Assessing the accuracy of a computerized decision support system for digoxin dosing in primary care: an observational study.

Background: This study was carried out as part of a European Union funded project (PharmDIS-e+), to develop and evaluate software aimed at assisting physicians with drug dosing. A drug that causes particular problems with drug dosing in primary care is digoxin because of its narrow therapeutic range and low therapeutic index.

Objectives: To determine (i) accuracy of the PharmDIS-e+ software for predicting serum digoxin levels in patients who are taking this drug regularly; (ii) whether there are statistically significant differences between predicted digoxin levels and those measured by a laboratory and (iii) whether there are differences between doses prescribed by general practitioners and those suggested by the program.

Prognostic factors for poor recovery in acute whiplash patients.

The objective of our prospective inception cohort study was to identify prognostic factors for poor recovery in patients with whiplash-associated disorders grade 1 or 2 who still had neck pain and accompanying complaints 2 weeks after the accident. The study was carried out in a primary health care setting in The Netherlands and included 125 patients. The primary outcome measure was functional recovery defined in terms of neck pain intensity or work disability without medication use.

Root proximity as a risk marker for periodontal disease: a case-control study.

Aim: The aim of this study is first, to examine the prevalence, symmetry and spread of root proximity using the measurement tools and classification as described in part I of the study, and second to examine whether root proximity is a risk marker for periodontal disease.

Material And Methods: The radiographs of 227 patients were examined. The study consisted of a study group of 197 patients with advanced periodontal disease with at least one site with bone loss more than one third of the root length and 30 controls without periodontal disease.

Classification, reproducibility and prevalence of root proximity in periodontal patients.

Aim: The primary aim of this study is to define and classify root proximity. The secondary aim is to examine the reproducibility of the measurement tools, to study the prevalence per inter-dental area and to examine whether the distance from the cemento-enamel junction (CEJ) to the bone crest (BC) differs between sites with root proximity and their contra-lateral sites without root proximity.

Material And Methods: In order to indicate the location of root proximity, a modification of the Shei ruler was developed, dividing the roots into three equal parts.

PIP1 and PIP2 aquaporins are differentially expressed during tobacco anther and stigma development.

Several processes during sexual reproduction in higher plants involve the movement of water between cells or tissues, such as occurs during dehiscence of the anther and hydration of the pollen grain after it is deposited on a stigma. To get more insight in these processes, a set of putative aquaporins was cloned and it was found that at least 15 are expressed in reproductive organs, which indicates that the control of water flow is important for reproduction. Functional studies in Xenopus laevis oocytes using two of the cDNAs showed that NtPIP2;1 is an efficient aquaporin, whereas NtPIP1;1 is not.

Expression of the ACC synthase and ACC oxidase coding genes after self-pollination and incongruous pollination of tobacco pistils.

In tobacco, as in other species, ethylene is produced in response to pollination. Although tobacco is a self-compatible species, it displays unilateral incongruity with other Nicotiana plants. Incongruous pollination also results in ethylene production, but this production differs depending on the pollen used and is related to the extent to which pollen tubes grow in the tobacco style.

Ethylene response to pollen tube growth in Nicotiana tabacum flowers.

In flowers of Nicotiana tabacum L., pollination induces a transient increase in ethylene production by the pistil. The characteristic dynamics of the increase in ethylene correspond to the main steps of the pollen-tube journey into the pistil: penetration into the stigma, growth through the style, entry into the ovary and fertilization.

Clinical practice guideline for the physiotherapy of patients with whiplash-associated disorders.

Study Design: A clinical practice guideline.

Objectives: To assist physiotherapists in decision making and to improve the efficacy and uniformity of care for patients with whiplash-associated disorders Grades I and II.

Summary Of Background Data: Whiplash constitutes a considerable problem in health care.

Does agrammatic speech constitute a regression to child language? A three-way comparison between agrammatic, child, and normal ellipsis.

When children are in the process of learning their mother tongue, they show frequent use of nonfinite clauses, even though they produce finite clauses at the same time, thereby demonstrating the availability of the functional domain associated with finiteness. In this study the hypothesis was tested that this behavior results from an overuse of the normal elliptical repertoire that has also been observed in agrammatic aphasia. The purpose of this overuse is prevention of computational overload.

Is there a role for computerized decision support for drug dosing in general practice? A questionnaire survey.

Objective: To determine: (i) whether general practitioners have difficulty with drug dosing; (ii) what information sources they currently use to help them with drug dosing; (iii) their views on the potential value of decision support software for drug dosing.

Design: Questionnaire survey.

Setting: Nottingham, U.

Clinical trials in palliative care: an ethical evaluation.

On first sight, clinical trials do not seem to fit well within the concept of palliative care. In palliative care, the needs and wishes of the patient set the norm while participation in experimental trials is potentially harmful for the patient. The dilemma seems hard to solve as optimal care for the dying and improvement of treatment for future patients are both imperative.

Palliative effect of chemotherapy: objective tumor response is associated with symptom improvement in patients with metastatic breast cancer.

Purpose: Because one of the goals of chemotherapy for metastatic breast cancer is to provide symptom palliation, we were interested in identifying the relationship between tumor shrinkage and improvement in disease-related symptoms.

Patients And Methods: Three hundred patients enrolled onto a randomized trial of metastatic breast cancer formed the basis of our study. The nine most common baseline symptoms were identified and followed.

Silencing gene expression of the ethylene-forming enzyme results in a reversible inhibition of ovule development in transgenic tobacco plants.

To study the role of ethylene in plant reproduction, we constructed transgenic tobacco plants in which the expression of a pistil-specific gene coding for the ethylene-forming enzyme 1-aminocyclopropane-1-carboxylate oxidase was inhibited. Flowers from transgenic plants showed female sterility due to an arrest in ovule development. Megasporogenesis did not occur, and ovules did not reach maturity.

Rational analyses of organelle trajectories in tobacco pollen tubes reveal characteristics of the actomyosin cytoskeleton.

To gain insight into the characteristics of organelle movement and the underlying actomyosin motility system in tobacco pollen tubes, we collected data points representing sequential organelle positions in control and cytochalasin-treated cells, and in a sample of extruded cytoplasm. These data were utilized to reconstruct approximately 900 tracks, representing individual organelle movements, and to produce a quantitative analysis of the movement properties, supported by statistical tests. Each reconstructed track appeared to be unique and to show irregularities in velocity and direction of movement.

Geneticization: the Cyprus paradigm.

Geneticization is a broad term referring to several related processes such as a spreading tendency to use a genetic model of disease explanation, a growing influence of genetics in medical practice, and the slow changing of individual and societal attitudes towards reproduction, prevention and control of disease. These processes can be demonstrated in medical literature on preventive genetic screening and counselling programs for beta-thalassaemia in Cyprus, the United Kingdom and Canada. The preventive possibilities of the new genetic and diagnostic technologies have been quickly understood and advocated by health professionals, and their educational strategies have created a web of social control, in marked contrast to the alleged voluntary decision-making process and free choice.

Interactive computer-assisted position acquisition procedure designed for the analysis of organelle movement in pollen tubes.

An interactive computer-assisted video microscopy method has been developed for the acquisition of extensive data on the sequential positions of pollen tube organelles, which cannot be automatically tracked using geometric or motion patterns. The method consists of video microscopy, analog and digital contrast enhancement, digital time-lapsing of the images, and interactive selection of positions in a coordinate system corresponding to the cell shape and real size. Data on 15,000 positions acquired with this method have been used to make quantitative analyses of the movement patterns of the organelles.

The localization of histone H3.3 in germ line chromatin of Drosophila males as established with a histone H3.3-specific antiserum.

A rabbit antiserum, specific for the histone H3.3 replacement variant, was raised with the aid of a histone H3.3-specific peptide.

Euthanasia and international human rights law: prolegomena for an international debate.

In this paper we examine in what respects international human rights law can provide a basis for the establishment of an international debate on euthanasia. Such a debate seems imperative, as in many countries euthanasia is considered taboo in the context of medical practice, yet at the same time, supposedly, decisions are taken to intentionally shorten patients' lives. In the Netherlands, the act of euthanasia will not lead to the prosecution of the physician involved if the physician has complied with certain procedures.