Science.gov (United States)

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 ...

British Library Electronic Table of Contents (United Kingdom)

The first cardiac pacemaker implants occurred in the late 1950s and involved insertion of epicardial or epimyocardial leads and abdominal pulse generators. By the mid 1960s, cardiologists were making attempts to insert transvenous leads into the right ventricle. These early unipolar leads had large, polished, high polarization electrodes, no fixation device, and no lumen in which to place a stylet for lead positioning. The lead implantation procedures were usually long and the irradiation to both patient and operator excessive. Pulse generators were powered by zinc-mercury cells, which were large, unreliable, and prone to sudden output failure. Postoperative complications such as lead dislodgement, exit block, and premature power source failure were very common with most patients requiring...

UK PubMed Central (United Kingdom)

AimsA better understanding of the ionic mechanisms for cardiac automaticity can lead to better strategies for engineering bio-artificial pacemakers. Here, we attempted to better...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundThe circadian rhythm in mammals is orchestrated by a central pacemaker in the brain, but most peripheral tissues contain their own intrinsic circadian oscillators. The...Full Text Available

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Presentation of electromagnetic sources constituted by various radio transmitters contributing to different radio communication services in the environment. Results of a measures campaign to assess the electromagnetic field in the close neighbourhood of various stations. Analysis by frequency domains. (author)

British Library Electronic Table of Contents (United Kingdom)

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...

British Library Electronic Table of Contents (United Kingdom)

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 ...

British Library Electronic Table of Contents (United Kingdom)

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 ...

UK PubMed Central (United Kingdom)

BackgroundThe survival of hemodialysis patients requiring dialysis depends on the long-term functioning and patency of the vascular access. Prosthetic vascular grafts are inevitably...Full Text Available

UK PubMed Central (United Kingdom)

Lymphocytes from patients with insulin-dependent diabetes mellitus (IDDM), a chronic autoimmune disease, have recently been shown to have decreased surface expression of MHC class I antigens. Since...Full Text Available

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Fifty-nine patients underwent free flap osteocutaneous reconstruction that consisted of flaps of the dorsum of the foot in 26 patients and iliac crest flaps in 33 with a success rate of 92 percent and a mortality rate of 1.6 percent. These flaps, which require the expertise of microvascular surgeons, are time-consuming and complicate operating room and time management, but they represent a remarkable advance in reconstruction that can facilitate cosmetic and functional recovery of the patient. In particular, they promote healing in radiation-recurrent oral cancer and represent a definitive form of management for established radionecrosis of the mandible. The large volume of tissue available with iliac crest osteocutaneous grafts permits the management of patients with extensive cancer involving the skin, mucosa, and bone, but cancer control may still be disappointing and there is a need for improved ...

British Library Electronic Table of Contents (United Kingdom)

Lung transplantation has become an accepted option for many patients with end-stage pulmonary diseases. Anesthesia and surgery following lung transplantation may be required for various diseases that may affect both systemic organs and the transplanted graft. When a patient with a lung transplant undergoes surgery, there is the potential for interference with lung function, depending on the type of intervention and its anatomical site. Accurate preoperative evaluation, an understanding of the physiology of the transplanted lung, proper airway instrumentation, individualized management of intraoperative ventilation, and fluid balance are essential for a positive perioperative outcome.

UK PubMed Central (United Kingdom)

To determine if the enhanced glycemic response to epinephrine in patients with insulin-dependent diabetes mellitus (IDDM) is the result of increased adrenergic sensitivity per se, increased glucagon...Full Text Available

Science.gov (United States)

Radioimmunochemical assay was used to study the hypophyseal and peripheral hormones activity in 60 patients with chronic alcoholism, stage II. A correlation has been established between the patient's age and prolactin and FSH concentrations, as well as between the duration of the recent hard drinking and the concentrations of prolactin, testosterone, FSH and interstitial cell stimulating hormone. It has been shown that the manifestation of the alcoholic abstinent syndrome depended on the prolactin concentration. The test sensitivity estimated by the prolactin level rise and the testosterone level reduction reached 92.3%. The specificity of the changes detected comprised 25%. A conclusion has been made that the disorders noted in the patients with chronic alcoholic intoxication can be used as an objective test in the alcoholism diagnosis. PMID:3936321

International Nuclear Information System (INIS)

Objective: To assess the efficacy, prospects and future of conservative management of beta thalassemia major patients in a developing country. Design: Patients registered at IHBTS were studied over a period of three years. They consented to being managed on moderate transfusion regimen, aiming to maintain a pre-transfusion haemoglobin(Hgb) level of 9.0 plus minus 1.0 g per dL. We studied their transfusion requirements, status for transfusion transmitted infections (TTls), serum ferritin levels and complications developing as a result of iron overload. Subjects: Initially all registered patients were included in this study. Sporadic patients as well as dropouts occurring due to any reason, (patients concurrently seeking treatment at other centres as well, or complying poorly to advised chelation therapy) were excluded from the study. The data presented here conforms to a cohort of 60 ...

International Nuclear Information System (INIS)

Combined treatment of 131 patients aged 3-16 with local form of Ewing's sarcoma is carried out. Survival rate per year was studied in patients without diagnosed metastases depending on chemiotherapy method. It is stated that improved results of treatment of children with Ewing's sarcoma may be achieved by combining radiotherapy with long-term systemic polychemotherapy. The most efficient and expedient method of radiotherapy of long bone sarcoma in children is dialy three-field irradiation with 2 Gy at SFD to the tumor 60 Gy, and adjacent tissues - 40 Gy.

British Library Electronic Table of Contents (United Kingdom)

The survival of acetabular components depends on several factors: wear, osteolysis and septic or aseptic loosening. Osteolysis seems to be the main cause for concern in cementless arthroplasties. Acetabular osteolysis results from particle debris and segmental unloading of acetabular bone by rigid sockets. We investigated a cementless elastic monoblock socket with regard to acetabular osteolysis and aseptic loosening in a cohort of young patients. We evaluated 158 hip arthroplasties with a minimum follow-up of ten?years (ten to 18) and a mean age of 42?years (18?50). The overall revision rate at 14?years was 80% with a 98% survival rate for aseptic loosening. The mean polyethylene wear rate was 0.11?mm/year. Progressive acetabular osteolysis was seen in 3% of patients evaluated. In conclus...

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Cellular telephones emit a radiofrequency electromagnetic field, part of which is absorbed in the user's head. Many studies have been conducted to look for their possible health hazard to human, at the experimental, epidemiological or clinical level. After a short recall on dosimetry, the author describes the state-of-the art about harmful and irreversible effects, up to now not confirmed, and about some benign symptoms which look absolutely actual. A causal relationship of the electromagnetic field on these benign symptoms is however not proven; other, studies are running to evaluate their possible long-term consequences. Interferences with cardiac pacemakers can easily be avoided by holding the telephone handset farther than 10 cm. (author)

Science.gov (United States)

Electric utilities have been surprised by recent opposition to the construction of very-high-voltage transmission lines, which met with little resistance in the past. Concerns over health and safety factors are associated with the increase in the number of such lines, although their presence has always been an inconvenience and a hazard for those living and working in the immediate vicinity. The new lines present additional hazards due to the continuous flow of small electric currents and the charges that build up in the area of the towers and lines. The lines are also a threat to persons wearing cardiac pacemakers. There is experimental evidence from the Soviet Union and the U.S. that electric and magnetic fields at the frequencies of such power lines can have serious biological effects on growth rates and the functioning of the central nervous system. Full disclosure that possible risks are involved and the opportunity to avoid these risks is a public ...

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We determined the Na/K x-ray intensity ratio in frozen sections of myocardial tissues obtained at autopsy from patients who died from various causes, using electron probe analysis. We have been able to distinguish between the ischemically injured and normal cells. The method is simple, fast, and dependable even when the duration of ischemia is only 30 minutes.

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A custom-built graphite-coated transmission ionization chamber is compared to the VacuDAP 2001 (VacuTec, Dresden, Germany), which has transparent conductive electrodes. A study was made of the dependence of response on x-ray tube potential for both types of chamber under identical conditions of exposure using over-table and under-table x-ray tubes. Since the calibration factor is the dose-area product of the radiation incident on the patient per chamber reading, it depends on the intrinsic response of the chamber as well as the effect of material in the beam between the x-ray tube and patient. Differences of about 20% were measured between the intrinsic and the over-table calibration factors and between the over-table and the under-table calibration factors for both chambers. The VacuDAP display is specifically calibrated for the over-table condition and would overstate the actual DAP in the under-table ...

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As part of a U.S. multi-regional pilot study conducted by the six Centers for Radiological Physics, 12-mm-diameter by 0.4-mm-thick CaSO/sub 4/:Dy Teflon-embedded discs were evaluated and used to measure patient entrance exposure on 60 average patients at 12 clinical centers. The discs were found to have adequate sensitivity, reproducibility and linearity up to 69.7 microC kg-1 (270 mR). The minimum measurable exposure was estimated as 0.4 microC kg-1 (1.5 mR). All responses were corrected for energy dependence, which varied +/- 20% from 1.7 to 6.5 mm Al half-value layer. Patient entrance exposure values ranged from 1.3 to 28 microC kg-1 (5 to 110 mR), with a median value of 5.2 microC kg-1 (20 mR). This value agreed with exposure measurements made on the chest radiography equipment using an ionization chamber and a phantom which simulated an average patient, and with published ...

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The hypothesis of genetic defects in glycosaminoglycan (GAG) regulation among patients with insulin-dependent diabetes mellitus (IDDM) and nephropathy was assessed by studies in tissue cultures of fibroblasts obtained from 7 patients with normal urinary albumin excretion, 11 patients with diabetic nephropathy, and 6 nondiabetic control subjects. The incorporation of (2H) glucosamine and (35S) sulfate into hyaluronic acid (HA), chondroitin sulfate and dermatan sulfate (CS + DS), and heparan sulfate (HS) was measured in cells, matrix, and medium and related to micrograms of tissue protein. Large interindividual variations were seen in all three groups, and the incorporation of (3H) glucosamine into HA, CS + DS, and HS and (35S) sulfate into CS + DS and HS were not significantly different between the three groups. However, the fractional incorporation of (3H)glucosamine into HS was significantly reduced in ...

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January, 1992, to October, 1995, sixty-four patients with advanced head and neck cancer underwent head and neck reconstructive surgery using myocutaneous or revascularized flaps; in the same period, all patients were consecutively examined with CT and MRI. Myocutaneous flaps were used in 26 patients: 12 flaps were tubular and 14 linear. Revascularized flaps were used in 38 patients: to repair a large defect in 26 patients (14 latissimus dorsi flaps and 12 temporal muscle flaps) and to repair an oral damage in 12 patients (5 revascularized radial and 7 jejunal flaps). CT and MR images of myocutaneous flaps showed the flaps as fatty areas, repairing large surgical defects, hypodense at CT and hyperintense at MRI, with no post-contrast enhancement. The appearance of revascularized flaps at CT and MRI depends on the characteristics of the ...

International Nuclear Information System (INIS)

Purpose: Radiotherapy (RT) has been the predominant local treatment for Ewing's sarcoma of bone at the University of Florida. Twice-daily hyperfractionated RT was initiated in 1982 to improve local control and functional outcome. This retrospective review compares the results of once-daily vs. twice-daily RT in patients with primary Ewing's sarcoma of an extremity, with emphasis on functional outcome. Methods and Materials: Between June 1971 and January 1990, 37 patients were treated at the University of Florida for nonmetastatic Ewing's sarcoma of bone with a primary lesion in an extremity. Three patients underwent amputation. Of 34 patients treated with RT, 31 had RT alone and 3 had a combination of RT and local excision. Before 1982, 14 patients received once-daily RT; since 1982, 17 patients have received twice-daily RT. Doses of once-daily RT varied from 47 ...

British Library Electronic Table of Contents (United Kingdom)

The practice of medical tourism depends on successfully informing potential patients about procedure options, treatment facilities, tourism opportunities, travel arrangements, and destination countries. The promotion of medical tourism includes a wide range of marketing materials such as flyers, booklets, and websites. Yet, there is a paucity of knowledge about the dissemination, content, and reception of these promotional materials. Drawing on a thematic content analysis of the promotional print material distributed at the first medical tourism trade show in Canada in 2009, the main purpose of this article is to identify and understand the messages and images that companies use to market India as a global destination. While researchers and news media frequently cite low cost procedures as...

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Subcutaneous involvement frequently occurs in maxillary sinus carcinoma. Radical resection does not include removal of the skin at risk. In standard postoperative wedge-pair treatment plans, the surface dose is dependent upon beam weighting, beam energy, and patient contour. Thermoluminescent dosimetry (TLD) measurements were performed to evaluate the surface dose of patients undergoing postoperative irradiation of maxillary sinus carcinoma following primary resection. When 60 Gy was delivered to isocenter with a 45 degrees wedge pair and 6 MV photons with 1 cm bolus, the subcutaneous tissues at risk received {approximately} 30 Gy. Based upon presented TLD measurements, supplemental electron beam therapy to the subcutaneous tissues if primarily involved should be considered.

British Library Electronic Table of Contents (United Kingdom)

Colorectal cancer is the second most common cause of cancer death in the world and about half of the patients with colorectal cancer require adjuvant therapy after surgical resection. Therefore, the eradication of cancer cells via chemotherapy constitutes a viable approach to treating patients with colorectal cancer. In this study, the effects of bufalin isolated from a traditional Chinese medicine were evaluated and characterized in HT-29 and Caco-2 human colon cancer cells. Contrary to its well-documented apoptosis-promoting activity in other cancer cells, bufalin did not cause caspase-dependent cell death in colon cancer cells, as indicated by the absence of significant early apoptosis as well as poly(ADP-ribose) polymerase and caspase-3 cleavage. Instead, bufalin activated an autophagy...

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Purpose: Hormonal activity causes breast volume to change during the menstrual cycle. One possible cause of this volume change is thought to be due to water retention or oedema within the tissues. We used magnetic resonance imaging (MRI) to study the variation in breast volume and {sup 1}H Magnetic Resonance Spectroscopy (MRS) to measure T{sub 2} relaxation times which are known to increase with increasing tissue water content. We hypothesised that an increase in breast volume will elevate T{sub 2} relaxation due to the presence of an increased water content within the breast. T{sub 2} Relaxation time and volume were studied in fifteen control subjects and in a cohort of eight patients with cyclical mastalgia in order to determine whether changes in breast volume and T{sub 2} relaxation times differed in controls and patients during menses, ovulation and premenses. Method: Breast volume was determined by the Cavalieri method in combination with ...

International Nuclear Information System (INIS)

Scattered radiation generated in patient and imaging system has to be considered when quality-assurance tests involve dose detection or image-quality estimations. Measurement of automatic-exposure control dose can be altered by backscattering from intensifying screens of more than 10% and the equipment transmission factor can be overestimated up to a factor of 10 when only primary radiation is used. The sensitivity of intensifying screens depends on the angle of incidence of the radiation and so primary and scattered radiation are detected differently. The quality-control aspects of anti-scatter grids are discussed. (author).

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Contributions to the population dose due to medical applications of ionising radiation are presented. It appears that contributions due to radiotherapy and X ray diagnosis are of comparable magnitude. To account for the age dependency of the radiation risks, contributions in terms of somatically significant dose equivalent are calculated as 0.3 mSv per caput per annum for X ray diagnosis and as 0.2 mSv per caput per annum for radiotherapy, the latter referring to only doses to organs outside the target volume. (author).

International Nuclear Information System (INIS)

Central Nervous System (CNS) involvement, whether primary by the Human Immunodeficiency Virus - HIV - itself, or secondary (toxoplasmosis or lymphoma) is remarkably frequent in AIDS, in 40 to 70% of cases, depending upon the author. In order to study the natural history of this illness, a cohort of 25 asymptomatic seropositive patients have been established. Every 6 months these patients undergo biological and clinical examinations, as well as Magnetic Resonance brain scans. After two examinations at a 6 month's interval, the first results are reported. Out of these 25 cases, 9 present anomalies: One patient with diffuse cerebral atrophy and 8 others with high signal intensity areas on T2 weighted sequences, like those of the Multiple Sclerosis. No relationship could be demonstrated between the existence of these lesions and various criteria such as age, sex, risk factors and T4 cells count. The nature ...

British Library Electronic Table of Contents (United Kingdom)

Aims: The present study explored the integrative effect of genes encoding methadone pharmacokinetic and pharmacodynamic pathways on methadone maintenance doses in Han Chinese Patients. Materials & methods: Genomic DNA was extracted from 321 opioid-dependent patients and 202 healthy controls, and realtime-PCR and PCR-RFLP were conducted to determine the genotypes. Results: Pair-wise comparisons revealed that carriers of the variants ABCB1 3435C>T or CYP2B6 516G>T alleles were more likely to require a higher methadone dose than noncarriers (both p G or 939C>T allele had a two-fold chance of requiring a lower methadone dose than noncarriers (p = 0.001). Proportional odds regression with adjustment of cofactors demonstrated that ...

International Nuclear Information System (INIS)

Thirty-six patients with acquired immunodeficiency syndrome (AIDS), who were febrile but without localizing signs, underwent indium-111 leukocyte scintigraphy 24 hours after injection of labeled white blood cells (WBCs) and were restudied 48 hours after injection of gallium-67 citrate. Fifty-six abnormalities were identified as possible sources of the fever; 27 were confirmed with biopsy. Of these 27, 15 were identified only on In-111 WBC scans (including colitis, sinusitis, and focal bacterial pneumonia); six, only on Ga-67 scans (predominantly Pneumocystis carinii pneumonia and lymphadenopathy); and six, on both studies (predominantly pulmonary lesions). In-111 WBC scanning revealed 21 of 27 abnormalities (78%) and gallium scanning, 12 of 27 (44%). If only one scintigraphic study has been performed, particularly with Ga-67, a significant number of lesions would not have been detected. The authors believe radionuclide evaluation of the febrile AIDS ...

International Nuclear Information System (INIS)

The image quality of digital luminescent radiography (DLR) is sufficient for routine biplane chest radiography and for follow-up studies of heart size, pulmonary congestion, coin lesions, infiltrations, atelectasis, pleural effusions, and mediastinal and hilar lymph node enlargement. Chest radiography in the intensive care unit may in most cases be performed using the DLR technique. there is no need for repeat shots because of incorrect exposure, and the position of catheters, tubes, pacemakers, drains and artificial heart valves, the mediastinum, and the retrocardiac areas of the left lung are more confidently assessed on the edge-enhanced DLR films than on conventional films. Nevertheless, DLR is somewhat inferior to conventional film-screen radiography of the chest as it can demonstrate or rule out subtle pulmonary interstitial disease less confidently. There is no reduction of radiation exposure of the chest in DLR compared with modern film-screen systems. As a ...

International Nuclear Information System (INIS)

The results of 144 previously untreated cases of primary Ewing's sarcoma of bone are reported with a minimum follow-up of 5 years. This series was treated between 1972 and 1982 at Istituto Ortopedico Rizzoli with a combined therapy. The local control of the disease consisted of amputation (ten cases), resection followed by radiation therapy (35-45 Gy) (48 cases) and radiation therapy alone (40-60 Gy) (86 cases). Adjuvant chemotherapy, rigorously standardized, was performed according two different protocols: the first (85 cases treated in the period 1972-1978) consisted of vincristine (VCR) Adriamycin (doxorubicin) (ADM), and cyclophosphamide (EDX); the second (59 cases treated in the period 1979-1982) of VCR, ADM, EDX and dactinomycin (DACT). At a follow-up of 5 to 16 years (median, 9), 59 patients (41%) are continuously disease-free (CDF), 81 (56%) developed metastatic disease and/or local recurrence, and four (3%) had a second malignancy. Three factors seem to be ...

Science.gov (United States)

PMID:9410608

International Nuclear Information System (INIS)

Background and purpose: To compare 6 MV and 18 MV photon intensity modulated radiotherapy (IMRT) for non-small cell lung cancer. Materials and methods: Doses for a cohort of 10 patients, typical for our department, were computed with a commercially available convolution/superposition (CS) algorithm. Final dose computation was also performed with a dedicated IMRT Monte Carlo dose engine (MCDE). Results: CS plans showed higher D _9_5_% (Gy) for the GTV (68.13 vs 67.36, p = 0.004) and CTV (67.23 vs 66.87, p = 0.028) with 18 than with 6 MV photons. MCDE computations demonstrated higher doses with 6 MV than 18 MV in D _9_5_% for the PTV (64.62 vs 63.64, p = 0.009), PTV_o_p_t_i_m (65.48 vs 64.83, p = 0.014) and CTV (66.22 vs 65.64, p = 0.027). Dose inhomogeneity was lower with 18 than with 6 MV photons for GTV (0.08 vs 0.09, p = 0.007) and CTV (0.10 vs 0.11, p = 0.045) in CS but not MCDE plans. 6 MV photons significantly (D _3_3_%; p = 0.045) spared the esophagus in MCDE ...

International Nuclear Information System (INIS)

The authors investigated the role of Computerized Tomography in guiding fine needle biopsy (FNB) in small (2 2 cm in diameter for CT-guided FNB sensitivity, specificity and diagnostic accuracy. Cytologic specimens were positive for malignancy in 40/52 cases (76.9%) and negative in 12 (23.1%). Clinical-surgical follow-up confirmed all the positive cytologic findings (40 cases), while 2 of the extant 12 cases were false negatives (95.20% sensitivity, 100% specificity and 96.15% diagnostic accuracy). 158 of 195 nodules > 2 cm in diameter and with clinical surgical follow-up (81.3%) were positive for malignancy and 34 were negative (17.43%) (98.75% sensitivity, 97.14% specificity and 98.46% diagnostic accuracy). Pneumothorax occurred in 33 patients (16.5%) with nodules > 2 cm in diameter as a complication of biopsy. Hemoptysis occurred in 15 patients (7.5%). In the whole group of lung lesions, the complications were pneumothorax in 80 ...

Science.gov (United States)

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 ...

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In a previous survey we revealed uncertainty among responders about (a) whether or not to perform hemodialysis in patients with severely reduced renal function who had received contrast medium; and (b) when to perform hemodialysis in patients on regular treatment with hemodialysis or continuous ambulatory dialysis who received contrast medium. Therefore, the Contrast Media Safety Committee of The European Society of Urogenital Radiology decided to review the literature and to issue guidelines. The committee performed a Medline search. Based on this, a report and guidelines were prepared. The report was discussed at the Ninth European Symposium on Urogenital Radiology in Genoa, Italy. Hemodialysis and peritoneal dialysis safely remove both iodinated and gadolinium-based contrast media. The effectiveness of hemodialysis depends on many factors including blood and dialysate flow rate, permeability of dialysis membrane, ...

CERN Document Server

The activity assay of a radiopharmaceutical administration to a patient is normally achieved via the use of a radionuclide calibrator. Because of the different geometries and elemental compositions between plastic syringes and glass vials, the calibration factors for syringes may well be significantly different from those for the glass containers. The magnitude of these differences depends on the energies of the emitted photons. For some radionuclides variations have been observed of 70 %, it is therefore important to recalibrate for syringes or use syringe calibration factors. Calibration factors and volume correction factors have been derived for the NPL secondary standard radionuclide calibrator, for a variety of commonly used syringes and needles, for the most commonly used medical radionuclide.

British Library Electronic Table of Contents (United Kingdom)

Background: Intestinal failure (IF) is the dependence upon parenteral nutrition to maintain minimal energy requirements for growth and development. It may occur secondary to a loss of bowel length, disorders of motility, or both. Short bowel syndrome (SBS) is a malabsorptive state resulting from surgical resection, congenital defect, or diseases associated with loss of absorptive surface area. A particularly vexing problem is associated with whole bowel and/or segmental intestinal dysmotility. Motility disorders within the context of SBS and IF may relate to rapid intestinal transit secondary to loss of intestinal length, dysmotility associated with loss or poor antegrade peristalsis, or gastroparesis. Therapy may be classified into medical (prokinetic and antidiarrheal agents) and surgica...

International Nuclear Information System (INIS)

Somatostatin receptor scintigraphy (SRS) is a valuable method for the detection of somatostatin receptor-positive lesions. Most gastrinomas (over-)express the somatostatin receptor subtype 2 which can be targeted by In-111 labeled Octreotide. Different studies show a high sensitivity of SRS for the localization and staging of gastrinomas. SRS seems to be superior to other non-invasive imaging modalities and has been proven to significantly contribute to patient management. However, the sensitivity depends on the size and exact localization of the tumors. Smaller lesions and lesions located in the duodenum show a significantly lower sensitivity. In any case, SRS belongs to the routine imaging procedure for gastrinomas for localization and staging and can also be used for evaluation of the tumor progression. (author)

Science.gov (United States)

Antiquitin (ATQ) deficiency is the main cause of pyridoxine dependent epilepsy characterized by early onset epileptic encephalopathy responsive to large dosages of pyridoxine. Despite seizure control most patients have intellectual disability. Folinic acid responsive seizures (FARS) are genetically identical to ATQ deficiency. ATQ functions as an aldehyde dehydrogenase (ALDH7A1) in the lysine degradation pathway. Its deficiency results in accumulation of ?-aminoadipic semialdehyde (AASA), piperideine-6-carboxylate (P6C) and pipecolic acid, which serve as diagnostic markers in urine, plasma, and CSF. To interrupt seizures a dose of 100mg of pyridoxine-HCl is given intravenously, or orally/enterally with 30mg/kg/day. First administration may result in respiratory arrest in responders, and thus treatment should be performed with support of respiratory management. To make sure that late and masked response is not missed, treatment with oral/enteral ...

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The feasibility of self-expanding nitinol stents for treatment of infragenicular arteries following unsuccessful balloon angioplasty was assessed. Options for lower limb percutaneous revascularization are limited, especially for complex vessel obstruction. Depending on the lesion and the experience of the interventionalist, the failure rate of balloon angioplasty (PTA) ranges between 10 and 40%. Until recently, no self-expanding stent for the use in the infragenicular arteries was available. This is the first report of the results for 18 consecutive patients who received 4F sheath compatible self-expanding nitinol stents following unsuccessful PTA or early restenosis. Twenty-four stents were implanted in 21 lesions for various indications residual stenosis >50% due to heavy calcification, flow-limiting dissection, occluding thrombus resistant to thrombolyis, thrombaspiration, and PTA, and early restenosis after previous PTA. Stent ...

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A cross sectional study on the mineral density of the 3rd lumbar vertebral trabecular bone was carried out in 123 children less than 15 years old, comprising 44 controls, and 79 patients affected with conditions which are at risk for developing metabolic derangement of skeletal bone (34 patients taking antiepileptic drugs (AED), 29 undergoing glucocorticoid (GC) therapy and 16 bedridden patients), by using quantitative computed tomography (QCT) with a CaCO{sub 3} phantom. Serum Ca and alkaline-phosphatase (Alp) levels were measured at the time of QCT examinations in all. The results obtained were as follows: The QCT values in the control children showed neither age dependency nor a sexual difference before puberty. The QCT values in each group showed significant difference with one another; the control group>the AED group>the GC group>the bedridden group (p<0.05{approx}0.005). The serum Ca ...

UK PubMed Central (United Kingdom)

ObjectiveTo identify patient-care practices related to an increased prevalence of hepatitis C virus (HCV) infection among chronic hemodialysis patients.Full Text Available

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Short communication.

Science.gov (United States)

PMID:17142595

Science.gov (United States)

TIA (Transient Ischemic Attack)

KoreaScience (Korea)

Full Text Available

British Library Electronic Table of Contents (United Kingdom)

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...

International Nuclear Information System (INIS)

Electron beam therapy of lesions such as cutaneous metastatic carcinoma and reticulum cell sarcoma is performed via multiple portals for a wide irradiation field. However, the dose distribution in border areas is generally uneven, resulting in hot and cold dose areas depending on the intervals of the portals. We performed electron irradiation by the pendulum technique, especially on curved areas, and evaluated the technique in various respects. Pendulum electron beam irradiation is indicated when the length of the cone must be reduced in order to deliver the target volume near the skin surface as well as to avoid the occurrence of hot spots deep in the body. We prepared a 15cm rotating cone by cutting a 30cm fixed irradiation cone. The modification posed no disadvantages in terms of extent and flatness of the beam, or stability during rotation. After determining the relationship between the rotation speed and the dose, the technique was successfully applied to a ...

Science.gov (United States)

The brain hypothermia treatment is an attractive therapy for the neurologist because of its neuroprotection in hypoxic-ischemic encephalopathy patients. The present paper deals with the possibility of controlling the brain and other viscera in different temperatures from the viewpoint of system control. It is theoretically attempted to realize the special brain hypothermia treatment to cool only the head but to warm the body by using the simple apparatus such as the cooling cap, muffler and warming blanket. For this purpose, a biothermal system concerning the temperature difference between the brain and the other thoracico-abdominal viscus is synthesized from the biothermal model of hypothermic patient. The output controllability and the asymptotic stability of the system are examined on the basis of its structure. Then, the maximum temperature difference to be realized is shown dependent on the temperature range of the ...

International Nuclear Information System (INIS)

Thirty-seven patients with primary nonresectable intrahepatic cholangiocarcinoma (57% with prior treatment and/or metastasis) were prospectively treated with external radiation, chemotherapy, and "1"3"1I labelled anti-CEA. Therapy began in all trials with whole liver irradiation (21.0 Gy, 3.0 Gy/Fx, 4 days/week, 10 MV photons) with alternate treatment day chemotherapy (Adriamycin, 15 mg + 5-FU, 500 mg). One month after external beam therapy, chemotherapy was given (Adriamycin, 15 mg + 5-FU, 500 mg) followed the next day by the first administration of "1"3"1I anti-CEA. The treatment schedule used was 20 mCi day 0; 10 mCi day 5 as an outpatient. This schedule was derived from tumor dose estimates which indicated that 20 mCi (8-10 mCi/mg IgG) was sufficient to achieve tumor saturation with a tumor effective half-life of 3 to 5 days, depending upon the species of animal from which the antibody was obtained. The median tumor dose for the 20 mCi + 10 ...

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

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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

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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

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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

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

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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

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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

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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

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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

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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

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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

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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

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PMID:1481407

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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

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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

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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

International Nuclear Information System (INIS)

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.

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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

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PMID:16504974

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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 ...

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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

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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

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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

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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...

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Bone integrity and mineral status were studied with a noninvasive method in uremic patients with severe secondary hyperparathyroidism undergoing maintenance hemodialysis.

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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

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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. ...

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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 ...

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PMID:1461290

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PMID:12886534

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Short note.

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Melanoma (Skin)

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Severe Crohn's Disease; Anxiety

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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 ...

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... blood serum patients radioimmunoassay sampling tracer techniques isotope

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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

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... pathological changes patients radiation protection radiotherapy diseases

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British Library Electronic Table of Contents (United Kingdom)

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...

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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...

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

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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...

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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 ...

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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

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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).

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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 (...

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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 ...

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Summary.? Measuring von Willebrand factor (VWF) activity is essential to the diagnosis of von Willebrand disease (VWD). The VWF activity is usually assessed based on measurement of the ristocetin cofactor (VWF:RCo). However, that test is technically challenging and has high intra- and inter-assay variabilities. The HemosIL VWF activity (VWF:AC) is a fully automated assay, recently proposed as a good alternative to VWF:RCo for VWD diagnosis. This study was undertaken to assess this new method. First, the analytical performance of VWF:AC on an automated coagulo-meter (ACLTop) was determined, and then this new method was compared with VWF:RCo and the platelet function analyzer (PFA100) for 160 patients referred for VWD screening. The VWF:AC achieved acceptable precision with within-run and between-run coefficients of variation ranging from 2.3% to 14.1%, and linearity from 10% to 100%. Despite some marked differences between VWF:AC and VWF:RCo for 10 plasmas tested, ...

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

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We evaluated 190 children with very high-risk leukemia, who underwent allogeneic hematopoietic cell transplantation in 2 sequential treatment eras, to determine whether those treated with contemporary protocols had a high risk of relapse or toxic death, and whether non-HLA-identical transplantations yielded poor outcomes. For the recent cohorts, the 5-year overall survival rates were 65% for the 37 patients with acute lymphoblastic leukemia and 74% for the 46 with acute myeloid leukemia; these rates compared favorably with those of earlier cohorts (28%, n = 57; and 34%, n = 50, respectively). Improvement in the recent cohorts was observed regardless of donor type (sibling, 70% vs 24%; unrelated, 61% vs 37%; and haploidentical, 88% vs 19%), attributable to less infection (hazard ratio [HR] = 0.12; P = .005), regimen-related toxicity (HR = 0.25; P = .002), and leukemia-related death (HR = 0.40; P = .01). Survival probability was dependent on ...

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The absorbed dose delivered to the patient in brachytherapy is directly proportional to the source strength in terms of the reference air-kerma rate (RAKR). Verification of this quantity by the hospitals is widely recognized as an important part of a quality assurance program. An external audit was performed on behalf of the Secondary Standard Dosimetry Laboratory at the Swedish Radiation Protection Authority (SSI). The aim was to investigate how accurately the source-strength in 192Ir brachytherapy is determined at Swedish hospitals. The SSI reference well-type ion chamber and calibrated equipment were used to measure the RAKR of an 192Ir source in each of the 14 Swedish afterloading units. Comparisons with values determined by vendors and hospitals were made. Agreement in values of RAKR as determined by SSI, hospitals and vendors were in all cases within the +-3% uncertainty (at a coverage factor of k=2), typically guaranteed by the vendors. The good agreement ...

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Effects associated with the temperature dependence of the level density parameter, a(T), are investigated in connection with neutron evaporation processes. Different approximations, for this temperature dependence, are compared for the case of neutron emission from the compound nucleus /sup 209/Pb.

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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...

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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...

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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...

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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 ...

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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 ...

International Nuclear Information System (INIS)

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 ...

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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...

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The A-dependence of the nuclear structure functions is described rather well within the framework of the quark-parton-flucton model of nucleus. 16 refs. (author).

UK PubMed Central (United Kingdom)

Background:Children of people with alcohol dependence (COAs) are at high risk for behavioral and cognitive problems.Aim:Aim of...Full Text Available

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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 ...

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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 ...

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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 ...

International Nuclear Information System (INIS)

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 ...

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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 ...

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

AbstractBackgroundGender concordance between patients and their physicians is related to prevention screening and other quality indicators. Research suggests female...Full Text Available

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

International Nuclear Information System (INIS)

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 ...

UK PubMed Central (United Kingdom)

BackgroundTransarterial chemoembolization (TACE) therapy is an effective locoregional treatment in hepatocellular cancer (HCC) patients. For early modification of therapy, markers...Full Text Available

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

ObjectiveTo determine the prevalence of erectile dysfunction (ED) in HTLV-I infected patients, and its association with overactive bladder (OB).Full Text Available

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

Energy Technology Data Exchange (ETDEWEB)

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 ...

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

Energy Technology Data Exchange (ETDEWEB)

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 ...

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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

UK PubMed Central (United Kingdom)

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