Conceptual Database Modeling for Understanding and Developing Information Management Applications

Radiographics : a Review Publication of the Radiological Society of North America, Inc. May-Jun, 2001  |  Pubmed ID: 11353124

In response to rising health care costs and changing expectations concerning the quality of health care, information management is becoming increasingly important in the practice of medicine; more specifically, it is beginning to effect significant changes in radiology practice and patient care. Radiologic applications of information management include reporting diagnostic information generated from film interpretation as well as tracking utilization patterns of different imaging modalities and the variability of clinical outcomes, documenting the type of information sought by and provided to clinicians, and evaluating departmental quality standards and performance goals. Conceptual database modeling enables radiologists to understand and participate in the development of information systems, thereby improving the likelihood of successful results. In object-role modeling, groups of relevant objects and roles are identified and used to create elementary facts that form the "building blocks" for information models. The resultant models can easily be communicated, reviewed, and revised, allowing decreased development time and optimizing inclusion of relevant features in the target relational database. Increasing the amount of clinical and management input in the development process may help information systems better meet user needs, become accepted and more often used, and ultimately succeed.

Conceptual Database Modeling: a Method for Enabling End Users (radiologists) to Understand and Develop Their Information Management Applications

Journal of Digital Imaging : the Official Journal of the Society for Computer Applications in Radiology. Jun, 2001  |  Pubmed ID: 11442094

As medical technology advances at a rapid pace, clinicians become further and further removed from the design of their own technological tools. This is particularly evident with information management. For radiologists, clinical histories, patient reports, and other pertinent information require sophisticated tools for data handling. However, as databases grow more powerful and sophisticated, systems require the expertise of programmers and information technology personnel. The radiologist, the clinician end-user, must maintain involvement in the development of system tools to insure effective information management. Conceptual database modeling is a design method that serves to bridge the gap between the technological aspects of information management and its clinical applications. Conceptual database modeling involves developing information systems in simple language so that anyone can have input into the overall design. This presentation describes conceptual database modeling, using object role modeling, as a means by which end-users (clinicians) may participate in database development.

Characterization of a Spliced Leader Gene and of Trans-spliced MRNAs from Taenia Solium

Molecular and Biochemical Parasitology. Jun, 2002  |  Pubmed ID: 12076776

Identification and Characterization of PDZ-1, a N-ERMAD Specific Interaction Partner of the Echinococcus Multilocularis ERM Protein Elp

Molecular and Biochemical Parasitology. Mar, 2004  |  Pubmed ID: 14747152

Passive Dilation by Ureteral Stenting Before Ureteroscopy: Eliminating the Need for Active Dilation

The Journal of Urology. Sep, 2005  |  Pubmed ID: 16094062

We sought to evaluate the use of passive dilation by stenting of ureteral orifices that were inaccessible at initial cystoscopic evaluation in children before a ureteroscopic procedure.

Urologic Manifestations of Genetic Diseases

Drugs of Today (Barcelona, Spain : 1998). Sep, 2005  |  Pubmed ID: 16341293

Many genetic disorders have genitourinary manifestations in childhood. In order to care for these children, the physician should be aware of such potential manifestations. A succinct overview of the pediatric genetic disorders that have urologic manifestations is presented to assist in the evaluation of patients, counseling of parents and treatment of urologic manifestations of childhood genetic diseases.

Benign Vascular Lesions of the Scrotum

The Journal of Urology. Nov, 2006  |  Pubmed ID: 17070305

Current Diagnosis and Management of Fetal Genitourinary Abnormalities

The Urologic Clinics of North America. Feb, 2007  |  Pubmed ID: 17145364

Prenatal assessment with ultrasonography provides excellent imaging of fluid-filled structures (eg, hydronephrosis, renal cysts, and dilated bladder) and renal parenchyma. This information allows for the generation of a differential diagnosis, identification of associated anomalies, and assessment of the prenatal and postnatal risks of a given anomaly. This enhances parental education and prenatal and postnatal planning. This article discusses the current methods of diagnosis and management of fetal genitourinary anomalies, and also the postnatal evaluation and treatment of these conditions.

Muscle-bound Magnetic Resonance Imaging Helped Define a Large Paraurethral Mass

American Journal of Obstetrics and Gynecology. Apr, 2009  |  Pubmed ID: 19318160

Charlson Comorbidity Index and Success of Extracorporeal Shock Wave Lithotripsy

The Canadian Journal of Urology. Aug, 2009  |  Pubmed ID: 19671224

We examined the potential correlation between Charlson comorbidity index (CCI) and stone free rate after extracorporeal shock wave lithotripsy (ESWL).

TRAIL-deficient Mice Exhibit Delayed Regression of Retinal Neovascularization

The American Journal of Pathology. Dec, 2009  |  Pubmed ID: 19893042

While it is well established that tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) induces apoptosis in various cell types, the role of TRAIL in regulation of retinal neovascularization (NV) has not been described. Here we determined the role of TRAIL in retinal NV during oxygen-induced retinopathy using TRAIL deficient ((-/-)) mice. TRAIL and its receptor, DR5, were expressed in wild-type retinas at all time points evaluated (postnatal days 12, 17, 21, 24) during oxygen-induced retinopathy and in age-matched room air control animals. Localization of TRAIL(+) cells within the neovascular tufts of hyperoxia- exposed wild-type mice suggested TRAIL plays a role in oxygen-induced retinopathy. Retinal vascular development appeared normal in the TRAIL(-/-) mice, except for a small but significant difference in the capillary-free zone surrounding major arteries. A minimal difference in avascularity was observed at postnatal day 12 in the retinas of TRAIL(-/-) mice after hyperoxia-exposure compared with wild-type mice, suggesting that TRAIL does not play a major role in the vaso-obliterative phase of oxygen-induced retinopathy. However, at the peak of NV, TRAIL(-/-) mice had a significant increase in retinal neovascularization. In addition, when NV naturally regresses in wild-type mice, TRAIL(-/-) mice continued to display significantly high levels of NV. This was attributed to a significant decrease in neovascular tuft cells undergoing apoptosis in TRAIL(-/-) mice. Together, these data strongly suggest that TRAIL plays a role in the control of retinal NV.

Development and Implementation of an Oral Care Protocol for Patients with Cancer

Clinical Journal of Oncology Nursing. Dec, 2009  |  Pubmed ID: 19948471

On an inpatient oncology unit, mucositis is a recurrent issue with devastating effects on patients. Available interventions were limited, palliative in nature, and ineffective. Evidence-based preventive measures and treatments were needed; as a result, a nurse-driven, patient-centered oral care protocol was developed.

Altered Vascular Expression of EphrinB2 and EphB4 in a Model of Oxygen-induced Retinopathy

Developmental Dynamics : an Official Publication of the American Association of Anatomists. Jun, 2010  |  Pubmed ID: 20503366

EphrinB2 ligands and EphB4 receptors are expressed on endothelial cells (EC) of arteries and veins, respectively, and are essential for vascular development. To understand how these molecules regulate retinal neovascularization (NV), we evaluated their expression in a model of oxygen-induced retinopathy (OIR). EphrinB2 and EphB4 were expressed on arterial and venous trunks, respectively, and on a subset of deep capillary vessels. EphB4 expression was reduced following hyperoxia, while ephrinB2 expression remained unaltered. In addition, a subset of EphB4-positive veins regressed in a caspase-3-dependent manner during hyperoxia. Arteriovenous malformations were also observed with loss of arterial-venous boundaries. Finally, both ephrinB2 and EphB4 were expressed on a subset of neovascular tufts following hyperoxia. These data confirm the contribution of ECs from both venous and arterial origins to the development of retinal NV.

Evaluation of Pediatric Nephrolithiasis

Indian Journal of Urology : IJU : Journal of the Urological Society of India. Oct, 2010  |  Pubmed ID: 21369386

Nephrolithiasis in the pediatric population is an important cause of morbidity worldwide. Presenting signs and symptoms are often considerably different from those in adults. Vague abdominal pain, hematuria, and urinary tract infection are more common in children than the classic colicky flank pain. Imaging of suspected cases should be undertaken with careful consideration of diagnostic accuracy and the potentially harmful effects of ionizing radiation. Because children with nephrolithiasis have a high chance of recurrent stone formation, a thorough risk assessment and metabolic evaluation should be performed. This review discusses the presentation, acute evaluation and risk assessment of nephrolithiasis in the pediatric population.

Clinical and Magnetic Resonance Imaging Characteristics of Vaginal and Paraurethral Leiomyomas: Can They Be Diagnosed Before Surgery?

BJU International. Jun, 2010  |  Pubmed ID: 19889060

To describe the clinical and magnetic resonance imaging (MRI) characteristics of vaginal and paraurethral leiomyomas.

Racial Variation in Timing of Pyeloplasty: Prenatal Versus Postnatal Diagnosis

The Journal of Urology. Dec, 2011  |  Pubmed ID: 22014821

We have previously shown that nonwhite patients with ureteropelvic junction obstruction undergo pyeloplasty at a younger age than white patients. The mechanisms behind this finding are unclear, since there is no known racial variation in the natural history of ureteropelvic junction obstruction. We used a detailed clinical database to explain this phenomenon.

Characterization of FarR As a Highly Specialized, Growth Phase-dependent Transcriptional Regulator in Neisseria Meningitidis

International Journal of Medical Microbiology : IJMM. Apr, 2011  |  Pubmed ID: 21292554

Transcriptional regulators play an important role for the survival of Neisseria meningitidis within its human host. We have recently shown that FarR acts as transcriptional repressor of the adhesin nadA in N. meningitidis. Here, we examined the FarR regulon by microarray analyses, qRT-PCR, and electrophoretic mobility shift assays, revealing that FarR is a highly specific repressor of nadA. We demonstrate by reporter gene fusion assays that alterations of the FarR binding site within the nadA promoter are sufficient to induce transcription of nadA. Furthermore, farR expression is growth phase-dependent. The highest transcription rate was observed in the late-exponential growth phase of meningococci. Upon contact with active components of the complement system in normal human serum, expression of farR is slightly downregulated. Concluding, we present FarR as an exquisitely specialized, growth phase-dependent, possibly complement-responsive transcriptional regulator in N. meningitidis.

Retrograde Ureteral Access After Cross-trigonal Ureteral Reimplantation: A Straightforward Technique

Journal of Pediatric Urology. Feb, 2011  |  Pubmed ID: 20227349

Retrograde ureteral access after cross-trigonal ureteral reimplantation can be challenging. We present our experience with percutaneous retrograde ureteral catheterization, status post cross-trigonal ureteral reimplantation.

Durability of Antireflux Effect of Ureteral Reimplantation for Primary Vesicoureteral Reflux: Findings on Long-term Cystography

Urology. Jan, 2012  |  Pubmed ID: 22245304

OBJECTIVE: To evaluate the long-term durability of successful ureteral reimplantation (UR) for vesicoureteral reflux (VUR) through a review of late cystography (LC) findings. MATERIALS AND METHODS: We performed a retrospective chart review of all children with primary VUR who underwent successful open UR (grade 0 VUR into the reimplanted ureter[s] on initial cystogram) at our institution from January 1990 to December 2002. We identified successful UR patients who underwent LC ≥1 year after UR and reviewed the results for the presence of recurrent VUR into the reimplanted ureter(s). RESULTS: Seven-hundred ninety-four patients underwent successful open UR for primary VUR, of whom 60 (7.6%) had a subsequent LC. Preoperative VUR grade was ≤II in 20 (34.5%) and ≥III in 38 (65.5%). Median age at UR was 3.5 years (IQR 1.3-6.2 years); 51 (85%) were female. UR was intravesical in 45 (75%) and bilateral in 19 (32%). LC was performed at a median of 38.7 months after UR (IQR 19.6-66.1 months). Indication for LC was febrile urinary tract infection (UTI) in 16 (27%), nonfebrile UTIs in 15 (25%), follow-up of contralateral VUR in 16 (27%), and other clinical indications in 13 (21%). The recurrence rate was 0%; of the 79 reimplanted ureters, 100% (95% CI 95.4-100) had no VUR (grade 0). CONCLUSION: Among children who underwent successful open UR for primary VUR, there was no VUR recurrence on extended follow-up. This suggests that the late durability of open antireflux surgery is excellent.

Long-term Incidence of Urinary Tract Infection After Ureteral Reimplantation for Primary Vesicoureteral Reflux

Journal of Pediatric Urology. Jan, 2012  |  Pubmed ID: 22261484

OBJECTIVE: To determine the incidence of urinary tract infection (UTI) after ureteral reimplantation (UR) for primary vesicoureteral reflux (VUR). MATERIALS AND METHODS: In this retrospective review, the pyelonephritis-free survival of patients with primary VUR who underwent open UR from January 1990 to December 2002 was assessed using a Cox proportional hazards analysis. RESULTS: 1076 patients underwent open UR for primary VUR. 73.0% were female; median age was 4.7 years. 80.1% presented with UTI. Clinical success rate for non-tapered UR was 96.5%. Median follow-up was 2.9 years. 21.8% had at least one postoperative UTI. 6.5% had postoperative pyelonephritis (POP) at a median of 21 months postoperatively. On multivariate survival analysis female gender (OR 9.97, 95% CI 3.07-32.34), preoperative VUR grade ≥3 (2.14, 1.25-3.69), breakthrough preoperative UTI (2.00, 1.22-3.25), and preoperative renal scarring (1.86, 1.15-2.99) were associated with POP. CONCLUSION: POP is rare on long-term follow-up, suggesting that UR is effective in reducing pyelonephritis in this population.