Results of an experiment on the transition to the family practice service

The California Dental Association has developed a program--Quality Improvement through Lifelong Learning or QUIL3--that enables a dentist to privately and confidentially determine whether he or she meets current clinical practice standards and has the requisite knowledge to practice dentistry competently. Using the concept of continuous quality improvement (CQI), this innovative program was two years in development and attempts to positively and proactively address issues associated with dental performance. QUIL3 is an initial step.     

The effect of morphine and pentazocine on thrombocyte functional activity

Apart from main classic neuron types there is a small group of neurons known in literature as intermediate Lugaro cells. Two Lugaro cells types are distinguished: fusiform and those with triangular cell body. Fusiform cells vary not only in vertical, horizontal or diagonal position of cell body, but also have certain morphological peculiarities. Axons of some fusiform cells project either to molecular layer or reach Purkinje cells layer or remain at the level of granular layer. Along with it, there are true intermediate cells, described by Lugaro. These cell processes project from layer to layer. Neurons with triangular cell body located at different granular layer levels relate to the second group of Lugaro cells. Due to great extension of their processes Lugaro cells possess projection area ranging from molecular layer to white substance. Lugaro cells are independent neurons, always present in cerebellar cortex.     

Size and shape of soft-tissue facial profile: effects of age, gender, and skeletal class

We have determined the NMR structure of a ligand-binding domain of the granulocyte colony-stimulating factor (G-CSF) receptor, containing the highly conserved WSxWS motif. The domain consists of seven beta-strands with the fibronectin type III-like topology seen in several cytokine receptors. Comparisons between the spectra of the 15N-labelled domain with and without G-CSF indicate that the major ligand-recognition site is on the FG loop just upstream of the WSxWS sequence, and not on the BC loop which is mainly used in the growth hormone system. The WSxWS residues are suggested to contribute to ligand-recognition and to the protein architecture of the G-CSF receptor.     

Topographic and anatomic markers of the temporal pyramidal bone and their role in the surgical treatment of ear neoplasms

Topographic anatomical guide points were studied on 126 total preparations of the temporal bones. The relation of the temporal bone pyramid angles in sagittal and horizontal planes, the distance from spina suprameatum to the pyramid top, from spina suprameatum to promontorium, from promontorium to internal carotid artery with the shape of the skull has been established.     

Incidence of anemia in older people: an epidemiologic study in a well defined population

OBJECTIVE: To assess the incidence and clinical spectrum of anemia among older people. DESIGN: Inception cohort assembled and followed by medical records linkage until death or last clinical contact through January 1994. SETTING: Population-based study in Olmsted County, Minnesota. PARTICIPANTS: All 618 Olmsted County men and women aged 65 years or more with anemia by World Health Organization criteria that was first recognized in 1986. MEASUREMENTS: Age- and sex-adjusted incidence rates, corrected for prevalent anemia, and survival estimates using the Kaplan-Meier method, with calculation of standardized mortality ratios for specific causes of death. RESULTS: The corrected annual incidence of anemia rose with age, and rates were higher in men (90.3 per 1000; 95% CI, 79.2-101.4) than women (69.1 per 1000; 95% CI, 62.3-75.8). In 465 cases (75%), anemia was detected in conjunction with a hospitalization, but admission was due to anemia in only 57 instances. Half of the cases were caused by blood loss, two-thirds of these as a result of surgery. The cause of anemia was uncertain in 102 cases (16%). One-third of the patients were transfused with a median of 3 units each. Overall survival was worse than expected but was better among those with anemia caused by blood loss. Mortality attributable to malignancy, mental disorders, circulatory and respiratory diseases, ill-defined conditions, and injuries was significantly increased among these older patients with anemia. CONCLUSIONS: The incidence of anemia among older people is 4 to 6 times greater than that suspected clinically, rises with age, and is higher in men than in women. The apparent cause in half the cases is blood loss. Even mild anemia is associated with reduced survival, especially during the first year, but this could relate to underlying comorbid conditions.     

Body adaptation to the action of ecological factors at the cellular and subcellular levels

While poor drug compliance is a significant impediment to the effective treatment of hypertension, knowledge of what patients wish to know about their medications in order to improve compliance is very limited. To develop a preliminary understanding of patients' medication requirements and expectations, a simple 30-item questionnaire was developed and administered to 66 patients who were either taking antihypertensive drugs, or about to commence antihypertensive drug treatment. Ninety percent of patients wanted to know about all possible side effects of medications as well as the most likely side effects. Ninety-six percent wanted to know if their drug treatment would keep them well. In addition, most patients wanted to avoid multiple medications, were concerned about the prospect of life-long treatment, and were worried about potential drug interactions. Effects of the drugs on their lifestyles as well as any lifestyle changes required to augment drug therapy were other issues of concern. The elderly were less interested in many of these issues. A strong desire for further knowledge about their disease was noted in most subjects (82%). If compliance with medication therapy is to be improved, a better understanding of patients' concerns and fears about medications is required, particularly in a relatively asymptomatic disease like hypertension.     

Effect of aggregation on the kinetics of autoxidation of the polyene antibiotic amphotericin B

Two hundred and fifty four consecutive patients with gastric adenocarcinoma who underwent surgery were preoperatively evaluated with endoscopic ultrasonography (EUS). The results were compared with the post-operative histo-pathological staging. EUS was correct in determining the T and N stage in 83% and 66%, respectively. Although EUS was accurate in determining the absence of lymph node metastases (accuracy in stage N0: 93%), it was not reliable in determining stages N1 and N2 (64% and 52%, respectively). Since 88% of all T3 and T4 tumors had lymph node metastases, the concomitant T stage may be an important criterion for assessing the nature of endosonographically visualized lymph nodes. The actual R0-resection rate (78%) was almost identical to the rate predicted preoperatively by EUS (81%). We therefore consider EUS a valuable pretherapeutic procedure in patients with gastric carcinoma.