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This review briefly discusses the clinical and basic science rationale for vagus nerve stimulation (VNS) in treatment-resistant depression (TRD). As the number of treatment failures for depression increases, the likelihood of achieving remission during acute treatment decreases, and the risk of relapse increases with the number of treatment failures. Two open trials of adjunctive VNS for TRD showed positive acute results and a growing benefit over time. The results of the acute randomized controlled trial were not significant for the primary outcome (response by HRSD-24), but the secondary measure (IDS-SR-30) was significant for VNS. A 12-month nonrandomized comparative analysis of patients receiving adjunctive VNS with TRD patients receiving treatment as usual showed significant results f...

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Purpose: To assess long-term outcomes following percutaneous transluminal angioplasty (PTA) of congenital aortic coarctation in adults.Methods: Seventeen patients underwent PTA for symptomatic adult coarctation of the aorta. Sixteen patients, with a mean age of 28 years (range 15-60 years), were reviewed at a mean interval after angioplasty of 7.3 years (range 1.5-11 years). Assessment included magnetic resonance imaging (MRI), Doppler echocardiography, and clinical examination. Current clinical measurements were compared with pre- and immediate post-angioplasty measurements.Results: At follow-up 16 patients were alive and well. The patient not included in follow-up had undergone surgical repair and excision of the coarctation segment following PTA. Mean brachial systolic blood pressure for the group decreased from 174 mmHg before angioplasty to 130 mmHg at follow-up (p 0.0001). The mean gradient had fallen significantly ...

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PurposeTo evaluate the clinical characteristics and outcomes of cataract surgery in highly myopic Korean subjects.MethodsWe retrospectively reviewed...Full Text Available

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Objective. Cervical cancer patients who had an abandoned radical hysterectomy were evaluated for preoperative clinical predictors, complication rates, and outcomes. Study...Full Text Available

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We sought to determine the prevalence of metabolic syndrome (MS) in patients with acute myocardial infarction and its effect on clinical outcomes. Employing data from the Korea Acute Myocardial Infarction...Full Text Available

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The question of whether storage of red blood cells (RBCs) alters their capacity to deliver oxygen and affects patient outcomes remains in a state of clinical equipoise. Studies of the changes...Full Text Available

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Introduction: Generally agreed outcome criteria in psychosis are required to evaluate the effectiveness of new treatment strategies. The aim of this study is to explore clinical recovery...Full Text Available

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Study DesignThis is a retrospective study that was done according to clinical and radiological evaluation.PurposeWe analyzed the clinical and radiological...Full Text Available

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BackgroundControversy exists about how to effectively measure patient reported outcomes in IBS clinical trials. Pain numeric rating scales (NRS) are widely used in...Full Text Available

UK PubMed Central (United Kingdom)

IntroductionVarious multigene predictors of breast cancer clinical outcome have been commercialized, but proved to be prognostic only for hormone receptor (HR) subsets overexpressing...Full Text Available

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The purpose of this study was to compare the clinical outcomes and wound complications in coccygectomy with or without subperiosteal resection. This retrospective study included 25 patients who underwent...Full Text Available

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The relationship between malaria transmission intensity and clinical disease is important for predicting the outcome of control measures that reduce transmission. Comparisons of hospital data...Full Text Available

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Acute kidney injury (AKI) is a common clinical problem with significant clinical and economic consequences. A number of studies point to a rising incidence of AKI in the hospital and in the intensive...Full Text Available

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ObjectiveWe sought to determine the clinical outcomes of patients undergoing surgical aortic valve replacement with hemodynamically confirmed severe pulmonary hypertension and aortic stenosis and compare them with the outcomes of patients not undergoing aortic valve replacement and patients undergoing aortic valve replacement with mild-to-moderate pulmonary hypertension. MethodsA total of 317 patients with severe aortic stenosis (aortic valve area 35 mm Hg) was present in 81 patients, of whom 35 (43.2%) underwent surgical aortic valve replacement. We compared the clinical outcomes of these 35 patients with the 46 patient...

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The visual outcomes of Acanthamoeba keratitis, a rare cause of corneal infection, can be devastating. This paper reports two contact lens wearers with severe pain and photophobia who presented to the emergency room. Biomicroscopy revealed radial keratoneuritis in both individuals. Tissue culture on a nonnutrient agar plate with Escherichia coli overlay resulted in a heavy growth of Acanthamoeba. The inpatient treatment included 0.02% polyhexamethylene biguanide, chlorhexidine, neomycin/polymyxin B/bacitracin (Neosporin), and oral fluconazole, which successfully controlled the corneal infection and improvement in the best corrected visual acuity in both patients. Infection did not recur during the 12-month follow-up period. Acanthamoeba keratitis can present as radial keratoneuritis, mimicking other common corneal infections resulting in diagnostic and treatment delays. Early diagnosis and prudent treatment of Acanthamoeba ...

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BackgroundAlthough self-expandable metal stent (SEMS) insertion is widely used for relief of malignant colorectal obstructions, the immediate technical and clinical failure rates of SEMSs and the associated risk factors remain largely unknown. ObjectiveTo identify rates and factors predictive of technical and clinical failure of SEMSs when their use is attempted for the decompression of malignant colorectal obstruction. DesignRetrospective chart review. SettingA tertiary-care academic medical center in South Korea. PatientsThis study involved a total of 412 patients with malignant colorectal obstruction in whom SEMS insertion was attempted. InterventionPlacement of colonic SEMSs. Main Outcome MeasurementsTechnical success and immediate and long-term clinical success rates. ResultsTechnical...

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ObjectiveWe describe our clinical experiences and outcomes in patients who had thromboembolic complications occurring during endovascular treatment of intracerebral aneurysms with...Full Text Available

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The functional outcome after stroke is unpredictable; it is not accurately predicted by clinical pictures upon hospital admission. The presence of apoptotic neurons in the ischemic penumbra and perihematoma...Full Text Available

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OBJECTIVEModerately preterm infants (30–34 6/7 weeks’ gestational age) represent the largest population of NICU residents. Whether their clinical...Full Text Available

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ContextResponse Evaluation Criteria in Solid Tumors [RECIST (unidimensional)], World Health Organization [WHO (bi-dimensional)] and European Association for Study...Full Text Available

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ObjectiveThe purpose of this study was to compare clinical and radiological outcomes of percutaneous endoscopic lumbar discectomy (PELD) and open lumbar microdiscectomy (OLM) for...Full Text Available

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BackgroundInadequate platelet inhibition despite aspirin and clopidogrel therapy during and after a percutaneous coronary intervention is associated with an impaired clinical outcome....Full Text Available

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PMID:11004287

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Divided into diagnostic and treatment sections, this book provides a comprehensive overview of the most common medical procedures performed in modern clinical settings. Each section presents common names for the procedure; an outline of the disease or injury for which the procedure is performed; a brief review of the anatomical structures and physiological processes that are involved; staffing, equipment, and pre-procedure requirements; a detailed description of the procedure itself; and, a discussion of expected outcomes as well as potential complications. Each chapter includes a summary and

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Purpose: Efficacy and safety of the own single-center experience with moderately dosed radiosurgery (SRS) for limited (one to four) brain metastases were analyzed and correlated with patient- and treatment-related variables. Patients and Methods: Between 05/1998 and 10/2006, 93 patients received SRS for a total of 142 brain metastases. The median number of brain metastases treated per patient was one (range, one to four). 46 patients (49%) received initial SRS alone, 13 patients (14%) SRS with up-front whole-brain radiotherapy (WBRT), and 34 patients (37%) SRS for recurrent metastases after WBRT. Median dose was 16 Gy (range, 10-20 Gy). Results: Median overall survival (OS) was 7.5 months. The actuarial 6- and 12-month data for OS were 60% and 35%, for local brain control (LBC) 87% and 79%, and for distant brain control (DBC) 48% and 37%, respectively. Only ten of 46 patients (22%) with initial SRS alone ultimately received WBRT. Ten patients ...

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Purpose: To evaluate the initial and mid-term results of a new self-expanding low strut profile nitinol stent for treatment of atherosclerotic lesions stenoses and occlusions in the superficial femoral artery (SFA). Materials and Methods: In 8 patients (4 male, 4 female, mean age 74.8 {+-} 8.8 years) with SFA lesions and non-satisfying results after PTA treatment alone, 10 self-expanding nitinol Xpert stents were deployed via a 4 F sheath. Stent characteristics and handling were graded by the interventionalist. Fontaine classification, duplex flow measurements and ankle brachial index (ABI) at rest and stress were taken prior and one day after stent placement. Patients were followed 3, 6 and 12 months after the procedure obtaining the same parameters at each appointment. Results: Initial stent treatment was successful in all patients. Stent handling and positioning were rated very good and safe. All patients improved ...

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Despite advances in polymer and drug technology, the underlying stent platform remains a key determinant of clinical outcome. A clear understanding of stent design and the differences between various stent platforms are of increasing importance for the interventional cardiologist. Reduction in stent strut thickness has been associated with improved stent deliverability, improved procedural outcome, and lower rates of subsequent restenosis. Newer-generation 316L-SS stent designs have enabled reduced strut thickness while retaining radial strength and minimizing recoil, but with significant loss of radiopacity, leading to reduced visibility. Cobalt chromium alloys have enabled a reduction in stent strut thickness to around 80?90 mm while retaining modest radiopacity, but due to higher elasti...

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In the last 40 years, significant advances have been made in the understanding of the neurophysiologic processes involved in the experience of trauma and pain. This knowledge, together with the rapid growth and understanding in the behavioral health sciences, has expanded to include a much better appreciation of how these fields are converging and contribute to a process called neuroplasticity. These basic mechanisms common to all patients have important implications for clinical outcome and for improving clinical practice. This article is written for clinicians who manage patients with sacroiliac joint dysfunction, a specific type of nonspecific low back pain.

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Background:Acute Coronary Syndrome (ACS) can occur in patients with prior coronary artery bypass grafting (CABG). In the Gulf Registry of acute coronary events (Gulf RACE), we identified...Full Text Available

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We performed a randomized trial to compare IVF outcomes in 54 poor responder patients undergoing a microdose leuprolide acetate (LA) protocol or a GnRH antagonist protocol incorporating a luteal phase E2 patch and GnRH antagonist in the preceding menstrual cycle. Cancellation rates, number of oocytes retrieved, clinical pregnancy rates (PR), and ongoing PRs were similar between the two groups.

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The results of interstitial brachytherapy in 13 patients with malignant brain tumors (malignant glioma 9 cases, metastatic brain tumor 4 cases) were reported. In all patients, Ir-192 thin wires were implanted temporarily in afterloading catheters, which were implanted appropriately by means of MRI or CT guided stereotactic technique. Clinical results on CT scan were as follows: CR (complete response) 1 case, PR (partial response) 6 cases and NC (no change) 6 cases. Even in the NC group, tumor growth was inhibited temporarily. Tumor free intervals were ranged 2-17 months. In early series, the intervals were about 2 months due to incomplete arrangement of radioactive implants. In recent series, prolongation of tumor free interval more than 12 months was achieved due to precise arrangements of implants. MRI guided stereotactic interstitial brachytherapy may provide safe and precise intracranial arrangements of implants, which ...

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Background and purpose: stereotactic radiosurgery (SRS) and also fractionated stereotactic radiotherapy (SRT) offer high local control (LC) rates (> 90%). This study aimed to evaluate three-dimensional (3-D) tumor volume (TV) shrinkage and to assess quality of life (QoL) after SRS/SRT. Patients and methods: from 1999 to 2005, 35/74 patients were treated with SRS, and 39/74 with SRT. Median age was 60 years. Treatment was delivered by a linear accelerator. Median single dose was 13 Gy (SRS) or 54 Gy (SRT). Patients were followed up ? 12 months after SRS/SRT. LC and toxicity were evaluated by clinical examinations and magnetic resonance imaging. 3-D TV shrinkage was evaluated with the planning system. QoL was assessed using the questionnaire Short Form-36. Results: Median follow-up was 50/36 months (SRS/SRT). Actuarial 5-year freedom from progression/overall survival was 88.1%/100% (SRS), and 87.5%/87.2% (SRT). TV ...

UK PubMed Central (United Kingdom)

Liver biopsies in nine of 70 male alcoholics seen during a 12 month period showed predominantly portal fibrosis with fatty change, but little or no alcoholic hepatitis. None of the 30 female alcoholics...Full Text Available

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Introduction:Although radical prostatectomy (RP) is an effective treatment for prostate cancer, it has potentially deleterious effects on health-related quality of life (HRQoL)....Full Text Available

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This prospective controlled intervention study over 12 months evaluated the effect of exercise on muscular function, physical ability, and body composition in pre-pubertal boys. Sixty-eight boys aged...Full Text Available

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Abstract Toll-like receptor 2 (TLR2) is an immune sensor for gram-positive bacterial cell wall components. Single-nucleotide polymorphisms (SNPs) in the TLR2 gene that impair its function may, therefore, influence the risk and outcomes of gram-positive bacterial infections. In a cohort of 694 liver transplant recipients, we assessed the TLR2 SNP that is translated into an amino acid substitution of arginine for glutamine at position 753 (R753Q), and we found that its presence was associated with the clinical characteristics and outcomes of gram-positive bacterial infections. The proportions of patients with the TLR2 R753Q SNP did not significantly differ between those with gram-positive bacterial infections and those without gram-positive bacterial infections (9.6% versus 9.6%, P = 0.999)....

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Summary Background Pemphigus vulgaris and pemphigus foliaceus are rare, potentially life-threatening, autoimmune disorders characterized by antibodies to epidermal adhesion molecules. Clinical characteristics are painful chronic erosions of mucous membranes and of the skin. There are only few published studies on the impact of the disease on the health status (HS) of patients with these conditions. Objectives To assess the impact of disease on the HS of patients with pemphigus. Methods Fifty-eight patients enrolled at the Bullous Skin Diseases Unit of IDI-IRCCS in the period January-June 2006 were assessed for their HS using the Medical Outcomes Study 36-item short form health survey (SF-36) questionnaire and for anxiety and depression using the Institute for Personality and Ability Testin...

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Summary Background: Red blood cell (RBC) transfusion in hemorrhagic shock is life saving. However, several clinical trials have shown that blood transfusion in the critically ill patient might be associated with adverse outcomes. Furthermore, an association between prolonged blood storage and adverse effects of RBC transfusion has been postulated. The aim of this study is to examine the effect of blood storage time on resuscitation outcome, in an animal model of hemorrhagic shock. Methods: 20 Wistar rats were phlebotomized in order to induce reversible hemorrhagic shock. Half of them were resuscitated with blood stored for a short period of time (4 days), and the other ones were resuscitated with blood stored for a prolonged time (14 days). Blood samples for hemoglobin, pH, lactate, bicarb...

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BACKGROUND: Controversy exists as to whether patients with thick (Breslow depth >4 mm), clinically lymph node-negative melanoma require sentinel lymph node (SLN) biopsy. The authors examined the impact of SLN biopsy on prognosis and outcome in this patient population. METHODS: A review of the authors institutional review board-approved melanoma database identified 293 patients with T4 melanoma who underwent surgical excision between 1998 and 2007. Patient demographics, histologic features, and outcome were recorded and analyzed. RESULTS: Of 227 T4 patients who had an SLN biopsy, 107 (47%) were positive. The strongest predictors of a positive SLN included angiolymphatic invasion, satellitosis, or ulceration of the primary tumor. Patients with a T4 melanoma and a negative SLN had a significa...

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Correct ortopedic therapy for traumas of the cervical rachis requires perfect knowledge of the spatial balance of the fracture focus. The authors belive Computed Tomography (CT) to be the most suitable, and often indispensable, method for this purpose. Twenty-four patients were examined for traumatic pathology of the cervical rachis. In 7 cases with clinically minor traumas, the negative outcome of the traditional traumas, the negative outcome of the traditional exam was considered reliable and sufficient for therapeutic purposes. The extant 17 patients were examined also by means of CT, either to better dermine the characteristics of skeletal lesions already ascertained with traditional techniques or to asses the presence of clinically-suspected osteo-articular lesions, even with negative conventional X-rays. For 9 of these patients orthopedic treatment was considered sufficient, whereas 8 patients ...

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Abstract Gaseous microemboli (GME) remain a challenge for cardiopulmonary bypass (CPB) because there is a positive correlation between microemboli exposure during CPB and postoperative neurological injury. Thus, minimizing the number of GME delivered to pediatric patients undergoing CPB procedures would lead to better clinical outcomes. In this study, we used a simulated CPB model to evaluate the effectiveness of capturing GME and the degree of membrane pressure drop for a new membrane oxygenator, Capiox Baby FX05 (Terumo Corporation, Tokyo, Japan), which has an integrated arterial filter with open and closed purge line. We used identical components in this study as our clinical CPB circuit. Three emboli detection and classification quantifier transducers were placed at prepump, preoxygena...

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Summary Background:- Cholinesterase inhibitors form the mainstay of treatment for persons with mild-to-moderate Alzheimer-s disease (AD). The rivastigmine patch may increase compliance and the proportion of patients maintaining an efficacious dose compared with oral cholinesterase inhibitors. Objective:- To investigate the proportion of patients who reached and maintained the target rivastigmine patch dose compared with the target rivastigmine capsule dose reported in clinical trials. Methods:- This was a multicentre, 24-week, open-label study in persons with probable AD and a Mini-Mental State Examination (MMSE) score of --10 and --26. The primary outcome was the proportion of patients (ITT population) treated with 9.5-mg/24-h rivastigmine patch for at least 8-weeks at week 24. Secondary ...

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It is reported on examination-technical possibilities with craniocerebral Computer Tomography in the peri- and postnatal period. Some typical tomographic images from a 17 1/2 months period in our own patient material of 327 children are demonstrated. The special advantages of this new technical-extensive method are: exact diagnoses, observation possibility of the longitudinal section, and the absolute harmlessness to the child.

UK PubMed Central (United Kingdom)

SummaryWe consider the problem of estimating the effect of exposure on multiple continuous outcomes, when the outcomes are measured on different scales and are nested within multiple...Full Text Available

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The purpose of this study was to assess experimentally and clinically the usefulness of Fuji Computed Radiography (FCR) in angiographic examinations. FCR had a spatial resolution with much lower X-ray exposure doses, although the resolution of FCR was generally inferior to conventional films. When a contrast medium of 1% iodine concentration was used, FCR pinpointed a mass 1.5 mm in diameter; and conventional film could detect a mass 2.2 mm in diameter. The contrast of iodine in FCR examinations was stable. A high sensitivity of imaging plate allowed a wide range of visualization. In 148 selective angiographic examinatinons for 138 patients, FCR-subtraction images were superior to conventional film angiography for contrast resolution; it had a high sensitivity in detecting areas, such as the mediastimun and left lobe of the liver, and tumor stains in capillary phase. The capability of FCR arteriogram was as good as film arteriogram even with a half concentration of ...

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Serious complications due to coronary artery fistulae have been described. Most authors recommend early intervention at the time of diagnosis. We present a case of a fistula originating from a dilated left coronary artery and draining into the right atrium, which was diagnosed prenatally by color Doppler echocardiography. During pregnancy, the echocardiographic findings remained unchanged, and there were no signs of heart failure. After birth, the fistula was confirmed by angiography. Additionally, a persistent left superior vena cava draining into the coronary sinus and a very small ventricular septal defect were detected. The fistula was closed successfully by transcatheter coil embolization. At 17 months old the child was in good clinical condition. Prenatal diagnosis of coronary artery fistulae may be possible and may improve perinatal management and outcome. PMID:12047543

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Objectives Vietnamese patients? views on healthcare are changing as surgical interventions become more commonplace, but their views on perioperative care have remained largely unstudied during this period of rapid change. This study assesses Vietnamese patients? impression of anesthesia safety and postoperative pain in relation to clinical outcomes with the aim of improving patient-centered perioperative care. Methods The study cohort consisted of 180 hospitalized patients who were followed for 24?h following abdominal surgery. The assessments of these patients on the use of anesthesia and postoperative pain were measured by means of a 5-point Likert scale survey. Perioperative events were recorded on standardized forms by medical staff. The relationship between relevant factors affecting ...

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High-level expression of mitotic arrest defective protein 2 (MAD2), a central component of the spindle assembly checkpoint, has been observed in a variety of human malignancies. Aim of the present study was to observe the expression of MAD2 in human non-small-cell lung cancer (NSCLC) and explore its clinicopathologic significance and evaluate MAD2 expression as a prognostic marker. MAD2 transcript was found to be overexpressed in the great majority of lung cancers by semi-quantitative RT-PCR. A total of 358 NSCLCs were analyzed immunohistochemically on tissue microarrays. High-level MAD2 expression was observed in 26.3% (94 of 358 cases), and correlated with male sex (P=0.0002), tumor progression (pT status) (P=0.0009), visceral or parietal pleural invasion (P=0.0151), non-adenocarcinoma, ...

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Purpose Elective laparoscopic sigmoid resection (LSR) for symptomatic diverticular disease is supposed to have significant short-term advantages compared to open surgery (open sigmoid resection (OSR)). This opinion is rather based on inferences from trials on colonic resections for malignant diseases or minor laparoscopic surgery. This randomized controlled trial was conducted to compare quality of life as well as morbidity and clinical outcome after LSR vs. OSR following a midterm follow-up period. Methods Patients presenting with a symptomatic sigmoid diverticular disease stage II/III (Stock/Hansen) were randomly allocated to LSR or OSR in a prospective multicenter trial. Endpoints included the quality of life assessed with a standardized questionnaire, postoperative mortality, and compl...

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Objective:- To review the rate of inadvertent cystotomy during laparoscopic hysterectomy performed by the Sydney West Advanced Pelvic Surgery Unit (SWAPS). To compare this rate with other published data. To identify the risk factors for bladder injury at laparoscopic hysterectomy and to review the management and outcome following such injury. Method:- This was a retrospective observational study. All hysterectomies where the SWAPS clinical fellow was involved were included. The study period was from January 2001 to June 2009. Simple statistical formulae were used to analyse data in this study. Results:- There were 1223 hysterectomies performed during this period. Eighty-one percent of these were performed laparoscopically. There were 14 (1.1%) bladder injuries reported during this period. ...

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ABSTRACT Introduction. Significant progress has been made in the understanding of physiological and pharmacological mechanisms of human sexual functioning through preclinical research in animal models. Aim. To provide an evidence-based documentation of the experimental models evaluating male and female sexual function for useful clinical translation. Methods. Consensus discussion over the past 18 months leading to summarized views of seven experts from six countries. Main Outcome Measure. Report was based on the critical analysis of scientific information available in literature and subcommittee presentations, discussions, and exchanges of ideas and feedback. Results. Fundamental research in animal models has led to considerable understanding of the physiological mechanisms underlying desi...

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There are no specific diagnostic tests or a gold standard method for measuring disease activity and outcome in spondyloarthropathies (SpA). Many different methods have been developed to assess the signs and symptoms in SpA. The aim of this study was to evaluate the value of scintigraphy, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and Bath Ankilosing Spondylitis Disease Activity Index (BASDAI) in the evaluation of disease activity in early axial SpA diagnosed with magnetic resonance imaging (MRI). Thirty early MRI-positive axial SpA patients (23 males, 7 females) with a median age of 35 (18?55) years and a median duration of inflammatory low back pain of 24 (8?60) months were included in the study. In the patients with sacroiliitis, the sensitivity, specificity, and pos...

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Abstract Aims To determine, in the context of a trial in which counseling did not improve smoking cessation outcomes, whether this was due to a failure of the conceptual theory identifying treatment targets or the action theory specifying interventions. Design Data from a randomized clinical trial of smoking cessation counseling and bupropion SR were submitted to multi level modeling to test whether counseling influenced real time reports of cognitions, emotions and behaviors, and whether these targets predicted abstinence. Setting Center for Tobacco Research and Intervention, Madison, WI. Participants A total of 403 adult, daily smokers without contraindications to bupropion SR use. Participants were assigned randomly to receive individual counseling or no counseling and a 9 week course o...

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The commercially packed samples of raisins, dried figs and dried apricots were irradiated using doses in the range of 0.5-1.0 kGy for disinfestation and 0.5-5.0 kGy for sensory analysis with the dose rate ranging from 1.44 to 1.92 kGy/h. Pests on dried fruits were evaluated after 0, 1, 2 and 3 months of storage for irradiated dried figs and 1, 3, 6 and 12 months of storage for raisins and dried apricots. Sensory analysis of dried figs, dried apricots and raisins were carried out after 0, 1, 3, 6 and 12 months of storage. The results indicated that radiation processing at low doses (#approx#1.0 kGy) is an effective post-harvest treatment and quarantine control for these products with no adverse effects on sensory (marketing) attributes.

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As the HIV/AIDS epidemic and the spread of sexually transmitted infections (STIs) in China has come to the forefront of public health attention, female sex workers (FSWs) and their clients (CFSWs) are becoming increasingly important to HIV/STI prevention efforts. This secondary analysis uses data abstracted from the Chinese Health and Family Life Survey 1999-2000 to report prevalence rates of two STIs as well as sexual risk behaviors for CFSWs - men who paid for sex with FSWs in the past 12 months - in comparison with men who had not patronized FSWs. Among 1879 Chinese CFSWs who completed anonymous interviews and urine testing, 152 (6.3%, weighted) said they had paid for sex in the past 12 months and 18.8% of CFSWs (weighted) tested positive for gonorrhea. CFSWs were 10 times more likely t...

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Faced with a changing business emphasis, plus the need to reduce operations and maintenance costs in the North Sea, the Forties Field engineering partnership between BP and Brown and Root recognised the need to make radical changes in its organisational structure. An innovative change management programme was planned and executed inside 12 months with the purpose of right-sizing the Forties Operations Engineering team. Not only has the initiative succeeded in cutting costs by 40 per cent; it has also enhanced the quality of engineering support services supplied to the BP Forties platforms. (author)

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Two patients with femoral neck fractures, one displaced and one undisplaced, are presented. Preoperative intravital staining with tetracycline and Tc-MDP scintimetry both showed intact femoral head circulation while Tc-MDP-scintimetry 1 week after operation showed pronounced circulatory deficiency. SR"8"5-scintimetry performed at the same time was inconclusive. Segmental collapse was observed radiographically, 8 and 12 months postoperatively. The major vascular injury resulting in avascularity most probably occured during the procedure of osteosynthesis, and Tc-MDP-scintimetry was found suitable for early postoperative recognition of avascular necrosis in both fractures. (author).

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To determine the effectiveness and patency of percutaneous intervention in insufficient native arteriovenous hemodialysis fistulae (AVFs). Between March 1997 and September 2001, 67 cases of insufficient native AVFs resulted from central vein lesion, PTA was performed in 48 cases, and thrombolytic therapy with or without PTA in 11. In eight of the cases, in which central vein stenosis had led to the insufficency, percutaneous transluminal angioplasty (PTA) was performed, and in three of the eight, a stent was inserted. Angiography findings and complications, as well as success and patency rates in the non-thrombosis and thrombosis group, were evaluated; the central vein lesion group was analysed separately. Among 84 lesions observed at angiography, three were 54 cases of stenosis, 17 of occlusion, and 13 of combined thrombosis. The lesions were located in a proximal vein (n=51), distal vein (n=14), artery (n=6), and at the site of anastomosis (n=13). In the central vein lesion group ...

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The implementation of a three-dimensional conformal radiotherapy facility in the radiotherapy department of the Heinrich Heine University is described. Complex radiotherapy techniques with commercially available networked systems are introduced to improve clinical work. Over 18 month we have gained clinical experience with a PHILIPS Multileaf Collimator (MLC) mounted on a SL 25 linear accelerator. For a limited period the MLC was used as a conventional blocking device. The standard MLC-shapes are controlled with a stand-alone computer system. In addition, a three-dimensional treatment planning system (3-D-TPS / TMS-Radix, Helax AB) based on convolution/superposition algorithms was recently installed. Treatment optimization is achieved using static field arrangements with complete volumetric computerized tomographic patient data for 3-D-TPS. Conformal adaptation of the 95%-isodose to the Planning Target Volume (PTV, ICRU 50) results in ...

UK PubMed Central (United Kingdom)

SUMMARYIncreasingly multiple outcomes are collected in order to characterize treatment effectiveness or to evaluate the impact of large policy initiatives. Often the multiple...Full Text Available

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The aim of this study was to compare the results of different treatment strategies for osteochondral defects (OCD) of the talus. Electronic databases from 1966 to June 2000 were systematically screened. Thirty-nine studies fulfilled our inclusion criteria. No randomized clinical trials could be identified. The results of nonoperative treatment were described in 14 studies, of excision alone in 4, of excision and curettage in 10, of excision, curettage and drilling in 21, of cancellous bone grafting in 2, of fixation in 3, and of osteochondral transplantation in 1. Good or excellent results were found in 45% of the cases. Comparison of different surgical procedures showed that excision, curettage and drilling resulted in the highest mean success rate (86%), followed by excision and curettage (76%) and excision alone (38%). From the results of this systematic review we conclude that nonoperative treatment and excision alone are not to be recommended for treatment of ...

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The solid-pseudopapillary tumor (SPT) of the pancreas is a rare type of exocrine pancreatic neoplasm. SPT predominantly affects young women and female children, and is usually discovered incidentally. This tumor is generally benign with a low incidence of malignancy. A 13-year-old girl was admitted to the hospital with a few weeks' history of mild abdominal pain and jaundice. On physical examination, there was no palpable mass. The laboratory tests showed increased SR, CRP, high bilirubin, amylase and lipase serum levels. Ultrasound imaging revealed a solid lesion in the region of the pancreatic head. On MRI, precise tumor localization in the head of the pancreas with pancreatic duct dilatation and compression of the common bile duct were visualized. Pancreaticoduodenectomy and cholecystectomy was performed with good clinical outcome. Microscopic and immunohistochemical studies indicated that tumor cells were typical of SPT without any signs of ...

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In consistency with the increasing requests from Member States for establishing radiotherapy programmes, an IAEA Technical Co-operation project was initiated in Latin America aimed at improving the physical aspects (as a complement to the clinical issues) of quality assurance in radiotherapy; this ARCAL XXX project (RLA/6/032) was classified as a Model Project of the IAEA. Among the important outcomes of the project were (i) the training of a considerable number of medical physicists in hospitals of the region, (ii) the development of a protocol for quality control procedures, and (iii) the organization of quality audit site visits (to the participant countries) where the implementation in hospitals of the developed quality control procedures is verified. The present publication is the protocol for quality control of the physical aspects of radiotherapy. It contains detailed procedures on what should be measured by a medical physicist in a ...

Science.gov (United States)

This study was performed to assess the possibility that patient age may independently affect improvements in health-related quality of life following percutaneous coronary intervention. One hundred five patients undergoing elective percutaneous coronary intervention at a single tertiary referral center between January 10, 2001 and January 6, 2002 were enrolled and prospectively evaluated. Health-related quality of life was assessed before and 1 year following percutaneous coronary intervention using Short Form-12 and the Seattle Angina Questionnaire. For the purpose of analysis, patients were divided according to age (younger than 60, 60-70, and older than 70 years). One hundred patients (95%) completed both questionnaires. Baseline characteristics among the age groups were similar in terms of gender, cardiac risk factors, and procedural details. All health-related quality-of-life indices demonstrated improvements with at least four variables in each group achieving a ...

Science.gov (United States)

In 2000, the Accreditation Council of Graduate Medical Education (ACGME) laid out a definition of competence that included six specific areas of focus: patient care (including clinical reasoning), medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice. The ACGME's intention was to mandate increasingly reliable and valid assessment measures to be used by all training programs over the next decade, with the goal of providing "more credible, accurate, reliable and useful educational outcome data." In this article, the authors will review definitions of competency according to the new ACGME standards and examine the assessment tools currently available, including global evaluations, 360-degree evaluations, checklists, standardized examinations and direct observations. The authors will provide an overview of critical considerations in different assessment ...

International Nuclear Information System (INIS)

Purpose: To evaluate the outcome of repeat stereotactic radiosurgery (SRS) for acoustic neuromas, we assessed tumor control, clinical outcomes, and the risk of adverse radiation effects in patients whose tumors progressed after initial management. Methods and Materials: During a 21-year experience at our center, 1,352 patients underwent SRS as management for their acoustic neuromas. We retrospectively identified 6 patients who underwent SRS twice for the same tumor. The median patient age was 47 years (range, 35-71 years). All patients had imaging evidence of tumor progression despite initial SRS. One patient also had incomplete surgical resection after initial SRS. All patients were deaf at the time of the second SRS. The median radiosurgery target volume at the time of the initial SRS was 0.5 cc and was 2.1 cc at the time of the second SRS. The median margin dose at the time of the initial SRS was 13 Gy and was 11 Gy at ...

Science.gov (United States)

A large proportion of patients may develop chronic pain following cancer treatments such as surgery, radiotherapy, or chemotherapy. These patients can experience significant levels of physical and psychological morbidity. Our aim was to investigate a cognitive-behavioral pain management program (PMP) for cancer patients with chronic treatment-related pain. Thirteen patients (1 man, 12 women; mean age 52 yrs) completed the study, 9 of whom had a history of breast cancer and had received extensive medical treatment, including surgery. A combination of physical and psychological techniques were adapted from previous work in chronic benign pain and implemented by two therapists. Interventions included education, relaxation, exercise training, and goal setting. A variety of outcomes were examined to assess general fitness, psychological distress, coping success, activities of daily living, and pain report. The median number of interventions by each therapist was 10 (4 ...

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PMID:21305303

KoreaScience (Korea)

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This case report presents a case that underwent orthognathic treatment with anterior segmental osteotomies on both jaws. The patient was a 26-year-old female with maxillary protrusion, lip incompetence with an everted vermilion border. The overbite was +1.0mm, overjet +1.0mm. The pre-surgical orthodontic treatment included the extraction of the four first premolars and a multi-bracket treatment was started. After 12 months of pre-surgical orthodontic treatment, both the anterior maxillary and the anterior mandibular segments were retracted surgically by 5.5mm. The total treatment period was 18 months. An anterior segmental osteotomy can induce the remarkable structural changes for bimaxillary lip protrusion patients.

International Nuclear Information System (INIS)

The performance of a convolution/superposition based treatment planning system depends on the ability of the dose calculation algorithm to accurately account for physical interactions taking place in the tissue, key components of the linac head and on the accuracy of the photon beam model. Generally the user has little or no control over the performance of the dose calculation algorithm but is responsible for the accuracy of the beam model within the constraints imposed by the system. This study explores the dosimetric impact of limitations in photon beam modeling accuracy on complex 3D clinical treatment plans. A total of 70 photon beam models was created in the Pinnacle(TM) treatment planning system. Two of the models served as references for 6 MV and 15 MV beams, while the rest were created by perturbing the reference models in order to produce specific deviations in specific regions of the calculated dose profiles (central axis and transverse). The beam models ...

DEFF Research Database (Denmark)

PURPOSE OF REVIEW: To review the recent literature on the prognostic value of biomarkers of liver fibrosis and impaired liver function in patients with chronic hepatitis C with or without HIV coinfection. RECENT FINDINGS: A combination of standard blood tests seems to be useful in identifying patients at risk of liver-related complications. Findings from studies investigating the validity of the Model for End-Stage Liver Disease (MELD) score in HIV-infected liver transplant candidates are conflicting. Two large studies of HIV/hepatitis C virus (HCV) coinfected patients have shown that plasma levels of the fibrosis marker hyaluronic acid are a strong predictor of clinical complications. A smaller study found hyaluronic acid and two other fibrosis tests, aspartate aminotransferase-to-platelet ratio index (APRI) and Fib-4, to be independent predictors of mortality when included in models with the MELD or the Child-Pugh-Turcotte scores. SUMMARY: Although the data are ...

Energy Technology Data Exchange (ETDEWEB)

To evaluate the efficacy of percutaneous transluminal angioplasty (PTA) and stent insertion in central venous steno-occlusion. Between August 1992 and January 1998, 11 patients with symptomatic central venous steno-occlusion (six stenoses and five occlusions) underwent pereutaneous treatment. Eleven PTAs were performed and stents were introduced in two patients because of incomplete PTA. During follow-up, a total of eight revisions were performed in five patients with recurrence (six stenoses and two occlusions). Success and long term patency rates were evaluated. The length and degree of the lesion and degree of residual stenosis, as well as pressure gradient through the lesion and decrease of the gradient after PTA, were correlated with patency rates. Complications during the procedures and follow-up period were evaluated. The overall success rate was 89.5%;those of primary and revision intervention were 90. 9% and 87.5%, respectively. Primary and revision patency rates were 72.7% ...

UK PubMed Central (United Kingdom)

BackgroundWe aimed to compare visual and refractive outcome following phacoemulsification and intraocular lens implant (IOL) and combined one-site phacotrabeculectomy.MethodWe...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundThe link between maternal factors and birth outcomes is well established. Substantial changes in society and medical care over time have influenced women's reproductive...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundThe optimal treatment for locally recurrent rectal cancer (LRRC) is still a matter of debate. This study assessed the outcome of LRRC patients treated with multimodality...Full Text Available

UK PubMed Central (United Kingdom)

ObjectiveTo report the outcome of children with life-threatening asthma (LTA) admitted to a university Pediatric Intensive Care Unit (PICU).MethodsRetrospective...Full Text Available

UK PubMed Central (United Kingdom)

Study Objectives:To evaluate the value of mouth opening during sleep for predicting surgical outcomes after uvulopalatopharyngoplasty (UPPP).Methods:Retrospectively,...Full Text Available

UK PubMed Central (United Kingdom)

OBJECTIVE: The management and outcome of 138 abdominal shotgun wounds were examined over a 5-year period. SUMMARY BACKGROUND DATA: It has been proposed that exploratory laparotomy may be unnecessary...Full Text Available

UK PubMed Central (United Kingdom)

Although research demonstrates many negative family outcomes associated with single-parent households, little is known about processes that lead to positive outcomes for these families. Using...Full Text Available

UK PubMed Central (United Kingdom)

Much public health research has been directed to studies of cancer risks due to chemical agents. Recently, increasing attention has been given to adverse reproductive outcomes as another, shorter-term...Full Text Available

UK PubMed Central (United Kingdom)

Pneumatic dilation (PD) is an effective treatment for achalasia cardia. Outcome of PD, however, varies among different studies. Recently, some groups started considering laparoscopic myotomy to be competitive...Full Text Available

Science.gov (United States)

... commands may be input from a terminal or they ... up the outcomes of the stochastic parameters corre- ... queue of subproblems to be solved, the first ...

Science.gov (United States)

Carotid Artery Disease; Stroke; Amaurosis Fugax; Transient Ischemic Attack (TIA)

KoreaScience (Korea)

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KoreaScience (Korea)

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UK PubMed Central (United Kingdom)

Objective: The paper describes and evaluates the use of Clinical Digital Libraries Project (CDLP) digital library collections in terms of their facilitation of timely clinical information...Full Text Available

Science.gov (United States)

ICU telemedicine uses audiovisual conferencing technology to provide critical care from a remote location. Research is needed to best define the optimal use of ICU telemedicine, but efforts are hindered by methodological challenges and the lack of an organized delivery approach. We convened an interdisciplinary working group to develop a research agenda in ICU telemedicine, addressing both methodological and knowledge gaps in the field. To best inform clinical decision-making and health policy, future research should be organized around a conceptual framework that enables consistent descriptions of both the study setting and the telemedicine intervention. The framework should include standardized methods for assessing the preimplementation ICU environment and describing the telemedicine program. This framework will facilitate comparisons across studies and improve generalizability by permitting context-specific interpretation. Research based on this framework ...

International Nuclear Information System (INIS)

Brachytherapy refers to short distance treatment of cancer with radiation from small, encapsulated radionuclide sources. This type of treatment is given by placing sources directly into or near the volume to be treated. The dose is then delivered continuously, either over a short period of time (temporary implants) or over the lifetime of the source to a complete decay (permanent implants). This technique is extensively used in the treatments of gynecological, breast, prostate, head and neck, and other soft tissue cancers. The clinical outcomes of this treatment depend on accurate dosimetry and dose delivery. The patient is generally considered to be water equivalent. So the treatment planning system software generally is based on measured or calculated dose distributions in homogenous water medium. In real situation, the treatment volume is not homogenous water medium, but it is a heterogeneous medium consisting of bone, soft tissue, lung, air ...

Science.gov (United States)

Autoreactive cytotoxic CD8 T-cells (CTLs) play a key pathogenic role in the destruction of insulin-producing beta-cells resulting in type 1 diabetes. However, knowledge regarding their targets is limited, restricting the ability to monitor the course of the disease and immune interventions. In a multi-step discovery process to identify novel CTL epitopes in human preproinsulin (PPI), PPI was digested with purified human proteasomes, and resulting COOH-fragments aligned with algorithm-predicted HLA-binding peptides to yield nine potential HLA-A1, -A2, -A3 or -B7-restricted candidates. An UV-exchange method allowed the generation of a repertoire of multimers including low-affinity HLA-binding peptides. These were labeled with quantum dot-fluorochromes and encoded in a combinatorial fashion, allowing parallel and sensitive detection of specific, low-avidity T-cells. Significantly increased frequencies of T-cells against four novel PPI epitopes (PPI(4-13)/B7, PPI(29-38)/A2, PPI(76-84)/A3 ...

Science.gov (United States)

Haemangiomas usually develop within the first few weeks of life, most regressing spontaneously before the age of 7 years. Some may ulcerate or compromise a vital function, in which case systemic corticosteroids, surgery or radiotherapy may be helpful. All of these treatment modalities are associated with significant morbidity. Treatment with the 585 nm flashlamp pulsed dye laser is safe and effective in the management of superficial vascular malformations. We report seven patients, under 12 months of age, who presented with proliferative haemangiomas, causing functional impairment. Ulcerated lesions were present in four patients. The patients were treated with the 585 nm pulsed dye laser (fluences 7.0-9.25 J/cm2), at intervals of 4-8 weeks. All of the lesions showed a significant reduction in size, together with improvement in the colour and integrity of the overlying skin. Treatment with the 585 nm pulsed dye laser should be considered in the ...

Science.gov (United States)

The largest solar heating and cooling system undertaken to date is now operating at the George A. Towns Elementary School in Atlanta, Georgia. It is expected to provide more than 60 percent of the building's heating and cooling requirements, using commercially available components and techniques. The Towns project is a United States Energy Research and Development Administration-sponsored experiment. The principal components of the solar heating and cooling system designed for the school--the solar collector array, the existing gas-fired boiler, the absorption chiller, and hot and cold water underground tanks to provide thermal storage--are described. To derive maximum benefit from the experiment, the system is fully instrumented for accurate measurement of performance. Environmental data, including insolation and ambient temperture, humidity, and wind conditions will be recorded. The inlet temperatures, outlet temperatures, and the mass flow rates to the collectors, storage ...

International Nuclear Information System (INIS)

Spices and packaging materials were exposed to gamma irradiation at a dose of 10 KGy. Luncheon was prepared with irradiated or non-irradiated spices. Prepared luncheon was packaged in irradiated or non-irradiated packaging materials. Packaged luncheon was treated with 2 KGy. Treated and untreated packaged luncheon were kept in a refrigerator (1-4 Centigrade) for 12 months. Microbiological, nutritive and chemical characteristics of luncheon were evaluated after processing and during storage; whereas, sensory quality was evaluated only after irradiation. Gamma irradiation decreased the microorganisms counts of spices, packaging materials and packed luncheon and increased the shelf-life of packaged luncheon products. No major differences in moisture, protein, fat, ph value, total acidity, lipid peroxide and volatile basic nitrogen were observed due to irradiation. Sensory evaluation showed that all the combination treated luncheon were acceptable ...

Energy Technology Data Exchange (ETDEWEB)

Radon concentrations in homes have been shown to vary considerably with season. It is important to account for this by applying a correction factor to any home radon measurement of less than one year. To date, Irish radon measurement services have used correction factors based on data derived for the UK in the 1980s. In the absence of similar data for Ireland at the time, these were considered suitable for use due to the similarities between the climates, house types and lifestyles in the two countries. In order to better estimate the long-term radon concentration, measurements from 5640 Irish homes were used to derive a set of correction factors specifically for Ireland. These were generated by means of Fourier decomposition analysis and the new correction factors compared, using 95% confidence intervals, to those derived for the UK using the same analysis and to those currently in use for Ireland. In both cases, a significant difference was found between 10 of the ...

Energy Technology Data Exchange (ETDEWEB)

To evaluate the effectiveness of percutaneous transluminal angioplasty(PTA) and to determine the factors affecting the long-term patency rate in the management of insufficient hemodialytic arteriovenous fistula(AVF). Forty-nine cases of insufficient hemodialytic AVF were treated in 44 patients(native AVF:20, graft AVF:29, M:17, F:27, Age:22-70 years). In 28 thrombus patients, thrombolysis was performed with urokinase, and was followed by PTA. The initial success rate and complications of PTA were evaluated. According to the site and length of the stenosis, type and age of the AVF, the presence or abscence of thrombus, a history of diabetic mellitus, the patient's age, and the duration of renal failure, patency rates were compared within each subgroup using the Kaplan-Meier logrank test. The initial success rate of PTA for insufficient hemodialytic AVF was 88%(43/49), the patency rate of PTA was 67% at 6 months, and 50% at 12 months. ...

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The corrosion resistance of steel-reinforced mortar specimens made from alinite cement was investigated using ordinary Portland cement (OPC) specimens as reference. The specimens were prepared and exposed in three different environments: continuous exposure in tap water, interrupted exposure in tap water, and interrupted exposure in 3.5% NaCl solution. The steel weight loss and the half cell potential were measured vs. exposure time, up to the age of 12 months. Pore solution extraction and analysis and porosity determination were also performed. In continuous exposure in tap water, alinite cement provided adequate protection against corrosion. In interrupted exposure in tap water, a higher corrosion was observed for alinite cement compared to OPC. In the case of interrupted exposure in 3.5% NaCl solution, the simultaneous action of free chlorides and oxygen resulted in the depassivation of steel reinforcing bars in alinite and Portland cement ...

UK PubMed Central (United Kingdom)

AbstractObjective: This study examined the effectiveness of a telephone-based referral-care management (TBR-CM) intervention on psychiatric health...Full Text Available

UK PubMed Central (United Kingdom)

Increasing evidence suggests that sex differences exist in the etiology, presentation, treatment, and outcome from stroke. The reasons for these sex disparities are becoming increasingly explored, but...Full Text Available

UK PubMed Central (United Kingdom)

The visual outcome, histopathology, and electrodiagnostic tests of a man with a malignant melanoma of the choroid who received foveal argon laser photocoagulation prior to enucleatiion are described....Full Text Available

UK PubMed Central (United Kingdom)

Male reproductive proteins (MRPs), associated with sperm and semen, are the moieties responsible for carrying male genes into the next generation. Evolutionary biologists have focused on their...Full Text Available

British Library Electronic Table of Contents (United Kingdom)

Outcome from trauma, surgery, and a variety of other medical conditions has been shown to be positively affected by providing treatment at facilities experiencing a high volume of patients with those conditions. An electronic literature search was made to identify English-language articles available through March 2011, addressing the effect of patient treatment volume on outcome for patients with subarachnoid hemorrhage. Limited data were identified, with 16 citations included in the current review. Over 60% of hospitals fall into the lowest case-volume quartile. Outcome is influenced by patient volume, with better outcome occurring in high-volume centers treating >60 cases per year. Patients treated at low-volume hospitals are less likely to experience definitive treatment. Furthermore, t...

British Library Electronic Table of Contents (United Kingdom)

PurposeAlthough the safety and feasibility of partial adrenalectomy in patients with von Hippel-Lindau syndrome have been established, long-term outcomes have not been examined. In this study we evaluate the recurrence and functional outcomes in a von Hippel-Lindau syndrome cohort treated for pheochromocytoma with partial adrenalectomy with a followup of at least 5 years. Materials and MethodsWe reviewed the records of patients with von Hippel-Lindau syndrome treated with partial adrenalectomy for pheochromocytoma at the National Cancer Institute. Demographic, germline mutation status, surgical indication, oncologic and functional outcome data were collected. Local recurrence was defined as radiographic evidence of recurrent tumor on the ipsilateral side of partial adrenalectomy. Patients ...

CSIR Research Space (South Africa)

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UK PubMed Central (United Kingdom)

AimDetermine if periodontitis progression during pregnancy is associated with adverse birth outcomes.Materials...Full Text Available

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Minimally invasive treatment for small renal cell carcinoma (RCC) can be necessary in selected patients and, anyway, is desirable. In situ ablation techniques, including RFA, have been developed. The aim of this study is to evaluate the feasibility, safety and short-term local effectiveness of percutaneous US-guided RFA in a small series, as well as mid-term patient outcome. Thirteen patients with a total of 18 tumors (17 small lesions, 35 mm in size or less, and a larger one, 75 mm in size) underwent 19 RFA sessions. Seven patients had a solitary kidney, and three suffered from VHL disease, too. We treated four lesions in a patient with a bilateral tumor. In another patient, three lesions were ablated. Seventeen tumors were RCC; one was a metastasis from lung cancer. Eight lesions were parenchymal, six exophytic, two parenchymal/exophytic, one parenchymal/central and one central. A monopolar RF system with multitined expandable electrode needles was used. The ...

UK PubMed Central (United Kingdom)

The likelihood that past experience will produce correct guides to current practice depends on the signal-to-noise ratio for the clinical problem of interest. If the signal-to-noise ratio is high, the...Full Text Available

UK PubMed Central (United Kingdom)

In 2008, a clinical information tool was developed and embedded in the electronic health record system of an academic medical center. In 2009, the initial information tool, Clinical-e, was superseded...Full Text Available

UK PubMed Central (United Kingdom)

The clinical signs and postmortem findings in sheep from two flocks accidentally poisoned with monensin are described. Clinical signs began within 24 hours of exposure to monensin. In the acute stages...Full Text Available

UK PubMed Central (United Kingdom)

A questionnaire on the development of specialist clinics was distributed to the members of the Association of British Neurologists and completed by 104 members (85 consultants). Half of the respondents...Full Text Available

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A tunable diode laser is used to obtain infrared spectra of carbon dioxide in biological materials. The spectral resolution is sufficient to readily distinguish differing isotopic species. The technique may prove useful in clinical tests.

UK PubMed Central (United Kingdom)

In 2005, the American Medical Informatics Association undertook a set of activities relating to clinical decision support (CDS), with support from the office of the national coordinator and the Agency...Full Text Available

UK PubMed Central (United Kingdom)

There is ample historical verification of 46,XX congenital adrenal hyperplasia (CAH) patients being born with essentially male genitaliawhile outcome information is scant. Prior to glucocorticoid...Full Text Available

UK PubMed Central (United Kingdom)

Purpose:To study the outcome of in-the-bag implanted square-edge polymethyl methacrylate (PMMA) intraocular lenses (IOL) with and without primary posterior capsulotomy in...Full Text Available

Science.gov (United States)

PMID:20681969

Science.gov (United States)

PMID:21732206

Wastenet

for municipal waste iron ore sinter plants incinerators for clinical waste facilities of the non-ferrous metal

KoreaScience (Korea)

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Science.gov (United States)

Ceramic and Dental Enamel Wear

Science.gov (United States)

... The effectiveness of immune suppression with both 6-mercaptopurine and methotrexate was insufficient to permit induction of a clinically useful ...

Science.gov (United States)

Most common bacterial species causing peritonitis in the course of peritoneal dialysis (PDP) are coagulase-negative staphylococci, Staphylococcus aureus and streptococci. Haemophilus influenzae is rarely associated with PDP. Hereby we present the first known case of APD-associated peritonitis caused by non-type able H. influenzae (NTHi) presenting the beta-lactamase negative, ampicillin-resistant (BLNAR) phenotype. An 18 year old boy who had been treated with the APD for 12 months due to SLE was admitted in good general condition with diagnosis of PDP. Standard diagnostic and therapeutical procedures were initiated. Dialysis fluid was turbid with cytosis of 435 WBC/ml. From dialysis fluid pure culture of Gram-negative coccobacillus was isolated. The isolate was identified as a BLNAR phenotype. The same bacterium was isolated from nasal swab. Blood cultures were negative. After evaluation of antimicrobial susceptibility the treatment was changed ...

Energy Technology Data Exchange (ETDEWEB)

The Two-Column Aerosol Project (TCAP) field campaign will provide a detailed set of observations with which to (1) perform radiative and cloud condensation nuclei (CCN) closure studies, (2) evaluate a new retrieval algorithm for aerosol optical depth (AOD) in the presence of clouds using passive remote sensing, (3) extend a previously developed technique to investigate aerosol indirect effects, and (4) evaluate the performance of a detailed regional-scale model and a more parameterized global-scale model in simulating particle activation and AOD associated with the aging of anthropogenic aerosols. To meet these science objectives, the Atmospheric Radiation Measurement (ARM) Climate Research Facility will deploy the ARM Mobile Facility (AMF) and the Mobile Aerosol Observing System (MAOS) on Cape Cod, Massachusetts, for a 12-month period starting in the summer of 2012 in order to quantify aerosol properties, radiation, and cloud characteristics ...

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We wanted to evaluate the procedural success after percutaneous treatment of thrombosed native arteriovenous dialysis fistula insufficiency and the efficacy of performing mechanical thrombectomy with using the stone basket. From March 2004 to June 2005, 36 thrombosed native hemodialysis access shunts in the upper limbs (brachiocephalic fistulas: 16 and radiocephalic fistulas: 20) were percutaneously treated in 30 patients. Declotting procedures were performed with using urokinase (100,00-200,000 unit) and manual catheter-directed thrombo-aspiration in all the patients. Angioplasty (6 mm in diameter and 4 cm in length) was performed at the identified area of the stenosis and /or with maceration of the thrombus. In 14 cases with massive thrombosis that was refractory to the above mentioned declotting procedures, mechanical thrombectomy with using a Wittich nitinol stone basket (Cook, Bloomington, IN) was performed. Data regarding the procedural success rate and the patency rate were ...

Energy Technology Data Exchange (ETDEWEB)

We carried out a feeding study in rats aimed at extending our aboservations of contaminant-induced immunosuppression in harbour seals. Two herring batches were freeze-dried, supplemented and fed to female adult PVG rats for a period of 4 1/2 months. Daily contaminant intakes of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) toxic equivalents (TEQ) were estimated to be 0.3 ng/kg body weight and 1.6 ng/kg in the Atlantic and Baltic groups, respectively. At the end of the feeding experiment, no contaminant-related changes in spleen CD{sub 4}{sup +}/CD{sub 8}{sup +} cellularity, natural killer cell activity, or mitogen-induced proliferative responses of thymus or spleen cells could be detected. However, total thymocyte numbers and thymus CD{sub 4}{sup +}/CD{sub 8}{sup +} ratios were reduced in the Baltic group. A novel model was established to assess the specific T-cell response to rat cytomegalovirus (RCMV). When applied to the feeding study, no differences between the Atlantic and Baltic ...

International Nuclear Information System (INIS)

Purpose: To develop, test, evaluate and implement effective state-of-the-art teacher training in didactic skills and methods. The training concept should be designed and beneficial for medical teachers' postgraduate medical education (CME). Materials and methods: A 5-day workshop with 12 theoretical and 9 'hands-on' modules was designed and stepwise improved, according to the trainees' feedback. All trainees were trained in small groups (6 to 10 participants per workshop). The workshops consisted of mini-lectures, repeated micro teaching exercises and video-supported feedback concerning the following key-competencies: Communication of goals; methods to trigger interactivity; design of slides in power point presentations; effective feedback-techniques; and use of media, time-management, skills teaching, assessment methods (e.g. OSCE and others), evaluation and general presentation skills. The evaluation was based on two components: (A) trainees' scores in two objective structured ...

International Nuclear Information System (INIS)

Cervix cancer is the most common female cancer in Korea. In spite of their relatively local invasive tendency, still 44% of patient will develop recurrent cancer This result suggests that more aggressive local treatment may increase the cure rate but increased complication risk also cannot be avoidable. Various institutions proposed different treatment regimen, but recommended dose were about 4500 cGy for whole pelvis and 8000 cGy at point A, even though they agreed that those doses may not be satisfactory for control of bulky disease. 96 cases of invasive cervical cancer, treated with postoperative or primary radiation therapy were analyzed to determine the complication rate and prognostic factor in our treatment regimen which is 500-1000 cGy higher than other institution. Mean follow up duration was 21 months. Symptomatic patients including mild but persistent abdominal discomfort was 46%, but only 1 patient (1%) had operative treatment because of incomplete obstruction of small ...

Energy Technology Data Exchange (ETDEWEB)

The advanced detector development project at the University of Michigan has completed the first full year of its current funding. Our general goals are the development of radiation detectors and spectrometers that are capable of portable room temperature operation. Over the past 12 months, we have worked primarily in the development of semiconductor spectrometers with {open_quotes}single carrier{close_quotes} response that offer the promise of room temperature operation and good energy resolution in gamma ray spectroscopy. We have also begun a small scale effort at investigating the properties of a small non-spectroscopic detector system with directional characteristics that will allow identification of the approximate direction in which gamma rays are incident. These activities have made use of the extensive clean room facilities at the University of Michigan for semiconductor device fabrication, and also the radiation measurement capabilities ...

British Library Electronic Table of Contents (United Kingdom)

PurposeTo evaluate the effect of vitrectomy timing on outcomes for patients with crystalline retained lens fragments receiving vitrectomy 3+ days after cataract surgery. DesignSystematic review and meta-analysis of retrospective interventional cases series. MethodsSearches of MEDLINE (English, 1/1/85 through 7/30/2010) and article reference lists. Articles were screened for patients with crystalline retained lens fragments after surgery for age-related cataracts, discussion of vitrectomy timing, and, for the meta-analysis, patient totals for at least 1 outcome and multiple time periods, 10+ patients, and mean follow-up ?3 months. Outcomes included visual acuity, retinal detachment, increased intraocular pressure, intraocular infection/inflammation, cystoid macular edema, and corneal...

British Library Electronic Table of Contents (United Kingdom)

Background Trauma centers are designated to provide systematized multidisciplinary care to injured patients. Effective trauma systems reduce patient mortality by facilitating the treatment of injured patients at appropriately resourced hospitals. Several U.S. studies report reduced mortality among patients admitted directly to a level I trauma center compared with those admitted to hospitals with less resources. It has yet to be shown whether there is an outcome benefit associated with the ?level of hospital? initially treating severely injured trauma patients in Australia. This study was designed to determine whether the level of trauma center providing treatment impacts mortality and/or hospital length of stay. Methods Outcomes were evaluated for severely injured trauma patients with an ...

UK PubMed Central (United Kingdom)

BackgroundModern metal-on-metal hip resurfacing implants are being increasingly used for young and active patients, although the long-term outcome and failure mechanisms of these...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundResponse shift theory suggests that improvements in health lead patients to change their internal standards and re-assess former health states as worse than initially rated...Full Text Available

UK PubMed Central (United Kingdom)

This study describes procedures and outcomes in a functional analysis of problem behavior of 2 public school students. For a 13-year-old honors student, bizarre tacts (labeled as psychotic speech by...Full Text Available

UK PubMed Central (United Kingdom)

ObjectivesThe objective of this paper is to describe the complex mixed-methods design of a study conducted to assess health-related quality of life (HRQOL) outcomes...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundPatients’ general tendency to adhere to health care provider-recommended treatments is associated with a number of health outcomes, but whether it influences pain...Full Text Available

UK PubMed Central (United Kingdom)

Aim:Report of 125 pediatric patients of empyema thoracis treated by open decortication, highlighting the presentation, delay in referral, operative findings, the response...Full Text Available

UK PubMed Central (United Kingdom)

Hip fractures are associated with a high rate of mortality and profound temporary and sometimes permanent impairment of quality of life. Current guidelines indicate that surgeons should perform surgery...Full Text Available

UK PubMed Central (United Kingdom)

Disorders of mitochondrial fat metabolism lead to sudden death in infants and children. Although survival is possible, the underlying molecular mechanisms which enable this outcome have not yet been...Full Text Available

UK PubMed Central (United Kingdom)

Goals of workThe goal of this study was to evaluate, at a population level, the association between specialized palliative care services (SPCS) and short- and long-term caregiver...Full Text Available

UK PubMed Central (United Kingdom)

Background and objectives: The relationship between serum potassium (S_K) and mortality in chronic kidney disease (CKD) has not been systematically investigated.Design, setting, participants,...Full Text Available

UK PubMed Central (United Kingdom)

ObjectivesTo examine the strength of the volume–outcome relationship among paramedics, a group of providers that has not been previously studied in this context. By identifying...Full Text Available

UK PubMed Central (United Kingdom)

The refractive error in 15 eyes with threshold retinopathy of prematurity treated with diode laser photocoagulation was compared with 25 eyes with the same disease severity treated by cryotherapy. Myopia...Full Text Available

UK PubMed Central (United Kingdom)

Thirty chemicals or substances currently undergoing long-term carcinogenicity bioassays in rodents have been used in a project to further evaluate methods and information that may have the capability...Full Text Available

UK PubMed Central (United Kingdom)

AimsTo describe nurse burnout, job dissatisfaction, and quality of care in Japanese hospitals, and to determine how these outcomes are associated with work environment...Full Text Available

UK PubMed Central (United Kingdom)

Background and objectives: Blacks are over-represented among dialysis patients, but they have better survival rates than whites. It is unclear if the over-representation of blacks on dialysis is due...Full Text Available

UK PubMed Central (United Kingdom)

Cognitive rehabilitation is an effective intervention for addressing cognitive impairments in patients with schizophrenia. Previous research has shown that the early application of Cognitive...Full Text Available

UK PubMed Central (United Kingdom)

The identification of predictive biomarkers is at the core of modern toxicology. So far, a number of approaches have been proposed. These rely on statistical inference of toxicity response from either...Full Text Available

UK PubMed Central (United Kingdom)

Currently, the outcome of patients with intermediate-and poor-risk germ cell tumors at diagnosis is optimized by the use of risk-appropriate chemotherapy and post-chemotherapy surgical resection of...Full Text Available

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BackgroundHigh serum uric acid concentration (hyperuricemia) has been studied for its relationship with multiple adverse health outcomes, such as metabolic syndrome. Intervention...Full Text Available

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Electronic personal health records (ePHRs) can potentially maximize access and coordination of health information and improve patient/clinician collaboration, patient self-management, and health outcomes....Full Text Available

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BackgroundPregnant women are more susceptible to severe Plasmodium falciparum malaria, which can lead to poor maternal and fetal outcomes. Few data exist on the...Full Text Available

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Between 50 and 70% of patients with a terminal illness indicate a preference to remain at home for as long as possible until their death. Nevertheless, a much smaller percentage actually die at home...Full Text Available

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Objective To compile and evaluate the evidence on the effects on health and social outcomes of computer based peer to peer communities and electronic self support groups, used by people...Full Text Available

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The National Cancer Institute Laboratory of Human Carcinogenesis is seeking statements of capability or interest from parties interested in collaborative research to further develop, evaluate, or commercialize a gene signature for prognosis of hepatocellular carcinoma in patients.

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Equinovarus of the foot is the most common lower extremity deformity following traumatic brain injury. We evaluated outcomes of the split anterior tibialis tendon transfer (SPLATT) for correction of...Full Text Available

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In this letter we report the outcome for the microscopic approach for the semi-magic nuclei /sup 88/Sr and /sup 90/Zr. For comparison, we have also treated the semi-phenomenological version for the Migdal and SDI force.

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Inclusion of family members in the assessment of patients with chronic pain can improve outcomes. Family functioning can be assessed in four basic areas: boundaries, power, communication, and intimacy....Full Text Available

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Background:This study evaluated the outcomes of patients with complex or persistent thoracobiliary fistulae following penetrating liver trauma, who underwent endoscopic biliary intervention...Full Text Available

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IntroductionRadiotherapy outcomes might be further improved by a greater understanding of the individual variations in normal tissue reactions that determine tolerance. Most published...Full Text Available

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ObjectivesWe undertook a meta-analysis to assess outcomes for drug-eluting (DES) and bare metal stents (BMS) in percutaneous coronary intervention (PCI) for unprotected...Full Text Available

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AIM: To compare 2 different types of covered esophageal nitinol stents (Ultraflex and Choostent) in terms of efficacy, complications, and long-term outcome.METHODS: A retrospective review of...Full Text Available

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PurposeWound infection after an ileostomy reversal is a common problem. To reduce wound-related complications, purse-string skin closure was introduced as an alternative to conventional...Full Text Available

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IntroductionTransfusion is a common treatment in pediatric intensive care units (PICUs). Studies in adults suggest that prolonged storage of red blood cell units is associated with...Full Text Available

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... "N. Northwest Europe, 1944 - St. Lo 11-18 Jul Operation "Goodwood" 18-20 Jul Operation "Cobra" 24-26 Jul 0" Mortain 6-12 Aug Chartres 16' Au.g ...

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IntroductionLaparoscopic distal pancreatectomy has been described for more than a decade now and has been considered technically feasible, safe, and with reproducible outcomes. It...Full Text Available

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BackgroundHip surface replacement arthroplasty (SRA) can be an alternative for total hip arthroplasty. The short and long-term outcome of hip surface replacement arthroplasty mainly...Full Text Available

International Nuclear Information System (INIS)

Hung and Quyen's model (analysis of strategic interactions between players in the game theoretic framework) is first recapitulated. Solutions to the embargo game with the seller acting as the Stackelberg leader in both periods. Then the timing coordination issue is discussed and perfect equilibrium outcomes under different structures of leader-follower in the game are compared. Numerical simulations show that the structure corresponding to alternated leadership from one period to the other yields the perfect equilibrium outcome that is Pareto improving with respect to the structure where the buyer is first mover in both periods and Pareto dominant for some specific values of the parameters embedded in the game.

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Anesthetic techniques vary widely in the endovascular repair of abdominal aortic aneurysms (EVAR). Previous studies have demonstrated the feasibility of using local anesthesia. However, the ideal anesthetic technique has not been determined. This study examines whether anesthesic technique influences the outcomes of EVAR. Data regarding demographics, risk factors, procedural characteristics, recovery characteristics, treatment complications, acute ( 0.05, ANOVA). From these results we concluded that EVAR with local anesthesia is a safe and efficacious method that may reduce recovery times and postoperative medical morbidity compared to use of genera1 or spinal/epidural anesthesia.

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This report describes a case of toxic myopathy in a two year old sheltie dog with clinical signs of profound weakness, myoglobinuria, and muscle enzyme elevations. The clinical signs were likely related...Full Text Available

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Randomized clinical trials are designed with stopping boundaries to guide data monitoring committees with their decision making concerning ongoing trials. In particular, when extremely positive results...Full Text Available

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The planned spallation source can be of considerable significance for biomedical basic research and for clinically relevant diagnostic and therapeutic applications. The following gives a brief description and explanations for its possible use in clinical medicine: I. Treatment of Malignant Tumors II. Production of Isotopes for Biochemical Investigations in Living Organisms for Diagnostic Purposes.

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AbstractQuantities and types of ceramides and their relationships to physical properties of the horn covering the claws of clinically normal cows and cows with subclinical laminitis were...Full Text Available

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BackgroundThe aim of this study is to examine how clinicians and patients negotiate clinical need and treatment decisions within a context of finite resources. Dental implant treatment...Full Text Available

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BackgroundThe lack of adequate randomized clinical trials (RCT) has hindered identification of new therapies that are safe and effective for patients with primary focal segmental...Full Text Available

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BackgroundHepatitis A virus (HAV) strains detected in environmental and clinical samples were analysed to characterize the genotypes of HAV circulating in Greece. Fifty (50) sewage...Full Text Available

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Objectives: The authors designed and implemented a clinical data mart composed of an integrated information retrieval (IR) and relational database management system (RDBMS).Design:...Full Text Available

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PURPOSE We wanted to assess the impact of an electronic health record–based diabetes clinical decision support system on control of hemoglobin A_1c (glycated hemoglobin),...Full Text Available

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Membranous dysmenorrhea is an unusual clinical entity. It is characterized by the expulsion of huge fragments of endometrium during the menses, favored by hormonal abnormality or drug intake. This report describes a case with clinical, US, and MRI findings before the expulsion. Differential diagnoses are discussed. (orig.)

UK PubMed Central (United Kingdom)

This paper presents HEARTVIEW - a knowledge base (KB) that offers aid for clinical research in cardiology. This KB is an essential component of the medical workstation MW2000, now under development...Full Text Available

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Glossitis among U.S. military working dogs in South Vietnam was characterized by variable redness and loss of papillae on the anterodorsal third of the tongue; salivation, drooling, and inappetence were the principal clinical signs. Symptomatic treatment ...

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IntroductionIntrarenal pseudoaneurysm is a rare, yet clinically significant, complication of percutaneous nephrolithotomy. A high index of clinical suspicion is necessary in order...Full Text Available

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The definitive clinical trial which demonstrated the beneficial effects of photocoagulation in treating diabetic retinopathy was reported in 1976 in the American Journal of Ophthalmology by the Diabetic...Full Text Available

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Coryneform isolates from clinical specimens frequently cannot be identified by either reference laboratories or research laboratories. Many of these organisms are skin flora that belong to a large number...Full Text Available

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In support of a new clinical trial designed to compare the effects of crushed fresh garlic and two types of garlic supplement tablets (enteric-coated dried fresh garlic and dried aged garlic...Full Text Available

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Clinical-HINTS (Health Intelligence System) is a horizontally integrated decision support system (DSS) designed to meet the requirements for intelligent real-time clinical information management in critical care medical environments and to lay the foundation for the development of the next generation of intelligent medical instrumentation. The system presented was developed to refine and complement the information yielded by clinical laboratory investigations, thereby benefiting the management of the intensive care unit (ICU) patient. More specifically, Clinical-HINTS was developed to provide computer-based assistance with the acquisition, organisation and display, storage and retrieval, communication and generation of real-time patient-specific clinical information in an ICU. Clinical-HINTS is an object-oriented system developed in C+2 to run under Microsoft ...

UK PubMed Central (United Kingdom)

This article describes a new set of revised standards for the medical laboratory, which have been produced by Clinical Pathology Accreditation (UK) Ltd (CPA). The original standards have been in use...Full Text Available

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Background/AimsThe findings of several recent studies suggest that antinuclear antibodies (ANAs) are frequently detected in patients with acute hepatitis A (AHA). However, the clinical...Full Text Available

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The prevalence of chlamydial infection of the urethra was studied in 172 consecutive male patients attending a sexually transmitted disease clinic in Teheran. Chlamydia trachomatis was isolated in 8.8%...Full Text Available

UK PubMed Central (United Kingdom)

A methodology and toolkit are described which enable the automated metadata-driven creation of datamarts from clinical data warehouses. The software uses schema-to-schema transformation driven by an...Full Text Available

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The level of total extracellular neuraminidase produced by 74 clinical isolates of group B streptococci isolated from diseased or asymptomatically colonized infants was assayed. Extracellular neuraminidase...Full Text Available

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ObjectiveCompare occlusal contacts calculated from 3D virtual models created from clinical records to contacts identified clinically using shimstock and transillumination.Full Text Available

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A form for the clinical evaluation of bovine digital disease was developed. In this article, each section of the resulting Digit Evaluation Form is discussed and justified. By following the...Full Text Available

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German 2006 [1 p.] Germany Karger, Christian Heeg, Peter Jaekel, Oliver

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No abstract prepared

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Clinical questionWhat is the best treatment for bacterial conjunctivitis?ResultsTopical antibiotics expedite recovery from bacterial conjunctivitis....Full Text Available