A four-stage scoring system for brain maturation was established with MR imaging. First, gyration and myelination were analyzed in 50 anamnestically normal children (32-240 weeks postconceptional age). Subsequently 60 patients (same age range) with birth asphyxia, seizures, or developmental delays were evaluated analogously. T1- and T2-weighted images (500/30 and 3,000/120 [repetition time msec/echo time msec]) were obtained with a 2.35-T magnet in all children. Whereas gyration abnormalities were seen in some patients, all handicapped children presented with delayed myelination. In conclusion, prospective staging of brain development (gyration and myelination) is possible and is best obtained with T2-weighted images.
Background. Metabolic disturbances such as anoxia and hypoglycaemia are important in causing maldevelopment of the neonatal brain. While there have been some pathology studies of the effects of neonatal hypoglycaemia on brain development, reports of MRI findings in such infants have been rare. Objectives. To describe the MRI findings in neurologically handicapped children who had suffered from neonatal hypoglycaemia and to evaluate the relationship between the neurological impairment and neonatal hypoglycaemia. Materials and methods. We retrospectively evaluated the MRI findings in eight full-term infants with neonatal symptomatic hypoglycaemia who later exhibited neurological handicap. The age at which the MRI scans were obtained ranged from 9 months to 8 years 10 months (mean 4 years 1 month, median 4 years). Results. The most striking findings were prolonged T1 weighting and T2 weighting in the parieto-occipital periventricular deep white ...
BackgroundStress fractures are a significant problem among athletes and soldiers and may result in devastating complications or even permanent handicap. Genetic factors may increase...Full Text Available
BackgroundIntrapartum fetal hypoxia remains an important cause of death and permanent handicap and in a significant proportion of cases there is evidence of suboptimal care related...Full Text Available
The objective of this study was to evaluate the effect of pregabalin in painful cervical or lumbosacral radiculopathy treated in Primary Care settings under routine clinical practice. An observational,...Full Text Available
Aim:To present three patients with ocular disease who developed a range of complications following use of traditional medications.Settings...Full Text Available
Background:The aim of present study is to determine the long-term results of patients who undergo pars plana vitrectomy after retained nucleus into the vitreous.Setting:Service...Full Text Available
PURPOSE The Wells rule is widely used for clinical assessment of patients with suspected deep vein thrombosis (DVT), especially in the secondary care setting. Recently a new clinical decision...Full Text Available
PurposeWe previously reported a randomized phase II clinical trial combining a poxvirus-based vaccine encoding PSA with radiotherapy in patients with localized prostate...Full Text Available
The standard protocol in multislice spiral CT (MSCT) angiography for coronary arteries with fixed tube current-time settings leads to an overexposure and thus to an unnecessary high radiation dose in patients with lower weight when compared to heavier patients. The purpose of this study was to estimate the effect of reducing the radiation dose by adapting the tube current-time settings individually. Fifty patients underwent retrospectively ECG-gated MSCT of the heart. In 25 patients (group A{sub 1}) a standard protocol with constant tube current-time settings was used (4 x 1-mm collimation, 120 kV, 400 mAs{sub eff}). Subsequently, artificial image noise was added to the data of these patients simulating a directive for weight-adapted tube current-time settings (group A{sub 2}). In the other 25 ...
The standard protocol in multislice spiral CT (MSCT) angiography for coronary arteries with fixed tube current-time settings leads to an overexposure and thus to an unnecessary high radiation dose in patients with lower weight when compared to heavier patients. The purpose of this study was to estimate the effect of reducing the radiation dose by adapting the tube current-time settings individually. Fifty patients underwent retrospectively ECG-gated MSCT of the heart. In 25 patients (group A_1) a standard protocol with constant tube current-time settings was used (4 x 1-mm collimation, 120 kV, 400 mAs_e_f_f). Subsequently, artificial image noise was added to the data of these patients simulating a directive for weight-adapted tube current-time settings (group A_2). In the other 25 ...
Producing nuclear energy in order to reduce anthropic CO{sub 2} emission and to meet high energy demand, implies three conditions to the nuclear plants of the IV. generation: safety improvements, radioactive waste minimization, and fuel breeding for a sustainable use of the resources. The Thorium fuel cycle used in Molten Salt Reactors seems promising. Many numerical studies based on probabilistic codes are carried out in order to analyse the behaviour of such reactors. Nevertheless, one of the most important parameters is badly known: the alpha ratio of {sup 233}U, ratio of the neutron capture cross section to fission one for {sup 233}U. This key-parameter is necessary to calculate the breeding ratio and thus, the deployment capacities of those reactors. This Ph-D thesis was intended to prepare a precise measurement of the alpha ratio of {sup 233}U between 1 eV and 10 keV. Preliminary measurements have been performed on the experimental platform PEREN. This experimental environment is ...
BACKGROUNDLifestyle modifications are successfully employed to treat obese and overweight women with polycystic ovary syndrome (PCOS). The aims of the current pilot study were (i) to compare the efficacy on reproductive functions of a structured exercise training (SET) programme with a diet programme in obese PCOS patients and (ii) to study their clinical, hormonal and metabolic effects to elucidate potentially different mechanisms of action.METHODSForty obese PCOS patients with anovulatory infertility underwent a SET programme (SET group, n = 20) and a hypocaloric hyperproteic diet (diet group, n = 20). Clinical, hormonal and metabolic data were assessed at baseline, and at 12- and 24-week follow-ups. Primary endpoint was cumulative pregnancy rate.RESULTSThe two groups had similar demogra...
Background: In order to reconceptualize somatoform disorders (SFDs), the psychological characteristics of SFD patients are increasingly investigated. The cognitive style of magical thinking (MT) has not been studied so far in patients with SFDs. Sampling and Methods: In a cross-sectional study, 201 allergy workup patients were interviewed using the Structured Clinical Interview for DSM-IV; they answered a set of self-report questionnaires including the Schizotypal Personality Questionnaire subscale for MT and the Patient Health Questionnaire (PHQ). The expression of MT was explored in 61 patients with SFDs compared to 140 patients without SFDs. Results: Patients with SFDs reached higher scores of MT, also when controlled for gender, depression, and anxiety. In particular, they stated more frequently that they were ...
Objective To demonstrate clinical features of a patient subgroup presenting with polycystic ovary syndrome (PCOS) without polycystic ovary morphology. Design Retrospective study. Setting Hospital-based IVF center. Patient(s) In the present study, 876 PCOS patients were selected from women who visited the Reproductive Medicine Center at Shandong Provincial Hospital, Shandong University, between September 2004 and October 2006. Women with PCOS were divided into two groups based on ultrasound image: group A, PCOS patients with classic polycystic ovary (n = 800); group B, PCOS patients without polycystic ovary morphology (n = 76). The following available data were analyzed in the large cohort of women: body height, weight, waistline, hip circumference, hirsutism scores, family history, serum s...
OBJECTIVE--To investigate the cause of post-operative retention of urine in elderly men. DESIGN--Prospective study. SETTING--Northern General Hospital, Sheffield. PATIENTS--32 consecutive men (median...Full Text Available
BackgroundIntegration of medical care across clinicians and settings could enhance the quality of care for patients. To date, there is limited data on the levels of integration in...Full Text Available
More than 30 years of experience in developing a computer-based patient record system, The Medical Record (TMR), in multiple settings, in multiple specialty groups, and at multiple sites has taught...Full Text Available
OBJECTIVE--To review findings from studies of the influence of desktop computers on primary care consultations. DESIGN--Systematic review of world reports from 1984 to 1994. SETTING--The computerised...Full Text Available
The heterogeneity of metastatic breast cancer mandates the need to select therapies taking into account tumor and patient characteristics. Chemotherapy is indicated in the palliative setting especially...Full Text Available
Low kVp settings provide high conspicuity of contrast materials at CT but may result in high image noise, particularly in larger patients. Material decomposition at dual energy CT can differentiate...Full Text Available
The purpose of the meeting reported here was to develop a set of national evidence-based standards for assessing and managing patients with potentially resectable rectal cancer. This report represents...Full Text Available
In a mass casualty situation, medical personnel at the disaster site and other field treatment settings may need to monitor the vital signs of hundreds of seriously injured patients with minimal staffing....Full Text Available
BackgroundSeventy percent of urban populations in sub-Saharan Africa live in slums. Sustaining HIV patients in these high-risk and highly mobile settings is a major future challenge....Full Text Available
In this paper the main design requirements concerning the setting up of a telemetry ECG monitoring system are presented. The design's most important technical solutions as well as some details are also discussed. This system is intended to provide skilled medical assistance during the cardiac rehabilitation of both asymptomatic and high risk coronary patients
A team of physicians, pharmacists, and informatics professionals developed a CDSS added to a commercial electronic medical record system to provide prescribers with patient-specific maximum dosing recommendations...Full Text Available
PurposeTo review the frequency of hemorrhagic complications with sub-Tenons anesthesia in patients on aspirin, warfarin or clopidogrel.SettingSt. Jamess University Hospital, Leeds, United Kingdom.MethodsData were collected prospectively for patients having elective phacoemulsification under sub-Tenons anesthesia. Seventy-five patients were on aspirin, 65 were on warfarin, and 40 were on clopidogrel. Seventy-five patients on no anticoagulants were used as the control group. No changes in the anticoagulant regimen were made prior to surgery.ResultsNo sight-threatening hemorrhagic complications were noted, and no surgery was postponed or cancelled due to an anesthesic complication. Subconjunctival hemorrhage occurred in 19% in the control group, 40% in the clopidogrel group, 35% in the warfar...
Deltombe T, Gustin T. Selective tibial neurotomy in the treatment of spastic equinovarus foot in hemiplegic patients: a 2-year longitudinal follow-up of 30 cases. Objective To assess the long-term efficacy of selective tibial neurotomy in the treatment of spastic equinovarus foot in hemiplegic patients. Design Intervention study (before-after trial) with an observational design and 2-year follow-up. Setting Spasticity group in a university hospital. Participants Hemiplegic patients (N=30) with spastic equinovarus foot. Intervention A selective neurotomy was performed at the level of the motor nerve branches of the tibial nerve. Main Outcome Measures Spasticity (Ashworth scale), muscle strength (Medical Research Council scale), passive ankle dorsiflexion, gait parameters (6 min walking test...
Full text: Certain groups of patients have been excluded from ventilation lung scanning due to their inability to comply with instruction. Tetley Manufacturing have recently developed a Positive Ventilation Delivery System (PVDS) which assists in delivering Technegas to patients who are unable to cooperate fully. The aim of this study is to evaluate the PVDS in the clinical setting. Fifteen frail aged and psychogeriatric patients (n=l 5), mean age 78 years (range 60-93), were ventilated with Technegas using the PVDS. The decision to ventilate the patient with the PVDS was based on an initial assessment of the patients ability to comply with instructions, or failure of the conventional ventilation method, to produce an adequate count rate. Technegas was prepared in the usual manner and then delivered to the patients lungs by squeezing a black ...
Purpose: Extrahepatic cholangiocarcinoma is a rare malignancy. Despite radical resection, survival remains poor, with high rates of local and distant failure. To clarify the role of radiotherapy with chemotherapy, we performed a retrospective analysis of resected patients who had undergone chemoradiotherapy. Methods and Materials: A total of 45 patients (13 with proximal and 32 with distal disease) underwent resection plus radiotherapy (median dose, 50.4 Gy). All but 1 patient received concurrent fluoropyrimidine-based chemotherapy. The median follow-up was 30 months for all patients and 40 months for survivors. Results: Of the 45 patients, 33 underwent adjuvant radiotherapy, and 12 were treated neoadjuvantly. The 5-year actuarial overall survival, disease-free survival, metastasis-free survival, and locoregional control rates were 33%, 37%, 42%, and 78%, respectively. The median ...
The incidence of hepatocellular carcinoma (HCC) is increasing in developed countries and the general status of HCC patients is now by far better than a few years ago, allowing physicians to propose some different treatments of these patients. Among these treatments, intra-arterial injection of 131-iodine-labelled Lipiodol could be used in palliative, curative or adjuvant settings. After a brief summary of the modalities of this treatment, requiring the collaboration of Gastro-enterologists, Oncologists, Radiologists and Nuclear Medicine physicians, the different possibilities of therapeutic uses of this new approach are described and an outlook of these developments is proposed. (author)
As care shifts from institutional to home- and community-based settings, consumer health information technology (IT) must be designed to support patients' new health information management responsibilities. We developed and piloted a new methodology grounded in social network analysis and human factors engineering to explore two often overlooked aspects of this phenomenon: the task of health information communication with members of the social network and the context of culture. Such knowledge is necessary to inform the appropriate design of consumer health IT. We asked a culturally diverse sample of participants to describe what, to whom, why, and how they communicate health information and to provide direct feedback about the methodology. The methodology was acceptable to all participants and able to capture similarities and differences in their health information communication practices. Prior to the main study we will need to refine the ...
Objective: To describe the meaning of the theme of empowerment from research on health promotion in nursing from the perspective of nurses participating in the study. Methods: Manual data analysis and QSR NUD*IST Vivo were used to analyse the data generated by individual and focus group interviews and the critical incident technique with 32 qualified nurses working in an acute hospital setting in the UK. Results: The participants identified a number of issues related to the theme of empowerment. These included the nurse as patient informer, psychological supporter and rapport builder and the concepts of informed choice/decision making, gatekeeping, coping, patient assertiveness, self-esteem and confidence. Conclusion: Empowerment is a complex, multi-dimensional, contested concept which can...
Major depressive disorder and alcohol dependence are common and serious mental illnesses. There is a great interest in discovering useful treatments for both mood symptoms and alcohol abuse in those patients with depressive disorders and comorbid alcohol dependence. The primary purpose of this study was to evaluate the effectiveness and tolerability of mirtazapine for the treatment of patients with alcohol dependence comorbid with a depressive disorder in an open label, naturalistic multicentre treatment setting. The 17-item Hamilton Depression Rating Scale (HDRS), the Hamilton Anxiety Rating Scale (HARS) and the Clinical Global Impression-Severity (CGI-S) scale were measured at baseline and at weeks 4 and 8 for the assessment of treatment effectiveness. Alcohol craving was measured using ...
Background: While waiting for surgery, patients often exhibit fear and anxiety. Music is thought to be an alternative to medication to relieve anxiety. However, due to concerns about infection control, devices other than headphones may be considered for this purpose. Objectives: The purpose of this study was to determine the anxiety-relieving effect of broadcast versus headphone music playing for patients awaiting surgery. Design: A randomized controlled clinical study. Setting: The waiting area of an operating theater of a metropolitan teach hospital in Taiwan. Participants: Alert adult with age between 20 and 65 years old waiting for surgery without premedications. Methods: A total of 167 patients were randomly assigned to the headphone, broadcast and control groups. Both the headphone a...
Abstract It is well established that ageing handicaps the ability of prey to escape predators, yet surprisingly little is known about how ageing affects the ability of predators to catch prey. Research into long-lived predators has assumed that adults have uniform impacts on prey regardless of age. Here we use longitudinal data from repeated observations of individually-known wolves (Canis lupus) hunting elk (Cervus elaphus) in Yellowstone National Park to demonstrate that adult predatory performance declines with age and that an increasing ratio of senescent individuals in the wolf population depresses the rate of prey offtake. Because this ratio fluctuates independently of population size, predatory senescence may cause wolf populations of equal size but different age structure to have d...
A voice activated garage door opener was designed for a handicapped person to open a garage door without assistance. This design uses speech recognition of one word. The activating word that was chosen is "up". The frequency spectrum of "up" was captured on a soundboard and is the basis of this design. Filters are used to pick out three frequency bands in this spectrum. The output signals from these filters are then compared to three threshold voltages using voltage comparators. If the output signals from the filters are above the threshold voltages, the comparators go high. Monostable multivibrators are used on the output of the comparators to lengthen the high pulses. When all of the pulses from the monostable multivibrators are high at the same time, an AND gate output goes high. This high pulse activates the door opener. PMID:8329601
Forty-four patients with small cell carcinoma of the bronchus underwent CT and MR studies of the brain to detect cerebral metastases. All patients were studied with contrast-enhanced CT scans, short (T1-weighted) and long (T2-weighted), spin-echo (SE) and FLASH 90 grades sequences were also obtained. A quantitative comparison of the results was carried out to assess the sensitivity of the different techniques in the detection of brain metastases according to lesion diameter. Metastases were identified in 19/44 patients (43%). All techniques detected the lesions >2 cm; of the metastases <2 cm, 63/124 (51%) were detected only by GdDTPA SE-T1 and FLASH sequences and 11 more (9%) only by Gd-DTPA SE-T1 scans. All the lesions identified oh enhanced CT scans or on T2-weighted images were easily detected by Gd-DTPA scans. CT sensitivity was higher than that of pre-contrast ...
A prospective, side-by-side comparison study of two different lasers for the treatment of solar- induced telangiectasia was carried out in 14 patients at the Beckman Laser Institute and Medical Clinic. The argon tunable dye laser (Coherent, Palo Alto, Calif.) was used in the method modified from Orenstein and Nelson to completely treat discrete telangiectasias on one cheek. Specifically, the argon tunable dye laser (ATDL) was set at 0.7 - 0.8 watts, 585 nm wavelength, shutter-pulsed at 0.1 second duration with a spot size of 0.1 mm, and individual vessels were 'traced out' with 4X loupe magnification. Each patient's opposite cheek was then treated in the standard fashion with the flashlamp pulsed dye laser (Candela, Natick, Mass.) using a technique similar to Polla's et al. Specifically, the flashlamp pulsed dye laser (FPDL) was set at 585 nm wavelength, pulsed mode of 450 microseconds pulse duration, ...
To determine the usefulness of carbon dioxide(CO_2) indirect portography during TIPS procedure. We evalvated eight patients who had undergone TIPS due to variceal hemorrhage or ascites caused by portal hypertension. All patients but one with complete situs inversus underwent wedged right hepatic venography for visualization of the portal vein using CO_2. For CO_2 indirect portal venography, 50cc of CO_2 was injected by hand without prior injection of a small amount of CO_2. In three patients a 5-F angiographic catheter was wedged into the right hepatic vein, and in the other five a 9-F sheath from a Ring's transjugular access set was adjunctively wedged into the right hepatic vein over the 5-F catheter. The time required for portal vein puncture was defined as the time between the indirect portal venography procedure and the first procedure after successful portal vein puncture. All ...
The effect of 50 Hz and 60 Hz (frequencies of current distribution) and 20 kHz to 50 kHz (frequencies of induction cooktop) magnetic interference on implanted pacemakers have been assessed with the present generation of device technology. Sixty patients implanted in 1998 and 1999 with dual chamber pacemakers from 9 different manufacturers were monitored with telemetry while passing through, and standing between a system of two coils. They generated a 50 Hz or a 60 Hz magnetic field at 50 microT. Then, patients used a cooktop at different power. The recordings were made with the standard setting of "medically correct" sensing parameters chosen for the patients. Then pacemakers were reprogrammed to the unipolar mode, with the highest atrial (A) and ventricular (V) sensitivity that did not induce muscular inhibition while moving. Between each exposure (50 Hz, 60 Hz or 20 kHz to 50 kHz), the pacemaker ...
The accuracy of dose computation within the lungs depends strongly on the performance of the calculation algorithm in regions of electronic disequilibrium that arise near tissue inhomogeneities with large density variations. There is a lack of data evaluating the performance of highly developed analytical dose calculation algorithms compared to Monte Carlo computations in a clinical setting. We compared full Monte Carlo calculations (performed by our Monte Carlo dose engine MCDE) with two different commercial convolution/superposition (CS) implementations (Pinnacle-CS and Helax-TMS's collapsed cone model Helax-CC) and one pencil beam algorithm (Helax-TMS's pencil beam model Helax-PB) for 10 intensity modulated radiation therapy (IMRT) lung cancer patients. Treatment plans were created for two photon beam qualities (6 and 18 MV). For each dose calculation algorithm, patient, and beam quality, the following ...
For Monte Carlo simulations to be used as an alternative solution to perform scatter correction, accurate modelling of the scanner as well as speed is paramount. General-purpose Monte Carlo packages (Geant4, EGS, MCNP) allow a detailed description of the scanner but are not efficient at simulating voxel-based geometries (patient images). On the other hand, dedicated codes (SimSET, PETSIM) will perform well for voxel-based objects but will be poor in their capacity of simulating complex geometries such as a PET scanner. The approach adopted in this work was to couple a dedicated code (SimSET) with a general-purpose package (Geant4) to have the efficiency of the former and the capabilities of the latter. The combined SimSET+Geant4 code (SimG4) was assessed on the GE Advance PET scanner and compared to the use of SimSET only. A better description of the resolution and sensitivity of ...
Background 2009 pandemic influenza A(H1N1) has led to a global increase in severe respiratory illness. Little is known about kidney outcomes and dialytic requirements in critically ill patients infected with pandemic H1N1. Study Design Prospective observational study. Setting & Participants 50 patients with pandemic H1N1 admitted to any of 7 intensive care units in Manitoba, Canada, were prospectively followed. Outcome & Measurements Outcomes were kidney injury and kidney failure defined using RIFLE (risk, injury, failure, loss, end-stage disease) criteria or need for dialysis therapy. Results The pandemic H1N1 group was composed of 50 critically ill patients with pandemic H1N1 with severe respiratory syndrome (47 confirmed cases, 3 probable). Kidney injury, kidney failure, a...
In Europe, the use of anti-EGFR monoclonal antibodies is restricted to Kirsten RAS (KRAS) wild-type colorectal tumors. Information on the KRAS status of the patients tumor is thus key for clinical practice; however, there is little guidance or definition on which KRAS mutations to assess and how to assess them. To ensure the consistency and the quality of KRAS test results in Europe, an interlaboratory control network needs to be set up. This pilot study aimed to identify the variables that need to be assessed in a quality control scheme and to provide a first assessment in a selected set of laboratories. Fourteen different tumor cases were circulated between 13 laboratories by a central laboratory acting as the referent for the mutation status determination. This study illustrated that of...
Aim.- To identify what determinants influence the prevalence and accuracy of nursing diagnosis documentation in clinical practice. Background.- Nursing diagnoses guide and direct nursing care. They are the foundation for goal setting and provide the basis for interventions. The literature mentions several factors that influences nurses- documentation of diagnoses, such as a nurse-s level of education, patient-s condition and the ward environment. Design.- Systematic review. Method.- MEDLINE and CINAHL databases were searched using the following headings and keywords: nursing diagnosis, nursing documentation, hospitals, influence, utilisation, quality, implementation and accuracy. The search was limited to articles published between 1995-October 2009. Studies were only selected if they were...
This paper contributes to an understanding of pharmacogenomics-in-the-making by foregrounding a regulatory setting in which these technologies must be situated: decision-making about pharmaceutical reimbursement. Health care assessment organizations have been introduced in many countries to systematically address the issue of health care coverage. Using the example of Sweden, the process of deciding reimbursement status is shown to hinge on the creation of stable and clinically feasible categories of patients, diseases and drug responses. Through a series of analogous examples concerning conventional pharmaceuticals, it is argued that current mechanisms for categorizing reimbursable drugs could be upset when pharmacogenomic advances provide a means of making patients more specific objects ...
Severe affective and behavioral dysregulation, labeled as severe mood dysregulation (SMD), is a widely spread phenomenon among adolescent psychiatric patients. This phenotype constitutes severe impairment across multiple settings, including various symptoms, such as non-episodic anger, mood instability, and hyperarousal. Moreover, SMD patients often show depression and reduced need for sleep. Despite a lifetime prevalence of 3.3%, systematic research is still scarce, and treatments that have been established do not account for the range of symptoms present in SMD. Considering the circadian dysfunctions, two hormones, melatonin and cortisol, are essential. When these hormones are dysregulated, the circadian rhythm gets out of synchrony. Since evidence is emerging showing that the worse the ...
Much progress has been made in the clinical, biological and technical aspects of the T-cell-depleted haploidentical hematopoietic stem cell transplantation (HSCT). Our experience demonstrates that infusing a megadose of extensively T-cell-depleted hematopoietic peripheral blood stem cells after an immuno-myeloablative conditioning regimen in acute leukemia patients ensures sustained engraftment with minimal GvHD without the need of any post-transplant immunosuppressive treatment. Since our first successful pilot study, our efforts have concentrated on developing new conditioning regimens, optimizing the graft processing and improving the post-transplant immunological recovery. The results we have so far achieved in high risk acute leukemia patients show that haploidentical transplantation ...
In children and adolescents the Second Generation Antipsychotics (SGAs) represent the class of psychotropic drugs whose use has grown more significantly in recent years: they are primarily used for treatment of patients with disruptive behavior disorders, mood disorders and pervasive developmental disorders or mental retardation. In order to compare the efficacy and tolerability of antipsychotics against placebo or each other, a systematic Medline/PubMed search for randomized, double blind studies on SGA in patients younger than 18years of age at enrolment, was conducted. Papers on schizophrenia, discussed in another article of this specific issue, were excluded by the efficacy analysis. A set of standard efficacy and safety indices, such as treatment effect sizes (ES), the Numbers Needed ...
This study investigated the occurrence of free-living amoebae (FLA) in immunodeficiency wards of hospitals in Tehran, Iran. A total of 70 dust and biofilm samples from wards serving transplant, pediatric (malignancies), HIV, leukemia and oncology patients of five university hospitals were collected and examined for the presence of FLA using culturing and molecular approaches. Based on the morphology of the amoebae in plate cultures, primer sets were applied for molecular identification of Acanthamoeba, vahlkampfiid amoebae and Hartmannella. Out of 70 samples, 37 (52.9%) were positive for FLA. Acanthamoeba belonged to the T4 genotype was the most prevalent isolate. Presence of the T4 genotype on medical instruments, including an oxygen mask in an isolation room of an immunodeficiency pediat...
Since the fluoroscopic image during nasoenteral tube placements is used for guidance and not for diagnosis, a lower contrast image with increased quantum mottle can be easily tolerated. The three methods to reduce the radiation dose rate investigated consisted of removing camera from the image intensifier output phosphor, and setting the fluoroscopic mA to the minimum value so that the kVp could be maximized. Fluoroscopic frozen video frames of a clinical tube insertion comparing the images with and without the dose-saving techniques are presented. Measurements of the radiation dose rates using a Plexiglas phantom show that the dose for patient and staff during fluoroscopic-guided nasoenteral tube placements can be reduced by over a factor of 10 without significantly adversely affecting the actual placement procedure. (author).
Introduction: Haploidentical transplantation, with extensive T cell depletion to prevent GvHD, is associated with a high incidence of infection-related deaths. The key challenge is to improve immune recovery with allogeneic donor T cells without triggering GvHD. As T regulatory cells (Tregs) controlled GvHD in pre-clinical studies, the present study evaluated the impact of an infusion of donor CD4/CD25 + Tregs, followed by an inoculum of donor mature T cells (Tcons) and positively immunoselected CD34 + cells in the setting of haploidentical stem cell transplantation. Patients and methods: Twenty-eight patients were enrolled in this study (22 AML; 5 ALL; 1 NHL). All received immunoselected Tregs (CliniMACS, Miltenyi Biotec) followed by positively immunoselected CD34 + cells together with Tc...
Increasing evidence has been accumulated indicating the important role of epigenetic regulation in tumor genesis. Previously, we observed that the transfection of hepatitis C virus core (HCVc) protein led to malignant transformation in normal biliary cells, and that tumor suppressor gene RASSF1A was downregulated in many hilar cholangiocarcinoma patients by hypermethylation in the promoter region. In the present study, we found SET and MYND domain-containing protein 3 (SMYD3), a novel histone methyltransferase, was overexpressed in cholangiocarcinoma patients especially in those with HCV infection. Transfection of HCVc into hilar cholangiocarcinoma cell lines QBC939 and FRH0201 could upregulate the expression of SMYD3 and promote cell growth, which was consistent with the results of our cl...
Clin. Otolaryngol. 2009, 34, 438-446. Objective: To determine whether economic costs associated with a conservative management strategy for unilateral acoustic neuroma offer an economic advantage over active management options. Design: Cost and sensitivity analysis on a prospective cohort. Setting: Single centre study within a tertiary referral centre in Toronto, Canada. Participants: 72 patients (32 males, 40 females) aged 36 to 78 years with unilateral acoustic neuroma were assigned initially to a conservative management strategy. Entry criteria were small tumour size (less than 15mm in the cerebellopontine angle), patient preference and/or significant co-morbidity. Interventions: MRI scanning was performed every 6 months for the first year, annually subsequently and then every 2-3 years...
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...
LECTURE SERIES 14, 15, 17 January 2008 11:00 to 12:00 - Council Chamber, bldg. 503-1-001 Applications of accelerators to tumour therapy U. AMALDI, TERA Foundation & University of Milano Bicocca The first lecture is devoted to an historical review of the developments of the teletherapy techniques which make use of hadron beams and are collectively called "hadrontherapy". The main emphasis is on the use of protons and light ions, but also neutrons, pions and antiprotons are considered. The second lecture reviews the rationale behind the use of carbon ions in the treatment of radioresistant tumours and the results obtained both with proton and carbon ion beams on the 60 000 patients treated worldwide. The numbers of patients who would profit from hadrontherapy are presented together with the current landscape of running and planned hospital based centres. The main technical challenges set by this therapeutic modality are ...
Most papers appearing in the surgical literature dealing with wound ballistics concern themselves with wound management in the civilian setting. The pathophysiology of modern war wounds is contrasted with ballistic wounds commonly encountered in peacetime, but it should be noted that even in peacetime the modern terrorist may have access to sophisticated military weaponry, and that patients injured by them may fall within the catchment area of any civilian hospital. Management problems associated with both wound types are highlighted; areas of controversy are discussed. The orthodox military surgical approach to ballistic wounds is expounded and defended. PMID:1996857
The purpose of this study is to develop a geometrically accurate imaging protocol at 3 T magnetic resonance imaging (MRI) for stereotactic radiosurgery (SRS) treatment planning. In order to achieve this purpose, a methodology is developed to investigate the geometric accuracy and stability of 3 T MRI for SRS in phantom and patient evaluations. Forty patients were enrolled on a prospective clinical trial. After frame placement prior to SRS, each patient underwent 3 T MRI after 1.5 T MRI and CT. MR imaging protocols included a T1-weighted gradient echo sequence and a T2-weighted spin echo sequence. Phantom imaging was performed on 3 T prior to patient imaging using the same set-up and imaging protocols. Geometric accuracy in patients and phantoms yielded comparable results for external fiducial reference deviations and internal landmarks between 3 T and 1.5 T MRI ...
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 ...
Renal osteodystrophy is a metabolic bone disease and a common complication of end-stage chronic renal failure and maintenance dialysis treatment. In this study, we examined the correlation between quantifying bone scintigraphy and serum biochemical markers in hemodialysis patients. Bone scintigraphy with technetium-99m-hydroxy-methylene-diphosphonate ("9"9"mTc-HMDP) was performed on 28 patients on maintenance hemodialysis. Bone scintigraphy was performed using a standard protocol and was quantified by setting regions of interest (ROIs) over selected regions. The bone-to-soft-tissue ratio (B/ST ratio) at each region was calculated in all patients. The B/ST ratios were then compared with serum biochemical markers. The B/ST ratio for the skull correlated well with serum bone-specific alkaline phosphatase (BAP) (r=0.735, p<0.001), serum deoxypyridinoline (DPD) (r=0.806, p<0.001) and intact parathyroid ...
Purpose: calculation of conversion coefficients for the reconstruction of organ doses from entrance doses for abdomen radiographs of 0, 1, 5, 10, 15, and 30-year-old patients in conventional pediatric radiology for the radiographic settings recommended by the German and European guidelines for quality management in diagnostic radiology. Materials und method: using the commercially available personal computer program PCXMC developed by the Finnish Center for Radiation and Nuclear Safety (Saeteilyturvakeskus STUK), conversion coefficients for conventional abdomen radiographs were calculated performing Monte Carlo simulations in mathematical hermaphrodite phantom models describing patients of different ages. The possible clinical variation of beam collimation was taken into consideration by defining optimal and suboptimal radiation fields on the phantoms' surfaces. Results: conversion coefficients for the ...
PurposeTo evaluate the efficacy of photorefractive keratectomy (PRK) for residual refractive error after penetrating keratoplasty (PKP) for keratoconus. SettingPrivate ophthalmic clinic. DesignCase series. MethodConsecutive patients who had PRK augmented with topical mitomycin-C (MMC) after PKP for keratoconus were retrospectively reviewed. Patients were divided into a a low cylinder group (refractive cylinder 6.00 D). Visual acuity, refraction, and keratometry were analyzed preoperatively and 1, 3, 6, and 12 months postoperatively. ResultsThe study comprised 47 eyes (41 patients). The spherical equivalent (SE) decreased from -4.24 D +- 3.23 (SD) preoperatively to -0.71 +- 1.03 D 12 months postoperatively in the low cylinder group and from -4.19 +- 3.54 D to -2.45 +- 3.42 D, respectively, ...
To determine the diagnostic accuracy of iofetamine hydrochloride I 123 (IMP) with single photon emission computed tomography in Alzheimer's disease, we studied 58 patients with AD and 15 age-matched healthy control subjects. We used a qualitative method to assess regional IMP uptake in the entire brain and to rate image data sets as normal or abnormal without knowledge of subjects'clinical classification. The sensitivity and specificity of IMP with single photon emission computed tomography in AD were 88% and 87%, respectively. In 15 patients with mild cognitive deficits (Blessed Dementia Scale score, less than or equal to 10), sensitivity was 80%. With the use of a semiquantitative measure of regional cortical IMP uptake, the parietal lobes were the most functionally impaired in AD and the most strongly associated with the patients' Blessed Dementia Scale scores. These ...
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 MLC-field-shaping concerning ...
Participants in the conference selected to attend two different working group sessions. The working groups discussed different perspectives of system-based approaches to osteoporosis and fracture care. The group on postfracture case management recommended that nurse case managers be used to improve communication among patients, orthopaedic surgeons, and those providing ongoing clinical care. The hospital working group discussed the impact of and barriers to improved postfracture management in the hospital setting. The health systems group emphasized the difference between a closed system in which long-term benefits of interventions were more likely to be appreciated than in fee for service systems. The health information technology group discussed the advantages and challenges of electroni...
Objective. Preterm neonates are susceptible to infection due to a combination of sub-optimal immunity and increased exposure to invasive organisms. Invasive fungal infections are associated with significant morbidity and mortality among preterm infants cared for in the neonatal intensive care unit (NICU). Mannose-binding lectin (MBL) is a component of the innate immune system, which may be especially important in the neonatal setting. The objective of this study was to investigate the presence of any association between MBL gene polymorphism and nosocomial invasive fungal infection in preterm neonates. Methods. Codon 54 (B allele) polymorphism in exon 1 of the MBL gene was investigated in 31 patients diagnosed as nosocomial invasive fungal infection and 30 control preterm neonates. Results...
Delayed endolymphatic hydrops (DEH) is a unique disorder characterized by fluctuating otologic symptoms in the setting of preexisting unilateral deafness. The symptoms include aural fullness, fluctuating hearing, and/or episodes of vertigo similar to those observed in Meniere disease and may occur ipsilateral or contralateral to the previously deafened ear. In most reported cases, the unilateral deafness has been a profound sensorineural hearing loss with a sudden onset that has been variously attributed to bacterial or viral labyrinthitis, acoustic or cranial trauma, otosclerosis, and congenital CMV infection. Familial occurrence of the syndrome has not previously been reported in the literature. In this report, we describe two possible familial instances of delayed DEH. These patients ra...
Stenting for stenosis of the proximal vertebral artery (VA) is commonly performed via a femoral approach. However, iliofemoral occlusive disease such as arteriosclerosis obliterans sometimes prevents safe transfemoral access. In certain situations where both femoral access and ipsilateral brachial access are difficult because of a concomitant vascular diseases or particular anatomic setting, a contralateral brachial approach using the brachiobrachial pull-through technique may allow efficient and accurate stenting. A case of VA origin symptomatic stenosis successfully treated with stenting using the new pull-through technique from the contralateral brachial artery to the brachial artery on the affected side is described. (orig.)
Primary percutaneous coronary intervention (PPCI) is superior to thrombolysis (TL) as reperfusion therapy in ST-elevation myocardial infarction (STEMI). TL is a rapidly available, but semi-effective therapy (effective reperfusion in 50% of patients only), whereas PPCI is a potentially delayed, but highly effective therapy (effective reperfusion in >90%). Since TL loses its efficacy beyond 2?3?h after symptom onset, it is a significant reperfusion alternative to PPCI in early presenters only. The individual decision to treat an early presenter with PPCI or TL requires the evaluation of the time delay between potential start of TL or PPCI, the PCI-related delay (PRD). PRD is greatest, if TL is given in the prehospital setting. Until now, prehospital TL as the most rapidly available reperfusi...
Understanding Center for Medicare and Medicaid Services (CMS) documentation and coding rules is challenging for most physicians. To accurately bill for clinical services, physicians must learn a system that may initially seem daunting, but is in fact governed by a small number of straightforward rules. The Evaluation and Management (E/M) guidelines for all service codes specify 3 components: history, examination, and medical decision-making, each with a defined set of elements or characteristics. Service coding is based on the level of care supported by the number of history and examination elements and the complexity of decision-making. This article will clarify the guidelines for outpatient clinical services and suggest a practical method of selecting appropriate E/M codes. Because physicians must often choose between billing codes 99213 and 99214 for a visit by an established patient, it will particularly focus on the minimum documentation ...
To which idea of truth may medicine refer? Evidence-based medicine (EBM) is rooted in the scientific truth. To explain the meaning and to trace the evolution of scientific truth, this article outlines the history of the Scientific Revolution and of the parable of Modernity, up to the arrival of pragmatism and hermeneutics. Here, the concept of truth becomes somehow discomfiting and the momentum leans towards the integration of different points of view. The fuzzy set theory for the definition of disease, as well as the shift from disease to syndrome (which has operational relevance for geriatrics), seems to refer to a more complex perspective on knowledge, albeit one that is less defined as compared to the nosology in use. Supporters of narrative medicine seek the truth in the interpretation of the patients' stories, and take advantage of the medical humanities to find the truth in words, feelings and contact with the ...
A single exposure energy subtraction technique with a metal filter and an imaging plate for the Fuji Computed Radiography (FCR) system was developed for dual-energy subtraction radiography (DES) of the chest. By the use of this technique, 206 patients with suspected lung cancer were scanned in the clinical settings. The subtracted images in 200 patients, excluding six with poor image quality, were examined. Soft-tissue images (bone cancelled images) were useful in visualizing abnormality of the airway and nodules lying under the ribs; and bone images (soft-tissue cancelled images) in detecting rib metastases and the presence or absence of calcification in nodules. Additional information was acquired in 21 % (42/200). A single exposure is capable of neglecting motion artifacts. In addition, this technique may be of value in DES, which is considered to be one of the routine examinations, in view of low exposure doses. The ...
A single exposure energy subtraction technique with a metal filter and an imaging plate for the Fuji Computed Radiography (FCR) system was developed for dual-energy subtraction radiography (DES) of the chest. By the use of this technique, 206 patients with suspected lung cancer were scanned in the clinical settings. The subtracted images in 200 patients, excluding six with poor image quality, were examined. Soft-tissue images (bone cancelled images) were useful in visualizing abnormality of the airway and nodules lying under the ribs; and bone images (soft-tissue cancelled images) in detecting rib metastases and the presence or absence of calcification in nodules. Additional information was acquired in 21 % (42/200). A single exposure is capable of neglecting motion artifacts. In addition, this technique may be of value in DES, which is considered to be one of the routine examinations, in view of low exposure doses. The ...
National efforts to improve the quality and safety of health care present challenges for medical education and training. Today's doctors need to be skilled communicators who know how to identify, prevent and manage adverse events and near misses, how to use evidence and information, how to work safely in a team, how to practise ethically, and how to be workplace teachers and learners. These competencies (knowledge, skills and attitudes) are set out in the National Patient Safety Education Framework (NPSF) of the Australian Council for Safety and Quality in Health Care. The NPSF is designed to help medical schools, vocational colleges, health organisations and private practitioners develop curricula to enable health professionals to work safely. The NPSF describes what doctors (depending on their level of knowledge and experience) can do to demonstrate competencies in a range of quality and safety activities. Medical schools, vocational ...
The idea to couple the Treatment Planning System (TPS) to the information on the real boron distribution in the patient is the main added value of the new methodology set-up at DIMNP of University of Pisa, in collaboration with the JRC of Petten (NL). The methodology has been implemented in the new TPS, called BDTPS (Boron Distribution Treatment Planning System), which takes into account the actual boron distribution in the patient brain, while the standard TPS assumes a uniform boron distribution, absolutely far from the reality. Nowadays, Positron Emission Tomography (PET) is able to provide this in vivo information. The new TPS, based on the Monte Carlo technique, has been validated comparing the main BNCT parameters (thermal flux, boron dose, etc.) as measured during the irradiation of a special heterogeneous boron phantom (HEBOM), ad hoc designed, as calculated by the BDTPS and by the standard TPS SERA. An evident SERA ...
Purpose Cisplatin plus gemcitabine is a standard regimen for first-line treatment of advanced non-small-cell lung cancer (NSCLC). Phase II studies of pemetrexed plus platinum compounds have also shown activity in this setting. Patients and Methods This noninferiority, phase III, randomized study compared the overall survival between treatment arms using a fixed margin method (hazard ratio [HR] < 1.176) in 1,725 chemotherapy-naive patients with stage IIIB or IV NSCLC and an Eastern Cooperative Oncology Group performance status of 0 to 1. Patients received cisplatin 75 mg/m(2) on day 1 and gemcitabine 1,250 mg/m(2) on days 1 and 8 (n = 863) or cisplatin 75 mg/m(2) and pemetrexed 500 mg/m(2) on day 1 (n = 862) every 3 weeks for up to six cycles. Results Overall survival for cisplatin/pemetrexed was noninferior to cisplatin/ gemcitabine (median survival, 10.3 v 10.3 months, respectively; HR = 0.94; 95% ...
Pulsatile hormone secretion is observed in almost every hormonal system. The frequency of episodic hormone release ranges from approximately 10 to 100 pulses in 24 hours. This temporal mode of secretion is an important feature of intercellular information transfer in addition to a dose-response dependent regulation. It has been demonstrated in a number of experiments that changes in the temporal pattern of pulsatile hormone secretion specifically regulate cellular and organ function and structure. Recent evidence links osteoporosis, a disease characterized by loss of bone mass and structure, to changes in the dynamics of pulsatile parathyroid hormone (PTH) secretion. In our study we applied nonlinear and linear time series prediction to characterize the secretory dynamics of PTH in both healthy human subjects and patients with osteoporosis. Osteoporotic patients appear to lack periods of high predictability found in normal humans. In contrast ...
(1) To determine the accuracy of computed tomography (CT) in the evaluation of ligament tear and avulsion in patients with tibial plateau fracture. (2) To evaluate whether the presence or severity of fracture gap and articular depression can predict meniscal injury. A fellowship-trained musculoskeletal radiologist retrospectively reviewed knee CT and MRI examinations of 41 consecutive patients presenting to a level 1 trauma center with tibial plateau fractures. Fracture gap, articular depression, ligament tear and footprint avulsions were assessed on CT examinations. The MRI studies were examined for osseous and soft tissue injuries, including meniscal tear, meniscal displacement, ligament tear, and ligament avulsion. CT demonstrated torn ligaments with 80% sensitivity and 98% specificity. Only 2% of ligaments deemed intact on careful CT evaluation had partial or complete tears on MRI. Although the degree of fracture gap and articular ...
A central problem in diagnostic radiology is to compare a new X-ray picture with a previous picture and from this comparison be able to decide if anatomical changes have occurred in the patient or not. It is of primary interest that these pictures are identical in projection. If not it is difficult to decide with confidence if differences between the pictures are due to anatomical changes or differences in their projection geometry. In this thesis we present a non invasive method that makes it possible to find the relative changes in the projection geometry between the exposure of a previous picture and a new picture. The method presented is based on the projection slice theorem (central section theorem). Instead of an elaborate search for a single new picture a pre-planned set of pictures are exposed from a circular orbit above the patient. By using 3D Fourier transform techniques we are able to synthesize a new X-ray ...
To compare the accuracy in the detection and staging of various malignant tumors with high resolution whole-body MRI using parallel imaging with whole-body dual-modality PET-CT. Preliminary results of an interim analysis from a prospective, blinded study are presented, in which 20 patients (mean age 59 years, range 27-77 years) with different oncological diseases underwent whole-body dual modality FDG-PET-CT screening for tumor search or staging in case of confirmed or suspected metastatic disease. All patients also underwent whole-body MRI imaging with the use of parallel imaging (iPAT). High-resolution coronal T1w- and STIR-sequences of 5 body levels with 512 x 512 matrix, axial fast T2w imaging of lung and abdomen (HASTE), contrast-enhanced dynamic and static T1w-sequences of liver, brain, abdomen, and pelvis were performed. Using a 32-channel whole-body MRI scanner (Magnetom Avanto, Siemens Medical Solutions) with a total field of view of ...
Purpose: To quantify left ventricular function derived from retrospectively ECG-gated multislice spiral CT (MSCT) data sets in comparison to MRI. Materials and Methods: In 16 patients (14 males, 2 females, mean age 56.8 #+-# 11.5 years), retrospectively ECG-gated MSCT angiography of the coronary arteries and breath-hold steady state free precession cine MRI were performed. From MSCT data-sets, 20 axial image series were reconstructed every 5% of the RR interval. Multiplanar images were reformatted in the short axis orientation from axial images. End-systolic and end-diastolic images were selected. From these images end-systolic volume (ESV), end-diastolic volume (EDV) and stroke volume (SV) as well as the ejection fraction (EF) and myocardial mass (MM) were determined using the Simpson's method and compared with MRI. Furthermore, image quality was assessed for both imaging modalities using a four point grading scale. ...
The synapsin III gene, SYN3, which belongs to the family of synaptic vesicle-associated proteins, has been implicated in the modulation of neurotransmitter release and in synaptogenesis, suggesting a potential role in several neuropsychiatric diseases. The human SYN3 gene is located on chromosome 22q12-13, a candidate region implicated in previous linkage studies of schizophrenia. However, association studies of SYN3 and schizophrenia have produced inconsistent results. In this study, four SYN3 SNPs (rs133945 (-631 C>G), rs133946 (-196 G>A), rs9862 and rs1056484) were tested in three sets of totally 3759 samples that comprise 655 affected subjects and 626 controls in the Irish Case-Control Study of Schizophrenia (ICCSS), 1350 samples incorporating 273 pedigrees in the Irish Study of High Density Schizophrenia Families (ISHDSF), and 564 unrelated schizophrenia patients and 564 healthy individuals in a Chinese case-control sample. The ...
AIM: To assess the impact of the introduction of a computed tomography (CT) imaging protocol for multi-trauma patients on the workload, overall diagnostic yield, and effect on detection of cervical spine injury and pneumothorax. METHOD: Between February 1997 and April 2004, all patients presenting acutely to the Emergency Department (ED) with haemodynamically stable trauma (Abbreviated Injury Scale 3 or more) involving more than two body systems were imaged with a comprehensive pre-set helical CT protocol (including non-contrast head, cervical spine: cranio-cervical and cervico-thoracic junctions; and oral and intravenous contrast-enhanced thoracic, abdomen and pelvis) after initial triage and a standard trauma series of radiographs (chest, lateral C-spine and pelvis). Diagnosis of cervical spine fracture and pneumothorax was noted before and after the CT protocol was carried out and findings from all studies were recorded ...
Full text: Radiotherapy treatment planning (RTP) relies heavily on medical imaging. Until recently, the most important planning tool was the treatment simulator. The kilovoltage radiographic capabilities in a treatment simulator enabled the boundaries of treatment fields to be visualized with respect to bony anatomic landmarks. Perhaps the most important advance in treatment planning in recent years is the ability to visualize the passage of the beams with respect to a more accurate geometrical representation of the tumor and other soft tissue structures. This 'virtual simulation' uses a computer-based representation of a patient to determine the extent of the disease and the location of radiation sensitive normal tissue. Computer tomographic (CT) imaging produces a high-resolution three-dimensional representation of anatomy that can be correlated with other image sets such as magnetic resonance images (MRI) of function. Positron emission ...
Chinese herbs have been and still are widely used as important remedies in Oriental medicine. Over the recent years, a variety of biologically active constituents have been isolated from these sources and confirmed to have multifunctional activity in experimental studies. Honokiol is a small-molecule polyphenol isolated from the genus Magnolia. It is accompanied by other related polyphenols, including magnolol, with which it shares certain biological properties. Recently, honokiol and magnolol have been found to have anti-oxidative, anti-inflammatory, anti-tumor, and anti-microbial properties in preclinical models, without appreciable toxicity. These findings have increased interest in bringing honokiol and magnolol to the clinic as novel therapeutic agents in dermatology. In this review, the findings concerning the major mechanisms of action of honokiol and magnolol are described. Knowledge of the multiple activities of honokiol and magnolol can assist with the development of honokiol ...
Ionizing radiation is a standard treatment for various human solid tumors. However, several clinical studies showed that a significant proportion of patients undergoing radiotherapy for hepatocellular carcinoma (HCC) develop intrahepatic and extrahepatic metastasis. Understanding of radiation-induced cancer cell invasiveness and behavior is essential and of great important for developing suitable treatment strategies to contain cancer spread. Therefore, in this study we evaluated the effectiveness of using swept source optical coherence tomography (SS-OCT) to monitor the enhancement of HCC cell invasiveness by radiation. SS-OCT images were acquired and recorded to obtain three-dimensional data sets per four hours in 48 hours after irradiating HepG2 cells with 7.5 Gy. The cell migration behavior in three-dimensional tissue models was quantified from images of radiation-induced and sham-irradiated cells.
Trace elemental analysis was carried out in various parts of some anti-diabetic medicinal plants using PIXE technique. A 3 MeV proton beam was used to excite the samples. The elements Cl, K, Ca, Ti, Cr, Mn, Fe, Ni, Cu, Zn, Br, Rb and Sr were identified and their concentrations were estimated. The results of the present study provide justification for the usage of these medicinal plants in the treatment of diabetes mellitus (DM) since they are found to contain appreciable amounts of the elements K, Ca, Cr, Mn, Cu, and Zn, which are responsible for potentiating insulin action. Our results show that the analyzed medicinal plants can be considered as potential sources for providing a reasonable amount of the required elements other than diet to the patients of DM. Moreover, these results can be used to set new standards for prescribing the dosage of the herbal drugs prepared from these plant materials.
Objective: To investigate the feasibility of low-dose single-slice helical CT in pulmonary CT scan and evaluate the clinical application. Methods: Thirteen cases were selected out of 132 cases, in which low-dose (50mAs) single-slice helical CT scan of chest was performed. This set of cases included 7 cases of multiple metastatic nodules; 3 of solitary pulmonary, nodule; and 3 of pulmonary patchy lesions. Regular dose (170mAs) CT scan was also performed on all those patients. The regular dose and low dose CT scan were compared on sensitivity of detecting the lesions; the performance in demonstrating the details of the abnormalities; and the capability of revealing the segmental bronchi as well. Results: The same number and size of the pulmonary nodules were revealed with scan modalities loaded with different doses. No significant difference in demonstrating the details of the nodules and the segmental bronchi was found between both modalities ...
Background When assessing the function of the cardiovascular system, cardiac output (CO) is a substantial parameter. For its determination, numerous non-invasive techniques have been proposed in the recent years including inert gas rebreathing (IGR) and impedance cardiography (ICG). The aim of our study was to evaluate whether a novel ICG algorithm (electrical velocimetry) and IGR can be used interchangeably in the clinical setting. Methods A total of 120 consecutive stable patients were included resulting in two pairs of repeated non-invasive cardiac output measurements. Results The mean CO was 5.0???1.2?l/min (range 2.6?8.6?l/min) using IGR and 4.4???1.1?l/min (1.7?7.4?l/min) using ICG, respectively. Bland?Altman analysis revealed an acceptable agreement with a mean bias of 0.6???1.2?l/m...
Hyperglycemia frequently occurs with acute medical illness, especially among patients with cardiovascular disease, and has been linked to increased morbidity and mortality in critically ill patients....Full Text Available
The high incidence and mortality rates of prostate cancer have stimulated research for prevention, early diagnosis and appropriate treatment. DNA ploidy status of tumour cells is an important parameter with diagnostic and prognostic significance. In the current study, DNA ploidy analysis was performed using image cytometry technique and digital image processing and analysis. Tissue samples from prostate patients were stained using the Feulgen method. Images were acquired using a digital imaging microscopy system consisting of an Olympus BX-50 microscope equipped with a color CCD camera. Segmentation of such images is not a trivial problem because of the uneven background, intensity variations within the nuclei and cell clustering. In this study specific algorithms were developed in Matlab based on the most prominent image segmentation approaches that emanate from the field of Mathematical Morphology, focusing on region-based watershed segmentation. First biomedical ...
Background and purpose: the recent RTOG guidelines for future clinical developments in gynecologic malignancies included the investigation of dose escalation in the paraaortic (PO) region which is, however, very difficult to target due to the presence of critical organs such as kidneys, liver, spinal cord, and digestive structures. The aim of this study was to investigate intensity-modulated radiotherapy's (IMRT) possibilities of either increasing, in a safe way, the dose to 50-60 Gy in case of macroscopic disease or decreasing the dose to organs at risk (OR) when treatment is given in an adjuvant setting. Material and methods: the dosimetric charts of 14 patients irradiated to the PO region at the department of radiation oncology, university hospital of Liege, Belgium, in 2000 were analyzed in order to compare six-field conformal external-beam radio-therapy (CEBR) and five-beam IMRT approaches. Both CEBR and IMRT investigations were planned to ...
To determine a suitable combination of X-ray filter and tube kilovoltage for Fuji Computed Radiography (FCR), provide better detection of pulmonary nodules, and reduce patient exposure, we compared observer performance with different X-ray filters and tube voltages. Radiographs were obtained with a copper filter backed by aluminium, with a tungsten filter backed by yttrium and aluminium, and with a lead filter backed by yttrium and aluminium, at both 100 kVp and 135 kVp. Observer performance in detecting simulated lung nodules, which were placed on the posterior aspect of a chest phantom, was compared using receiver operating characteristic (ROC) techniques for each combination of the X-ray filter and tube voltage. The results of the study indicated that (1) nodule detection was superior for the images obtained with 135 kVq as compared with 100 kVp; (2) approximately equal detection rates were obtained for the three X-ray filter sets, although ...
To determine a suitable combination of X-ray filter and tube kilovoltage for Fuji Computed Radiography (FCR), provide better detection of pulmonary nodules, and reduce patient exposure, we compared observer performance with different X-ray filters and tube voltages. Radiographs were obtained with a copper filter backed by aluminium, with a tungsten filter backed by yttrium and aluminium, and with a lead filter backed by yttrium and aluminium, at both 100 kVp and 135 kVp. Observer performance in detecting simulated lung nodules, which were placed on the posterior aspect of a chest phantom, was compared using receiver operating characteristic (ROC) techniques for each combination of the X-ray filter and tube voltage. The results of the study indicated that 1) nodule detection was superior for the images obtained with 135 kVq as compared with 100 kVp; 2) approximately equal detection rates were obtained for the three X-ray filter sets, although ...
Aim of this retrospective study was to assess the capability of contrast-enhanced helical computerised tomography (CT) in sigmoid diverticulitis, especially relative to selection of the appropriate treatment. The findings of 41 patients were reviewed from 1998 to 1999 June. Contrast-enhanced helical CT is the imaging modality of choice in assessing mild or severe acute diverticulitis because it provides useful information for appropriate treatment planning in the emergency setting. This technique is most useful in questionable cases and in patients with suspected severe diverticulitis where a choice must be made between different treatment options. [Italian] Scopo di questo studio retrospettivo e' illustrare i molteplici aspetti radiologici della flogosi diverticolare sigmoidea con tomografia computerizzata (TC) spirale, con specifico riguardo alle implicazioni terapeutiche che scaturiscono dall'analisi e ...
ObjectiveTo identify patient-care practices related to an increased prevalence of hepatitis C virus (HCV) infection among chronic hemodialysis patients.Full Text Available
Carcinoma in situ in the contralateral testis was diagnosed in 27 of 500 patients (5.4%) with unilateral testicular germ cell cancer. Eight of the 27 patients received intensive chemotherapy for spread...Full Text Available
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...
To determine the efficacy and safety of Total Dose Infusion (TDI) of low molecular weight iron dextran for the treatment of iron deficiency anemia compared to oral iron replacement during pregnancy through improvement in hemoglobin (Hb) after intervention. Non-randomized control trial. A group of 100 pregnant women with gestational age greater than 12 weeks with confirmed diagnosis of iron deficiency anemia attending the antenatal clinics were enrolled in this study. Total dose iron infusion of low molecular iron dextran was given to these patients after calculating iron deficit, in a monitored in-patientsetting. Control comprised of a second group of 50 pregnant females matched for age, parity and baseline hemoglobin, tolerant to oral iron supplementation (ferrous sulphate 200 mg three times a day) attending the antenatal clinics during the same period. Post-treatment hemoglobin levels of study group as well as the oral ...
Purpose/Objective: With the advent of computed tomography and magnetic resonance imaging, the three dimensional representation of the patient anatomy has become an invaluable resource for better diagnosis and delineation of the target volume and sensitive structures in radiation therapy. Although the therapeutic linear accelerator industry has made available highly sophisticated equipment, the aggressiveness in dose prescription and delivery has to be complimented by accurate dose computation methods. We have adopted a convolution/superposition algorithm for the calculation of absolute dose that fully accounts for the external shape and internal structure of the patient for photon treatment radiotherapy. In this paper, we will discuss the principles of the convolution algorithm and we will show how the computed dose compares to clinically relevant treatment techniques. Materials and Methods: A computer controlled data acquisition system and a ...
On account of a raised appearing of plastic waste and shreddered light fraction (SLF) from old car utilization as well as legal handicaps experiments were carried out at the Institute of Ferrous Metallurgy (RWTH Aachen) on a laboratory rig to inject DSD (Duales System Deutschland)-plastic waste and SLF with the destination of a subsequent raw material utilization in the blast furnace and cupola furnace. The experiments on the laboratory rig with DSD plastics could verify that by injection of specific coal/plastic mixtures into the blast furnace the injection rate could be raised by an improvement in the conversion degree and therefore the amount of the inserted reducing agent can be lowered. The injection of SLF without reduction of the inert materials and of the contents on alloying elements and/or tramp elements by extensive preparation has no advantages according to the experiments for the blast furnace process. Pilot experiments on the cupola furnace showed ...
Objective:To create the International Spinal Cord Injury (SCI) Male Sexual Function Basic Data Set within the International SCI Data Sets.Setting:An international working group.Methods:The draft of the data set was developed by an international working group consisting of members appointed by the International Spinal Cord Society (ISCoS), the American Spinal Injury Association (ASIA) and a representative from the executive committee of the International SCI Standards and Data Sets. The data set was developed in an iterative process with review and comments by the members of the executive committee of the International SCI Standards and Data Sets, ISCoS scientific committee, ASIA Board and the ISCoS Council, as well as all the interested organizations and individuals. Next, the data set was...
Two sets of analytical correlations describing transitions between two-phase flow regimes are reviewed and discussed. One, the T-D set, is based on mechanistic models; the other, the Weisman set, on experimental correlations. The T-D set is preferred for horizontal flow, whereas the Weisman set seems preferrable for vertical flow. A computer code (FLOP) based on the T-D theory is described and applied to validate the theory.
PurposeThe purpose was to determine whether semantic set size, a measure of the number of semantic neighbors, influenced word learning, and whether the influence...Full Text Available
Background and purpose: the recent RTOG guidelines for future clinical developments in gynecologic malignancies included the investigation of dose escalation in the paraaortic (PO) region which is, however, very difficult to target due to the presence of critical organs such as kidneys, liver, spinal cord, and digestive structures. The aim of this study was to investigate intensity-modulated radiotherapy's (IMRT) possibilities of either increasing, in a safe way, the dose to 50-60 Gy in case of macroscopic disease or decreasing the dose to organs at risk (OR) when treatment is given in an adjuvant setting. Material and methods: the dosimetric charts of 14 patients irradiated to the PO region at the department of radiation oncology, university hospital of Liege, Belgium, in 2000 were analyzed in order to compare six-field conformal external-beam radio-therapy (CEBR) and five-beam IMRT approaches. Both CEBR and IMRT investigations were ...
Objective: To characterize the protocols with low-dose radiation in survey CT scans for localization. Methods: Eighty standard adult patients, head and body phantoms were recruited. Default protocols provided by operator's manual setting were that all the tube voltage for head, chest, abdomen and lumbar was 120 kV; the tube currents were 20,10,20 and 40 mA, respectively. Values of kV and mA in the low-dose experiments were optimized according to the device options. For chest and abdomen, the tube position were compared between default (0 degree) and 180 degree. Phantoms were scanned with above protocols, and the radiation doses were measured respectively. Paired t-test were used for comparisons of standard deviation in CT value, noise and exposure surface dose (ESD) between group with default protocols and group with optimized protocols. Results: The optimized protocols in low-dose CT survey scans were 80 kV, 10 mA for head, 80 kV, 10 mA for ...
Purpose: `Exoscopic` and endoscopic identification of colorectal pathologies via MRI. Methods: 5 patients (36-88 years), two normal and three with different colorectal pathologies (diverticular disease, polyps and carcinoma of the colon), were examined by MRI after colonoscopy. Subsequent to filling of the colon with a gadolinium-water mixture under MRI-monitoring, 3D-data sets of the colon were acquired in prone and supine positions over a 28 sec breathold interval. Subsequently multiplanar T{sub 1}-weighted 2D-sequences were acquired before and following i.v. administration of Gd-DTPA (0.1 mmol/kg BW). All imaging was performed in the coronal orientation. The 3D-data were interactively analysed based on various displays: Maximum intensity projection (MIP), surface shadowed display (SSD), multiplanar reconstruction (MPR), virtual colonoscopy (VC). Results: All of the colorectal pathologies could be interactively diagnosed by MPR. On MIP images ...
Patients who fail to attend initial appointments reduce clinic efficiency. To maximize attendance by newly referred outpatients, we introduced a mandatory group orientation clinic for all new patients...Full Text Available
One hundred and fifty patients requiring maintenance haemodialysis were investigated to determine the incidence and pattern of tuberculosis. Twenty patients were found to have tuberculosis, giving an...Full Text Available
In a group of 32 patients with terminal renal failure the initial hypocalcaemia was corrected after two months' adequate maintenance haemodialysis. In seven patients hypercalcaemia occurred with a...Full Text Available
BackgroundPersonal health records (PHRs) provide patients with access to personal health information (PHI) and targeted education. The use of PHRs has the potential to improve a...Full Text Available
By analyzing the data of 459 patients who completed the Supportive Care Needs Survey (SCNS), the prevalence, medical and non-medical predictors of unmet needs were investigated. Breast cancer patients...Full Text Available
Background/Objective:Three patients with spinal cord injury (SCI) and 3 able-bodied (AB) patients were infused with naloxone during a study to examine their neuroendocrine...Full Text Available
Background:Encouragement of stroke patients to resume driving is important to promote their reintegration into the community. Limited rehabilitation has been performed in this regard,...Full Text Available
Using plasma glutathione S-transferase measurements hepatocellular integrity was assessed in groups of hyperthyroid and hypothyroid patients before and after treatment. Ten of 14 hyperthyroid patients...Full Text Available
OBJECTIVE: To evaluate prospectively the efficacy of a single fraction of high-dose radiotherapy in patients with Kaposi's sarcoma. PATIENTS: Between 1994 and 2004, 47 patients with Kaposi's sarcoma...Full Text Available
A patient’s electronic medical record contains a large amount of unstructured textual information. As patient records become increasingly dense owing to an aging population and increased occurrence...Full Text Available
BackgroundAcute kidney injury (AKI) is associated with increased short-term mortality of septic patients; however, the exact influence of AKI on long-term mortality in such patients...Full Text Available
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
OBJECTIVE: To assess the motor function of the left, supposedly unaffected, limbs of patients with an acute right vascular hemiplegia. METHODS: Fifteen patients with an acute vascular right hemiplegia...Full Text Available
The DNA sequences were determined for the lipoprotein lipase (LPL) gene from five unrelated Japanese patients with familial LPL deficiency. The results demonstrated that all five patients are homozygotes...Full Text Available
BackgroundDiagnostic delay in patients with tuberculosis (TB) leads to ongoing TB transmission, higher mortality rates and increased patient and government health expenditure. Qualitative...Full Text Available
Patients treated with bleomycin are at risk of developing the acute adult respiratory distress syndrome post-operatively. In a prospective study of 12 patients who had received bleomycin preoperatively...Full Text Available
BackgroundIn patients with Stage 5 Chronic Kidney Disease who require renal replacement therapy a major decision concerns modality choice. However, many patients defer the decision...Full Text Available
BackgroundCompared to healthy controls, cancer patients have a higher risk of unemployment, which has negative social and economic impacts on the patients and on society at large....Full Text Available
The performance of the Lung Imaging Fluorescence Endoscope (LIFE) system was compared with conventional bronchoscopy in 158 patients: 68 patients with invasive cancer, 42 patients with abnormal sputum...Full Text Available
Background & objectives: Fatigue is a debilitating symptom experienced by patients undergoing dialysis, but there is only limited information on its prevalence and its association with patient...Full Text Available
In a combined clinical, radiological, and laboratory study of 77 patients throughout the leprosy spectrum, 10 patients had an enthesitis which has not been described previously as far as is known and...Full Text Available
Patients do considerable information work. Technologies that help patients manage health information so they can play active roles in their health-care, such as personal health records, provide...Full Text Available
BackgroundThe effects of intervention programs on health-related quality of life (HRQOL) of patients with hip fracture have not been well studied. We hypothesized that older patients...Full Text Available
The increased risk of thrombosis in patients with active cancer has multiple causes. Acute thrombosis of the aorta is an exceedingly rare but potentially devastating complication in patients with cancer...Full Text Available
BackgroundClassification systems may be useful to direct more aggressive treatment to cancer patients with a relatively poor prognosis. The definition of 'poor prognosis' often lacks...Full Text Available
Six patient assessment systems that have explicit decision rules for replicating team judgments on level of care patient placement were selected for analysis. The six were selected because of their...Full Text Available
Forty-three patients with basal and squamous cell carcinomata arising on the pinna were treated radically using a 10 MeV electron beam. The technique and dosage are described and discussed. Primary cancer control with retention of the pinna was achieved in 34 patients. Salvage pinnectomy was performed in four patients for recurrence and one patient for radiation necrosis. Two patients with large primary tumours failed to resolve and died of their disease. The advantages for the patient of the policy of primary radical electron beam therapy are discussed.
In connection with some applications of asymptotic numbers and asymptotic functions, proposed by Khr.Khristov, the problem of describing subsets of asymptotic numbers closed with respect to algebraic operations arises. The algebraic operations with asymptotic numbers are defined by classes of their representatives. All trivial or noncharacteristic solutions are avoided. A procedure for constructing sets of elements closed under action of an algebraic operation or a combination of two or more of them is given. It turns out that the closed sets are given by their kernels, the last being the minimal subsets which generate the whole set by the introduced algebraic operations. It is proved that such kernels exist always. . The closed sets are described by their correspondence with the kernels. (S.P.).
We present and explain numerical results illustrating the mechanism of a type of discontinuous bifurcation of a chaotic set that occurs in typical dynamical systems. After the bifurcation, the chaotic set acquires new pieces located at a finite distance from its location just before the bifurcation, and these new pieces were not part of a previously existing chaotic set. A scaling law is given describing the creation of unstable periodic orbits following such a bifurcation. We also provide numerical evidence of such a bifurcation for a nonattracting chaotic set of the H{acute e}non map. {copyright} {ital 1998} {ital The American Physical Society}
As a generalization of fuzzy set, hesitant fuzzy set is a very useful tool in situations where there are some difficulties in determining the membership of an element to a set caused by a doubt between a few different values. The aim of this paper is to develop a series of aggregation operators for hesitant fuzzy information. We first discuss the relationship between intutionistic fuzzy set and hesitant fuzzy set, based on which we develop some operations and aggregation operators for hesitant fuzzy elements. The correlations among the aggregation operators are further discussed. Finally, we give their application in solving decision making problems.
Forty-one patients were treated with epidural neurolysis using 50 % ethyl alcohol 2 ml. Thirty eight patients were suffering from cancer pain and three patients were complaining of chronic benign pain. Alcohol block was repeated 2.3 times (mean) in the same patient. Thirty patients were followed after the treatment. Forty-seven percent of the patients reported 70 % or greater pain relief and 20 % of the patients reported about 50 % pain relief. Duration of pain relief was from 9 days to 203 days with a mean duration of 54 days. Adverse effects were reported 43 % of the patients. There is no miserable adverse effect. Adverse effect reported most was pain with epidural injection of drugs after the alcohol block had been performed. PMID:8544293
BackgroundApproximately 25% of ischemic stroke patients awaken with neurological deficits. In these patients, in whom the time from symptom onset is uncertain, brain imaging is a...Full Text Available
A patient with Cushing's syndrome due to a nonresectable chromophobe adenoma underwent external irradiation of the hypothalamic-pituitary area. The signs of Cushing's syndrome ameliorated subsequently...Full Text Available
Although clinic environments are a primary location for exchanging information with clinicians, patients experience these spaces as harsh environments to access, use, exchange, and manage information....Full Text Available
The ultrastructure of conjunctival melanocytic lesions in 49 patients was evaluated to find significant differences between benign and malignant cells. The patients studied included 9 with benign epithelial...Full Text Available
Although the life expectancy of thalassemia patients has markedly improved over the last few decades, patients still suffer from many complications of this congenital disease. The presence of a high...Full Text Available
ObjectivesTo determine the content and extent, design, and relative importance of patient assessment courses in the professional pharmacy curriculum.MethodsA...Full Text Available
We describe the successful creation of a transjugular intrahepatic portosystemic shunt (TIPS) in a patient with complete situs inversus using a simple modification of the standard TIPS technique.
BackgroundProvision of consumer information and patient education are considered an essential part of chronic disease management programmes developed for patients with heart failure....Full Text Available
PurposeTo identify the extent of persistence (period of time of continuous therapy with the drug prescribed) of glaucoma patients treated with prostaglandins (latanoprost, bimatoprost,...Full Text Available
Two experiments used the McGill Pain Questionnaire (MPQ) to examine the affective dimension of pain in patients whose pain was secondary to malignancy. In experiment I, segregating groups of cancer patients on the basis of extreme scores (high versus low) on the MPQ failed to produce segregation on independent measures of affect and infirmity. This outcome contrasts with earlier work with chronic benign pain patients. Experiment II compared cancer pain patients matched with benign pain patients on intensity of pain report on the affective dimension of the MPQ. Cancer pain patients reported a reliably higher affective loading to their pain. These data suggest that cancer pain patients employ different criteria than benign pain patients in selecting affective pain descriptors. Possible explanations for this difference are ...
The Model for the Assessment of Psychosocial Problems (MAPP) can help family medicine residents effectively assess patients with psychosocial problems. Following a patient-centred clinical method, MAPP...Full Text Available
Direct radiological measurements of the mineral content of femoral bone were performed in 13 patients on maintenance dialysis. They were found to be sufficiently sensitive to be used for monitoring,...Full Text Available
A group of patients is described who developed the clinical features of foveomacular retinitis. No causative factors were isolated, and all patients strongly denied any type of sun gazing. It is possible...Full Text Available
Purpose:To report crystal formation as a complication of intravitreal ganciclovir injection.Patients and methods:A 73-year-old female patient with...Full Text Available
This exploratory research paper investigated the coping strategies of families of hospitalized psychiatric patients and identified their positive and negative coping strategies. In this paper, the coping...Full Text Available
The purpose of this study was to investigate the extent of consumer demand for patient-oriented pharmacy services. Data, collected via a self-administered questionnaire distributed to 300 households,...Full Text Available
The evaluation of hepatic histology and treatment of hepatitis C virus (HCV)/HIV-coinfected patients is rapidly changing. HCV has become an important cause of mortality in HIV-infected patients. Consequently, assessment of liver histology in all coinfected patients is particularly important. The evaluation of hepatic histology is shifting from reliance on the liver biopsy toward noninvasive modalities. Additionally, the importance of HCV-associated morbidity and mortality in HIV-infected patients has prompted increasing numbers of these patients to be HCV treatment candidates. Prospective trials in coinfected patients have reported lower sustained virologic responses compared to HCV-monoinfected patients. Consequently, the numbers of coinfected nonresponders to pegylated interferon/ribavir...
Background Increasing numbers of cancer patients are using the Internet, but little is known about their attitudes toward online health care.Full Text Available
Bone integrity and mineral status were studied with a noninvasive method in uremic patients with severe secondary hyperparathyroidism undergoing maintenance hemodialysis.
The Systems Development Group and the Pharmacy Service of the Washington D.C. VAMC are involved in automating the administrative and clinical data requirements of a satellite out-patient pharmacy....Full Text Available
Hypertension affects most hemodialysis patients and is often poorly controlled. Adequate control of blood pressure is difficult with conventional hemodialysis alone but is important to improve...Full Text Available
BackgroundAdnexal masses are not uncommon in patients with breast cancer. Breast cancer and ovarian malignancies are known to be associated. In patients with breast cancer and co-existing...Full Text Available
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 ...
Metal oxide semiconductor (MOS) integrated circuits, with the benefits of low power consumption, represent the state of the art technology for implantable medical devices. Three significant sources of radiation are classified as having the ability to damage or alter the behavior of implantable electronics; Secondary neutron cosmic radiation, alpha particle radiation from the device packaging and therapeutic doses(up to 70 G{gamma}) of high energy radiation used in radiation oncology. The effects of alpha particle radiation from the packaging may be eliminated by the use of polyimide or silicone rubber die coatings. The relatively low incidence of therapeutic radiation incident on an implantable device and the use of die coating leaves cosmic radiation induced secondary neutron single event upset (SEU) as the main pervasive ionising radiation threat to the reliability of implantable devices. A theoretical model which predicts the susceptibility of a RAM cell to secondary neutron cosmic ...
The extent measurement error on CT colonography influences polyp categorisation according to established management guidelines is studied using twenty-eight observers of varying experience to classify polyps seen at CT colonography as either 'medium' (maximal diameter 6-9 mm) or 'large' (maximal diameter 10 mm or larger). Comparison was then made with the reference diameter obtained in each patient via colonoscopy. The Bland-Altman method was used to assess agreement between observer measurements and colonoscopy, and differences in measurement and categorisation was assessed using Kruskal-Wallis and Chi-squared test statistics respectively. Observer measurements on average underestimated the diameter of polyps when compared to the reference value, by approximately 2-3 mm, irrespective of observer experience. Ninety-five percent limits of agreement were relatively wide for all observer groups, and had sufficient span to encompass ...
Purpose: This study presents a dosimetric optimization effort aiming to compare intensity-modulated (IM) X-rays and IM protons in 4 different orbital and paraorbital tumors. These are most challenging targets for standard radiotherapy due to their close relationship with the eyes and related structures. Methods and Materials: A primary orbital lymphoma, an optic nerve meningioma, a sphenoidal ridge meningioma protruding into the orbit, and a pediatric parameningeal paraorbital rhabdomyosarcoma were selected for the purpose of this study. Planning target volumes (PTVs) and organs at risk (OAR) were defined in each patient CT data set for each tumor site. IM X-ray and IM proton three-dimensional treatment plans were implemented. The following total tumor doses were prescribed: 30 Gy for the orbital lymphoma, 54 Gy for both meningiomas, and 50.4 Gy for the rhabdomyosarcoma case. Dose-volume histograms (DVHs) were obtained for all targets and OAR ...
Objective. To compare turbo inversion recovery magnitude (TIRM) with standard T1-weighted (T1-W) and T2-weighted (T2-W) MR sequences in the very early detection of acute osteomyelitis in children. Materials and methods. In 15 children with osteomyelitis, 15 sets of T1-W spin-echo (SE) (TR/TE, 400-640/12-17), T2-W turbo spin-echo (TSE) (TR/TE/ETL, 3290-4465/112-120/11), and TIRM (TR/TE/TI, 4000-6120/60/160) images were acquired with a 1.0-T magnet. Contrast-to-noise (C/N) ratios and percentage of signal between lesion and normal bone marrow were analysed with a computer-assisted image analysing system in a region of interest (ROI). Results. In 13 of 15 patients, the absolute signal enhancement in a ROI on the TIRM images was better than on the T1-W SE and T2-W TSE images and in 14 of 15 cases, C/N ratios were also better on the TIRM images than on the other sequences. In the other cases, the TIRM signal was diagnostically equivalent. On the TIRM ...
Background and Purpose: Total-body irradiation (TBI) is an important part of the conditioning regimen for hematopoietic stem cell transplantation (HSCT) in patients with hematologic malignancies. The results after treatment with various TBI regimes were compared, and dose-effect relationships for the endpoints relapse incidence, disease-free survival, treatment-related mortality, and overall survival were derived. The aim was to define requirements for an optimal treatment schedule with respect to leukemic cell kill and late normal-tissue morbidity. Material and Methods: A literature search was performed. Three randomized studies, four studies comparing results of two or three TBI regimens, and nine reports with results of one specific TBI regimen were identified. Biologically effective doses (BEDs) were calculated. The results of the randomized studies and the studies comparing results of two or three TBI regimens were pooled, and the pooled relative risk (RR) was ...
Background and Purpose: Total-body irradiation (TBI) is an important part of the conditioning regimen for hematopoietic stem cell transplantation (HSCT) in patients with hematologic malignancies. The results after treatment with various TBI regimes were compared, and dose-effect relationships for the endpoints relapse incidence, disease-free survival, treatment-related mortality, and overall survival were derived. The aim was to define requirements for an optimal treatment schedule with respect to leukemic cell kill and late normal-tissue morbidity. Material and Methods: A literature search was performed. Three randomized studies, four studies comparing results of two or three TBI regimens, and nine reports with results of one specific TBI regimen were identified. Biologically effective doses (BEDs) were calculated. The results of the randomized studies and the studies comparing results of two or three TBI regimens were pooled, and the pooled relative risk (RR) was ...
Purpose: To develop an accurate, fast, and robust algorithm for registering portal and computed tomographic (CT) images for radiotherapy using a combination of sparse and dense field data that complement each other. Methods and Materials: Gradient Feature Weighted Minimax (GFW Minimax) method was developed to register multiple portal images to three-dimensional CT images. Its performance was compared with that of three others: Minimax, Mutual Information, and Gilhuijs' method. Phantom and prostate cancer patient images were used. Effects of registration errors on tumor control probability (TCP) and normal tissue complication probability (NTCP) were investigated as a relative measure. Results: Registration of four portals to CTs resulted in 30% lower error when compared with registration with two portals. Computation time increased by nearly 50%. GFW Minimax performed the best, followed by Gilhuijs' method, the Minimax method, and Mutual Information. Conclusions: ...
Purpose: To evaluate the significance of preoperative localization of abnormal parathyroid glands to the surgical outcome in patients with primary hyperparathyroidism. Material and Methods: Thirty-nine patients with primary hyperparathyroidism were studied preoperatively with US (39 patients), CT (30 patients) and MR imaging (18 patients). The overall diagnostic accuracy for US was 87%, CT 66% and MR 94%. In patients with a single parathyroid adenoma US was the most cost-effective localization technique with a detection rate of 96%. CT had a lower detection rate (78%) but was of particular value for fairly large ectopic adenomas in the root of the neck. MR imaging was a good confirmatory test (93%). In patients with multiple gland disease (primary hyperplasia and multiple adenomas), no single localization study alone was sufficient. ...
The role of MRT in the prebiopsy diagnosis of muscular and vascular inflammatory conditions was evaluated prospectively and an optimal method of examination was investigated. 92 patients with a suspected diagnosis of myositis (60 cases) or vasculitis (32 cases) were examined, in each case two extremities were studied using transverse T_1 and T_2 weighted SE sequences and double echo STIR sequences on a 0.5 Tesla (56 patients) or 1.5 Tesla magnet (36 patients; T5/S15 Gyroscan, Philips). The site of the biopsy depended on the MRT findings. In 41 patients the suspected diagnosis was confirmed histologically, in two patients an infective myositis was diagnosed on clinical grounds despite negative histology. MRT demonstrated muscle oedema in 86% of patients. There were negative findings after immuno-suppressive therapy (two patients), in focal ...
Therapeutic effect of p-aminobenzoic acid-N-xyloside Na (K-247) were studied. Eleven patients with a variety of solid tumors were treated with K-247 alone. K-247 was given orally 800 mg daily for 4 weeks. As for side effect of the drug, only mild gastritis was observed in a few patients. Partial response (over 25% reduction of tumor size) with a median duration of two months was observed in 3 patients. These cases were metastatic tumor of lung from the carcinoma of thyroid, metastatic tumors of lung from the carcinoma of kidney, and mediastinal tumor. In eight patients the response was classified as no change and in one patient there was progressive disease. Thus K-247 has some therapeutic activity in patients with solid tumor. Combination therapy of irradiation and administration of K-247 were also studied. In the twelve patients receiving ...
This report deals with the preliminary results of trials in the DATECA project with stage I, II and III patients with non-seminomatous germ cell tumours. Stage 1 patients were randomized between infradiaphragmatic irradiation and observation. No significant difference in recurrence rates has been observed as yet. Eighteen of 95 patients had recurrence with a median time to relapse of 3 months. Fifteen patients achieved complete remission after treatment by combination chemotherapy while 3 patients are still undergoing treatment. Stage II patients received 6 series of cis-platinum, bleomycin, and vinblastine. The patients were initially randomized to receive chemotherapy alone versus chemotherapy plus irradiation. Irradiation led to increased toxicity and decreased doses of the antineoplastic drugs. Fifty-one patients ...
This report deals with the preliminary results of trials in the DATECA project with stage I, II and III patients with non-seminomatous germ cell tumours. Stage 1 patients were randomized between infradiaphragmatic irradiation and observation. No significant difference in recurrence rates has been observed as yet. Eighteen of 95 patients had recurrence with a median time to relapse of 3 months. Fifteen patients achieved complete remission after treatment by combiantion chemotherapy while 3 patients are still undergoing treatment. Stage II patients received 6 series of cis-platinum, bleomycin, and vinblastine. The patients were initially randomized to receive chemotherapy alone versus chemotherapy plus irradiation. Irradiation led to increased toxicity and decreased doses of the antineoplastic drugs. Fifty-one patients ...
Purpose of this work is to evaluate the effectiveness and role of CT in blunt diaphragmatic injuries by reviewing our 8-year experience. It is reviewed the preoperative CT findings of 35 patients with surgically confirmed diaphragmatic rupture. Surgical repair was performed in the acute setting (within 12 hours of trauma) in 22 cases, and late (8 months-5 years) in 13 cases. Twenty-eight patients (80%) were examined with conventional CT and 7 (20%) with Helical CT. Of the 13 patients examined long after trauma, the left hemi diaphragm was ruptured in 12 cases (with visceral herniation in 4), and the right hemi diaphragm in 1, with no herniation. The diaphragmatic rent was found in the dome (15 cases, 43%), muscolotendinous junction (11 cases, 31%), muscular portion (8 cases, 23%), and at the muscular attachments on the ribs (1 case, 3%). As for the site of diaphragmatic injury, CT never depicted the ...
Purpose: Treatment results and the pattern of relapse were evaluated in the multimodal treatment of Ewing's sarcomas of the chest wall. Methods and Materials: In a retrospective analysis, 114 patients with non-metastatic Ewing's sarcoma of the chest wall were evaluated. They were treated in the CESS 81, CESS 86, or EICESS 92 studies between January 1981 and December 1993. The treatment consisted of polychemotherapy (VACA, VAIA, or EVAIA) and local therapy, either surgery alone (14 patients), radiotherapy alone (28 patients) or a combination of both (71 patients). The median follow-up was 46.6 months (range 5-170). A relapse analysis for all patients with local or combined relapses was performed. Results: Overall survival was 60% after 5 years, event-free survival was 50%. Thirty-seven patients had a systemic relapse (32.4%), 11 patients had ...
The purpose of this study is to evaluate the radiologic findings of the extraosseous Ewing's sarcoma. Six patients with pathologically confirmed extraosseous Ewing's sarcoma were retrospectively reviewed. Patients included two men and four women with an average age of 21.5 years (age range 9-48 years). Plain radiographs (six patients), magnetic resonance (MR) images (five patients), computed tomographic (CT) scans (three patients) and whole body scintigraphy (two patients) were reviewed and analyzed. Images were evaluated with regard to lesion location, size, margin, muscle or bone involvement and intrinsic imaging characteristics on CT and MRI. The tumors were located in the thigh (three patients), back (two patients) and upper arm (one patient). The tumors ranged in size from 2.3 cm to 7.5 cm ...
Two patients receiving maintenance dialysis therapy developed osteonecrosis, the first in the humeral head and the second in the talus. Both patients lacked known risk factors for developing osteonecrosis. A possible pathogenic role of secondary hyperparathyroidism in this disorder is suggested. Rheumatologists evaluating patients receiving maintenance dialysis with rheumatic manifestations should be aware of this potential complication. PMID:2185360
Between October 1990 and March 1991, 8 patients with cystic lesions in the region of the posterior bladder wall, the seminal vesicles and the prostate were examined by MRI. In all cases there was accurate characterisation of the lesion and of its anatomy. In 3 patients with abnormalities in the retrovesical space there was very good agreement with the operative findings. 4 patients were treated conservatively. In these patients there was good agreement with the findings on cystoscopy, CT and sonography. (orig.).
Background Limited data is available for investigating the long-term safety and effects of intracoronary progenitor cell therapy in patients with acute myocardial infarction (AMI). Objective To assess the clinical course, NT-proBNP and MRI data as objective markers of cardiac function of the TOPCARE-AMI patients at 5-year follow-up. Design The TOPCARE-AMI trial was the first randomized study investigating the effects of intracoronary infusion of circulating (CPC) or bone marrow-derived progenitor cells (BMC) in 59 patients with successfully reperfused AMI. Results Five-year follow-up data were completed in 55 patients, 3 patients were lost to follow-up. None of the patients showed any signs of intramyocardial calcification or tumors at 5?years. One patient died during the initial hospitali...
Objective: To investigate the X-ray radiation dose patients dealt with the hepatic intervention. Methods: Thermoluminescence and tissue-equivalent anthropomorphic phantom were used to measure the X-ray radiation dose in patients dealt with the hepatic intervention in 85 patients. Results: The peak skin dose in the patients who accepted hepatic intervention was from 179.95 to 1759.00 mGy, effective dose approached 29.22 mSv (male), 29.27 mSv (female). Conclusion: Hepatic intervention is now regarded as an important therapeutic method for liver cancer. However, the patients were exposed to too much X-ray radiation during interventional procedures. Some more effective protection should be taken to decrease the X-ray radiation dose accepted by patients. (authors)
Purpose We retrospectively analyzed the results of percutaneous nephrolithotomy operations for treatment of staghorn kidney stone disease in elderly patients and compared surgical parameters and outcomes with a control group of young adult patients. Patients and method Between 2002 and 2010, 300 consecutive patients underwent percutaneous nephrolithotomy operation for treatment of staghorn kidney stone disease. Forty-five of the patients were older than 65?years and considered to be in elderly group. Thirty-seven of the patients were between the ages 18 and 36?years and considered to be the control group. Surgical parameters and outcomes were compared between groups. Results There were no significant differences between groups for stone area, operation time, difference in hemoglobin levels...
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 ...
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...
Background: The Internet has become a popular source of health information for patients with a variety of medical concerns; however, research examining patient interactions on the Internet has been limited. Purpose: Four questions were examined in a survey study of hysterectomy patients who visited http://www.hystersisters.com: (a) Do hysterectomy patients use the support Web site because they perceive their proximal sources of social support to be inadequate? (b) What kinds of support do patients receive from the Web site? (c) What attributes characterize the "Hystersisters" that are perceived to be most helpful? (d) How do informational sources vary depending on the nature of the patient concern? Methods: Women (N = 137) responded to questions about social support, Web site use, and perc...
A destructive spondyloarthropathy is reported in four patients undergoing maintenance hemodialysis for chronic renal disease. In a separate investigation a controlled, prospective radiographic study of the cervical spine revealed this spondyloarthropathy in 4 (15%) of 26 long-term dialysis patients. A single disk level was involved in three patients, and two disc levels were involved in one patient. This spondyloarthropathy correlated with the duration of dialysis but not with the radiographic evidence of renal osteodystrophy or severity of laboratory abnormalities associated with hyperparathyroidism. Three of these four patients also had discovertebral erosions or destruction involving the lumbar spine. Cervical spine flexion views revealed evidence of ligamentous laxity or instability in three (12%) dialysis patients, all with vertebral resorption and disc ...
Abstract Purpose: To compare the safety and efficiency of conventional monopolar, plasmakinetic and holmium laser transurethral resection of bladder tumor (CM-TURBT, PK-TURBT and HoL-TURBT) while managing primary non-muscle invasive bladder cancer. Patients and Methods: From 2005 to 2009, 173 patients with primary non-muscle invasive bladder cancer underwent endoscopic surgery. Among them, 51 patients underwent CM-TURBT, 58 patients underwent PK-TURBT, and 64 patients underwent HoL-TURBT. All patients were divided into three risk groups (low, intermediate, and high) based on the European Association of Urology guidelines and prognostic factors of recurrence. Clinical data, included preoperative, operative, and postoperative management and follow-up, were recorded. Results: Patient demograp...
Somatostatin receptor expression has been demonstrated on a number of plasma cell lines. Therefore, we questioned whether somatostatin receptor scintigraphy (SRS) can be used to demonstrate in vivo multiple myeloma (MM) activity. SRS was performed in newly diagnosed (n = 9) or relapsing (n = 18) MM patients or in patients with localized plasmacytoma (n = 2). The results were compared with radiographic findings. A positive SRS was demonstrated in 44% of the newly diagnosed patients, in 83% of the relapsed patients and in both patients with plasmacytoma. The SRS findings corresponded with radiographic abnormalities in 40% of the patients. However, in relapsed patients 60% demonstrated increased SRS uptake in areas without new radiographic abnormalities. The positive SRS corresponded with histologically proven disease activity and responded ...
Staging bone scans or skeletal surveys were obtained of 97 patients with endometrial carcinoma. Of the 77 patients with Stage I or II disease, no metastases were identified at staging. Three patients in the entire series demonstrated bony metastases; all of these metastases were detectable by radionuclide bone scan and radiographic bone survey. Eighty-nine patients were examined with radionuclide liver/spleen scanning at the time of staging. Four of the 89 initial scans were interpreted as demonstrating hepatocellular disease, and all four patients had abnormal liver function studies. Only one patient demonstrated a possible hepatic metastasis at initial diagnosis. This patient also had abnormal liver function studies. Based on these results, bone surveys and radionuclide bone scans are not indicated as screening procedures in endometrial ...
After some observations about the tests of the research exposed in the literature, authors illustrate the tests for 142 patients divided into 5 groups: a) patients affected with acute viral hepatitis; b) patients affected with praegressa acute viral hepatitis; c) relatives of patients with acute viral hepatitis; d) volunteers; e) patients affected with chronic uraemia under dialisis periodic treatment. After the testing control, authors, conclude with an hipotesis: a possible epidemic function of faeces, urine saliva, in the passage of the acute viral hepatitis. PMID:488577
Intraspinal synovial cysts were diagnosed in six patients during a 5-year period and retrospectively studied. Plain films of the lumbar spine showed degenerative changes in all patients. Lumbar myelography showed a posterior and lateral defect caused by extradural compression. Using CT without contrast enhancement established the diagnosis in five of the six patients. In four cases MRI was performed, three before and after injection of gadolinium diethyline-triamine penta-acetic acid (Gd-DTPA). Including the patient with a false-negative CT, MRI was positive in all patients. (orig.)
Computerized tomography of the adrenal glands was performed in 10 patients with Cushing's syndrome using a G.E. 8800 CT/T Body Scanner. The tomographic findings of unilateral adrenal masses in 4 patients were confirmed by surgery. In the remaining 6 patients, computerized tomography did not identify any masses, and both glands were well visualized and showed normal shape. In these patients, measurement of the adrenal glands revealed both normal (n=1) and enlarged glands (n=5). The findings of adrenalectomy (n=4) or transphenoidal surgery and follow-up (n=2) established the diagnosis of adrenal phyperplasia in all patients. (Author).
To evaluate whether children with and without autism could exhibit (a) functional equivalence in the course of yoked repeated-reversal training and (b) reversal learning set, 6 children, in...Full Text Available
BACKGROUND:Canadian chronic pain prevalence estimates range from 11% to 66%, are affected by sampling and measurement bias, and largely represent urban settings.OBJECTIVES:To...Full Text Available
ObjectiveTo evaluate the association of physical activity with left ventricular structure and function in the general population in a community setting.Full Text Available
ObjectiveTo develop consistent variable names and a common database structure for the data elements in the International Spinal Cord Injury (SCI) Data Sets.Full Text Available
Harborth [{\\it Elemente der Mathematik}, Vol. 33 (5), 116--118, 1978] proved that every set of 10 points in the plane, no three on a line, contains an empty convex pentagon. From this it follows that the number of disjoint empty convex pentagons in any set of $n$ points in the plane is least $\\lfloor\\frac{n}{10}\\rfloor$. In this paper we prove that every set of 19 points in the plane, no three on a line, contains two disjoint empty convex pentagons. We also show that any set of $2m+9$ points in the plane, where $m$ is a positive integer, can be subdivided into three disjoint convex regions, two of which contains $m$ points each, and another contains a set of 9 points containing an empty convex pentagon. Combining these two results, we obtain non-trivial lower bounds on the number of disjoint empty convex pentagons in planar points sets. We show that the ...
This paper hopes to share the insights we experienced during designing, building, and running an indexing solution for a large set of radiological reports and images in a production environment for...Full Text Available
It is often argued that Nursing Minimal Data Sets (NMDSs) have advantages for the nursing profession. The NMDSs that have been developed and applied in some countries have many features in common,...Full Text Available
The data set consists of the following: - Biochemical analysis of Deschampsia leaves and root; - Chromatographic Analysis of membrane lipids (lipid profile) ...
Problems of classification and regression estimation in which objects are represented by multidimensional arrays of features are considered. Many practical statements can be reduced to such problems, for example, the popular approach to the description of images as a set of patches and a set of descriptors in each patch or the description of an object in the form of a set of distances from it to certain support objects selected based on a set of features. For solving problems concerning the objects thus described, a generalization of the relevance vector model is proposed. In this generalization, specific regularization coefficients are defined for each dimension of the multidimensional array of the object description; the resultant regularization coefficient for a given element in the mul...
In application, there is also a little filtering of the tie points with RANSAC .... Sets the multiplier that is used to adjust the sigma (or uncertainty) of ...
In this paper we have investigated the performance of PSO Particle Swarm Optimization based clustering on few real world data sets and one artificial data set. The performances are measured by two metric namely quantization error and inter-cluster distance. The K means clustering algorithm is first implemented for all data sets, the results of which form the basis of comparison of PSO based approaches. We have explored different variants of PSO such as gbest, lbest ring, lbest vonneumann and Hybrid PSO for comparison purposes. The results reveal that PSO based clustering algorithms perform better compared to K means in all data sets.
... CJCSI 3141.01C, Responsibilities for the Management and ... of a multivolume set of CJCS unclassified and ... (1) CJCSM 3122.01A, Joint Operation ...
... projects that will result in the reduction of energy consumption in compliance with the objectives set forth in the Army Facilities Energy Plan, without ...
An operator of FE-closure is introduced on the set of functions of a multivalued logic based on the systems of functional equations. It is proved that, for every k ? 2, the FE-closure operator generates a finite classification on the set P k of functions of k-valued logic. The least class in this classification is shown to be the class H k of all homogeneous functions. Also a series of corollaries are obtained concerning the finite FE-generating sets in the FE-closed classes.
Let X and W be two sets. We introduce and study the subdifferential of an extended real valued function defined on X at a point, with respect to a duality from the set of functions on X into the set of functions on W (by a duality we mean a mapping transforming infima into suprema). We also consider some particular cases as, e.g., when the duality is a (Fenchel-Moreau) conjugation.
There are about fifty SET domain protein methyltransferases (PMTs) in the human genome, that transfer a methyl group from S-adenosyl-L-methionine (SAM) to substrate lysines on histone tails or other peptides. A number of structures in complex with cofactor, substrate, or inhibitors revealed the mechanisms of substrate recognition, methylation state specificity, and chemical inhibition. Based on these structures, we review the structural chemistry of SET domain PMTs, and propose general concepts towards the development of selective inhibitors.
The asymptotic functions are a new type of generalized functions. But they are not functionals on some space of test-functions as the distributions of Schwartz. They are mappings of the set denoted by A into A, where A is the set of the asymptotic numbers introduced by Christov. On its part A is a totally-ordered set of generalized numbers including the system of real numbers R as well as infinitesimals and infinitely large numbers. Every two asymptotic functions can be multiplied. On the other hand, the distributions have realizations as asymptotic functions in a certain sense. (author).
Purpose/Objective: At present, treatment verification between portal and reference images is performed based on manually-identified features by radiation oncologist, which is both time-consuming and potentially error-prone. There is a demand for the computerized verification procedure in clinical application. The purpose of this study is to develop a computerized portal verification scheme for pelvic treatment fields. Materials/Methods: The automated verification system involves image acquisition, image feature extraction, feature matching between reference and portal images and quantitative evaluation of patient setup. Electronic portal images with a matrix size of 256 x 256 and 12 bit gray levels were acquired using a liquid matrix electronic portal imaging device. Simulation images were acquired by digitizing simulation films using a TV camera into images with 256 x 256 matrix and 8 bit gray levels. Initially a Canny edge detector is applied to identify the ...
Objective was to present our 8 year experience in the prevention of the obturator nerve reflex during transurethral resection of bladder tumors. This study was performed in Ataturk University Hospital between 1999 and 2007. We retrospectively reviewed the records of 89 patients with inferolateral bladder tumors, who underwent transurethral resection under epidural or general anesthesia and requested obturator nerve reflex inhibition. Epidural anesthesia was administered to 57 patients, while the remaining 32 patients underwent general anesthesia via mask; and succinylcholine was administered prior to resection. Of the 57 patients received epidural anesthesia, 18 were diagnosed as inferolateral bladder tumors during endoscopy and had to undergo general anesthesia. Obturator nerve block was attempted preoperatively in 39 patients. However, a nerve identification failure, hematoma and ...
Purpose To analyze the clinical profile, management and outcome of non-hematological tumors in head and neck region in children less than 18?years of age. Patients and methods Medical records of patients (0?18?years) presenting with non-hematological tumors of head and neck region from 2000 to 2010 were reviewed. Result Out of the 78 patients identified, 50 were males with median age of 14?years (3?months to 18?years). Histologically, 58 out of the 78 patients had malignant tumors and 20 were metastatic at presentation. Common site of tumor origin was noted as thyroid (23/78), salivary glands (21/78) and nasopharynx (13/78). Out of 78 patients, 44 patients were treated by surgery, 26 patients received radiation and 13 patients received chemotherapy, while 9 patients received radio-iodine (...
Objective:? Primary hyperparathyroidism (HPT) is characterised by autonomous secretion of PTH from enlarged parathyroid glands leading, in most patients, to asymptomatic hypercalcaemia. Familial hypocalciuric hypercalcaemia (FHH) is an autosomal dominant disorder caused by inactivating mutations in the calcium sensing receptor (CaSR) gene; it is characterised by lifelong and usually asymptomatic hypercalcaemia. Establishing the correct diagnosis is important because surgery can be curative in HPT, but ineffective in FHH. There is overlap in the diagnostic criteria for the two disorders and some patients carrying inactivating mutations in the CaSR gene, which is suggestive of FHH, also have HPT with hyperplastic parathyroid glands or adenomas. Design and Patients:? CaSR gene mutations were analyzed and clinical and biochemical parameters evaluated in 139 consecutive out-patients presenting with ...
Thirty-nine previously untreated patients with squamous cell carcinoma of the tongue were treated by irradiation or a combination of irradiation and surgery, with or without chemotherapy, between January 1971 and December 1980. All of the patients had a follow-up period of at least nine years. Twenty-two patients were men and 17 were women. The average age was 50.1 years, with a range of 30 to 74 years. The absolute five-year survival rate was 82.1% and the cumulative ten-year survival rate 76.9% for these 39 patients. Cervical node metastases were clinically found on admission in 14 patients whose five-year survival rate was 64.3%, whereas it was 92.0% for 25 patients without metastasis. The absolute five-year survival rate decreased from 92.3% for patients with stage I lesions to 90.9%, 87.5% and 42.9% for those with stage II, stage III ...
There is limited information on the incidence of acute kidney injury (AKI) in patients with traumatic brain injury (TBI) although AKI may contribute to morbidity and mortality. We investigated the incidence of AKI in patients with moderate and severe TBI and the association of AKI with risk factors and outcomes in these patients. We studied all TBI patients over 16 years of age admitted to the two designated trauma hospitals in the state of Victoria, Australia from 1 January to 31 December 2008. Patients were included if they had head trauma and presented with a Glasgow coma scale (GCS) <13. Prospectively collected data from the hospital trauma registries, ICUs, and pathology databases were analyzed retrospectively. Risk injury failure loss end (RIFLE) criteria were used to categorize rena...
The prospective study includes 25 patients without pathology of the femoral head for the evaluation of the normal femoral head perfusion. In addition 34 patients with femoral head necrosis underwent i.a. DSA preoperatively before pedicled pelvic bone grafting. 15 patients after pelvic bone graft operation and 7 patients with medial femoral head fracture were also examined via superselective DSA. In cases with femoral head necrosis a rarefaction or interruption of the rami nutricii proximales, or an occlusion of the medial circumflex femoral artery were observed. Patients with medial femoral neck fracture showed an interruption of the rami nutricii proximales of the femoral head. Postoperative DSA - after pedicled pelvic bone graft - revealed a regular arterial graft perfusion in 82%. (orig.).
Soluble TWEAK is a member of the TNF-alpha family of cytokines that has been shown to predict mortality in patients with heart failure. Pulmonary artery hypertension is a devastating disease, in which right ventricular function has been shown to be the major determinant of prognosis. In this hypothesis-generating study, we sought to evaluate the potential usefulness of sTWEAK in the prediction of disease severity in patients with pulmonary artery hypertension. We therefore conducted a retrospective analysis of sTWEAK serum levels in 95 stable patients with PAH. For all patients data on hemodynamic parameters, biomarkers and functional exercise tests were available. Compared to controls, patients with PAH showed significantly decreased levels of sTWEAK [median 314?pg/ml (interquartile range...
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 ...
To determine the proportion of rheumatoid arthritis (RA) patients receiving preventive health care according to US Preventive Services Task Force recommendations compared with a community-based population sample, with emphasis on dyslipidemia testing, given the increased risk of cardiovascular disease (CVD) in RA patients. Patients with RA (ICD-9 code 714.0 at ?2 office visits with a rheumatologist) and a primary care physician (PCP) at the Geisinger Health System (GHS) were identified through electronic health records. The records were searched back from 3/31/08 for the length of time required to satisfy each outcome measure. Percentages were compared with population testing rates using the Pearson Chi-square test. Eight hundred and thirty-one RA patients were compared to 169,476 subjects...
In a retrospective single-centre study 170 consecutive patients were included who received a Kotz modular prosthesis after resection of bone tumours of the proximal femur to evaluate the management of prosthetic infection. Infection occurred in 12 of 166 patients available for follow-up (six males; six females; mean age, 47?years; range, ten to 75?years) after a mean of 39?months (range, one to 166?months; infection rate, 7.2%). Mean follow-up was 54?months (range, four to 200?months). One patient died of septic shock. Two patients were treated by wound revision only. Treatment of infection in the remaining patients was one-stage revision in eight and hip disarticulation in one. Infection control by one-stage revision was achieved in five of eight patients; re-infection occurred in three p...
Context. Cardiovascular medication overdoses can be difficult to treat. Various treatment modalities are currently recommended. Objective. To describe patient outcomes and adverse events of high-dose insulin therapy in consecutive overdose patients in cardiogenic shock after implementation of a high-dose insulin protocol (1-10 U/kg/h, while avoiding or tapering off vasopressors). Methods. This is an observational consecutive case series of patients identified from a registry. Data were collected by retrospective chart review of patients treated by our toxicology service with this protocol from February 2007 until March 2010. Results. Twelve patients were treated with high-dose insulin. The mean age was 36.5 years (SD 11.7). Seven patients had pre-existing vasopressor therapy, and all were ...
Abstract Introduction.- There are no studies on the sexual function of male patients with Behet's disease (BD), but it is probable that male sexual dysfunction may be seen in this chronic condition. Aim.- The aim of this study was to assess the effect of BD on male sexual function and psychiatric status, and to examine the relationship between sexual function and depression in this population. Methods.- Patients with a diagnosis of BD for at least one year were included in the study. The patients' age, educational level, and duration of disease were recorded. A healthy control group was selected with highly similar characteristics to the patient group. The sexual functions of the patient and the control groups were assessed using the International Index of Erectile Functions (IIEF), and th...
Background There is increasing recognition that lower nurse staffing levels are associated with higher morbidity and mortality among medical and surgical patients. The degree to which this applies to elderly patients with hip fractures is unclear. Questions/purposes We conducted a pilot study using administrative data as an initial step in investigating the relationship between nurse staffing levels and in-hospital mortality among elderly patients with hip fractures. Patients and Methods We retrospectively reviewed administrative data for 13,343 patients 65?years or older with a primary diagnosis of hip fracture admitted to 39 Michigan hospitals between 2003 and 2006. We used logistic regression to calculate the change in predicted probability of in-hospital death conferred by differences ...
Objective: To compare pediatric patients with periventricular leukomalacia (PVL) with normal children by using diffusion tensor MR imaging. Methods: Diffusion tensor images were obtained in 15 pediatric patients with PVL and 15 age-matched normal children. Regions of interest were drawn to measure the fractional anisotropy (FA) in bilateral posterior limb of internal capsule, bilateral optic radiation, genu of corpus callosum, and splenium of corpus callosum. The values of PVL patients and normal children were compared using non-dependent samples T-test. Results: The FA values of regions of interest prescribed were significantly lower in PVL patients than in normal children (P<0.01). Conclusion: Diffusion tensor imaging may reveal retard of myelination of fiber tracts in PVL patients. It can be a potential tool in evaluating the brain development of children. (authors)
This study is for chemoradiotherapy of unresectable and recurrent cholangiocarcinoma (CCC). Between April 2005 and March 2007, 5 patients were evaluated for unresectable and recurrent CCC. All patients were performed percutaneous transhepatic biliary drainage (PTBD) and treated with chemoradiotherapy. The radiation method was an external beam radiotherapy (EBRT) and remote after loading system (RALS). The chemotherapy was 5-fluorouracil (FU) and gemcitabine by intravenous injection. Three patients had unresectable and 2 had recurrent CCC. As for the side effects, 4 patients had a slight neutropenia and 1 had an uncontrollable gastric bleeding. No patient had cholangitis. The mean survival time for unresectable and recurrent CCC was 13.7 months and 17 months, respectively. Our results indicated that chemoradiotherapy had been consistent with efficacy in patients ...
Contrast agent-enhanced CT scans in nine male patients with histologically proved benign lymphoepithelial lesions of the perotid gland were reviewed. All scans showed cystic-appearing masses with peripheral rim enhancement corresponding to the macroscopic appearance of the lesion. Five patients were seropositive for human immunodeficiency virus (HIV) infection or had infections seen in acquired immunodeficiency syndrome. Three patients were members of high-risk groups. Only one patient had symptoms of the SICCA syndrome. Once a rare cause of parotid gland enlargement, benign lymphoepithelial lesions have recently been seen with increasing frequency in patients with HIV infection. Although the CT appearance is not pathognomic, correlation results of aspiration cytology and with clinical history can lead to a preoperative diagnosis of a benign lymphoepithelial lesion.
All patients with von Willebrand?s disease (vWD) who showed an arterial or venous thrombosis and were reported in the literature have been evaluated. 11 patients had arterial thrombosis while 19 had venous thrombosis for a total of 30 cases. 9 out the 11 cases with arterial thrombosis had myocardial infarction. Two had cerebral thrombosis. Associated risk factors for arterial thrombosis were available only for three patients who showed, respectively, smoking and dyslipidemia (2 cases) and smoking and intravenous desmopressin infusion (1 case). The majority of patients with venous thrombosis showed DVT with or without PE. Four patients presented with apparently isolated PE. In two instances thrombosis occurred in unusual sites (central retinal vein and portal vein, respectively). Several as...
Background There is some evidence that a patient?s pre-operative condition influences short-term and long-term post-operative outcomes. The aim of the present study is to compare the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) and modified Glasgow prognostic score (mGPS) models in the prediction of post-operative outcome, both short term and long term, in patients undergoing resection of oesophago-gastric cancer. Patients and Methods Patients who underwent curative resection for oesophago-gastric cancer from January 2005 to May 2009 and who had data to score the POSSUM, P-POSSUM, O-POSSUM and mGPS models were included in the study. Observed morbidity and mortality rates were compared with predicted outcome in different risk groups. Bot...
Abstract Objective:- This study explored 12-month outcome and its associations to social adjustment-related variables in patients with first-episode non-affective psychosis in Finland and Spain. Methods:- Forty-nine Finnish and 37 Spanish patients were evaluated at admission on various characteristics of social adjustment. Outcome was measured for 68 (79%) patients by the Brief Psychiatric Rating Scale, Global Assessment Scale, and Grip on Life. Results:- One-fourth of the patients experienced psychotic symptoms at follow-up. Sixty per-cent of the patients showed good global functioning and Grip on Life. In both patient groups, poor earlier global functioning, weak social network, poor Grip on Life, and psychological dependence on family of origin were associated with poor outcome. In the ...
Level set method based segmentation provides an efficient tool for topological and geometrical shape handling. Conventional level set surfaces are only $C^0$ continuous since the level set evolution involves linear interpolation to compute derivatives. Bajaj et al. present a higher order method to evaluate level set surfaces that are $C^2$ continuous, but are slow due to high computational burden. In this paper, we provide a higher order GPU based solver for fast and efficient segmentation of large volumetric images. We also extend the higher order method to multi-domain segmentation. Our streaming solver is efficient in memory usage.
In this paper we propose an entropy measure for interval-valued intuitionistic fuzzy sets, which generalizes three entropy measures defined independently by Szmidt, Wang and Huang, for intuitionistic fuzzy sets. We also give an approach to construct similarity measures using entropy measures for interval-valued intuitionistic fuzzy sets. In particular, the proposed entropy measure for interval-valued intuitionistic fuzzy sets can yield a similarity measure. Several illustrative examples are given to demonstrate the practicality and effectiveness of the proposed formulas. We apply the similarity measure to solve problems on pattern recognitions, multi-criteria fuzzy decision making and medical diagnosis.
We propose and evaluate a memory-based model of Hick's law, the approximately linear increase in choice reaction time with the logarithm of set size (the number of stimulus-response alternatives). According to the model, Hick's law reflects a combination of associative interference during retrieval from declarative memory and occasional savings for stimulus-response repetitions due to non-retrieval. Fits to existing data sets show that the model accounts for the basic set-size effect, changes in the set-size effect with practice, and stimulus-response-repetition effects that challenge the information-theoretic view of Hick's law. We derive the model's prediction of an interaction between set size, stimulus fan (the number of responses associated with a particular stimulus), and stimulus-re...
Parallel imaging and echo sharing techniques have markedly reduced the acquisition times for MRI of large volumes. Dynamic 2 and 3-dimensional data sets of the chest with high temporal resolution (up to 10 images/s with single slice and 2 volume/s) allow an analysis of respiratory motion of the lungs and tumors. Time-resolved 2D series in preselected planes can be used to observe respiratory motion during free breathing or after respiratory commands, e.g. to exclude chest wall invasion by a tumor or for diagnosing impairment of respiratory mechanics. Time-resolved 3D-series (4D-MRI) allow monitoring of the spatial displacement of the lungs and tumors as a whole volume. Present limitations such as an overestimation of tumor size and an underestimation of displacement due to a limited temporal resolution are expected to be overcome with further technical developments. However, 4D-MRI already appears to be the appropriate tool to select patients ...
The aim of this retrospective study was to determine the safety and efficacy of chemoembolization (TACE) as palliative treatment for patients with unresectable intrahepatic cholangiocarcinoma (CCA) and to compare the results with those in the literature. Fifteen patients with histology-proven CCA (5 men, 10 women) had received palliative treatment with TACE over a 6-year period. The treatment protocol comprised repeated TACE at a minimum of 8-week intervals. TACE was performed with a mixture of 10 ml Lipiodol and 10 mg mitomycin C injected into the tumor-supplying vessels. Follow-up investigations after 8-10 weeks comprised contrast-enhanced multislice spiral CT and laboratory control. Statistical evaluation included survival analysis using the Kaplan-Meier method. During the investigation period 58 TACEs (3.9 #+-# 3.8; 1-15) were performed in 15 patients. Mean tumor size was 10.8 #+-# 4.6 cm (range, 2.0-18.0 cm). Unifocal ...
In this study, we investigated the effects of one- and two-staged orchiopexy on testicular volume and serum testosterone levels in cases with high, abdominally localized, bilateral nonpalpable testes. Between March 1996 and April 2001, orchiopexy was performed on 46 testes in 23 patients with bilateral nonpalpable testes. In 15 of the 23 patients, a two-stage Fowler-Stephens orchiopexy was performed, and in 8 of the 23 patients, a one-stage laparoscopic orchiopexy was performed. For one patient who lacked both testes, bilateral prosthetic testes were inserted. The patients' ages were between 20 and 23 years (average, 21 years). In the first stage of the two-stage orchiopexy, the spermatic artery was ligated laparoscopically. Six months later, open surgery orchiopexy was performed. Patients were followed for 2 to 16 months (average, 10 months) and were evaluated ...
BACKGROUND: The urgent need for patient safety education for healthcare students has been recognised by many accreditation bodies, but to date there has been sporadic attention to undergraduate/graduate medical programmes. Medical students themselves have identified quality and safety of care as an important area of instruction; as future doctors and healthcare leaders, they must be prepared to practise safe healthcare. Medical education has yet to fully embrace patient safety concepts and principles into existing medical curricula. Universities are continuing to produce graduate doctors lacking in the patient safety knowledge, skills and behaviours thought necessary to deliver safe care. A significant challenge is that patient safety is still a relatively new concept and area of study; thus, many medical educators are unfamiliar with the literature and unsure how to integrate ...
The aim of this study was to evaluate the results of postoperative radiotherapy in a case of perihilar cholagiocarcinoma by analyzing overall survival rate, patterns of failure, prognostic factors for overall survival, and toxicity. Between January 1998 and March 2008, 38 patients with perihilar cholangiocarcinoma underwent a surgical resection and adjuvant radiotherapy. The median patient age was 59 years (range, 28 to 72 years), which included 23 men and 15 women. The extent of surgery was complete resection in 9 patients, microscopically positive margins in 25 patients, and a subtotal resection in 4 patients. The tumor bed and regional lymphatics initially received 45 Gy or 50 Gy, but was subsequently boosted to a total dose of 59.4 Gy or 60 Gy in incompletely resected patients. The median radiotherapy dose was 59.4 Gy. Concurrent chemotherapy was ...
A sensitive radio-assay for ferritin was developed and used to examine serum ferritin levels in 105 patients with recurrent oral ulceration (ROU), 41 patients with Behcet's syndrome (BS), 42 with other ulcerative oral lesions, 35 patients with non-ulcerative oral lesions and in 78 controls. Ferritin levels increased with age and were significantly higher in males than females. The mean ferritin concentrations in male patients with ROU, BS or with other oral ulcers were significantly reduced in comparison with controls, and in female patients were significantly reduced in those with major aphthous ulcers. The prevalence of low serum ferritin levels was about 8% in patients with ROU, 15% in BS and 9.5% in patients with other ulcerative oral lesions, compared with less than 3% in patients with non-ulcerative oral ...
BACKGROUND: The urgent need for patient safety education for healthcare students has been recognised by many accreditation bodies, but to date there has been sporadic attention to undergraduate/graduate medical programmes. Medical students themselves have identified quality and safety of care as an important area of instruction; as future doctors and healthcare leaders, they must be prepared to practise safe healthcare. Medical education has yet to fully embrace patient safety concepts and principles into existing medical curricula. Universities are continuing to produce graduate doctors lacking in the patient safety knowledge, skills and behaviours thought necessary to deliver safe care. A significant challenge is that patient safety is still a relatively new concept and area of study; thus, many medical educators are unfamiliar with the literature and unsure how to integrate ...
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%, ...
The frequency of peripheral pulmonary artery stenosis in patients after surgical repair of tetralogy of Fallot (TOF) ranges from 20 to 40%. This can be either primary or secondary to the surgical intervention. The influence of resulting lung perfusion alterations on the life quality of patients is difficult to predict. The aim of this study was to compare the utility of the diagnostic procedures in this group of patients, with particular focus on lung perfusion scintigraphy. This study comprised 104 patients who underwent repair of TOF at ages from 5 months to 25 years. The patients have been followed up for from 4.2 to 25 years. On the basis of chest X-ray peripheral pulmonary artery stenosis was suspected in 11 patients, in 12 on the basis of echocardiography examination. Lung perfusion scintigraphy has been performed on 87 patients. The ...
Background and purpose: A diagnosis of malignancy and its treatment is a very stressful time for patients and their families. This study was conducted to determine the impact of more intensive written information on patients' anxiety levels. The secondary aim was to determine the impact of this information on patients' satisfaction levels. Materials and methods: This prospective randomized trial consisted of patients with a pathological diagnosis of cancer having radical radiotherapy (RT). Patients were randomized to receive the more intensive information (including written information and a telephone call from the research nurse) or not to receive the more intensive information at the time of their initial consultation with the radiation oncologist. Study questionnaires measuring anxiety (STAI form) were completed prior to their first consultation (baseline) at the time of ...
Of 1850 patients with cholelithiasis diagnosed in the past 17 years, 1116 female and 734 male, 598 patients (32.3%) presented with one or more of three major symptoms, i.e., abdominal pain, fever and jaundice, whereas the remainder (67.7%) had none of these symptoms. The proportion of the asymptomatic patients was similar in all age groups, being around 70%. Only 20 per cent of 680 asymptomatic patients, followed for 10 to 17 years (median 13.3 years), developed biliary symptoms. Older patients over 70 years of age had a higher rate of change to the symptomatic group, as compared with younger patients under 70, 29.5% vs. 19.3%, respectively. During this period, carcinoma of the gallbladder developed in one of the asymptomatic patients (0.1%). Oral dissolution therapy was successful in only 4.2 per cent of attempted cases and associated with ...
Patient decision support systems have a promising role in the delivery of health care. However, the best approach for further development of these systems is a matter of speculation. To help chart a...Full Text Available
BackgroundThe cachexia-anorexia syndrome impacts on patients' physical independence and quality of life. New treatments are required and need to be evaluated using acceptable and...Full Text Available
Background:The manufacturers of oral bisphosphonates (alendronate, risedronate) recommend avoiding use of these drugs in patients with renal impairment. However, many patients who...Full Text Available
Forty-two patients were treated with intravenous cefoxitin, a new cephamycin antibiotic. These patients had postoperative abdominal sepsis (26), intrathoracic infections (6), urinary tract infections...Full Text Available
Background and objectives: The pathogenesis of acquired nephrogenic systemic fibrosis recently described for patients with renal insufficiency and a history of exposition to gadolinium-based magnetic...Full Text Available
Femur fractures typically affect elderly patients with multiple co-morbidities. Pain control can be difficult, requiring intensive nursing and physician care as elderly patients may manifest cardiovascular...Full Text Available
ObjectiveThe objective of this study was to identify patterns of brain activation elicited by erotic visual stimuli in patients treated with either Selective Serotonin Reuptake Inhibitors...Full Text Available
A patient is presented with a cervical spinal cord transection which occurred after a motor vehicle accident in which the air bag deployed and the seat belt was not in use. The patient had complete...Full Text Available
Successful management of a patient with tracheo-innominate artery erosion requires the rapid institution of specific resuscitative and operative measures. Ten patients seen at the Charity Hospital of...Full Text Available
Two large, prospective, randomized, controlled trials have shown a beneficial effect of intensive insulin therapy (IIT) on the kidney function of critically ill patients. The data from these trials...Full Text Available
Over a 7-year period transient hyperthyroidism was diagnosed in 35 patients seen in a consulting practice in a community hospital. The patients were followed up for an average of 15 months. Initially...Full Text Available
BackgroundIn France, it is estimated that 24% of HIV-infected patients are also infected with HCV. Longitudinal studies addressing clinical and public health questions related to...Full Text Available
ContextMusic and surgery.ObjectiveTo determine the effect of live classical piano music on vital signs of patients undergoing ophthalmic surgery.DesignRetrospective...Full Text Available
AbstractBackgroundGender concordance between patients and their physicians is related to prevention screening and other quality indicators. Research suggests female...Full Text Available
Aging is a risk factor for heart failure, which is a leading cause of death world-wide. Elderly patients are more likely than young patients to experience a myocardial infarction (MI) and are...Full Text Available
Background and objectives: While many patients with end-stage renal disease (ESRD) have impaired physical and psychologic well-being, less is known about these health domains in patients with advanced...Full Text Available
BackgroundThe natural history of bronchial preinvasive lesions and the risk of developing lung cancer in patients with these lesions are not clear. Previous studies have treated...Full Text Available
Chronic pain patients who show aberrant drug-related behavior often are discontinued from treatment when they are noncompliant with their use of opioids for pain. The purpose of this study was...Full Text Available
We ran a comparative analysis of all patients for whom a positive culture of Mycobacterium tuberculosis complex was available between April 2004 and October 2005 and whose HIV serology...Full Text Available
Fresh blood has many potential advantages over older blood, but there is no evidence that these properties translate into clinical benefit for intensive care patients. The observational multicenter...Full Text Available
During 1975 we studied 100 patients--77 men and 23 women--who had a history of alcohol abuse and disturbed liver function test results. On presentation the women were less likely to be suspected of...Full Text Available
OJECTIVEThis study seeks to identify practices of self-medication in the treatment of ocular emergencies. We examine patients’ use of both homemade preparations and manufactured...Full Text Available
BackgroundPercutaneous endoscopic gastrostomy (PEG) allows long-term tube feeding. Safety of pull-type and introducer PEG placement in oncology patients with head/neck or oesophageal...Full Text Available
BackgroundSafety for diabetic patients means providing the most suitable treatment for each type of diabetic in order to improve monitoring and to prevent the adverse effects of...Full Text Available
This paper presents a new deformable model using both population and patient-specific statistics to segment the prostate from CT images. There are two novelties in the proposed method. First,...Full Text Available
BackgroundPatients with ST-elevation myocardial infarction (STEMI) treated with fibrinolysis are increasingly, and ever earlier, referred for routine coronary angiography and where...Full Text Available
BackgroundSymptomatic heterotopic ossification (HO) in multiple trauma patients may lead to follow up surgery, furthermore the long-term outcome can be restricted. Knowledge of the...Full Text Available
PurposeTo present full ophthalmologic examination and retinal nerve fiber layer (RNFL) photographs of autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) patients...Full Text Available
Bone scintigraphy was performed in 16 men with newly diagnosed prostatic carcinoma before orchiectomy as well as 2 weeks and 2 months after operation. The uptake in the lower thoracic and lumbar vertebrae was registered up to 240 min after injection of /sup 99m/Tc-MDP and was then calculated for each patient and vertebra. The relative standard deviation in measured uptake due to measuring technique was estimated to be +-7%. In eight patients, who had normal bone scintigraphies before orchiectomy, there were no changes in the uptake values after operation. The remaining eight patients had widespread metastatic involvement prior to treatment, six of these patients showed a so-called 'flare phenomenon' in the abnormal vertebrae which means an initial increase in uptake after operation followed by a decreased uptake in response to therapy. One patient had a ...
Bone scintigraphy was performed in 16 men with newly diagnosed prostatic carcinoma before orchiectomy as well as 2 weeks and 2 months after operation. The uptake in the lower thoracic and lumbar vertebrae was registered up to 240 min after injection of "9"9"mTc-MDP and was then calculated for each patient and vertebra. The relative standard deviation in measured uptake due to measuring technique was estimated to be #+-#7%. In eight patients, who had normal bone scintigraphies before orchiectomy, there were no changes in the uptake values after operation. The remaining eight patients had widespread metastatic involvement prior to treatment, six of these patients showed a so-called 'flare phenomenon' in the abnormal vertebrae which means an initial increase in uptake after operation followed by a decreased uptake in response to therapy. One patient had a continuously increased uptake ...
This clinical report described the oral rehabilitation of a cleft lip and palate patient with removable partial denture. Although implant-supported fixed treatment was presented as part of the optimum...Full Text Available
BackgroundTransarterial chemoembolization (TACE) therapy is an effective locoregional treatment in hepatocellular cancer (HCC) patients. For early modification of therapy, markers...Full Text Available
BackgroundTo assess the relationship between improved regional and global myocardial function in patients with ischemic cardiomyopathy in response to β-blocker therapy or...Full Text Available
A large percentage of patients with HIV/AIDS will develop dermatological complications. Consequently, all practising clinicians and pathologists in regions with a high prevalence of HIV/AIDS must be...Full Text Available
Background. Diabetes mellitus (DM) confers high vascular risk and is a growing national epidemic. We assessed clinical characteristics and prevalence of diagnosed DM among patients...Full Text Available
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
Forty-four patients with histologically proven Hodgkin's disease underwent initial treatment with extended-field radiation therapy. Nineteen of these patients also received combination chemotherapy....Full Text Available
SummaryRadiotherapy is used commonly in the treatment of gynecologic malignancies. Many patients experience emotional distress prior to the initiation of radiotherapy, during...Full Text Available
Study objective:To describe sleep characteristics and rapid eye movement (REM) sleep behavior disorder in patients with Guadeloupean atypical parkinsonism (Gd-PSP), a tauopathy resembling...Full Text Available
Incidence of esophageal cancer (EC) is rising more rapidly in the Western world than that of any other cancer. Despite advances in therapy, more than 50% of patients have incurable disease at the time...Full Text Available
We quantified antibody responses to the HCV proteome that are associated with sustained virologic response (SVR) in HIV/HCV co-infected patients treated with pegylated interferon and ribavirin....Full Text Available
Although patients with cleft lip and palate (CLP) are not seen regularly in general dental practice, this is a frequent congenital anomaly; approximately one in every 800 live births results in a CLP....Full Text Available
ObjectiveTo determine the prevalence of pathogens that cause sexually transmitted infections (STIs) in semen from asymptomatic male infertility patients with and...Full Text Available
ObjectiveTo determine the prevalence of erectile dysfunction (ED) in HTLV-I infected patients, and its association with overactive bladder (OB).Full Text Available
BackgroundHealthcare professionals can play a crucial role in optimizing the health status of patients with cardiovascular risk factors (abdominal obesity, high blood pressure, low...Full Text Available
This program focused on practice-level service change as a means of improving patient care and developing leadership skills of 19 general practitioners (GPs) and aimed to: promote and support change...Full Text Available
IntroductionPatients undergoing selective minor emergency and elective procedures are followed up by a nurse-led structured telephone review six weeks post-operatively in our hospital....Full Text Available
Idiopathic frozen shoulder is a common medical diagnosis for patients seeking physical therapy. Radiographic and surgical evidence exists that describes the coracohumeral ligament (CHL) as a major contributor...Full Text Available
The plasma protein binding of phenytoin was investigated in 100 epileptic patients, using equilibrium dialysis at 37 degrees C. The unbound fractions of phenytoin in plasma formed a skewed distribution,...Full Text Available
The pharmacokinetics of fusidic acid and 3-ketofusidic acid were investigated in cholestatic and noncholestatic patients after intravenous administration of single and multiple doses of 500 mg of sodium...Full Text Available
The pharmacokinetics of oral fluoroquinolone antibiotics in normal volunteers have been studied extensively; however, limited patient data exist. Enoxacin steady-state pharmacokinetics and bioavailability...Full Text Available
Nowadays, percutaneous pulmonary valve implantation is a successful alternative to surgery for patients requiring treatment of pulmonary valve dysfunction. However, owing to the wide variety of implantation...Full Text Available
BackgroundLittle is known about the role European patient organisations play in the process of deciding on reimbursement for medicines. Therefore we explore the...Full Text Available
The outcome of patients admitted to intensive care units is known to be influenced by such factors as age, previous health status, severity of disease, and diagnosis. To estimate the outcome of such...Full Text Available
Background and objectives: Patients receiving dialysis have a high burden of cardiovascular disease. Some receive coronary artery revascularization but the optimal method is controversial.Design,...Full Text Available
PURPOSE: To determine the frequency of ophthalmic abnormalities in patients with cutaneous T-cell lymphoma (mycosis fungoides and Sézary syndrome) and T-cell lymphoma involving the skin and...Full Text Available
Purpose:To evaluate the midterm efficacy and safety of the iStent® glaucoma device in patients with secondary open-angle glaucoma.Patients...Full Text Available
BackgroundNorway, and particularly Oslo, has the highest reported incidence of hip fractures in the world. It is increasingly common to care for older hip fracture patients in orthogeriatric...Full Text Available
Aims: To study the expression of nuclear β catenin in patients with colorectal cancer, colorectal adenoma, and colorectal polyps to elucidate its role in carcinogenesis, and its...Full Text Available
Over a 5-year period (1976-1980) 499 patients with non-seminomatous testicular germ cell tumours were included in the Danish Testicular Carcinoma Study (DATECA). The 3-year crude survival for patients in clinical stages I, II and III was 91, 77 and 45 per cent, respectively. In stage I the relapse-free survival for patients given radiation combined with bleomycin and vincristine was significantly higher than that for patients given radiation alone. No difference in the crude survival for patients given radiation combined with bleomycin and vincristine was significantly higher than that for patients given radiation alone. No difference in the crude survival was observed. For stage II patients maintenance chemotherapy following radiation combined with bleomycin and vincristine did not improve relapse-free or crude survival. The survival of ...
Over a 5-year period (1976-1980) 499 patients with non-seminomatous testicular germ cell tumours were included in the Danish Testicular Carcinoma Study (DATECA). The 3-year crude survival for patients in clinical stages I, II and III was 91, 77 and 45 per cent, respectively. In stage I the relapse-free survival for patients given radiation combined with bleomycin and vincristine was significantly higher than that for patients given radiation alone. No difference in the crude survival for patients given radiation combined with bleomycin and vincristine was significantly higher than that for patients given radiation alone. No difference in the crude survival was observed. For stage II patients maintenance chemotherapy following radiation combined with bleomycin and vincristine did not improve relapse-free or crude survival. The survival of ...
BackgroundAlthough considerable progress has been made in the treatment of chronic kidney disease, compromised quality of life continues to be a significant problem for patients...Full Text Available
BackgroundMyelomatous pleural effusion (MPE) is rare in myeloma patients. We present a consecutive series of patients with MPE in a single institution.MethodsWe...Full Text Available
The pharmacokinetic parameters of amikacin and ceftazidime were assessed in four patients undergoing hemofiltration for septic shock. The parameters were assessed during hemofiltration and in the interim...Full Text Available
AIMS OF THE STUDY: Type-2 diabetic patients have excessive cardiovascular mortality, primarily related to diabetic nephropathy. The extent of the morbidity due to nephropathy in type-2 diabetes mellitus...Full Text Available
Specific criteria have been developed based on computerized dynamic posturography (CDP) to assist clinicians in identifying patients with psychogenic balance problems (Cyr and Cevette, Full Text Available
During 1978 there was a marked increase in the number of patients with meningococcal infection in the Hamilton area. Of 21 patients admitted to St. Joseph's Hospital, Hamilton, two thirds were under...Full Text Available
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
Background:In 2007, the American College of Cardiology/American Heart Association (ACC/AHA) published new guidelines for the diagnosis and management of patients with unstable angina/non-ST...Full Text Available
The prognosis for patients with newly diagnosed malignant gliomas remains poor; however there have been some recent advances in treatment that have generated optimism. Medical management usually includes...Full Text Available
The needs of hospitalized geriatric patients differ from the needs of hospitalized younger adults. In an attempt to improve systems of care for the older adult, the Centers for Medicare and Medicaid...Full Text Available
Sixty-six patients in whom the macula was detached before surgery were observed for at least 1 year after retinal reattachment. Macular abnormalities were recognised clinically in most patients with...Full Text Available
Conducting rigorous psychosocial intervention research with cancer patients has many challenges including encouraging them to join studies, asking them to engage in interventions or be part...Full Text Available
A Legionella-like organism, strain 1677-MI-H, was isolated from the bronchoscopy washings of a patient with pneumonia who had a 2-year history of progressive, chronic lymphocytic leukemia. The growth...Full Text Available
Although management of warfarin is challenging for patients with chronic kidney disease (CKD), no prospective studies have compared response to warfarin among patients with minimal, moderate, and severe...Full Text Available
... of the American Medical Association JAMA PATIENT PAGE Cardiopulmonary Resuscitation W hen the heart stops beating (cardiac arrest), ... circulation (blood flow) returns or is restored. Providing cardiopulmonary resuscitation ( CPR ) is a way to keep some circulation ...
The lysosomal catabolism of sulfatide requires arylsulfatase A and a specific sphingolipid activator protein, SAP-1. While most patients with metachromatic leukodystrophy have mutations in the gene...Full Text Available
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
Exercise-training might be a logical method to reverse muscle atrophy and weakness in patients treated with glucocorticoids. The purpose of the present investigation was to establish whether a treatment...Full Text Available
OBJECTIVE:To evaluate the profile of osteoporosis treatment among patients hospitalized due to hip fractures at a tertiary-level university hospital. To compare the impact of hospitalization...Full Text Available
Background: Hypoparathyroidism is one of the most important endocrine complications of thalassemia major. This study was conducted to evaluate the prevalence of intracerebral calcifications in patients with thalassemia with and without hypoparathyroidism. Methods: 47 beta-thalassemia patients with hypoparathyroidism underwent a brain CT scan to investigate the presence and extent of intracerebral calcification. 30 age- and sex-matched beta-thalassemic patients with normal parathyroid function who had undergone brain CT for headache, or some other minor neurologic problems were also enrolled in the study serving as controls. The amount of intracerebral calcification, hematologic parameters, and some clinical findings were compared between both groups. Results: Intracerebral calcification was present in 54.2% of beta-thalassemia patients with hypoparathyroidism. The most frequent sites of calcification ...
Of 868 patients admitted with pancreatitis between 1971 and 1976, coexisting hyperbilirubinemia was noted in 125 (14%). The patient population was primarily composed of alcoholics (84%) with chronic...Full Text Available
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
Background:Increasing evidence shows the importance of young age, estrogen receptor (ER), progesterone receptor (PR) status, and HER-2 expression in patients with breast cancers.Patients...Full Text Available
AIMS: To examine the frequency of intraocular metastases in patients who had died of cancer, in an eye bank and necropsy population sample. METHODS: The first group included 302 cancer cases received...Full Text Available
Purpose:The risks and benefits of continuing bisphosphonate therapy beyond 5 years in patients with primary osteoporosis have not been well established.Methods:We...Full Text Available
BackgroundA systematic review was conducted to evaluate the literature regarding the impact of follow-up on colorectal cancer patient survival and, in a second phase, recommendations...Full Text Available
A 17-year-old H1N1-positive patient was successfully extubated after 25 days of ventilatory support for treatment of viral pneumonia which was complicated by empyema thoracis due to Candida...Full Text Available
BackgroundManagement of benign tracheal stenosis (BTS) varies with the type and extent of the disease and influenced by the patient's age and general health status, hence we sought...Full Text Available
Emergency Departments (ED) are fast-paced, information-intensive environments where patient care team members must address their information needs quickly and accurately. We conducted a qualitative...Full Text Available
The presence of DNA-anti-DNA complexes in sera from patients with systemic lupus erythematosus (SLE) was investigated by two new radioimmunoassays (RIA) developed for this purpose and by measuring the...Full Text Available
AIM: To investigate clinical characteristics associated with the presence of irritable bowel syndrome (IBS) symptoms in hemodialysis (HD) patients.METHODS: This was a cross-sectional study. A...Full Text Available
ObjectiveWhile essential for patient care, information related to medication is often written as free text in clinical records and, therefore, difficult to use in computerized systems....Full Text Available
To study the expression of Fc receptors in human alveolar macrophages (AM), the cells were collected from 12 healthy controls and 22 patients with sarcoidosis and the activity involved in binding to...Full Text Available
Metastatic testicular germ cell tumours are cured in approximately 85% of patients using cisplatin-based combination chemotherapy. Patients who fail to respond have a poor prognosis, and there is a...Full Text Available
The method of linear analogue self-assessment (LASA) was used to quantify the views concerning day care which were held by patients attending a geriatric day hospital. The results suggest that day hospitals...Full Text Available
BackgroundIt is known that diabetes and stress are directly or indirectly related, and that it is important to evaluate stress in patients with diabetes. The relationship between...Full Text Available
ObjectivesTo assess Croatian community pharmacists' patient care competencies using the General Level Framework (GLF).MethodsThe competencies of...Full Text Available
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
Background:There is a need for simple imaging parameters capable of predicting therapeutic outcome.Methods:This retrospective study analysed 50 patients...Full Text Available
BackgroundElevated cardiac troponin I (cTnI) is frequently observed in patients with severe sepsis and septic shock. However, the mechanisms underlying cTnI release in these patients...Full Text Available
This work is a retrospective study of 86 patients with squamous cell (51) and basal cell (35) carcinoma of the face. The median age was 67 years. The staging is as following: 31 cases T{sub 1} and T{sub 2}, 55 patients T{sub 3} and T{sub 4}. All patients were considered NO. Electron beam was used in all cases and energy ranged from 5 to 15 MeV depending on the thickness of the tumor. The total tumor dose was 60-70 Gy delivered in 6 weeks. In 7 cases of very old patients the authors have used concentrated irradiation: 3 patients received 21 Gy in one fraction and 4 patients 48 Gy in 8 fractions. 96.8% patients T{sub 1} i T{sub 2} are NED contrary to 56.4% T{sub 3} i T{sub 4}. Cosmetic results were considered as good in 52, fairly good in 7 and bad in 2 patients.
AimsTo describe the pharmacokinetic–pharmacodynamic (PK–PD) characteristics of the direct thrombin inhibitor dabigatran in hip replacement patients by assessing coagulation...Full Text Available
SummaryBackgroundPatients undergoing dialysis have a substantially increased risk of cardiovascular mortality and morbidity. Although several trials have shown the...Full Text Available
IntroductionIn critically ill patients the relationship between the storage age of red blood cells (RBCs) transfused and outcomes are controversial. To determine if duration of RBC...Full Text Available
Psychological illness influences the experience and expression of pain and disability. We tested three null hypotheses: (1) patients with nonspecific pain (medically unexplained and idiopathic) and...Full Text Available
ObjectiveThe aim of this study was to ascertain whether all cervical cancer patients who received adjuvant concurrent chemoradiation (CCRT) for high risk of treatment failure after...Full Text Available
It is usually very complex to design an Integrated Information System in a hospital that includes both in-patient and out-patient medical care data. The difficulty appears because each department...Full Text Available
BackgroundThere is a dearth of data relating UK general practice workload to personal and social markers of individual patients.AimTo test whether there is a significant association...Full Text Available
Cognitive decline has been described in elderly patients with schizophrenia, but the underlying pathology remains unknown. Some studies report increases in plaques and neurofibrillary tangles,...Full Text Available
Communication problems have been implicated in many safety and quality issues, but tools to examine communication networks and their impact on patient outcomes are only beginning to become available....Full Text Available
Aims:To investigate the relationship between the duration of comatose state, severity of rhabdomyolysis and frequency of peripheral nerve injury (PNI) in patients following...Full Text Available
BackgroundLoss to follow-up (LTF) challenges the reporting of antiretroviral treatment (ART) programmes, since it encompasses patients alive but lost to programme and deaths misclassified...Full Text Available
AIMSTo evaluate and compare the risk of specific safety outcomes in patients prescribed ibuprofen and paracetamol concomitantly with those in patients prescribed ibuprofen or paracetamol...Full Text Available
Antiplatelet agents are the cornerstone of treatment for patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Clopidogrel, when added to aspirin, has demonstrated...Full Text Available
The goal of community-based services for frail older patients is to help them achieve the greatest degree of functional ability and independence. The services available include case management, geriatric...Full Text Available
Ten coccygectomies were performed. Patients were all females (aged 26-74, average 46). All patients expressed satisfaction after the operation (one was deceased at the time of follow up). The material...Full Text Available
Because the results with cobalt-57-bleomycin (57Co-bleo) as a tumour-seeking agent in patients with pulmonary tumours were promising, a prospective study was carried out to test the sensitivity and...Full Text Available
BackgroundThe purpose of our study was to evaluate the clinical value of hybrid SPECT/CT for the assessment of patients with painful total knee arthroplasty (TKA).MethodsTwenty-three...Full Text Available
BackgroundEchocardiography is widely used in the management of patients with cardiogenic shock (CS). Left ventricular ejection fraction (EF) has been shown to be an independent predictor...Full Text Available
BackgroundThe elevated serum and peritoneal cytokine concentrations responsible for the systemic response syndrome (SIRS) and multiorgan failure in patients with severe acute pancreatitis...Full Text Available
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
Clinical features and treatment outcome were compared in depressed outpatients with and without a history of emotional and physical abuse (EPA), including childhood maltreatment. Patients were...Full Text Available
Background & AimsData are conflicting on the benefit of selective serotonin reuptake inhibitors (SSRIs) for patients with irritable bowel syndrome (IBS);...Full Text Available
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
Approximately 20% to 30% of patients who undergo coronary arteriography for the evaluation of chest pain are found to have normal coronary arteries. These patients have a survival rate comparable to...Full Text Available
The measurement of bone loss in patients undergoing maintenance dialysis over a period of two and a half years is reported. The tendency to lose bone is a likely event in renal failure, but depends...Full Text Available
Evidence suggests that patients with irritable bowel syndrome (IBS) are hyper-responsive to environmental, physical, and visceral stimuli. IBS patients also frequently report poor sleep quality....Full Text Available
Social support is a critical, yet underutilized resource when undergoing cancer care. Underutilization occurs in two conditions: (a) when patients fail to seek out information, material assistance,...Full Text Available
This study was designed to identify the causes of the development of carpal tunnel syndrome (CTS) associated with end stage kidney disease (ESKD). A total of 112 patients with ESKD, 64 on hemodialysis...Full Text Available
PurposeTo analyze the contributions of cytochrome P4501B1 (CYP1B1) mutations to primary congenital glaucoma (PCG) in Spanish patients.MethodsWe...Full Text Available
Of 400 patients with brucellosis, 104 (26%) had arthritis, of whom 96 could be followed up. The systemic disease in the 96 patients was acute in 54 (56%), subacute in 24 (25%), and chronic in 18 (19%)....Full Text Available
Anemia commonly affects critically ill patients. The causes are multifactorial and include acute blood loss, blood loss from diagnostic testing and blunted red blood cell production. Blood transfusions...Full Text Available
In 29 patients with urinary obstruction due to prostatic enlargement, medium-fill water cystometry was performed before prostatectomy and again 3 months after. A high incidence of detrusor hyperreflexia...Full Text Available
BackgroundComputer-based health-risk assessments are electronic surveys which can be completed by patients privately, for example during their waiting time...Full Text Available
Anxiety may cause adverse outcomes through physiologic pathways in patients with cardiac disease. The purpose of this dissertation was to investigate anxiety and its correlates in persons with acute myocardial infarction (AMI) and heart failure (HF). The ...
The two categories of anti-albumin antibodies (AAA), namely precipitins (AA-P) and agglutinins (AA-Aggl), were investigated in 260 patients with morphologically diagnosed chronic liver diseases (CLD)....Full Text Available
Objectives:The aim of this study was to analyze clinical records of dental patients attending the Dental Department at the University of Jordan Hospital: a teaching hospital in Jordan....Full Text Available
BackgroundPatient organisations may be exposed to conflicts of interest and undue influence through pharmaceutical industry (Pharma) donations. We examined advertising and disclosure...Full Text Available
Very few areas of medical science have experienced more rapid development of new and beneficial treatment approaches during the past two decades than the disciplines required for total care of patients...Full Text Available
There are a range of barriers precluding patients from fully engaging in and benefiting from the spectrum of eHealth interventions developed to support patient access to health information, disease...Full Text Available
Five methods of personality assessment are evaluated to provide guidance for the psychological treatment of patients with chronic back pain. Patient pain drawings, pentothal pain studies, stress score...Full Text Available
Twenty-five patients with ovarian carcinoma who had been operated and treated with chemotherapy underwent clinical examination and CT before reintervention (second-look laparotomy) to detect the presence of eventual recurrences. The prediction of recurrence based on CT and clinical findings was compared with the surgical findings at reintervention. CT proved to be more accurate than clinical examination in detecting recurrences; this was especially true for masses in the abdominal cavity, with the exception of small peritoneal nodules. The authors suggest the use of CT for staging the patients candidate to reintervention. This might help to avoid reintervantion in patients with persistent disease and to plan treatment.
Results are presented applying an enteral nutrition by means of probes with Cosilat in complex therapy of patients with radiotherapeutic late effects of the colon. This nutrition was prescribed with the intention to gave the colon a functional recovery and to guarantee optimal conditions for repair of radiation injuries. Good results were seen in 27 of 28 patients (96.7%), the situation of one patient (3.3%) continued without any change. Cosilat has a high nutritive value, good organoleptic qualities and is well digested without any complications. (author).
Background The American Association for the Study of Liver Diseases (AASLD) guidelines recommend that antibiotic prophylaxis should be instituted in any patient with cirrhosis and gastrointestinal hemorrhage, and that oral norfloxacin, intravenous ciprofloxacin, and ceftriaxone are preferable. However, the antimicrobial spectrum of the first generation of cephalosporins (cefazolin) covers a wide range of bacteria species, including community-acquired strains of Escherichia coli and Klebsiella pneumoniae, but their efficacy as prophylactic antibiotics in cirrhotic patients with acute hemorrhage was seldom warranted in the literature. This study aimed to explore the effects of cefazolin on the outcome of cirrhotic patients with acute variceal hemorrhage after endoscopic interventions. Method...
To evaluate the role of positron emission tomography-computed tomography (PET-CT) in staging and determining early treatment response to chemotherapy in children with neuroblastoma (NB) and its correlation with the final outcome. Patients and Methods: Seventeen patients of NB with mean age of 51.5 months (age range 2-132 months; 14 males, 3 females) underwent serial "1"8F-fluorodeoxyglucose (FDG) PET-CT imaging. All 17 patients were for staging before any treatment. Twelve of 17 patients underwent "1"3"1I meta-iodobezylguanidine (MIBG) scan and bone scan. MIBG uptake was seen in the primary lesion in 11/12 patients. MIBG uptake in bones was seen in 3/12 patients. All bone lesions were concordant on MIBG and bone scan. Early response to chemotherapy was evaluated after two cycles using PET-CT. A 30% reduction in longest diameter was taken as cut-off value for ...
Iodine-131 MIBG, a radiolabeled adrenergic neuron-blocking agent, decreased rapidly from the heart and liver of patients with adrenergic dysfunction and pheochromocytoma when compared with eight controls. However, there was no significant difference in the rate of (/sup 131/I)MIBG decrease in these organs between controls and patients in the intervals subsequent to 4 hr. These findings suggest that adrenergic neuronal uptake of (/sup 131/I)MIBG in these organs is smaller in the patients than in the controls. Measurements of time-activity relationships of radioiodinated MIBG may be useful for assessment of adrenergic function of these organs and thus of generalized disorders of adrenergic innervation.
Surface doses received by patients and operators were measured during 30 interventional radiological procedures (ten percutaneous transhepatic biliary drainages, ten percutaneous nephrostomies, ten percutaneous transluminal angioplasties). In addition, organ doses to the patient were determined using an Alderson-Rando phantom. These served as a basis for calculating the so-called somatic dose indices. It was found that the somatic radiation risk to the patient is relatively small despite prolonged periods of fluoroscopy. However, exposure of the hands and lenses of the operator could easily reach the limits thought acceptable while carrying out these procedures with additional angiography. (orig).
Dosimetric studies in 80 patients examined with the tomographic device 'Somatom' are reported. The gonad doses are compared to those of conventional radiographic techniques.
Thirty-two patients with AIDS related complex (ARC) or acquired immunodeficiency syndrome (AIDS) underwent /sup 67/Ga scans as part of their evaluation. Three patterns of /sup 67/Ga biodistribution were found: lymph node uptake alone; diffuse pulmonary uptake; normal scan. Gallium-67 scans were useful in identifying clinically occult Pneumocystis carinii pneumonia in seven of 15 patients with ARC who were asymptomatic and had normal chest radiographs. Gallium scans are a useful ancillary procedure in the evaluation of patients with ARC or AIDS.
Over the years, nurses, doctors and scientists have sought ways of assessing the impact of pain on patients. While many of the instruments devised have been extremely useful in identifying the nature and intensity of pain, defining the effect it has on people's lives and perceptions has proved much more problematic. Based on the work she carried out with patients suffering from chronic benign pain, Karen Rose explores one aspect of these effects--the feeling of isolation. By using a four-step anthropological approach to identify the impact of pain, she argues, nurses can arrive at a realistic and accurate assessment of how patients are coping. PMID:7947167
Oral mucositis associated with head and neck radiotherapy can substantially hinder completion of cancer therapy. Alleviation of this often severe stomatitis can provide enhanced patient comfort and facilitate appropriate care. A double-blind format was used in a pilot project to measure, against a control rinse, the effectiveness of an oral rinse consisting of hydrocortisone, nystatin, tetracycline, and diphenhydramine in controlling radiation-related mucositis. A combination of clinical evaluation and patient responses to a questionnaire was used to judge the results of the topical medications. Patients using the experimental medication developed less mucositis than did patients in the control group.
Radionuclide x-ray fluorescence analysis was used for the determination of Fe, Zn, Br and Rb levels in whole blood from dilated cardiomyopathy patients and from a control group. The XRF-system consisted of a radionuclide source "1"0"9Cd, a semiconductor Si/Li detector connected to a multichannel analyzer. Fe content in blood of patients was significantly lower than that of the control. Zn content showed no deviation from normal range. Values for Br and Rb in patients highly exceed the range reported for them. (author) 4 tabs.; 9 refs.
The three projects of the research program are aimed at the epidemiological study of long-term radiation effects in patients injected with radium-224. They are: late effects in "2"2"4Ra treated ankylosing spondylitis patients, late effects in "2"2"4Ra treated juvenile and adult patients, and epidemiology of radiation carcinogenesis. The data from these patients are a unique source of information for risk analysis of incorporated bone seeking radionuclides in man. (R.P.) 5 refs., 3 tabs.
Thirty-seven patients with histologic proof of cholangiocarcinoma at the confluence were examined by computed tomography (CT) to determine whether this examination is of value in the assessment of these patients for surgery and whether there are any features specific to this type of tumor. Thirty-two patients showed intrahepatic duct dilatation; six of these showed dilatation of ducts in one lobe only. Eighteen patients had intrahepatic low-attenuation areas, while eight had a mass lesion in the porta hepatis. The results of this study show that CT provides useful anatomic information preoperatively but that the appearances are nonspecific. Lobar atrophy is highly suggestive of hilar cholangiocarcinoma, either of long-standing or with unilateral portal venous involvement.
We studied 129 AIDS patients with suspected or proved intracranial manifestations of the disease. The purpose of this study was to compare the diagnostic sensitivity of unenhanced and contrast enhanced CT and unenhanced T{sub 2}-weighted MR. Thus, in 20% of our patients MR but not CT was diagnostic. In another 20% MR provided additional diagnostic information. In conclusion, MR is recommended as the imaging modality of choice in AIDS patients with non-conclusive cranial CT. (orig./GDG).
Surgical resection is the only curative treatment strategy for intrahepatic cholangiocarcinoma (CC). Therefore, accurate staging is essential for appropriate management of patients with CC. We assessed the usefulness of 2-["1"8F]fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) in the staging of CC. We undertook a retrospective review of FDG PET images in 21 patients (10 female, 11 male; mean age 57 years) diagnosed with CC. Ten patients had hilar CC and 11, peripheral CC. Patients underwent abdominal magnetic resonance imaging (MRI) (n=20) and computed tomography (CT) (n=12) for the evaluation of primary tumours, and chest radiography and whole-body bone scintigraphy for work-up of distant metastases. For semi-quantitative analysis, the maximum voxel standardised uptake value (SUV_m_a_x) was obtained from the primary tumour. All peripheral CCs showed intensely increased FDG uptake, and ...
To evaluate the predictive factors for treatment response and prognostic factors affecting survival outcomes after concurrent chemoradiotherapy (CCRT) for patients with anal squamous cell carcinoma. Medical records of forty two patients with histologically confirmed analsquamous cell carcinoma, who had complete CCRT between 1993 and 2008, were reviewed retrospectively. Median age was 61.5 years (39-89 years), and median radiotherapy (RT) dose was 50.4 Gy (30.0-64.0 Gy). A total of 36 patients had equal to or less than T2 stage (85.7%). Fourteen patients (33.3%) showed regional nodal metastasis, 36 patients (85.7%) were treated with 5-fluorouracil (5-FU) plus mitomycin, and the remaining patients were treated by 5-FU plus cisplatinum. The median follow--up time was 62 months (2-202 months).The 5-year overall survival, locoregional relapse-free survival, ...
The accurate staging of rectal carcinoma is very important for treatment planning. The histological data obtained from surgical specimens of 22 patients with rectal carcinoma were compared with pre-and postoperative endorectal US findings and with preoperative CT results. According to an adapted version of Astler and Coller classification, the different degrees of tumor spread into the rectal wall were represented as follows: stage A: 1 patient; stage B1: 5 patients; stage B2: 6 patients; stage C1: 1 patient; stage C2: 8 patients and stage D: 1 patient. Preoperative staging, based on the overall results of CT and US, was in agreement with histology in 19 of 22 cases. Individual analysis of US and CT results, in comparison with histological data, showed US staging accuracy to be 77.3% (17/22 patients). US accuracy in ...
BackgroundSouth Africa has a high tuberculosis (TB)-human immunodeficiency virus (HIV) coinfection rate of 73%, yet only 46% of TB patients are tested for HIV. To date, relatively...Full Text Available
To optimize the emergency care of patients with multiple injuries, a special emergency room with integrated radiological equipment has been developed. It consists of a linear array of a computed tomography system, a mobile C-arm with an integrated scattered radiation grid for conventional films and a C-arm fluorographic system. The intent is to avoid delay caused by transport and repositioning of the patient. It enables all necessary diagnostic procedures to be performed within a minimal amount of time. (orig./MG).
In this retrospective study, 28 cases of Ewing's sarcoma are reviewed for the onset of metastasis. Bone scans demonstrated bone metastasis in three out of 28 patients at presentation. Of the 22 patients free of metastases at presentation, ten subsequently developed bone metastases. In six of these patients, the bone scan was the earliest demonstrator of metastatic disease. Bone scans are recommended at presentation and periodically during follow-up.
The value of biliary scintigraphy was studied in 180 patients with suspected biliary tract disease. Most of the patients were investigated additionally by conventional techniques such as cholecystography, cholangiography and ultrasonography. It is concluded that biliary scintigraphy is a simple and safe technique for visualization of the biliary tract. It is particularly useful in the evaluation of acute cholecystitis, in patients with iodine sensitivity obstructive from nonobstructive jaundice.
BackgroundEffectiveness of services for patients diagnosed with severe mental illness (SMI) may improve when treatment plans are needs based. A regional Cumulative Needs for Care...Full Text Available
Cytomegalovirus (CMV)-seropositive patients with ESRD may have more CD4+ T cells lacking the co-stimulatory molecule CD28 (CD4+CD28null) than CMV-seronegative patients. Increased...Full Text Available
Total potassium was assayed in 150 normal weight and obese females (cervical carcinoma-52, endometrial carcinoma-25 and breast cancer-73) by measurements of 40K spontaneous radiation in a low-background chamber. Control group included 30 healthy and 25 obese females. Computations of body cell and extracellular mass and fat were carried out on the basis of the said measurements. Extracellular fluid volume was measured in 38 patients by X-ray fluorescence method using sodium bromide. The results pointed to a body cell mass deficit matched by increased extracellular mass due to a higher fat level in patients with breast, endometrial and cervical carcinoma. The said correlation was particularly pronounced in obese patients. The beneficial effect of treatment was more often observed in patients with normal body weight. PMID:3739295
Background/Objectives: Cardiotoxic drug poisoning can lead to severe cardiac shock (CS) and death. B-type natriuretic peptide (BNP) is a well-established diagnostic and prognostic marker in heart failure but has never been assessed in patients with cardiotoxic drug poisoning. The aim of the study was to determine whether BNP could be useful for early stratification of patients admitted to intensive care unit. Methods: 30 consecutive patients experiencing shock and cardiotoxic drug exposure were enrolled in a prospective monocentric study and underwent at least two BNP measurements within the first 24 h after admission. Results: While BNP values on admission were poorly informative, subsequent BNP measurements (11 +- 6 h after admission) were significantly increased in patients with CS comp...
Systemic sclerosis (SSc) is a disorder characterized by skin thickness and vasculopathy. The objective of the study was to evaluate the therapeutic effect and safety of the association of pentoxyphylline and vitamin E in SSc patients. Twelve SSc patients (American College of Rheumatology criteria) enrolled this 24-week open-label study. Patients received daily 800?mg of pentoxyphylline and 800?UI of vitamin E and were evaluated at 4-week interval. The primary efficacy endpoint was the change in Modified Rodnan Skin Score (MRSS) at week 24. Nine diffuse SSc patients treated 6?months with cyclophosphamide were used as a historical control group. The mean age of the treated group was 43.6?years, and ten of 12 (84%) patients were women. Their mean MRSS reduced from 25.7 to 18.7 (p?=?0.03) at 1...
The treatment of acetabular bone defects presents a great challenge in revision total hip arthroplasty (THA). The purpose of this study was to evaluate the clinical and radiological outcome of revision THA using jumbo cups for acetabular reconstruction after applying the bone-grafting technique. We studied 17?patients with acetabular defects ranging from Type 2A to Type 3A according to Paprosky`s classification. According to the AAOS-score twelve patients were classified as Type II and five patients as Type III. Uncemented press-fit cups with an outer diameter larger than 64?mm were used in all cases. Fifteen patients received morselized bone allografts. In eight patients an additional screw fixation was necessary. The mean follow-up period was 82?months (range 33?149). The mean Harris Hip...
Abstract Lyme neuroborreliosis (LNB) is a serious but treatable disease. The diagnosis of LNB poses a challenge to clinicians, and improved tests are needed. The C6-peptide ELISA is frequently used on serum but not on cerebrospinal fluid (CSF). Data on the sensitivity of the C6-peptide ELISA in CSF in patients suffering from LNB have been conflicting. Serum-CSF pairs from 59 LNB patients, 36 Lyme non-neuroborreliosis cases, 69 infectious meningitis/encephalitis controls and 74 neurological controls were tested in a C6-peptide ELISA. With the optimal cut-off of 1.1, the sensitivity of the C6-peptide ELISA for LNB patients in CSF was 95%, and the specificity was 83% in the Lyme non-neuroborreliosis patients, 96% in the infectious controls, and 97% in the neurological controls. These results ...
Twenty-two patients with vertebral primaries were registered in the Intergroup Ewing's Sarcoma Study between 1973 and 1977. The radiation doses to the primary tumors ranged between 3800 and 6200 rad. All patients received intensive combination chemotherapy. After a followup ranging between 14 and 62 months, 14 patients remained disease-free. All patients with primary tumor of the cervical and dorsal spine remained disease-free. Of eight patients with lesions in the distal spine, (sacrococcygeal region) six developed recurrence, in three a local recurrence was observed despite doses of 6000 rad or higher. Doses of 5000 rad or less (in addition to combination chemotherapy as used in the Intergroup Ewing's Study) appear adequate in controlling the primary tumors of the proximal segments of the spinal column.
Abstract The fit of patient coping style and psychotherapy focus has been suggested as improving treatment outcome. This article reviews the definitions, measures, and previous research surrounding this hypothesis. An original meta-analysis of 12 carefully selected studies (N = 1,291 patients) resulted in a weighted, mean effect size (d) of .55 in favor of a fit between externalizing patients and symptom-focused treatment or, alternatively, internalizing patients and insight-focused treatment. This medium-size effect indicates that nondiagnostic patient factors, like coping style, are important considerations in the selection of effective therapies. Clinical examples and clinical recommendations are provided. 2010 Wiley Periodicals, Inc. J Clin Psychol: In Session 67:176-183, 2011.
BackgroundAlthough benign ampullary tumors are removed endoscopically, due to their potential to progress to malignant disease, the favored treatment for adenocarcinoma is pancreaticoduodenectomy. We reviewed our institutions experience in order to identify which patients were at highest risk of disease progression following surgical resection, as well as evaluate whether localized T1 tumors are best treated by pancreaticoduodenectomy. MethodsWe retrospectively reviewed 157 patients who presented with an ampullary mass, from 2001 to 2010, and identified 51 with benign adenoma and 106 with adenocarcinoma. ResultsPatients with malignant tumors most often presented with larger tumors and jaundice, which alone was predictive of survival (OR = 67). Forty-five percent of patients with pathologic...