Utilidad de la técnica de Gram en exudados uretrales en la consulta de atención primaria / Usefulness of the Gram stain in urethral exudates in the Primary Care Unit

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Towards Implementation of OMOP in a German University Hospital Consortium.

BACKGROUND: In 2015, the German Federal Ministry of Education and Research initiated a large data integration and data sharing research initiative to improve the reuse of data from patient care and translational research. The Observational Medical Outcomes Partnership (OMOP) common data model and the Observational Health Data Sciences and Informatics (OHDSI) tools could be used as a core element in this initiative for harmonizing the terminologies used as well as facilitating the federation of research analyses across institutions. OBJECTIVE: To realize an OMOP/OHDSI-based pilot implementation within a consortium of eight German university hospitals, evaluate the applicability to support data harmonization and sharing among them, and identify potential enhancement requirements. METHODS: The vocabularies and terminological mapping required for importing the fact data were prepared, and the process for importing the data from the source files was designed. For eight German university hospitals, a virtual machine preconfigured with the OMOP database and the OHDSI tools as well as the jobs to import the data and conduct the analysis was provided. Last, a federated/distributed query to test the approach was executed. RESULTS: While the mapping of ICD-10 German Modification succeeded with a rate of 98.8% of all terms for diagnoses, the procedures could not be mapped and hence an extension to the OMOP standard terminologies had to be made.Overall, the data of 3 million inpatients with approximately 26 million conditions, 21 million procedures, and 23 million observations have been imported.A federated query to identify a cohort of colorectal cancer patients was successfully executed and yielded 16,701 patient cases visualized in a Sunburst plot. CONCLUSION: OMOP/OHDSI is a viable open source solution for data integration in a German research consortium. Once the terminology problems can be solved, researchers can build on an active community for further development.

Search for three-nucleon force effects in analyzing powers for p-->d elastic scattering.

A series of measurements have been performed at KVI to obtain the vector analyzing power A(y) of the (2)H(p-->,pd) reaction as a function of incident beam energy at energies of 120, 135, 150, and 170 MeV. For all these measurements, a range of theta(c.m.) from 30 degrees to 170 degrees has been covered. The purpose of these investigations is to observe possible spin-dependent effects beyond two-nucleon forces. When compared to the predictions of Faddeev calculations, based on two-nucleon forces only, significant deviations are observed at all energies and at center-of-mass angles between 70 degrees and 130 degrees. The addition of present-day three-nucleon forces does not improve the description of the data, demonstrating the still insufficient understanding of the properties of three-nucleon systems.

Three-nucleon force and the A(y) puzzle in intermediate energy p--> + d and d--> + p elastic scattering

New vector analyzing-power data on p-->+d elastic scattering at E(p) = 150 and 190 MeV have been measured. These are presented together with existing data and with recent d-->+p vector and tensor analyzing power data at E(d) = 270 MeV. The strong negative extremum of both vector analyzing powers A(p)(y) and A(d)(y) at straight theta(c.m.) approximately 80 degrees -120 degrees is underestimated by Faddeev calculations using modern NN forces. Inclusion of the Tucson-Melbourne 3N force shifts the minima upwards, but with conflicting results for A(p)(y), and leading to a good description for A(d)(y). An A(p)(y) puzzle, previously thought to exist at energies E(N)

Internal dynamics of human ubiquitin revealed by 13C-relaxation studies of randomly fractionally labeled protein.

The use of random, fractional 13C-enrichment combined with low pass filtration has allowed the determination of NMR relaxation parameters at an unprecedented number of sites within recombinant human ubiquitin. Essentially complete 1H, 13C, and 15N resonance assignments for the protein are reported. Carbon spin lattice and heteronuclear NOE relaxation data have been analyzed in the context of the Lipari-Szabo "model free" formalism. The generalized order parameters for 56 main chain alpha C-H vectors have been determined and are found to correspond to the highly restricted motion seen in previous studies of the motion of amide N-H vectors. In distinct contrast, the analysis presented here indicates an unexpected range of dynamics within the interior of the protein. The generalized order parameters of 45 methyl groups of human ubiquitin have been determined. The methyl groups of Thr and Ala residues show generalized order parameters ranging from the Woessner limit (0.111) to below 0.01. Generalized order parameters for all methyl groups of the seven isoleucine residues were determined. With one exception, the generalized order parameters of the gamma methyls were equal to or greater than the corresponding delta methyls, indicating higher mobility away from the main chain. Generalized order parameters for 11 methyl groups of leucine residues were also determined. In six of the seven cases where the generalized order parameters of both prochiral methyl groups were determined, the pro-R methyl consistently shows a higher value than the pro-S methyl group. Generalized order parameters for seven methyl groups of four valines were also determined. There is no apparent correlation of methyl group prochirality with the value of the generalized order parameter. These data have several implications and generally indicate that the interior of the protein is heterogeneously dynamic.

[Mortality differences in lung surgery]. / Letalitätsunterschiede bei Lungenoperationen.

The surgical mortality rate in a total of 1,100 patients with lung cancer was investigated. Since it was found that, in part, mortality extended to beyond 30 days, the differences to be seen on the 50th post-operative day are presented. A considerable negative bias was established for upper, as compared with lower, lobe resection, a negative bias for resection on the right side, and a special negative bias for right-sided pulmonectomy - which, till now, had also been considered to exist for bilobectomy of the lower and middle lobes. It is suggested that these differences be taken into account when assessing operability and preparing surgical statistics.

[Preoperative lung function data of patients dying within 50 days and of surgical patients surviving longer than 6 months]. / Präoperative Lungenfunktionsdaten von innerhalb 50 Tagen Verstorbenen und von Resezierten, die länger als sechs Monate überlebten.

A sequence of parameters is presented in the order of importance for functional operational ability diagnosis obtained from quotients of preoperative averages of findings in patients who dies postoperatively and in survivors. It appears that the following parameters are particularly important: pressure of a. pulmonalis under stress, perfusion scintigram and respiratory gas analyses, whereas e.g. in TGV%N, BGA under stress and FEV1 predicted via scintigram, no differences worth mentioning were seen. Reference is made to differences in respiratory and blood gas analysis before and after resection of the upper and lower lobes.

[Crux medicorum: Ondine's curse (author's transl)]. / Crux medicorum: Undine's Fluch.

All known cases of the Ondine's curse syndrome with lifethreatening complications in consequence of narcosis, sedatives or oxygen-administration are reported. The avoidance of accidents requires blood gas analysis and more attention to the less well-known phenomenon--possibly a cause of the sudden-death-syndrome.

[On respiratory stimulation by aminophenazol in global insufficiency due to chronic-obstructive diseases of the lungs (author's transl)]. / Zur Atemstimulation mit Amiphenazol bei Globalinsuffizienz infolge chronisch obstruktiver Lungenkrankheit

For evaluation of a respiratory analeptic as supplementary therapy in global insufficiency blood gas analyses were performed on 19 patients under normal room air conditions as well as under oxygen breathing. It could be proved that with 2,4-diamino-5-phenylthiazol (aminophenazol; Daptazile) respiratory depression associated associated with chronic obstructive pulmonary diseases can be influenced and that here is statistically significant improvement of respiration. Effects of mechanical breathing and hyperventilatin are discussed -- basing on the present evaluation results they need not be expected. Side effects were not registered. With simultaneous and exhaustive application of all therapeutic means for the remedy of pulmonary obstruction amiphenazol is recommended for use in cases of pulmonary hypoventilation and primary central respiratory depression.