counterion binding by the micelle, and interaction among the surfactant monomers in the binary and ternary combinations have been quantitatively assessed in the light of the regular solution theories of Rubingh and that of Rubingh and Holland.

Does Wechsler Intelligence Scale administration and scoring proficiency improve during assessment training?

Studies have found that Wechsler scale administration and scoring proficiency is not easily attained during graduate training. These findings may be related to methodological issues. Using a single-group repeated measures design, this study documents statistically significant, though modest, error reduction on the WAIS-III and WISC-III during a graduate course in assessment.

Tamoxifen treatment and new-onset depression in breast cancer patients.

The authors conducted a retrospective cohort study of female patients diagnosed with breast cancer (BRCA), evaluating the risk of new-onset depression associated with tamoxifen treatment among those with estrogen receptor-positive (ER+) tumors, versus estrogen receptor-negative (ER-) tumors, who were not receiving tamoxifen. A total cohort of 2,943 patients was identified. The hazard-ratio for new-onset depression in the tamoxifen group was nonsignificant.

Design of ECG-based anaesthesia monitor/pain monitor.

Design of Anaesthesia monitor/ Pain monitor, using ECG signal only, is presented in this paper. During surgical operations, ECG is picked-up as a routine procedure; the same ECG is used here, hence it is almost noninvasive. Initially heart rate variability (HRV) spectrum is obtained from R-R intervals (RRIs) and the respiratory peak is identified.

The excess medical cost and health problems of family members of persons diagnosed with alcohol or drug problems.

Background: Having a family member with substance use problems affects family functioning, which may lead to increased medical problems and increased health care utilization and costs in the other family members.

Aim: We sought to estimate the excess medical costs and prevalence of diagnosed health conditions of family members of persons with an alcohol or drug diagnosis (AOD) compared with the family members of similar persons without an AOD.

Methods: Using a large health plan's administrative databases, we identified persons who received an AOD between 2001 and 2004 and a similar group of persons with no AOD during that time.

Dose effect of soy supplementation in prostate cancer: a pilot study.

We performed a pilot study to determine the dose effect of soy supplement on serum hormonal levels, estrogen receptor alpha (ERalpha) and androgen receptor (AR) expression in patients scheduled to undergo prostatectomy. Cohorts of 3-4 eligible patients received escalating doses of a commercial soy supplement, Flav-ein, from the time of study enrollment until prostatectomy. Serum levels of prostate specific antigen (PSA), testosterone, and estrogen were measured at study enrollment and prior to prostatectomy.

Attention-deficit/hyperactivity disorder in children: excess costs before and after initial diagnosis and treatment cost differences by ethnicity.

Objectives: To estimate the excess costs for children in the years surrounding initial diagnosis of attention-deficit/hyperactivity disorder (ADHD) and to estimate differences in treatment costs by ethnicity.

Design: We identified children diagnosed with ADHD and estimated their health service costs in the 2 years before and 2 years after initial diagnosis of ADHD. Costs were compared with those for children without ADHD.

A comparison of health care utilization and costs of children with and without autism spectrum disorders in a large group-model health plan.

Objective: Data on the current costs of medical services for children with autism spectrum disorders are lacking. Our purpose for this study was to compare health care utilization and costs of children with and without autism spectrum disorders in the same health plan.

Patients And Methods: Participants included all 2- to 18-year-old children with autism spectrum disorders (n = 3053) and a random sample of children without autism spectrum disorders (n = 30529) who were continuously enrolled in the Kaiser Permanente Medical Care Program in northern California between July 1, 2003, and June 30, 2004.

Cost-sharing for emergency care and unfavorable clinical events: findings from the safety and financial ramifications of ED copayments study.

Objective: To evaluate the effect of emergency department (ED) copayment levels on ED use and unfavorable clinical events. Data Source/Study Setting. Kaiser Permanente-Northern California (KPNC), a prepaid integrated delivery system.

Progress in pediatric asthma surveillance II: geospatial patterns of asthma in Alameda County, California.

Introduction: As with many diseases, the epidemic of asthma among children over the past few decades has been shaped by a social and environmental context that is becoming progressively more evident. Commonly used methods for asthma surveillance, however, are based on national rather than local data. The purpose of this study was to develop high-resolution asthma surveillance techniques responsive to the needs of health care professionals and local child health and social justice advocates.