Physician- and counselor-tailored hybrid computer interfaces for cancer genetics risk analysis software.

During development of the Strang Breast Cancer Risk Evaluator, different computer interfaces were designed, implemented and tested for useability by physicians and genetics counselors during a counseling session. The current BCRE 2.3 implements a hybrid interface, combining modern GUI (graphical user interface) windows, buttons, and menus with a linear, sequence-of-operations chronological progression reminiscent of interfaces prior to the GUI revolution. Although such hybrids are considered by many interface specialists inappropriate to modern broad-spectrum computer applications, vertical market applications, including this one, can capitalize on such hybridization effectively. The hybrid interface provides multiple visual cues and directions to the user as to the next appropriate action, thereby allowing a physician or counselor to concentrate his/her attention on the patient, returning his/her gaze to the screen at sporadic and widely spaced moments. Hybrid interfaces combine specific interface elements--such as triple-scale checkboxes, text and design metaphors, "next step" helper icons, color-coded content, and color and graphically tailored on-screen reports (all of which constitute GUI elements)--with a strictly linear data accrual, approval, calculation, storage and reporting progression (which sequence constitutes a pre-GUI interface design). A first-generation design is presented: a hybrid combining the visual efficiency of GUI-improved interfaces with the practical efficiencies of stream-lined and linear progressions.

A large scale comparative study in general practice with nitroglycerin spray and tablet formulations in elderly patients with angina pectoris.

In an 8-week comparative study, 410 patients were treated with nitroglycerin spray and 387 with conventional 500 mcg sublingual tablets. Data were analysed to compare the two treatments and to compare the results in older patients (greater than or equal to 65 y) with younger patients (less than 65 y). Spray was significantly superior to tablets in terms of number of patients helped, speed of pain relief and reduction in the number of attacks from pre-study levels. The occurrence of headache was significantly less in the spray group. There was no significant difference in the number or nature of adverse events but more spray patients reported taste disturbance. The clinical advantages seen in the entire population were maintained when the two age categories were considered separately. Further, 95% of patients found the spray convenient. The authors conclude that improved efficacy together with improved stability of the spray without loss of convenience makes Nitrolingual spray an acceptable alternative to tablets irrespective of patients' age.

A large scale, general practice based investigation into the clinical efficacy and tolerability of cefuroxime axetil in women with uncomplicated urinary tract infection.

Female patients presenting to their general practitioner with symptoms of uncomplicated urinary tract infection (cystitis) were entered into one of three therapeutic trials in a study programme of cefuroxime axetil (125 mg twice daily or 250 mg twice daily) conducted throughout the United Kingdom. On entry to the study, demographic information, infection recurrence rate and clinical signs and symptoms were recorded and the patient given medication for 7-days' treatment. Post-treatment, clinical signs and symptoms were re-assessed and adverse event data collected. Of the 672 patients who entered the programme, 605 patients completed the course of treatment of whom 510 were taking the 125 mg and 95 taking the 250 mg dosage. No significant difference in clinical efficacy or adverse events was found between the two dosage regimens. Analysis of the changes in symptom severity from the pre-treatment to the post-treatment evaluation for all patients showed a highly significant improvement (p less than 0.001). One hundred and five (15.6%) of the patients who entered the study reported a total of 132 adverse events, 16 of whom were withdrawn from treatment. The most frequent event was diarrhoea/loose motions. This study shows that cefuroxime axetil appears to be effective and well-tolerated for the treatment of cystitis in general practice.

An epidemiological survey of Raynaud's phenomenon.

A questionnaire was sent to 1000 patients with Raynaud's phenomenon (RP) and an equal number of controls in order to accumulate one of the largest patient data banks currently available. Five-hundred and seventy-one correctly completed paired returns were processed so as to investigate the association between Raynaud's phenomenon and other factors suspected of influencing the condition. The involvement of female sex hormones in RP was indicated by the predominance of women (93%), a 6% (P less than 0.02) higher incidence of infertility and the influence of menstruation (15%), the menopause (73%) and pregnancy (53%) on symptoms. Patients with scleroderma had a 5% higher incidence of stillbirths. A familial predisposition for RP was noted dependent on age at onset of symptoms (age less than 30, 14% greater than 30, 4.9%). The Raynaud's group overall had a significantly higher percentage who had been treated for migraine (7% higher P less than 0.01), angina (3% higher P less than 0.05) and duodenal ulcer (3% higher P less than 0.001). Of the respondents who had undergone sympathectomy (n = 140, 24.5% of the total), 18.6% claimed lasting benefit and 66.4% claimed no benefit after one year. The mean age at sympathectomy was 38.6 years (S.D. +/- 13 range 14-78) with a mean age of start of symptoms of 29.2 years (S.D. +/- 14.7, range 0-70). There was no significant difference between the effects of sympathectomy on those patients with and those without associated conditions.