Variation in the use of percutaneous biopsy for diagnosis of breast abnormalities in Ontario.

Background: Preoperative diagnosis of breast abnormalities is currently the standard of care. A population-based study to determine the use of percutaneous needle biopsy for breast diagnosis in Ontario was performed.

Methods: A total of 17,068 women undergoing breast tissue sampling (percutaneous needle biopsy or surgical excision) for diagnosis between April 1, 2002, and December 31, 2002, and without a previous cancer diagnosis were identified.

Tumour dormancy in breast cancer: an update.

Delayed recurrences, common in breast cancer, are well explained by the concept of tumour dormancy. Numerous publications describe clinical times to disease recurrence or death, using mathematical approaches to infer mechanisms responsible for delayed recurrences. However, most of the clinical literature discussing tumour dormancy uses data from over a half century ago and much has since changed.

Driver headway: how close is too close on a motorway?

Driver headway has recently become an important question with much attention being given to unsafe headway or 'tailgating'. This paper reviews a series of recent studies undertaken at the University of Southampton, which have sought to measure and model distance keeping, demonstrating how following distance depends on a wide range of factors, some of which are only recently being explored. These include variations in following distance for any particular driver and the relationship with time to collision, variations in following distances of drivers of differing nationalities and the ability of the driver to 'read the road ahead', which may be affected by interaction with different vehicle types.

Surgical case costing: trauma is underfunded according to resource intensity weights.

Objective: To determine whether rate-based funding using resource intensity weights (RIWs) adequately represents trauma case costs.

Design: A prospective time-in-motion resource utilization pilot study to assure the effectiveness of the computerized hospital Transition-One data acquisition system, followed by a retrospective observational case costing study. Patient costs with no identifing data were used, and all costs were tabulated as mean cost per group.

Triple "E" syndrome: bilateral locked posterior fracture dislocation of the shoulders.

Bilateral locked posterior fracture dislocation of the shoulders is one of the least common injuries of the shoulder, and this injury has been suggested to be pathognomonic of seizures when diagnosed in the absence of trauma. The authors present a case of idiopathic bilateral locked posterior fracture dislocations of the shoulder, along with a review of the medical literature. The authors also present the "triple E syndrome," describing the possible etiologies of this injury: epilepsy (or any convulsive seizure), electrocution, or extreme trauma.

Primary biliary cirrhosis and hemolytic anemia confusing serum bilirubin levels.

Hemolysis is observed in more than 50% of patients with cirrhosis. However, there has been little documentation of the association of primary biliary cirrhosis with autoimmune hemolytic anemia. Two cases, found within a single practice, of primary biliary cirrhosis coexisting with autoimmune hemolysis and a third case coexisting with hereditary spherocytosis are presented.

Examination of the use of fuzzy sets to describe relative speed perception.

In recent years a range of new methods have been proposed with which to describe and evaluate driver behaviour. One such method is that of fuzzy logic, where variables used in the driver decision-making process may be described linguistically, allowing a quantifiable degree of uncertainty to be introduced. This paper explores the use of such a formalism to describe the driver perception of 'closing speed' between two vehicles engaged in 'car-following' on a motorway, and by using data from an instrumented vehicle experiment, it tests a number of models using relative speed, visual angle and the time to collision.

A collision model for safety evaluation of autonomous intelligent cruise control.

This paper describes a general framework for safety evaluation of autonomous intelligent cruise control in rear-end collisions. Using data and specifications from prototype devices, two collision models are developed. One model considers a train of four cars, one of which is equipped with autonomous intelligent cruise control.

Pharmacological characterization of grooming induced by a selective NK-1 tachykinin receptor agonist.

Bilateral intranigral administration of the selective NK-1 tachykinin receptor agonist [AcArg6, Sar9, Met(O2)11]SP6-11 (0-1 nmol total bilateral dose) selectively induced grooming in rats. This response was blocked by concurrent intranigral administration of the NK-1 tachykinin receptor antagonist RP 67580 (2 nmol), but not by NK-2 (L-659,877) or NK-3 ([Trp7, beta-Ala8]NKA4-10) antagonists. Pretreatment with systemic opioid (naloxone 1.

Rekindling the nursing diagnosis flame.

In today's complex and rapidly changing health care environment, it is not enough for nurses to possess advanced technological skills. Rather, they need clinical-judgement, decision-making and diagnostic skills far beyond previous expectations.