Health care requirements planning: a conceptual framework

A clearly defined closed-loop operations management system comparable to the Manufacturing Resource Planning System (MRP-II) does not exist in the health care industry. Therefore, a study was conducted to evaluate the basic modules of MRP-II in terms of their applicability for developing a workable health care requirements planning system.     

Lateral Impact Validation of a Geometrically Accurate Full Body Finite Element Model for Blunt Injury Prediction

This study presents four validation cases of a mid-sized male (M50) full human body finite element model—two lateral sled tests at 6.7 m/s, one sled test at 8.9 m/s, and a lateral drop test. Model results were compared to transient force curves, peak force, chest compression, and number of fractures from the studies. For one of the 6.7 m/s impacts (flat wall impact), the peak thoracic, abdominal and pelvic loads were 8.7, 3.1 and 14.9 kN for the model and 5.2 ± 1.1 kN, 3.1 ± 1.1 kN, and 6.3 ± 2.3 kN for the tests. For the same test setup in the 8.9 m/s case, they were 12.6, 6, and 21.9 kN for the model and 9.1 ± 1.5 kN, 4.9 ± 1.1 kN, and 17.4 ± 6.8 kN for the experiments. The combined torso load and the pelvis load simulated in a second rigid wall impact at 6.7 m/s were 11.4 and 15.6 kN, respectively, compared to 8.5 ± 0.2 kN and 8.3 ± 1.8 kN experimentally. The peak thorax load in the drop test was 6.7 kN for the model, within the range in the cadavers, 5.8–7.4 kN. When analyzing rib fractures, the model predicted Abbreviated Injury Scale scores within the reported range in three of four cases. Objective comparison methods were used to quantitatively compare the model results to the literature studies. The results show a good match in the thorax and abdomen regions while the pelvis results over predicted the reaction loads from the literature studies. These results are an important milestone in the development and validation of this globally developed average male FEA model in lateral impact.     

Hand ischemia resulting from a transradial intervention: Successful management with radial artery angioplasty

We describe a case of hand ischemia resulting from transradial catheterization. This was successfully treated with angioplasty of the radial artery occlusion, but stresses the importance of a preprocedure evaluation of the dual blood supply to the hand before transradial access. © 2010 Wiley‐Liss, Inc.     

Oral health status of a long-term-care, veteran population

Abstract – The Department of Veterans Affairs (VA) operates the largest, integrated health care system in the United States of America. The projected need for long-term-care in the VA health care system parallels an expected increase in need for care in the United States, but precedes the need for care in the general population by 25–30 yr. The VA's Office of Dentistry, in an effort to estimate the resource requirements of this swelling group of veterans, initiated in 1986–7 an oral health survey of long-term care patients. The overall goals were to describe the oral health status of VA nursing home care units (NHCU) residents and to develop a methodology for estimating future dental health services utilization. This study describes the oral health status of the study population. Demographic and oral health data were collected for 650 long-term care residents of six VA NHCUs between October 1986 and July 1987. Data were collected on sociodemographic status, medical history, dental caries, periodontal diseases, oral soft tissue pathology, and the presence of dental prostheses. Caries and periodontal disease were evaluated using the United States National Institute of Dental Research Survey of Employed Adults and Seniors protocols. The oral health status of the population is described using DMF and ESI indices, the prevalence of oral lesions, levels of tooth loss, oral hygiene scores, and the status of existing dentures. Findings show moderate levels of untreated dental caries and periodontal disease and significant tooth loss which increased with age. A need for preventive therapy, restorative dentistry, conservative periodontal therapy, and prosthodontic care was evident. Soft tissue oral pathologies were rare and frequently related to prostheses use. The subject's overall willingness for care was high. Subjects were found to have a high number of medical comorbidities, and one third of all subjects had to be excluded from the periodontal examination for medical reasons or non-cooperation.     

Lack of association between increased carotid intima-media thickening and decreased HDL-cholesterol in a family with a novel ABCA1 variant,G2265T

Low HDL-cholesterol (HDL-C) concentrations are inversely correlated with cardiovascular disease, and previous studies have demonstrated that variants in the ATP-binding cassette transporter, ABCA1, are responsible for a proportion of HDL-C deficiency states. We identified a novel variant in ABCA1 in a kindred with decreased HDL-C. This variant was not identified in >200 chromosomes of healthy individuals. The proband, a heterozygote for G2265T, developed premature coronary artery disease. In addition to low HDL-C, six biological family members heterozygous for the ABCA1 variant exhibited low HDL-C concentrations compared with unaffected family members (0.83 +/- 0.32 vs 1.33 +/- 0.36 mmol/L; P = 0.009). Despite the decreased HDL-C, carotid artery B-mode ultrasound studies failed to reveal increased intima-media thickening in affected individuals compared with age- and sex-matched controls. Although these data extend previous observations that a single defective ABCA1 allele may lead to decreased HDL-C, associated evidence of early atherosclerosis was not confirmed.     

Isolation of antibody to human placental alkaline phosphatase (PLAP) from extracts of human placentae

PROBLEM: Human placental alkaline phosphatase (PLAP) is a unique placental antigen bound to the syncytiotrophoblast, which may be able to elicit a specific immune response in pregnancy. METHOD OF STUDY: Antibody to PLAP was purified from placental extracts by: a) acid elution of membrane vesicles; b) purifying complexes of PLAP with human antibody on monoclonal antibodies to PLAP followed by denaturation of the enzyme; and c) by denaturation of PLAP in placental extracts and purification of antibody to PLAP on PLAP columns. RESULTS AND CONCLUSIONS: Specific antibody to PLAP is present in placental extracts, and is mostly bound to placental membrane preparations. PLAP is therefore immunogenic in pregnancy and could serve as a useful monitor of pregnancy-specific immunological responses. Since a similar enzyme appears in some cancers, it is possible that the immunization against PLAP in pregnancy will help to protect against the development of ovarian and endometrial cancer (the 'fetal antigen' hypothesis).