Data sources for pharmacoeconomic and health services research

Different types of databases available for health-related research, the data contained in these databases, and potential applications for pharmacists or researchers are discussed. Case studies that demonstrate uses for health databases are presented. Databases can be organized by facility, by health care provider, by disease or organ, or by sector. The types of data they contain include financial data, utilization data, demographic data, and outcomes data. Data can be obtained from the public sector, the private sector, or the researcher's own health system. The costs and time associated with using existing databases are often less than those required to collect data, but the quality and accessibility of the data must also be considered. The researcher's choice of database will depend on the research question. Health care databases can be used for health management and decision-making, quality review and evaluation, outcomes research, episode-of-illness studies, and evaluation of treatment protocols. Researchers must comply with patient-confidentiality and other agreements when accessing data. The format of the data needs to be matched with the hardware and software to be used in the analysis, and the data need to be loaded, verified, and cleaned before use. In deciding which of the many available data sources to use, researchers must determine the appropriate balance between external data and data available within their own health systems. The decision on whether to use existing data sources or to collect data prospectively will depend on the research question, the available resources, and the scope of the study.     

Further studies on the influence of genotype and dietary protein on the performance of broilers

An experiment was conducted to quantify genetic differences in response to dietary protein level of male vs female broilers. Broilers (1 d old) from a "high-yield" strain cross (Ross x Ross 208) and a "fast-growing" strain cross (Peterson x Arbor Acres) were placed on fresh pine shavings in floor pens. From Day 0 to 18, all birds were fed a 23% CP starter diet. During Days 18 to 53 male birds were fed either a 16, 18, 20, 22, 24, or 26% CP diet (3,200 kcal ME/kg) and female birds were fed the 16, 20, or 24% CP diet. Significant differences (P < 0.05) were noted in the performance of the different strains. Ross x Ross 208 male birds had a higher body weight (3.37 vs 3.16 kg), higher feed intake (7.08 vs 6.78 kg), higher breast yield (31.76 vs 29.25%), higher carcass yield (73.90 vs 71.85%), and a lower adjusted feed conversion ratio (FCR; 2.10 vs 2.16 g:g) than Peterson x Arbor Acres males at 53 d of age. As compared to Peterson x Arbor Acres females, Ross x Ross 208 female broilers also had a higher body weight (2.68 vs 2.55 kg), higher breast meat yield (33.61 vs 30.80%), higher carcass yield (75.31 vs 73.91%), and lower adjusted FCR (1.97 vs 2.04 g:g). Qualitative differences in the response of these strains were confirmed and better qualitative data is presented that can be used to predict the important output parameters from the import inputs in broiler production.     

Muscarinic elicitation of EEG asymmetry in freely moving rats

A method for determining whether structures distributed along a cell's membrane represent a random spatial distribution is presented in this paper. Two three-dimensional (3-D) images are acquired from one cell by wide-field digital imaging of cells which have been labeled with two different fluorescent antibodies. Prior to spatial analysis, a constrained regularized least squares restoration of the images is performed. This is followed by registration via fiducial markers (dual-labeled beads). A deformable model is then used to map data near the surface to the surface. Finally, each resulting data set is analyzed to determine whether it is spatially random. To do this, we generalize the test for complete spatial randomness of points in a plane, to test voxels distributed along a voxelized membrane in three dimensions. We also test whether the distribution of one protein is independent of the distribution of a second protein. The method is applied to compare the distribution of the protein kinase C to that of vinculin. Vinculin is a protein which anchors intracellular filaments to the cell's plasma membrane. It is also used as a (sparse) membrane marker for the deformable model. Protein kinase C facilitates molecular motors inside the cell. These may be associated with actin and myosin filaments.     

Analysis and neural network modeling of the nonlinear correlates of habituation in the vestibulo-ocular reflex

Through the process of habituation, continued exposure to low-frequency (0.01 Hz) rotation in the dark produced suppression of the low-frequency response of the vestibulo-ocular reflex (VOR) in goldfish. The response did not decay gradually, as might be expected from an error-driven learning process, but displayed several nonlinear and nonstationary features. They included asymmetrical response suppression, magnitude-dependent suppression for lower- but not higher-magnitude head rotations, and abrupt-onset suppressions suggestive of a switching mechanism. Microinjection of lidocaine into the vestibulocerebellum of habituated goldfish resulted in a temporary dishabituation. This suggests that the vestibulocerebellum mediates habituation, presumably through Purkinje cell inhibition of vestibular nuclei neurons. The habituated VOR data were simulated with a feed-forward, nonlinear neural network model of the VOR in which only Purkinje cell inhibition of vestibular nuclei neurons was varied. The model suggests that Purkinje cell inhibition may switch in to introduce nonstationarities, and cause asymmetry and magnitude-dependency in the VOR to emerge from the essential nonlinearity of vestibular nuclei neurons.     

Kinetics of human erythrocyte acetylcholinesterase inhibition by a novel derivative of physostigmine: phenserine

The elastic properties of carotid arteries of spontaneously hypertensive rats (SHR) and normotensive controls (Wistar-Kyoto rats [WKY]) were examined in vivo, in situ, and in vitro. The changes of internal diameter were measured with a high-resolution A-mode echo-tracking device simultaneously with the intra-arterial pressure at the carotid. The internal diameter at mean arterial blood pressure (MBP) was substantially smaller in vitro than in vivo in SHR (-33.8%) and WKY (-48.3%). The arterial distensibility was lower in vitro in all arteries compared with in vivo conditions (SHR, -30.1%; WKY, -60.4%; at MBP) despite a reduced incremental elastic modulus in vitro (SHR, -56.9%; WKY, -45.1%; at MBP). However, the in vitro and in vivo measurements show consistent elastic behavior of the carotid arteries between both strains of rats. Carotid arteries from WKY were also examined in situ. Although no significant reduction in internal diameter could be observed in situ, distensibility was dramatically decreased (-87% at MBP). These results emphasize the importance of considering the original vascular geometry when determining elastic properties of arteries. We conclude that experimental conditions are likely to be a critical determinant for the assessment of the mechanical properties of conduit vessels.     

National surveillance of dialysis associated diseases in the United States, 1995

Many fundamental and hot band absorption lines of 28Si35Cl+, 28Si37Cl+, 29Si35Cl+, and 30Si35Cl+ have been detectedbetween 630 and 700 cm-1 in a SiCl4/He discharge using diode laser velocity modulation spectroscopy. The datahave been fitted to give seven mass independent coefficients Ukl. The derived spectroscopic constants for 28Si35Cl+ include omegae = 678.24316(18) cm-1 and Be = 0.2870288(14) cm-1. The equilibrium internuclear distance is re =1.9439105(46) ?. The equilibrium dissociation energy calculated from Dunham's expanded Morse potential is De =49 431(57) cm-1. Copyright 1998 Academic Press.     

Characterization of the mouse Myoc/Tigr gene

Mutations in the myocilin (MYOC), also known as Trabecular meshwork-Inducible Glucocorticoid Response (TIGR) gene can lead to juvenile open-angle glaucoma in human and may be responsible for at least 3% of primary open-angle glaucoma. To develop a mouse model of primary open angle glaucoma, and to get deeper insight into the mechanisms of the MYOC/TIGR gene regulation and function, we have isolated and characterized full size mouse Myoc/Tigr cDNA and genomic clones. The mouse and human MYOC/TIGR genes have the same exon-intron structure and contain 3 exons, although the mouse gene is 6 kb shorter than the human gene (10 kb versus 16 kb) due to differences in the length of introns. The MYOC/TIGR gene encodes a moderately conserved protein, which is 82% identical between human and mouse. The encoded protein is 14 amino acids shorter at the N-terminus in the mouse than in the human (490 versus 504 amino acids). Mouse and human MYOC/TIGR genes show a similar pattern of expression in adult ocular and nonocular tissues. The mouse Myoc/Tigr gene was mapped to Chromosome 1 at position 82.8 cM from the centromere. All residues, which were identified in the human MYOC/TIGR protein as critical for glaucoma development, are conserved in the mouse Myoc/Tigr.     

Diagnostic tools in the evaluation of patients with viral hepatitis undergoing liver transplantation

Familiarity with the diagnostic parameters of viral hepatitis is imperative in the liver transplantation arena. Chronic viral hepatitis B and C are among the most common categories of end-stage liver disease. The preoperative diagnosis, determination of recurrent infection, and the assessment of antiviral therapeutic efficacy are dependent on appropriate virological testing. Furthermore, liver transplant personnel are at a high risk for parenterally transmitted viral hepatitis infection. Knowledge and understanding of the serological patterns of acute and chronic viral hepatitis, as well as recognition of the immune status for one or more of these viruses, will facilitate prevention and treatment of viral hepatitis for these health care providers.