Canine DNA subjected to whole genome amplification is suitable for a wide range of molecular applications.

Molecular and genetic studies of canine disease phenotypes can be limited by the amount of DNA available for analysis. New methods have been developed to amplify the genomic DNA of a species producing large quantities of DNA from small starting amounts. Whole genome amplification (WGA) of DNA is now being used in human studies, although this technique has not been applied extensively in veterinary research.

Ten-year in vivo wear measurement of a fully congruent mobile bearing unicompartmental knee arthroplasty.

Polyethylene particulate wear debris continues to be implicated in the aetiology of aseptic loosening following knee arthroplasty. The Oxford unicompartmental knee arthroplasty employs a spherical femoral component and a fully congruous meniscal bearing to increase contact area and theoretically reduce the potential for polyethylene wear. This study measures the in vivo ten-year linear wear of the device, using a roentgenstereophotogrammetric technique.

The Acute Care Undergraduate TEaching (ACUTE) Initiative: consensus development of core competencies in acute care for undergraduates in the United Kingdom.

Background: The care of the acutely ill patient in hospital is often sub-optimal. Poor recognition of critical illness combined with a lack of knowledge, failure to appreciate the clinical urgency of a situation, a lack of supervision, failure to seek advice and poor communication have been identified as contributory factors. At present the training of medical students in these important skills is fragmented.

Ten years of CLIVE (Computer-Aided Learning in Veterinary Education) in the United Kingdom.

This paper outlines the work of the CLIVE (Computer-Aided Learning in Veterinary Education) project over a 10-year period, set against the backdrop of changes in education policy and learning technology developments. The consortium of six UK veterinary schools and 14 international Associate Member Schools has been very successful. Sustaining these partnerships requires that the project redefine itself and adapt to cater to the diverse learning needs of today's students and to changing professional and societal needs on an international scale.

A novel method for in vivo knee prosthesis wear measurement.

Wear remains an important cause of failure in knee replacement. Of the current methods of early performance assessment or prediction, simulators have been un-physiological, single X-ray film analyses remain limited by accuracy and retrieval and survival methods have a prohibitive time scale. An accurate method is needed to allow a timely assessment of polyethylene component wear in vivo, when a new design is introduced, in order to predict likely outcome.

In vivo measurement of total knee replacement wear.

Polyethylene wear is one of the most important causes of failure of total knee replacements (TKRs). Currently, wear can only be accurately measured by retrieval studies. There is a need for a method to measure wear accurately in vivo.

Medicaid managed care: the last bastion of the HMO?

States rely on health maintenance organizations (HMOs) for their Medicaid beneficiaries because they offer guaranteed access to comprehensive benefits at a predictable cost. This is true despite movement away from HMOs, or at least the more restrictive variants, in the private sector. Plans that focus on Medicaid are becoming more central to states' programs as commercial plans exit.

A randomized, controlled pilot trial of a school intervention for children with sickle cell anemia.

Objective: To investigate the feasibility and efficacy of a randomized clinical pilot trial comparing routine services (RS) with a school intervention program (SIP) for children with sickle cell anemia (SCA).

Method: Twenty-four children (ages 8-12 years) with SCA were randomized to RS or SIP. General disease knowledge, consumer satisfaction, self-concept, and school absences were evaluated.

The provision and practice of renal replacement therapy on adult intensive care units in the United Kingdom.

This study surveyed the availability and current practice of renal replacement therapy on adult general intensive care units in the United Kingdom. Questionnaires were returned from 236 units (89%). Renal replacement therapy was provided by 212 (90%) of responding units, treating 9442 patients per year.

Disease management: a leap of faith to lower-cost, higher-quality health care.

With managed care's promise to reduce costs and improve quality waning, employers and health plans are exploring more targeted ways to control rapidly rising health costs. Disease management programs, which focus on patients with chronic conditions such as asthma and diabetes, are growing in popularity, according to findings from the Center for Studying Health System Change's (HSC) 2002-03 site visits to 12 nationally representative communities. In addition to condition-based disease management programs, some health plans and employers are using intensive case management services to coordinate care for high-risk patients with potentially costly and complex medical conditions.

Prospective cohort study showing changes in the monthly incidence of Pneumocystis carinii pneumonia.

Pneumocystis carinii pneumonia (PCP) remains a serious opportunistic infection in HIV infected individuals. Seasonal changes in climate are associated with changes within individual susceptibility to infection. The possibility of monthly variability in the incidence of PCP was therefore examined by means of a cohort study of a database of 8640 HIV infected individuals attending the Chelsea and Westminster Hospital.

Re-admissions to the State Hospital at Carstairs, 1992-1997.

Objective: To examine the incidence and characteristics of re-admissions to the State Hospital over the six year inclusive period of January 1992 to December 1997. RESONS FOR THE STUDY: RISK ASSESSMENT: A re-admission to a high-security setting may be the result of a failed risk assessment at the time of discharge. An analysis of re-admissions might reveal facts that will improve risk prediction.

Cutting back but not cutting out: small employers respond to premium increases.

Rising premiums and a weak economy are generating questions about the potential erosion of health insurance coverage, particularly for the more than 46 million Americans who work for small firms. People working in small firms typically have less access to coverage than those in large firms. In 2000 and early 2001, the Center for Studying Health System Change (HSC) conducted its third round of site visits to 12 nationally representative metropolitan areas and found that while few small employers actually dropped coverage, many increased the employee share of premiums, raised copayments and deductibles, switched products and carriers and/or reduced benefits.

Gender and age differences in plasma carnitine, muscle strength, and exercise tolerance in haemodialysis patients.

Background: Haemodialysis patients have impaired exercise tolerance that may be related to impaired carnitine availability and/or alterations in carnitine metabolism. As carnitine metabolism is sex- and age-related, we examined plasma free and esterified carnitine concentrations, muscle strength, and estimated exercise tolerance in female (n=51) and male (n=63) patients of different ages (18-86 years).

Methods: Concentrations of free carnitine and acetylcarnitine were determined in the plasma of patients.

Hyponatraemic states following 3,4-methylenedioxymethamphetamine (MDMA, 'ecstasy') ingestion.

Background: Life-threatening and fatal hyponatraemic complications following ecstasy use have previously been documented.

Aim: To define clinical features of hyponatraemia following the ingestion of 3,4-methylenedioxymethamphetamine (MDMA, 'ecstasy').

Design: Retrospective case series.

The signature of supernova ejecta in the X-ray afterglow of the gamma-ray burst 011211.

Now that gamma-ray bursts (GRBs) have been determined to lie at cosmological distances, their isotropic burst energies are estimated to be as high as 1054 erg (ref. 2), making them the most energetic phenomena in the Universe. The nature of the progenitors responsible for the bursts remains, however, elusive.

Preventive health services use, lifestyle health behavior risks, and self-reported health status of women in Ohio by ethnicity and completed education status.

This study assessed the health status and behavior of college-educated and non-college-educated African American women and European American women in Ohio. Analyses focused on health services utilization, health status, and life style/health behaviors from the 1998 Ohio Family Health Survey. College-educated African American women used more preventive health services and had better health status than non-college-educated African American women.

Premium subsidies for employer-sponsored health coverage: an emerging state and local strategy to reach the uninsured.

With nearly 75 percent of the uninsured living in households with at least one full-time worker, there has been renewed policy interest in strategies to expand coverage by subsidizing employer-sponsored insurance. Six of the 12 nationally representative communities that the Center for Studying Health System Change (HSC) tracks have premium assistance, or subsidy, programs planned or underway. Policy makers are enthusiastic about the potential to expand coverage through these programs, but enrollment has been modest to date.

Differential activities of decapeptide agonists of human C5a: the conformational effects of backbone N-methylation.

Analogues of the potent, conformationally biased, decapeptide agonist of human C5a anaphylatoxin, C5a(65-74)Y65,F67,P69,P71,D-Ala73 (YSFKPMPLaR, peptide 54), were synthesized with methyl groups occupying specific amide nitrogen atoms along the peptide backbone. This N-methylation induced crucial extended backbone conformations in a manner similar to the two Pro residues, but without eliminating the contributions made by the side-chain of the residue for which Pro was substituted. The presence of backbone N-methyl groups on peptide 54 analogues had pronounced detrimental effects on the ability to bind and activate C5aRs expressed on human PMNs, but not on the ability to contract smooth muscle of human umbilical artery.

Provider network instability: implications for choice, costs and continuity of care.

Many health care issues of greatest concern to consumers-including provider choice, costs and continuity of care-depend on health plans' ability to maintain adequate networks of hospitals, physicians and other caregivers. When providers drop out of plan networks, consumers may suddenly face the choice of changing caregivers or paying more for out-of-network care. Network instability is increasingly common in health care markets across the country and can arise from health plan-provider contract disputes and provider organization insolvencies.

Recurrence of light chain nephropathy in a renal allograft. A case report and review of the literature.

Myeloma and monoclonal gammopathies can affect the kidney in many ways with cast nephropathy and light chain deposition disease being the most commonly recognised histological entities. Renal transplantation in these patients remains controversial both because of the risk of recurrent disease affecting the graft and also because of concerns around the possibility of disease relapse within the patient. We suggest that the histological pattern of disease within the native kidneys is crucial in the overall assessment of these patients for renal transplantation.

The role of physician communication in improving compliance with mammography screening among women ages 50-79 in a commercial HMO.

Despite its efficacy, mammography is substantially underutilized by older women, even those who have access to regular health care. The factors influencing mammogram compliance status are distinctively examined in this study using a commercial health maintenance organization (HMO) population of women ages 50-79 in which there are no known barriers (financial, access, or knowledge) to mammogram compliance. Two variables were significant predictors of compliance status based on logistic regression analyses: belief that a woman should get a mammogram one or more times per year, and willingness to get a mammogram if the physician recommends it.