Paediatric palliative care is a holistic approach aimed at addressing the complex issues related to the care of children and families facing chronic life limiting illnesses. The needs of children are...Full Text Available
During 1968-77, 572 consecutive children with one or more positive urine cultures who were referred by their family doctors to one paediatric surgical outpatient clinic were investigated and prospectively...Full Text Available
OBJECTIVE: To recommend appropriate intake of nutrients, food sources and feeding practices for premature infants. OPTIONS: Unfortified milk from the premature infant's own mother, fortified milk from...Full Text Available
In a joint study conducted by the University Clinic of Radiology, Graz, and the Medical University Clinic, Innsbruck, the results of computer tomography examinations of the abdomen and pelvis in 23 cases of tumours in children are discussed. In children computer tomography resents special difficulties on account of the very poorly developed fatty layers between the organs and the increased incidence of movement artifacts. The importance of computer tomography for the diagnosis of abdominal and pelvic tumours is discussed.
The radiation dose to a series of adult and paediatric patients undergoing cardiac catheterisations and adults having percutaneous transluminal coronary angioplasty has been measured/determined directly using lithium fluoride thermoluminescent dosemeters and indirectly using an air ionisation chamber which indicated exposure-area product. Somatic and genetic risks are estimated from the dosimetry results. It is suggested that the magnitude of the radiation hazard is negligible compared with other clinical hazards associated with these procedures. (author).
All Streptococcus pneumoniae strains isolated from paediatricclinical samples at Heraklion University General Hospital in the 10-year period 2000-2009 were tested for serotype and susceptibility to antimicrobials. Among a total of 258 strains, 159 were isolated in the 5-year period 2000-2004, before the introduction of the heptavalent pneumococcal conjugate vaccine (PCV7), and 99 in the post-PCV7 5-year period 2005-2009. The prevalence of PCV7-included serotypes decreased in the post-PCV7 period (p?=?0.0002), but an increase was observed for serotypes 7F (p?=?0.002) and 19A (p?=?0.004). Pan-susceptibility rates and susceptibility to cotrimoxazole increased in the post-PCV7 period (p?=?0.01 and p?=?0.008, respectively), but serotype 19A emerged as a contributor to multi-resistance (p?=?0.007). PCV7 was followed by decreased S. pneumoniae resistance and prevalence of vaccine-related serotypes but increased prevalence of serotypes 7F and 19A. ...
SummaryObjective:Formalizing clinicalpractice guidelines (CPGs) for a subsequent computer-supported processing is a challenging, but burdensome and...Full Text Available
BackgroundHealth-Related Quality of Life assessment is widely used in clinical research, but rarely in clinicalpractice. Barriers including practical difficulties administering...Full Text Available
Background:- Diagnoses of paediatric bipolar disorder have increased over the last two decades in the United States, where high levels of comorbidity with ADHD have also been reported. Aims:- To explore how British clinicians apply these diagnoses. Method:- We compared 378 young people under the age of 18 who received a diagnosis of bipolar disorder and/or ADHD from a large NHS mental health trust between 1992 and 2007. Results:- Children with bipolar disorder were rare in this sample (n-=-35, 1.0%), particularly under the age of 13 (n-=-9, 0.3%). Children with bipolar disorder presented more often with affective and psychotic symptoms than children with ADHD. Irritability was common in both disorders. Core ADHD symptoms were prevalent in both conditions but occurred in a greater proportio...
The likelihood that past experience will produce correct guides to current practice depends on the signal-to-noise ratio for the clinical problem of interest. If the signal-to-noise ratio is high, the...Full Text Available
BackgroundTraumatic paediatric arterial injuries are a great challenge due to low incidence and specific characteristics of paediatric anatomy and physiology. The aim of the present...Full Text Available
BackgroundTo evaluate the performance of three different advanced treatment techniques on a group of complex paediatric cancer cases.MethodsCT...Full Text Available
A small regional survey of direct spectrophotometric methods and a larger Australian and New Zealand survey of paediatric bilirubin analyses are described. The overall performance of both groups was...Full Text Available
AbstractOBJECTIVETo provide an overview of the 2009 edition of the Rourke Baby Record (RBR), which incorporates recent research in the literature relating to preventive health care for children aged 0 to 5 years.QUALITY OF EVIDENCERecommendations are identified as supported by good, fair, or consensus evidence, according to the classification of the Canadian Task Force on Preventive Health Care.MAIN MESSAGENew information and recommendations are given for growth monitoring, nutrition, developmental surveillance, physical examination maneuvers, immunization schedules, and advice for parents. Anticipatory guidance updates relate to injury prevention, infant swaddling, literacy facilitation, nonparental child care, parenting skills programs, serum lead levels, over-the-counter cough and cold medications, pacifiers, antipyretics, insect repellents, and dental care and oral health. The 2009 RBR is available in English and French in both National and Ontario versions and is endorsed by the ...
Incorporation of clinical decision support (CDS) capabilities is required to realize the greatest benefits from computerized provider order entry (CPOE) systems. Discussions at a conference on CDS in...Full Text Available
BackgroundThe use of measurement tools is an essential part of good evidence-based practice; however, physiotherapists (PTs) are not always confident when selecting, administering,...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 clinicalpractice. An observational,...Full Text Available
Objective: The aim of this study was to investigate the impact of a program of repeated assessments, feedback, and training on the quality of coded clinical data in general practice.Design:...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
BackgroundThere is need for a cognitive test battery that can be easily used in clinicalpractice to detect or monitor cognitive performance in patients with multiple sclerosis (MS)....Full Text Available
Background:To encourage evidence-based practice, an Annals of Internal Medicine editorial called for a new professional on clinical teams: an informationist trained...Full Text Available
The success of monoclonal antibodies in clinicalpractice is dependent on good design. Finding a suitable target is the most important part as other properties of the antibody can be altered by genetic...Full Text Available
The supernatural fears associated with the experience of isolated sleep paralysis in the culture of developing countries is sometimes associated with the evolution of somatic symptoms of psychological...Full Text Available
BackgroundAdequate pain assessment is critical for evaluating the efficacy of analgesic treatment in clinicalpractice and during the development of new therapies. Yet the currently...Full Text Available
Consultant and advanced practice are relatively new concepts in radiography. There is evidence to show that as the career progression framework is being adopted the numbers of consultant and advanced practitioners in radiography are growing with the latter growing at a faster rate. The article considers the concept of advanced and consultant practice and the education requirements to support development. Preparation for an advanced practice role begins at the practitioner stage. Masters' level programmes are available to support the development of advanced practice. Education needs to be flexible as new advanced practice roles emerge. It is necessary to take practitioners beyond a defined modality to include leadership and people skills. These are essential for those aspiring to become consultants. Consultants require a high level of clinical knowledge ...
Despite the many advances in scientific research over the last several decades, cutting edge technologies and therapeutics often take many years to find their way into widespread use. The dissemination and uptake of best practices into clinical care is sometimes a neglected component of research that is essential to improve the population?s health. Type 2 translational research, sometimes called ?Proof in Practice Research,? seeks to maximize the yield of what has been learned from the bench and from carefully controlled clinical trials and to extend those benefits to a larger population. One aspect of type 2 translational research, sometimes called evidence implementation or implementation science, applies what has been learned about clinical medicine to achieve best practices across prov...
AbstractThe optimal definition of the size, shape and location of gross tumour volume is one of the most important steps in the planning of radiation therapy, and necessitates a proper...Full Text Available
BackgroundIt is well documented that the translation of knowledge into clinicalpractice is a slow and haphazard process. This is no less true for dental healthcare than other types...Full Text Available
AbstractIndividual informed consent is a key ethical obligation for clinical studies, but empirical studies show that key requirements are often not met. Common recommendations to strengthen...Full Text Available
BackgroundAlthough propofol is commonly used for general anaesthesia of normothermic patients in clinicalpractice, little information is available in the literature regarding the...Full Text Available
Calculations of dose per monitor unit (D∕MU) are required in addition to measurements to increase patient safety in the clinicalpractice of proton radiotherapy. As in conventional photon and...Full Text Available
Continuing Medical Education (CME) is a requirement among practicing physicians to promote continuous enhancement of clinical knowledge to reflect new developments in medical care. Previous research...Full Text Available
Middle segment pancreatectomy (MSP) is a new operation where the advantages of parenchymal preservation are counterbalanced by a high postoperative complication rate and unease among surgeons with adopting...Full Text Available
Multimodality imaging with PET/CT and SPECT/CT has become commonplace in clinicalpractice and in preclinical and basic medical research. Do other combinations of imaging modalities have a similar...Full Text Available
To assess the practical significance of reported increases in the prevalence of vancomycin-susceptible strains of Neisseria gonorrhoeae on isolation of this organism, antibiotic-free chocolate agar...Full Text Available
BackgroundCavernous hemangiomas are the most frequent neoplasms of the liver and in routine clinicalpractice they often need to be differentiated from malignant tumors and other...Full Text Available
The word “gratitude” has a number of different meanings, depending on the context. However, a practicalclinical definition is as follows—gratitude is the appreciation...Full Text Available
Broth disk elution procedures represent one of the most practical means for clinical laboratories to perform routine antibiotic susceptibility tests on anaerobic bacteria. The accuracy of five disk...Full Text Available
BackgroundOsteoporosis affects over 200 million people worldwide, and represents a significant cost burden. Although guidelines are available for best practice in osteoporosis, evidence...Full Text Available
Premature circuit clotting is a major problem in daily practice of continuous renal replacement therapy (CRRT), increasing blood loss, workload, and costs. Early clotting is related to bioincompatibility,...Full Text Available
Background/Objective:Applying practice-based evidence research methodology to spinal cord injury (SCI) rehabilitation requires taxonomy (typology or classification) of rehabilitation...Full Text Available
An animated test is made for mice with malignant tumors irradiated by a self-made millimetre wave radiator for medical purpose. It is observed that S-180 sarcomas in mice after irradiation has been distinctly suppressed. And remarkable effects are shown through a lot of clinicalpractices on peptic ulcer, skin-deep ulcer, acute and chromic soft tissue injuries etc.
Delirium occurs in up to 65% of older hip fracture patients. Developing delirium in hospital has been associated with a variety of adverse outcomes. Trials have shown that multi-component preventive...Full Text Available
Purpose Skilled placement of peripherally inserted central catheters (PICC) has a profound impact on patient well-being and costs of care. The use of ultrasound-guided methods and prescribed training for cannulation skills are evidence-based practice recommendations. The purpose of this study was to compare two methods of PICC instruction on the acquisition of applied skills. Methods Residents were randomly assigned to one of two groups (N?=?16/16) of this blind-rater study and were trained to perform ultrasound-guided PICC cannulation using either simulation or apprenticeship methods. All residents were assessed placing a PICC in applied clinical patient care. Results Residents who completed simulation training had significantly better transfer of skills to applied clinicalpractice than ...
Purpose: The purpose of this research was to identify the extent and scope of changes to radiography practice. Method: Questionnaires were sent to radiology managers at acute National Health Service (NHS) hospitals in 2000 as a follow-up to an initial survey conducted in 1998. Information was sought on region, teaching/non-teaching status, the nature of extended role tasks undertaken and the year in which these tasks were first undertaken. Results: Some 172 questionnaires were returned from a total of 253 dispatched (68%). In 161 hospitals radiographers administered intravenous injections and performed barium enemas in 119 hospitals, while a red-dot system was in operation in 141 hospitals. Reporting by radiographers had increased since 1998. Replies indicated that, at 124 hospitals, radiographers were reporting in ultrasound. Skeletal reporting was the second most-frequently-reported activity, with 63 hospitals indicating that radiographers reported in this ...
Fetal growth restriction (FGR) is an adverse pregnancy outcome associated with significant perinatal and paediatric morbidity and mortality, and an increased risk of chronic disease later in adult life....Full Text Available
Aim.- To identify what determinants influence the prevalence and accuracy of nursing diagnosis documentation in clinicalpractice. 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...
PURPOSE.- The study aims to clinically validate the defining characteristics (DCs) of the nursing diagnosis (ND) of Activity Intolerance for patients with ischemic heart disease and refractory angina. METHODS.- Cross-sectional study was used, involving 22 patients with ND of Activity Intolerance. The Fehring method was used to validate the ND. FINDINGS.- Most DCs presented reliability indexes between 0.5 and 0.79. Three DCs presented reliability indexes - 0.8. CONCLUSION.- All DCs were validated, and electrocardiographic changes indicating ischemia, verbal report of fatigue, and abnormal rate response to activity were considered as DC major. IMPLICATIONS FOR NURSING PRACTICE.- This study is relevant in daily nursing practice for guidance in establishing the care plan and describing the ass...
Summary Objective To evaluate the cost-effectiveness of an educational outreach intervention to improve primary respiratory care by South African nurses. Methods Cost-effectiveness analysis alongside a pragmatic cluster randomised controlled trial, with individual patient data. The intervention, the Practical Approach to Lung Health in South Africa (PALSA), comprised educational outreach based on syndromic clinicalpractice guidelines for tuberculosis, asthma, chronic obstructive pulmonary disease, pneumonia and other respiratory diseases. The study included 1999 patients aged 15 or over with cough or difficult breathing, attending 40 primary care clinics staffed by nurses in the Free State province. They were interviewed at first presentation, and 1856 (93%) were interviewed 3 months late...
In everyday radiotherapy we must carry out the determination of absorbed dose measurement according to JARP's protocol. We explained an outline of JARP's 1974 and 1986 protocol in electron beam therapy, and mentioned it about the matter that should examined. To use it easily in clinic, a simplified procedure based on precisely to JARP's 1986 protocol is practical, the character of this procedure settles briefly the determination of mean incident energy of electron beams and get ready to table of ionization to absorbed dose conversion factor for various ionization chamber. Also, this procedure almost not influence on the accuracy of determination. We described systematically practical procedure for requisite absorbed dose calculation in a patient in electron beam therapy. (author).
This paper is to report a case of multi-ruptured complex pseudoaneurysm confirmed by three-dimensional DSA. Under three-dimensional DSA guidance, the thrombin was injected into lumens in the attempt to cure the pseudoaneurysm. As the result was unsatisfactory, fibrin sealant was used to inject into the lumens again, and good curative effect was obtained. In clinical interventional practice, the incidence of pseudoaneurysm has been steadily increasing and the lesions have become more and more complex. In this paper the authors have discussed the diagnostic and therapeutic methods of complex pseudoaneurysm in order to provide clinical physicians with useful information. (authors)
In the last 40 years, significant advances have been made in the understanding of the neurophysiologic processes involved in the experience of trauma and pain. This knowledge, together with the rapid growth and understanding in the behavioral health sciences, has expanded to include a much better appreciation of how these fields are converging and contribute to a process called neuroplasticity. These basic mechanisms common to all patients have important implications for clinical outcome and for improving clinicalpractice. This article is written for clinicians who manage patients with sacroiliac joint dysfunction, a specific type of nonspecific low back pain.
Within the past decade two important groups of radiopharmaceuticals labelled with /sup 123/I were introduced into the clinical application opening new areas of metabolic studies in nuclear medicine: radioiodinated fatty acids were developed for metabolic studies of the myocardium and radioiodinated amphetamine derivatives were prepared for studying brain diseases by means of SPECT. It must be emphasized that the radiochemical problems with both groups of compounds are practically the same since both are radioiodinated by a nucleophilic substitution mechanism using /sup 123/I directly in its anionic form. The clinical application of brain imaging agents, particularly the one of p-/sup 123/I-iodo-N-isopropylamphetamine, is important and will presumably increase as soon as the details of the individual biochemical steps, which are involved in brain uptake mechanisms, are evaluated. It is felt that the potential of the ...
Objective.The interest of dental research in metal-free restorations has been rising in the last 20 years following the introduction of innovative all-ceramic materials in the daily practice. In particular, high strength ceramics and related CAD/CAM techniques have widely increased the clinical indications of metal-free prostheses, showing more favourable mechanical characteristics compared to the early ceramic materials.The purpose of the present paper is providing a brief review on the all-ceramic dental materials, evaluating pros and cons in the light of the most recent scientific results and of the authors? clinical experience.Materials. A structured review of the literature was given on the basis of medical and engineering papers published in the last decades on the use of dental cera...
Summary A prospective and randomized trial design is of utmost interest when it comes to evaluating new developments in the management of cardiovascular medicine. By defining the primary end point and a profound related statistic new therapeutic options can be tested with an adequate number of patients. The course of the trial is supervised by a Clinical Events Committee and a Data and Safety Monitoring Board. Registries are promising tools for describing how the results of clinical trials are translated into daily practice. Their drawbacks include lack of control of the clinical endpoints and their uniform definition and lack of a control group. There are numerous examples from cardiology of the limited usefulness of data obtained from registry studies with their often unexpected results ...
Gadolinium (Gd) based contrast agents (GBCAs) in magnetic resonance imaging (MRI) are used in daily clinicalpractice and appear safe in most patients; however, nephrogenic systemic fibrosis...Full Text Available
Epiphyseal plates of growing bones are sensitive to ionizing radiation and this poses problems for the paediatric radiotherapist. In this case report we describe a child in whom electron beam therapy to the groin delivered only low dose radiation to the proximal hip epiphyses - 130 cGy fractionated over 5 weeks - but who suffered late maldevelopment. We explore the success of various radiotherapy techniques in minimizing the dose to the hip epiphyses in four other children. The appropriate positioning of the limb, the choice of treatment modality and, where possible, individual shielding blocks are considered and their effect on the dose to the hip estimated. Absorbed doses of radiation delivered to the midpoint of the proximal femoral epiphyses have been retrospectively determined. (author).
Despite advances in polymer and drug technology, the underlying stent platform remains a key determinant of clinical outcome. A clear understanding of stent design and the differences between various stent platforms are of increasing importance for the interventional cardiologist. Reduction in stent strut thickness has been associated with improved stent deliverability, improved procedural outcome, and lower rates of subsequent restenosis. Newer-generation 316L-SS stent designs have enabled reduced strut thickness while retaining radial strength and minimizing recoil, but with significant loss of radiopacity, leading to reduced visibility. Cobalt chromium alloys have enabled a reduction in stent strut thickness to around 80?90 mm while retaining modest radiopacity, but due to higher elasti...
The world of antibiotic drug discovery and development is driven by the necessity to overcome antibiotic resistance in common Gram-positive and Gram-negative pathogens. However, the lack of Gram-negative activity among both recently approved antibiotics and compounds in the developmental pipeline is a general trend despite the fact that the plethora of covered drug targets are well-conserved across the bacterial kingdom. Such intrinsic resistance in Gram-negative bacteria is largely attributed to the activity of multidrug resistance (MDR) efflux pumps. Moreover, these pumps also play a significant role in acquired clinical resistance. Together, these considerations make efflux pumps attractive targets for inhibition in that the resultant efflux pump inhibitor (EPI)/antibiotic combination d...
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 ...
The purpose of this note is to provide guidance to those who have duties under the Health and Safety at Work Act and other relevant legislation. It gives guidance on the practical application of legislation, concerning radiotherapy equipment. Two particular issues arise out of the requirements of Regulation 33 of the Ionising Radiations Regulations 1985 (IRR85) in relation to equipment which is used for medical exposures. These are the requirement to select, install and maintain this type of equipment in such a way that it is capable of restricting, so far as reasonably practicable, the medical exposure of any person where this is compatible with the intended clinical purpose, including the need to ensure that equipment used for radiotherapy is properly calibrated, and the requirement to notify the Health and Safety Executive (HSE) when an incident occurs involving a malfunction or defect in any 'radiation ...
The objectives of this paper are to discuss the following aspects of physiopathology of iodine nutrition related to thyroid irradiation by nuclear accidents: (1) The cycle of iodine in nature, the dietary sources of iodine and the recommended dietary allowances for iodine. (2) The anomalies of thyroid metabolism induced by iodine deficiency. The caricatural situation as seen in endemic goitre will be used as mode. (3) The specific paediatric aspects of adaptation to iodine deficiency. (4) The present status of iodine nutrition in Europe. (author).
The doctorate in Counselor Education and Supervision is the terminal degree in the field of counselor education within the U.S. The authors surveyed CACREP-accredited doctoral programs to assess department characteristics, clinical experience and credentials, research experience, and the admission, retention, and evaluation of students. Results indicated that the PhD was a preferable degree to other degree offerings. Programs were found to be diverse in their policies and procedures relating to admissions and retention, time to complete the program, and student expectations. International students and faculty representation was found to be sparse in CACREP-doctoral programs. Implications for future research and practice are offered.
Of the radionuclides with physical properties most suited for use with monoclonal antibody for tumor imaging or therapy, few are more available or desirable than Pb-203, 212 and Bi-212. Yet no clinical studies have as yet been possible solely due to the lability in vivo of known complexes. We now report that bismuth complexes of the ligands p-SCN-Bz-DOTA and p-SCN-Bz-trans-cyclohexylDTPA are effective at protecting Bi-206 from release when linked to immunoproteins. Practicable, efficient ligand syntheses will be reported. Initial studies reveal that antibody is labeled efficiently with radiolead DOTA complexes. Preliminary studies indicate stability in vivo.
For over 50 years, electron beams have been an important modality for providing an accurate dose of radiation to superficial cancers and disease and for limiting the dose to underlying normal tissues and structures. This review looks at many of the important contributions of physics and dosimetry to the development and utilization of electron beam therapy, including electron treatment machines, dose specification and calibration, dose measurement, electron transport calculations, treatment and treatment-planning tools, and clinical utilization, including special procedures. Also, future changes in the practice of electron therapy resulting from challenges to its utilization and from potential future technology are discussed. (review)
Control of human filarial infections currently depends on chemotherapeutic strategies predominantly directed at microfilariae. Doxycycline therapy in an extended daily dose regimen sterilizes and kills adult stages, but the utility of this drug for routine field use remains an issue of concern. No macrofilaricidal drugs with efficacy after one or two doses are available for use, delaying the achievement of the elimination or eradication of onchocerciasis and lymphatic filariasis. Moxidectin, a macrocyclic lactone, is currently in clinical trials for onchocerciasis. A few other drugs that have already been approved for use in veterinary practice or in human medicine for other indications are available for investigation. Early drug discovery pipelines are poorly populated and the process of ...
The clinical and radiographic features of the intermediate form of osteopetrosis in two sibs are presented in which the disorder appears to have been inherited as a recessive trait. Although this form of osteopetrosis has been poorly delineated, its recognition is practically important in order to give an accurate prognosis. This paper also presents an unusual complication of bilateral avascular necrosis of the femoral head in the younger sib. Radiographic changes of the femoral heads suggest those of Legg-Calve-Perthes disease, though the possibility of avascular necrosis following unrecognized femoral neck fracture is not completely excluded. (orig.).
Spinal cord stimulation (SCS) is frequently used for relief of chronic benign pain resistant to conservative therapies. Clinicalpractice suggests, at least in patients with failed back surgery syndrome (FBSS), the possibility that SCS significantly improves motor performances. We present here the case of a 41-years-old female patient with FBSS, who showed a clear improvement in muscle strength after SCS, persisting at 6-months follow-up. We speculate that the electrical stimulation of posterior columns could potentiate the caudal, segmental spinal reflexes resulting in a facilitation of motoneurons activation. PMID:16175150
In dual-energy projection radiography with double exposures, rapid energy switching is mandatory to eliminate motion artifacts, but it is costly for use in a clinical environment. We developed a system with practical exposure intervals at reasonable cost by modifying a condenser-type X-ray generator. A commercially available system for digital radiography (Fuji Computed Radiography, FCR) was used to subtract images. This report dealt with technical factors to obtain adequate kV and mAs settings in this technique.
In dual-energy projection radiography with double exposures, rapid energy switching is mandatory to eliminate motion artifacts, but it is costly for use in a clinical environment. We developed a system with practical exposure intervals at reasonable cost by modifying a condenser-type X-ray generator. A commercially available system for digital radiography (Fuji Computed Radiography, FCR) was used to subtract images. This report dealt with technical factors to obtain adequate kV and mAs settings in this technique. (author).
The utilization of the Ellis-formula for the determination of the tolerance of normal connective tissue is described. Beyond this, the formula is adapted to so-called critical organs. The individual suppositions implicated by the Ellis-formula are commented. Because of the verifyable congruency of the Ellis-formula with data obtained in clinicalpractice also by other authors, this conception is presented for the provisional determination of the limits of tolerance of normal tissue together with a computerized programme elaborated for use in different therapeutic techniques. (orig.).
The quality insurance in radiotherapy in the frame of highly complex technical process as Intensity modulated radiotherapy (I.M.R.T.) needs independent control of the delivered dose to the patient. Actually, up to now, most of the radiotherapy treatments rely only on computed dosimetry through a rather complicated series of linked simulation tool. This dosimetry approach requires also qualified treatment means based on cautious quality insurance procedures. However, erroneous parameters could be difficult to detect and systematical errors could happen leading to radiotherapy accidents. In this context, in vivo dosimetry has a critical role of final control of the delivered dose. As many beam incidences and ports are used for any photon therapy treatment, external control could be very tedious and time consuming. Therefore, innovations are needed for in vivo dosimetry to provide ergonomic and efficient tools for these controls. This paper presents a review of technologies and products ...
It has been five years since the last in-depth American College of Nuclear Physicians/Society of Nuclear Medicine Symposium on the subject of single photon emission computed tomography (SPECT) was held. Because this subject was nominated as the single most desired topic we have selected SPECT imaging as the basis for this year's program. The objectives of this symposium are to survey the progress of SPECT clinical applications that have taken place over the last five years and to provide practical and timely guidelines to users of SPECT so that this exciting imaging modality can be fully integrated into the evaluation of pathologic processes. The first half was devoted to a consideration of technical factors important in SPECT acquisition and the second half was devoted to those organ systems about which sufficient clinical SPECT imaging data are available. With respect to the technical aspect of the program we have ...
Purpose. To report a comparative prospective long-term functional analysis after Riboflavin UV A corneal cross-linking (CXL) in three different age groups of patients affected by progressive keratoconus (KC). Methods. Functional analysis comprised paediatric patients (?18 years) included 152 eyes (29.5%); intermediate group (19-26 years) 286 eyes (55.4%), and adults (?27 years) 78 eyes (15.1%). CXL was performed according to the Siena protocol by using the Vega CBM (Caporossi-Baiocchi-Mazzotta) X linker (CSO, Florence, Italy) at Siena University by the same authors. Pre- and post-op examinations included UCVA, BSCVA, corneal topography, and surface aberrometry (CSO Eye Top, Florence, Italy), at 48 months followup. Results. At 48 months followup paediatrics, intermediate, and adult patients showed a mean gain in UCVA of +0.2, +0.14 and +0.12 Snellen lines. BSCVA gained by a mean of +0.21, +0.2, and +0.1 Snellen lines. K(max) was reduced by a ...
The role of nurse practitioner has been established because of a shortage of doctors. In May 2007, the first cohort of 582 nurse practitioners were licensed in Taiwan. The post of nurse practitioner in Taiwan is formally moving towards systematization and the most urgent matters in that regard are the sorting out of contentious issues and the establishment of clear job descriptions. Competence in critical thinking and problem-based learning is important and has to be improved with practice. The application of teaching assessment tools such as direct observation procedural skills (DOPS), objective structured clinical examination (OSCE), miniclinical evaluation exercises (Mini-CEX), and 360 degree assessments may contribute to the improvement of nurse practitioners' skills in conducting research, appraising evidence-based nursing literature, and developing teaching strategies and advanced systems by making policy clear, evaluating, auditing and ...
The ability to use an acoustic stethoscope to detect lung and/or heart sounds, and then to then communicate one's interpretation of those sounds is an essential skill for many medical professionals. Interpretation of lung and heart sounds, in the context of history and other examination findings, often aids the differential diagnosis. Bedside assessment of changing auscultation findings may also guide treatment. Learning lung and heart auscultation skills typically involves listening to pre-recorded normal and adventitious sounds, often followed by laboratory instruction to guide stethoscope placement, and finally correlating the sounds with the associated pathophysiology and pathology. Recently, medical simulation has become an important tool for teaching prior to clinicalpractice, and for evaluating bedside auscultation skills. When simulating cardiovascular or pulmonary problems, high-quality lung and heart sounds should be able to ...
Most of the tissue banks in the Asia Pacific region have been using ionising radiation at 25 kGy to sterilise human tissues for save clinical usage. Under tissue banking quality system, any dose employed for sterilisation has to be validated and the validation exercise has to be a part of quality document. Tissue grafts, unlike medical items, are not produced in large number per each processing batch and tissues relatively have a different microbial population. A Code of Practice established by the International Atomic Energy Agency (IAEA) in 2004 offers several validation methods using smaller number of samples compared to ISO 11137 (1995), which is meant for medical products. The methods emphasise on bioburden determination, followed by sterility test on samples after they were exposed to verification dose for attaining of sterility assurance level (SAL) of 10{sup -1}. This paper describes our experience in using the IAEA Code of ...
In 2000, the Accreditation Council of Graduate Medical Education (ACGME) laid out a definition of competence that included six specific areas of focus: patient care (including clinical reasoning), medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice. The ACGME's intention was to mandate increasingly reliable and valid assessment measures to be used by all training programs over the next decade, with the goal of providing "more credible, accurate, reliable and useful educational outcome data." In this article, the authors will review definitions of competency according to the new ACGME standards and examine the assessment tools currently available, including global evaluations, 360-degree evaluations, checklists, standardized examinations and direct observations. The authors will provide an overview of critical considerations in ...
Success in improving treatment outcomes in childhood cancer has been achieved almost exclusively through multicenter and multidisciplinary clinical and applied research over several decades. While biologically rational as well as empirical approaches have led to combination chemotherapy and multimodality approaches to therapy, which have given rise to evidence-based practice standards, similar scientific rigor has not always been as evidently applied to modalities utilized to assess initial disease burden and, more important, response to investigational approaches to therapy. As the empirical approach to therapeutic advances has likely maximized its benefit, future progress will require translation of biologic discovery most notably from the areas of genomics and proteomics. Hence, attempts to improve efficacy of therapy will require a parallel effort to minimize collateral damage of future therapeutic approaches, and such a parallel approach ...
The main facets of professor N.I. Pirogov's professional activity are outlined. Forensic medicine (in the first place its organizational and practical aspects) was an integral component of his scientific and clinical work, along with applied anatomy and surgery. Landmark publications of N.I. Pirogov are listed with special reference to those concerned with forensic medical expertise of medical malpractice cases, postmortem inspection and intravital examination procedures, wound ballistics studies, the atlas of forensic pathology, etc. The surgeon and anatomist N.I. Pirogov can be justly regarded as a founder of forensic medicine in this country. PMID:21866839
Radiation protection in medicine has unique aspects and is an essential element of medical practice. Medical uses of radiation occur throughout the world, from large cities to rural clinics. It has been estimated that the number of medical procedures using radiation grew from about 1.7 billion in 1980 to almost 4 billion in 2007. In spite of these large numbers, there are many parts of the world without adequate equipment, where the ability to perform additional medical procedures would likely result in a net benefit. Medicine accounts for more than 99.9% of the per caput effective dose from man-made sources. The goal in medical exposure is not to give the lowest dose, but to provide the correct dose to enable the practitioner to make the diagnosis or cure a tumour. Too little or too much ...
Introduction: Patients in underdeveloped nations have limited access to life-saving medical technology including cardiac rhythm management (CRM) devices. We evaluated alternative means to provide such technology to this patient population while assessing the safety and efficacy of such a practice. Methods: Patients in the United States with clinical indications for extraction of CRM devices were consented. Antemortem CRM devices were cleaned and sterilized following a protocol established at our institution. Surveillance in vitro cultures were performed for quality assurance. The functional status of pulse generators was tested with a pacing system analyzer to confirm at least 70% battery life. Most generators were transported, in person, to an implanting institution in Nicaragua. Recipien...
Heavy ions used for biomedical studies fragment when they pass through matter. It is known that different fragments cause different types of biological damage. In this paper, results pertaining to differrent kinds of secondary fragments produced by a /sup 28/Si beam at 463 MeV/nucleon in its interaction with nuclear emulsion are presented. It is observed that the production frequencies of secondary fragments are independent of the target. Partial production cross sections and fluences of the secondary fragments are also discussed. The partial production cross sections for different fragments at three lower energy ranges are practically the same within their statistical errors except for the cross section for Li fragments, which is larger by almost a factor of 1.5 at the lowest energy investigated. The dose contributions of the primary Si beam and its components at different points of the Bragg curve are presented for two different energy regions.
A newly developed method to support tissue characterization in routine MR imaging is presented. It represents a compromise between the practical requirements of clinical routine (short measurement time, multisection imaging) and the necessary accuracy of the relaxation parameter evaluation. The sequence employed is a modification of the PHAPS technique and works with two excitation pulses. It allows the simultaneous acquisition of all measurement data for the subsequent T1, T2, and rho evaluations. T1 is determined with a specially designed computation formula based on four signal ratios. A multiexponential T2 analysis is performed with use of 28 echoes. From these parameters, relative proton density can be computed.
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 clinicalpractice; 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...
Abstract Intense controversy surrounds the management of disorders of sex development, particularly in relation to the validity of parental consent for genital surgery and the removal of gonadal tissue carried out during infancy or childhood. Past practices have been heavily criticised on ethical grounds by patient advocacy organisations, who have demanded a moratorium on these kinds of operations unless authorised by a court. Some doctors and hospital administrators have been influenced by the controversy and have referred cases to the Family Court of Australia, where a series of judgements have now established legal precedents that apply across Australia, restricting the circumstances in which parents can give consent for surgery. An alternative approach is to use a hospital-based Clinic...
Summation Copper-64 (T1/2?=?12.7 hours; ?+, 0.653?MeV [17.8 %]; ??, 0.579?MeV [38.4 %]) has decay characteristics that allow for positron emission tomography (PET) imaging and targeted radiotherapy of cancer. The well-established coordination chemistry of copper allows for its reaction with a wide variety of chelator systems that can potentially be linked to peptides and other biologically relevant small molecules, antibodies, proteins, and nanoparticles. The 12.7-hours half-life of 64Cu provides the flexibility to image both smaller molecules and larger, slower clearing proteins and nanoparticles. In a practical sense, the radionuclide or the 64Cu-radiopharmaceuticals can be easily shipped for PET imaging studies at sites remote to the production facility. Due to the versatility of 64Cu, ...
Abstract Rationale, aims and objectives- Finding ways to incorporate disparate types of evidence into research syntheses has the potential to build a better evidence base for clinicalpractice and policy. Yet conducting such mixed research synthesis studies is challenging. Researchers have to determine whether and how to use adjusted and unadjusted quantitative findings in combination with each other and with qualitative findings. Methods- Among quantitative findings, adjustment for confounding, either via study design or statistical analysis, can be a considerable source of heterogeneity. Yet there is no consensus about the best way to synthesize findings resulting from different methods for addressing confounding. When synthesizing qualitative and quantitative findings, additional consid...
Aims The aim of this study is to examine the dose?response relationships between age, ?lifestyle factors?? (body mass index, tobacco smoking, sports), and symptomatic knee osteoarthritis in a population-based case?control study. Additionally, the study aims to investigate the mode of interaction between body mass index (BMI) and physical workload (occupational kneeling/squatting and lifting/carrying of loads) with respect to the risk of symptomatic knee osteoarthritis. Methods In five orthopedic clinics and five practices, 295 male patients aged 25?70 with radiographically confirmed knee osteoarthritis associated with chronic complaints were recruited. The control group comprised 327 male control subjects. In a structured personal interview, body weight at different ages, body height, cumu...
The authors have studied the distribution of H-3 labelled schistosomicidal drug in mice by autoradiography. The H-3-labelled substances were found in liver and kidney and in successfully decreasing amounts in brain, lung, heart, fat, testis, pancreas and spleen. In various cells the silver granules were present mainly in the cytoplasms but a few in the nucleus. After administration of this labelled schistosomicidal drug, the mice were killed and studied in groups successively at 4, 8, 24 hrs. No difference in the distribution of silver granules were observed. This fact indicated that, this drug was rapidly absorbed and highly concentrated with a long duration of reservation in liver. All of these favours the schistosomicidal effect of the drug. As this drug was highly concentrated in the cytoplasm of liver cells, that might provide a pathophysiologic basis for the explanation of jaundice in the clinicalpractice. Moreover, the appearance of ...
Combination of radiotherapy and chemotherapy (CRC) is actually one important way of research in oncology. Theoretical advantages are: (1) Spatial cooperation; (2) Additivity, which is only obtained if the toxicity of each modality are different; (3) Supra-additivity, which needs a rigorous in vitro definition; the only way to prove it is to make an isobologram analysis. This model has however, some limitations: qualitative variable could not be used, results could be different, depending on the cell line and isoeffect chosen...In fact, a supra-additivity was only demonstrated for cis platinum and etoposide. Interactions mechanisms were: (1) at the molecular level, creation of new lesions or inhibition of radiation lesions repair; (2) At the cellular level, either cytokinetic cooperation with S-phase dependent drugs, or synchronization for the drugs which blocked the cells in M-phase; (3) At the tissular level, reoxygenation, cycle redistribution. In clinical ...
Aim: To investigate interpretative accuracy and reporting time for radiologists performing computed tomography (CT) colonography in day-to-day non-academic clinicalpractice. Materials and methods: Thirteen radiologists from seven centres, who were reporting CT colonography in non-academic daily clinicalpractice, interpreted a dataset of 15 colonoscopically validated cases in a controlled environment. Ten cases had either a cancer or polyp >10 mm; one case had a medium polyp and four were normal. Correct case categorization and interpretation times were compared using analysis of variance to aggregated results obtained from both experienced observers and observers recently trained using 50 cases, working in an academic environment. The effect of experience was determined using Spearman's rank correlation. Results: Individual accuracy was highly variable, range 53% (95% CI 27-79%) to 93% ...
Full text: Introduction. Children, especially premature infants and neonates, are at a much higher risk to obtain an X ray induced disturbance of life - particularly cancer. On the one hand this is due to their longer life expectancy and on the other hand it is due to their higher cell proliferation rate. The paediatric radiology unit of the Inselspital Bern recently installed some of the most advanced X ray equipment nowadays available. It is based on the two latest digital technologies: double read computed radiography (CR) and direct digital radiography (DR). Only the implementation of these digital radiography systems permits the digital acquisition and additionally the analysis of acquired data. The systematic analysis of large amounts of biometric data and exposition data is the basis for further dose reduction and a systematic quality control (QC). Patients are increasingly critical concerning radiation exposure - especially parents regarding their children. ...
Background The Norwood procedure consists of three palliative operations, performed in neonates with hypoplastic left heart syndrome. Especially the first stage (Norwood I) is associated with the highest mortality rates in paediatric cardiac surgery (up to 25%). During surgery, the aorta is reconstructed and a systemic-to-pulmonary shunt is applied. Originally the modified Blalock-Taussig shunt was used, but recently the right-ventricle-to-pulmonary-artery shunt is increasingly being employed. We reviewed the results of our operative strategy, where an individualised choice of shunt is made. Furthermore, attempts to reduce interstage mortality (between Norwood I and II) were assessed. Methods All neonates who underwent Norwood stage I palliation from August 2004 until November 2010 were in...
The number of multislice CT (MSCT) scans performed in polytraumatized children has increased rapidly. There is growing concern regarding the radiation dose in MSCT and its long-term consequences, especially in children. To determine the effective dose to polytraumatized children who undergo whole-body MSCT. A total of 51 traumatized children aged 0-16 years underwent a polytrauma protocol CT scan between November 2004 and August 2006 at our institution. The effective dose was calculated retrospectively by a computer program (CT-Expo 1.5, Hannover, Germany). The mean effective dose was 20.8 mSv (range 8.6-48.9 mSv, SD{+-}7.9 mSv). There was no statistically significant difference in the effective dose between male and female patients. Whole-body MSCT is a superior diagnostic tool in polytraumatized children with 20.8 mSv per patient being a justified mean effective dose. In a potentially life-threatening situation whole-body MSCT provides the clinicians with relevant information to ...
Objective: The paper describes and evaluates the use of Clinical Digital Libraries Project (CDLP) digital library collections in terms of their facilitation of timely clinical information...Full Text Available
The introduction of positron emission tomography (PET)/magnetic resonance (MR) systems into medical practice in the foreseeable future may not only lead to a gain in clinical diagnosis compared to PET/computed tomography (CT) imaging due to the superior soft-tissue contrast of the MR technology but can also substantially reduce exposure of patients to ionizing radiation. On the other hand, there are also risks and health effects associated with the use of diagnostic MR devices that have to be considered carefully. This review article summarizes biophysical and biological aspects, which are of relevance for the assessment of health effects related to the exposure of patients to both ionizing radiation in PET and magnetic and electromagnetic fields in MR. On this basis, some considerations concerning the justification and optimization of PET/MR examinations are presented - as far as this is possible at this very early stage. Current safety ...
In consistency with the increasing requests from Member States for establishing radiotherapy programmes, an IAEA Technical Co-operation project was initiated in Latin America aimed at improving the physical aspects (as a complement to the clinical issues) of quality assurance in radiotherapy; this ARCAL XXX project (RLA/6/032) was classified as a Model Project of the IAEA. Among the important outcomes of the project were (i) the training of a considerable number of medical physicists in hospitals of the region, (ii) the development of a protocol for quality control procedures, and (iii) the organization of quality audit site visits (to the participant countries) where the implementation in hospitals of the developed quality control procedures is verified. The present publication is the protocol for quality control of the physical aspects of radiotherapy. It contains detailed procedures on what should be measured by a medical physicist in a radiotherapy treatment ...
Organic farming (or ecological agriculture) is of growing importance in the agricultural sector worldwide. In the Nordic countries, 1-10% of the arable land was in organic production in 1999. Organic farming can be seen as an approach to agriculture where the aim is to create integrated, humane, environmentally and economically sustainable agricultural production systems. Principles like nutrient recycling, prevention rather than treatment and the precautionary principle are included in aims and standards. Animal welfare is another hallmark of organic livestock production but despite this, several studies have indicated severe health problems e.g. in organic poultry production in Denmark. Also the quality of animal food products in relation to human health, particularly the risk of zoonotic infections, has been debated. For these reasons there is a need for improvement of production methods and animal health status. Vets play an important role in this development through work in ...
Despite its great usefulness in the performance of the recording procedures prescribed by the X-Ray Ordinance the dose-area product is much less frequently measured for X-ray exposures than during fluorscopic examinations. The great multitude of measuring units, mainly on account of different scales of the measuring equipments themselves, is a cause of uncertainty in clinical routine and should be eliminated as far as the circumstances would permit. As the determination of the organ dose is relevant only in very few cases and does not necessarily require previous measurements of the dose-area product, these are of limited practical value in the assessment of individual radiation exposures during radiographic examinations. The measurements may, however, be very helpful in determinations of the radiation dose to the total population, if the future retrievability of the values obtained is ensured. In addition to some measuring values showing past ...
The fundamental recommendations of the ICRP issued in its publication of 1990 stipulate the general principle of performance of dose measurements at regular intervals in the field of diagnostic radiology, for the purpose of equipment performance checking and optimization of radiological protection. In response to this requirement, the Federal Ministry, in cooperation with experts and the competent supervising authorities, has issued an order to install dose-area-product meters in angiographic examination systems, imaging systems and fluoroscopic screen devices primarily used for examining infants and children up to the age of 12. This is done in response to reported cases of adverse effects of radiation exposure and the high priority given to radiological protection in the examination of infants and children. In 1992, an expert group was convened to discuss and elaborate instructions for including dose-area product measurement in the dosimetry activities in medical diagnostic ...
Hepatobiliary scintigraphy is the only non-invasive technique providing real-time assessment of hepatocytes function and bile progression from the liver to the intestine; for this reason it is of great importance in the study of jaundice and many other disorders of the liver and the biliary tract in children. Ultrasonography is the initial method of evaluating the intra- and extrahepatic bile ducts dilatation: the differential diagnosis between biliary atresia and neonatal hepatitis cannot however be done without hepatobiliary scintigraphy. Cystic fibrosis patients also require hepatobiliary scintigraphy; liver and biliary tract disease can really occur independently of the underlying disease severity and the presence of steatorrhoea. Hepatobiliary imaging in children who have undergone liver transplantation is of major importance; it can assess vascularity, parenchymal function biliary drainage, possible presence of a bile leak and obstruction; it has very good sensitivity and ...
The current study investigated relations among ethnic similarity in caregiver-therapist pairs of youth participating in Multisystemic Therapy, therapist adherence, and youth long-term behavioral and criminal outcomes. Participants were 1,979 youth and families treated by 429 therapists across provider organizations in 45 sites. Relations were found, independently, and in the presence of ethnic similarity, between adherence and reductions in youth externalizing and internalizing behavior problems 1-year posttreatment and youth criminal charges 4 years posttreatment. Relations between ethnic similarity and outcomes were found only for reductions in youth externalizing behavior problems and not when adherence was included in the model. Adherence ratings were higher, however, in ethnically similar caregiver-therapist pairs, and evidence was found that this increased adherence predicted slightly better outcomes for youth. Implications for further research and clinical ...
In electron beam therapy, tissue overdose due to electrons backscattered from lead has been profusely studied. To quantify this dose enhancement effect, an electron backscatter factor (EBF) wasdefined as the ratio of dose at the tissue-inhomogeneity interface with and without the scatterer present. The dependence of the EBF on energy at the scatterer surface is not well known for energies lower than 3 MeV which is the most frequent clinical situation. In this work, we have done Monte Carlo calculations with the GEANT code to study EBF in lead at this energy range. The applicability of this code and the developed procedure for dose estimation has been experimentally verified. The dependence of the EBF on the beam energy incident on the scatterer has been studied for different nominal beam energies incident at the phantom's surface. The results show a trend of increase of EBF with the beam energy incident on the scatterer between 0.5 and 1.5 MeV, keeping ...
Cerebral angiography, pneumoencephalography, and radioisotope brain scan with their differing diagnostic abilities have provided the neurologist and neurosurgeon with extremely valuable diagnostic techniques. It is doubtful, however, if any of these now conventional methods had the enormous impact on the practice of neurology that computer assisted axial tomography (C.A.T.) is beginning to have. Here, for the first time, is a test which, without significant risk or discomfort, can demonstrate some normal intracranial (and intraorbital) structures, can demonstrate some normal intracranial pathology and, in many cases, can make the potentially dangerous contrast studies unnecessary. After only a few months experience with C.A.T. in a clinical setting, it has become obvious that there will have to be a reappraisal of the accepted investigative work-up of many conditions. While it is too early to have formulated strict criteria for the use of ...
In less than a decade computed tomography (CT scanning) had a profound impact on diagnostic radiology. Radiology of the orbit is no exception. As early as 1973, reports published in the radiological literature indicated that this new noninvasive imaging method was a highly effective way of demonstrating intraorbital mass lesions. As CT scanners became widely available, computed tomography became a significant adjunct to ophthalmological diagnosis. Today the main indications for CT scanning of the orbit are: (1) suspected mass lesions, most frequently presenting as exophthalmos, (2) orbital trauma, including foreign bodies, (3) some congenital anomalies, and (4) suspicion of extension into the orbit of extraorbital disease processes. Along with ultrasonography, another new noninvasive imaging technique, CT has replaced a number of more invasive and often less effective diagnostic methods, such as orbital pneumography, venography, and arteriography as major imaging techniques in orbital ...
Objective: To evaluate the quality and usefulness of direct digital radiography system in roentgenogram of chest in clinicalpractice. Methods: 1000 cases of chest roentgenograms with digital radiography and high kV conventional radiography were selected for analysis by 3 senior radiologists. Results: 1. With digital radiography system, the quality of chest film was assessed as grade A in 50.6%, grade B in 38.5%, grade C in 10.9%, and no waste film. 2. With conventional high kV radiography, the quality of chest film was assessed as grade A in 41.1%, grade B in 44.1%, grade C in 13.3%, and waste film in 1.5%. The direct digital radiography was statistically superior to the conventional high kV radiography. 3. The fine structure of the lungs could be revealed in 100.0% of chest roentgenogram with direct digital radiograph system, which was significantly higher than that acquired with the conventional high KV radiography (78.6%, P < 0.001). ...
Postresection villus hyperplasia is a major compensatory mechanism in the short-bowel patient. Substances capable of augmenting postresection mucosal hyperplasia could have therapeutic implications. Human growth hormone (hGH) and human growth hormone releasing factor (hGHRF) stimulate growth of the gastrointestinal tract; however, the diabetogenic actions of growth hormone limit its usefulness in clinicalpractice. Plerocercoid larvae of the tapeworm Spirometra mansonoides produce an analog of hGH void of diabetogenic side effects. We assessed effects of plerocercoid growth factor (PGF) on mucosal adaptation following 70% proximal jejunoileal resection in young rats. Mucosal weight, DNA, protein, and total sucrase activity per centimeter of bowel were increased in resected PGF-treated animals compared to resected controls. We conclude PGF augments intrinsic postresection mucosal hyperplasia following extensive intestinal resection. PMID:3665682
IMRT with inverse planning allows simultaneous integrated boost strategies that exploit the heterogeneous dose distribution within the planning target volumes (PTVs). In this scenario, the location of cold spots within the target becomes a crucial issue and has to be related to the distribution of the clonogenic cell density (CCD). The main aim of this work is to provide the means to calculate the optimal prescription dose in a relative inhomogeneous dose distribution. To achieve this, the prescription dose has to be assigned to obtain the same tumor control probability (TCP) as the ideal homogeneous distribution, taking into account different CCDs in different PTVs (i.e. visible and subclinical regions). An adapted formulation of the linear-quadratic model, within the F-factor formalism, has been derived to preserve a chosen TCP value for the whole target volume. The F-factor has been investigated to show its potential applications in clinical ...
PURPOSE We wanted to assess computer capabilities in a primary care practice-based research network and to understand how receptive the practices were to new ideas for automation of practice...Full Text Available
High-energy ionizing radiation is a prominent modality for the treatment of many cancers. The approaches to electron dose calculation can be categorized into semi-empirical models (e.g. Fermi-Eyges, convolution-superposition) and probabilistic methods (e.g. Monte Carlo). A third approach to dose calculation has only recently attracted attention in the medical physics community. This approach is based on the deterministic kinetic equations of radiative transfer. We derive a macroscopic partial differential equation model for electron transport in tissue. This model involves an angular closure in the phase space. It is exact for the free streaming and the isotropic regime. We solve it numerically by a newly developed HLLC scheme based on Berthon et al (2007 J. Sci. Comput. 31 347-89) that exactly preserves the key properties of the analytical solution on the discrete level. We discuss several test cases taken from the medical physics literature. A test case with an academic ...
The objective of this study was to simplify the opacifying mixing process of the bone cement and contrast used for percutaneous vertebroplasty (PVP). We performed a biomechanical study of polymethyl methacrylate (PMMA) (Corinplast 3) using three different mixtures of PMMA, monomer, and contrast: group I, 2:1; group II, 3:2; group III, 3:2:1 ratio of powder/monomer/iodinated contrast (Omnipaque). In vitro biomechanical testing of ultimate compressive strength was carried out in all samples. Following the conclusion of a proper bone cement mixture regimen drawn from the in vitro study, PVP was performed in 125 patients: 58 with cancer, 12 with hemangioma, and 54 with osteoporotic fracture. The ultimate compressive strength in group III was decreased by 38% compared to groups II and I. Proper fluoroscopic visualization was achieved in all PVP procedures using this mixture. There were no major complications associated with injection of the cement mixture. Complete (CR) and partial response ...
The objective of this study was to simplify the opacifying mixing process of the bone cement and contrast used for percutaneous vertebroplasty (PVP). We performed a biomechanical study of polymethyl methacrylate (PMMA) (Corinplast{sup TM} 3) using three different mixtures of PMMA, monomer, and contrast: group I, 2:1; group II, 3:2; group III, 3:2:1 ratio of powder/monomer/iodinated contrast (Omnipaque). In vitro biomechanical testing of ultimate compressive strength was carried out in all samples. Following the conclusion of a proper bone cement mixture regimen drawn from the in vitro study, PVP was performed in 125 patients: 58 with cancer, 12 with hemangioma, and 54 with osteoporotic fracture. The ultimate compressive strength in group III was decreased by 38% compared to groups II and I. Proper fluoroscopic visualization was achieved in all PVP procedures using this mixture. There were no major complications associated with injection of the cement mixture. Complete (CR) and partial ...
Background: In an effort to standardise radiological practices in the Republic of Ireland, current legislation states that 'written protocols for every type of standard radiological practice shall be established'. In order to fulfil this requirement the Irish Medical Council recommends the protocols issued by the Commission of European Communitees (CEC) for adoption in the country. Whilst this document does provide good guidance with regard to various radiographic factors, patient shielding instructions are notably ambiguous. The aim of this study was to remove some of this ambiguity by defining the optimal method of positioning patient shielding in antero-posterior (AP) and lateral lumbar spine radiographic examinations. These projections were chosen on the basis of their area of coverage being in close to and in some cases including the reproductive organs. They also represent the highest source of collective population dose ...
Background: In an effort to standardise radiological practices in the Republic of Ireland, current legislation states that 'written protocols for every type of standard radiological practice shall be established'. In order to fulfil this requirement the Irish Medical Council recommends the protocols issued by the Commission of European Communitees (CEC) for adoption in the country. Whilst this document does provide good guidance with regard to various radiographic factors, patient shielding instructions are notably ambiguous. The aim of this study was to remove some of this ambiguity by defining the optimal method of positioning patient shielding in antero-posterior (AP) and lateral lumbar spine radiographic examinations. These projections were chosen on the basis of their area of coverage being in close to and in some cases including the reproductive organs. They also represent the highest source of collective population dose of any ...
Dose calculations for radiation arc therapy are traditionally performed by approximating continuous delivery arcs with multiple static beams. For 3D conformal arc treatments, the shape and weight variation per degree is usually small enough to allow arcs to be approximated by static beams separated by 5"0-10"0. But with intensity-modulated arc therapy (IMAT), the variation in shape and dose per degree can be large enough to require a finer angular spacing. With the increase in the number of beams, a deterministic dose calculation method, such as collapsed-cone convolution/superposition, will require proportionally longer computational times, which may not be practicalclinically. We propose to use a homegrown Monte Carlo kernel-superposition technique (MCKS) to compute doses for rotational delivery. The IMAT plans were generated with 36 static beams, which were subsequently interpolated into finer angular intervals for dose calculation to mimic ...
Phase-contrast imaging with a practical cone-beam X-ray tube has been realized for clinical use in digital mammography using computed radiography (CR). To perform phase-contrast imaging, the X-ray detector must be distanced from an object so that the phase-contrast image achieves magnification; in a mammography unit dedicated to phase-contrast imaging, the magnification ratio is 1.75. When using an X-ray tube with a 0.1-mm focal spot, it appears that the penumbra in magnification blurs both projected images and the phase contrast, which generates an edge effect. However, where the sampling pitch of the CR plate is 43.75 {mu}m, the blur stretches the width of the phase contrast so that unit pixels in the detector can capture it. Note that the width of an ideal phase contrast using an X-ray point source results in a phase contrast too narrow for detection with CR. In addition to phase contrast improving image quality, a re-scaling effect ...
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
Study DesignThis is a retrospective study that was done according to clinical and radiological evaluation.PurposeWe analyzed the clinical and radiological...Full Text Available
The Clinical Summary is a Web-based application for accessing the clinical database at the Massachusetts General Hospital. The application has been developed to give physicians in our health care community...Full Text Available
In 2008, a clinical information tool was developed and embedded in the electronic health record system of an academic medical center. In 2009, the initial information tool, Clinical-e, was superseded...Full Text Available
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
The clinical signs and postmortem findings in sheep from two flocks accidentally poisoned with monensin are described. Clinical signs began within 24 hours of exposure to monensin. In the acute stages...Full Text Available
BACKGROUND. In recognition of the emotional problems which frequently underlie somatic complaints, practices increasingly offer counselling as part of their services to patients. In an inner city practice,...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
A questionnaire on the development of specialist clinics was distributed to the members of the Association of British Neurologists and completed by 104 members (85 consultants). Half of the respondents...Full Text Available
As controlled clinical vocabularies assume an increasing role in modern clinical information systems, so the issue of their quality demands greater attention. In order to meet the resulting stringent...Full Text Available
PURPOSE: To determine the risk factors and clinical signs of Curvularia keratitis and to evaluate the management and outcome of this corneal phaeohyphomycosis. METHODS: We reviewed clinical and laboratory...Full Text Available
A tunable diode laser is used to obtain infrared spectra of carbon dioxide in biological materials. The spectral resolution is sufficient to readily distinguish differing isotopic species. The technique may prove useful in clinical tests.
Although coagulase-negative staphylococci (C-NS) have been implicated in certain human infections, they are generally regarded as contaminants, and their clinical significance is questioned. To assess...Full Text Available
In 2005, the American Medical Informatics Association undertook a set of activities relating to clinical decision support (CDS), with support from the office of the national coordinator and the Agency...Full Text Available
Introduction: Generally agreed outcome criteria in psychosis are required to evaluate the effectiveness of new treatment strategies. The aim of this study is to explore clinical recovery...Full Text Available
PurposeTo evaluate the clinical characteristics and outcomes of cataract surgery in highly myopic Korean subjects.MethodsWe retrospectively reviewed...Full Text Available
AIM: To evaluate the prevalence of upper gastrointestinal symptoms and their association with clinical and functional characteristics in elderly outpatients.METHODS: The study involved 3238 outpatients...Full Text Available
Purpose: The nint version of the licensing regulation for medical doctors (Approbation Regulation (AR)) sets a benchmark in terms of practical experience, interdigitation of preclinical and clinical studies, interdisciplinary approach, economic efficiency, independence of students, added new teaching and learning modalities, and ongoing evaluation of the progress of the medical students. It is the aim to implement these major points of the AR in a model course for diagnostic radiology and radiation protection within the scope of the Virtual University of Bavaria and test them in practice. Materials and Methods: In cooperation with residents and board certified radiologists, students developed the virtual course 'Web-Based Training (WBT) Radiology' in diagnostic radiology and radiation protection for students in the first clinical semester. A representative target group taken from the ...
OBJECTIVE: To determine the household prevalence of firearms in Pennsylvania, and describe the storage practices for these weapons. DESIGN: A statewide telephone survey of 3,620 Pennsylvania adults...Full Text Available
... The effectiveness of immune suppression with both 6-mercaptopurine and methotrexate was insufficient to permit induction of a clinically useful ...
Background: the fact that therapeutic irradiation can induce significant stenosis in the arteries of the head, neck, and chest, as welt as in the aorta and the iliac arteries, is familiar in daily practice and well documented in the literature. By contrast, radiation-induced renal artery stenosis seems to be a less widely known complication. Patients and methods: the sudden onset of medically refractory arterial hypertension and coma in a 27-year-old man is reported, who had been treated at age 20 with chemotherapy and radiotherapy for Ewing's sarcoma in the lumbar region. This treatment had been performed at the hospital of Sion, Switzerland in 2001. Also, the relevant literature from 1965 to 2007 is reviewed to underscore various aspects of this problem and to demonstrate the clinical relevance of renal artery stenosis as a potential long-term sequela of radiotherapy. Conclusion: radiation-induced renal artery stenosis has only rarely been ...
In radiotherapy treatment planning, convolution/superposition algorithms currently represent the best practical approach for accurate photon dose calculation in heterogeneous tissues. In this work, the implementation, accuracy and performance of the FFT convolution (FFTC) and multigrid superposition (MGS) algorithms are presented. The FFTC and MGS models use the same 'TERMA' calculation and are commissioned using the same parameters. Both models use the same spectra, incorporate the same off-axis softening and base incident lateral fluence on the same measurements. In addition, corrections are explicitly applied to the polyenergetic and parallel kernel approximations, and electron contamination is modelled. Spectra generated by Monte Carlo (MC) modelling of treatment heads are used. Calculations using the MC spectra were in excellent agreement with measurements for many linear accelerator types. To speed up the calculations, a number of calculation techniques were ...
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 anesthetic bag synchronously with the patients breathing, until a count rate of approximately 1000 counts/second was ...
No research has compared expressions of weight bias across different subgroups of obese individuals. This study compared attitudes toward and beliefs about obesity in women with and without binge eating disorder (BED) and examined whether these attitudes are related to psychological factors. Fifty obese women with BED were compared with an age- and body mass index (BMI)-matched group of 50 obese women without BED on a battery of established measures of anti-fat attitudes and beliefs about weight controllability and psychological factors (self-esteem, depression, and eating disorder features). The ageand BMI-matched groups did not differ with respect to beliefs about obesity or attitudes toward obese persons, or in self-esteem or depression. Correlational analyses conducted separately within each group revealed that women with BED who reported more favorable attitudes towards obese persons had higher self-esteem and lower levels of depression, whereas there were no significant ...
... We assume that A is chosen so that the claim in question meets whatever are the conventional requirements for confidence in the context at hand. ...
Due mainly to competitive pressures, the practice of offering electric and telephone service under contracts or special tariffs negotiated individually between a utility and its customers has increased in importance in recent years. Moreover, the practice is likely to become still more widespread in the future. This creates questions of public policy that are of interest to regulators and ratepayers alike such as how to supervise the practice, how to encourage utilities to compete while preventing cross-subsidization and anticompetitive behavior, and how the practice will ultimately affect utilities and ratepayers. This report sheds light on the topic by describing approaches that have been taken by the various regulatory commissions and by providing a framework for analyzing such contractors.
BACKGROUND: Denys-Drash Syndrome (DDS) is an uncommon disorder that appears sporadically and in rare cases may be inherited as an autosomal dominant trait It manifests either at birth or within the first year of life and typically consists of the triad of congenital nephropathy, Wilms tumour and intersex disorder. CASE REPORT: A 10 year-old Caucasian girl was referred to the Dental Department, at Glasgow Royal Hospital for Sick Children by her Paediatric Nephrologist Consultant. The patient was being teased by her peers over her markedly discoloured teeth. The dental history revealed that the patient was a regular dental attendee from an early age. She was dentally anxious having only experienced dental treatment under general anaesthesia (GA) when she was 4 years old. Apparently her primary dentition also showed a generalised discolouration. TREATMENT: This consisted of multiple visits for diet analysis and tooth brushing instruction with the use of disclosing ...
PurposeWe conducted a comparative study of Clinical Target Volume (CTV) definition of pelvic lymph nodes by multiple GU radiation oncologists looking at the levels...Full Text Available
This report describes a case of toxic myopathy in a two year old sheltie dog with clinical signs of profound weakness, myoglobinuria, and muscle enzyme elevations. The clinical signs were likely related...Full Text Available
The clinical management of adults with low-grade gliomas (LGGs) remains a challenge. There is no curative treatment, and management of individual patients is a matter of deciding optimal timing as well...Full Text Available
Objective. Cervical cancer patients who had an abandoned radical hysterectomy were evaluated for preoperative clinical predictors, complication rates, and outcomes. Study...Full Text Available
Randomized clinical trials are designed with stopping boundaries to guide data monitoring committees with their decision making concerning ongoing trials. In particular, when extremely positive results...Full Text Available
Sex-related influences on pain and analgesia have become a topic of tremendous scientific and clinical interest, especially in the last 10 to 15 years. Members of our research group published...Full Text Available
The planned spallation source can be of considerable significance for biomedical basic research and for clinically relevant diagnostic and therapeutic applications. The following gives a brief description and explanations for its possible use in clinical medicine: I. Treatment of Malignant Tumors II. Production of Isotopes for Biochemical Investigations in Living Organisms for Diagnostic Purposes.
The relationship between malaria transmission intensity and clinical disease is important for predicting the outcome of control measures that reduce transmission. Comparisons of hospital data...Full Text Available
This paper discusses the clinical application and main objective of testicular imaging. The authors present cases that represent a spectrum of the abnormalities which might be detected by testicular imaging, with special attention given to testicular torsion and the acute diseases which may mimic it clinically. Accuracy of the test is noted.
AbstractQuantities and types of ceramides and their relationships to physical properties of the horn covering the claws of clinically normal cows and cows with subclinical laminitis were...Full Text Available
The ubiquity and ease of use of the Web have made it an increasingly popular medium for communication of health-related information. Web interfaces to commercially available clinical information systems...Full Text Available
BackgroundPercutaneous endoscopic lumbar discectomy is a relatively new technique. Very few studies have reported the clinical outcome of percutaneous endoscopic discectomy in terms...Full Text Available
BackgroundThe aim of this study is to examine how clinicians and patients negotiate clinical need and treatment decisions within a context of finite resources. Dental implant treatment...Full Text Available
Over the past 10 years, the original partnership of clinician and statistician for the running of clinical research projects, especially clinical trials, has come to be supplemented by the data manager...Full Text Available
BackgroundThe lack of adequate randomized clinical trials (RCT) has hindered identification of new therapies that are safe and effective for patients with primary focal segmental...Full Text Available
A double-blind, placebo-controlled clinical trial of a homeopathic treatment of neonatal calf diarrhoea was performed using 44 calves in 12 dairy herds. Calves with spontaneously derived diarrhoea were...Full Text Available
BackgroundHepatitis A virus (HAV) strains detected in environmental and clinical samples were analysed to characterize the genotypes of HAV circulating in Greece. Fifty (50) sewage...Full Text Available
Objectives: The authors designed and implemented a clinical data mart composed of an integrated information retrieval (IR) and relational database management system (RDBMS).Design:...Full Text Available
Policies and regulations in the current health care environment have impacted the manner in which patient data - especially protected health information (PHI) - are handled in the clinical and...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
PURPOSE We wanted to assess the impact of an electronic health record–based diabetes clinical decision support system on control of hemoglobin A1c (glycated hemoglobin),...Full Text Available
Purpose:The oral chemotherapy cycle management program (CMP) provides clinical management support to patients receiving certain oral chemotherapies. The CMP includes a dose-monitoring...Full Text Available
Membranous dysmenorrhea is an unusual clinical entity. It is characterized by the expulsion of huge fragments of endometrium during the menses, favored by hormonal abnormality or drug intake. This report describes a case with clinical, US, and MRI findings before the expulsion. Differential diagnoses are discussed. (orig.)
This paper presents HEARTVIEW - a knowledge base (KB) that offers aid for clinical research in cardiology. This KB is an essential component of the medical workstation MW2000, now under development...Full Text Available
The effect of growth phase on expression of virulence-associated factors was studied by Northern hybridization in an M1T1 clinical isolate of Streptococcus pyogenes. Expression of M...Full Text Available
Glossitis among U.S. military working dogs in South Vietnam was characterized by variable redness and loss of papillae on the anterodorsal third of the tongue; salivation, drooling, and inappetence were the principal clinical signs. Symptomatic treatment ...
The clinical significance, Gram stain reaction, and genus affiliation of Gardnerella vaginalis have been controversial since Gardner and Dukes described the organism as the cause of "nonspecific vaginitis,"...Full Text Available
IntroductionIntrarenal pseudoaneurysm is a rare, yet clinically significant, complication of percutaneous nephrolithotomy. A high index of clinical suspicion is necessary in order...Full Text Available
Objective:To investigate the combined effect of both pioglitazone and methotrexate on disease activity of rheumatoid arthritis in a biphasic study; experimental and clinical.Methods:Experimentally:...Full Text Available
The definitive clinical trial which demonstrated the beneficial effects of photocoagulation in treating diabetic retinopathy was reported in 1976 in the American Journal of Ophthalmology by the Diabetic...Full Text Available
Real-time PCR has the potential to streamline detection and identification of Cryptosporidium spp. in human clinical samples. In the present...Full Text Available
Coryneform isolates from clinical specimens frequently cannot be identified by either reference laboratories or research laboratories. Many of these organisms are skin flora that belong to a large number...Full Text Available
Patients with adhesive capsulitis were clinically evaluated to establish whether pain elicited by pressure on the coracoid area may be considered a pathognomonic sign of this condition. The study group...Full Text Available
In support of a new clinical trial designed to compare the effects of crushed fresh garlic and two types of garlic supplement tablets (enteric-coated dried fresh garlic and dried aged garlic...Full Text Available
BackgroundIn cancer research, most clinical variables have already been investigated and are now well established. The use of transcriptomic variables has raised two problems: restricting...Full Text Available
Clinical-HINTS (Health Intelligence System) is a horizontally integrated decision support system (DSS) designed to meet the requirements for intelligent real-time clinical information management in critical care medical environments and to lay the foundation for the development of the next generation of intelligent medical instrumentation. The system presented was developed to refine and complement the information yielded by clinical laboratory investigations, thereby benefiting the management of the intensive care unit (ICU) patient. More specifically, Clinical-HINTS was developed to provide computer-based assistance with the acquisition, organisation and display, storage and retrieval, communication and generation of real-time patient-specific clinical information in an ICU. Clinical-HINTS is an object-oriented system developed in C+2 to run under Microsoft ...
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
This article describes a new set of revised standards for the medical laboratory, which have been produced by Clinical Pathology Accreditation (UK) Ltd (CPA). The original standards have been in use...Full Text Available
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
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
The purpose of this study was to determine the clinical significance of nodal micrometastasis detected by immunohistochemistry in patients that had undergone curative surgery for pancreatic cancer....Full Text Available
ObjectiveDisc herniations at the L1-L2 and L2-L3 levels are different from those at lower levels of the lumbar spine with regard to clinical characteristics and surgical outcome....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
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
Metastases to the cerebellopontine angles (CPAs) are rare. Typically, the clinical course is one of rapid onset and progression of crarial nerve deficits. The clinical presentation and course of carcinoma...Full Text Available
A methodology and toolkit are described which enable the automated metadata-driven creation of datamarts from clinical data warehouses. The software uses schema-to-schema transformation driven by an...Full Text Available
IntroductionThe goal of this study was to identify serum markers that are modulated by treatment with golimumab with or without methotrexate (MTX) and are associated with clinical...Full Text Available
The level of total extracellular neuraminidase produced by 74 clinical isolates of group B streptococci isolated from diseased or asymptomatically colonized infants was assayed. Extracellular neuraminidase...Full Text Available
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
The question of whether storage of red blood cells (RBCs) alters their capacity to deliver oxygen and affects patient outcomes remains in a state of clinical equipoise. Studies of the changes...Full Text Available
Acute kidney injury (AKI) is a common clinical problem with significant clinical and economic consequences. A number of studies point to a rising incidence of AKI in the hospital and in the intensive...Full Text Available
ObjectiveCompare occlusal contacts calculated from 3D virtual models created from clinical records to contacts identified clinically using shimstock and transillumination.Full Text Available
Recent health care policies and regulations have impacted the manner in which patient data – especially protected health information (PHI) – are handled in both the clinical...Full Text Available
A form for the clinical evaluation of bovine digital disease was developed. In this article, each section of the resulting Digit Evaluation Form is discussed and justified. By following the...Full Text Available
Objective To establish current practice in the use of Read codes for diabetes.Design Cross sectional study.Setting 17 practices in the Battersea...Full Text Available
BackgroundSubstance use and poor dietary practices are prevalent among adolescents. The purpose of this study was to examine frequency of substance use and associations between cigarette,...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
ObjectiveTo identify patient-care practices related to an increased prevalence of hepatitis C virus (HCV) infection among chronic hemodialysis patients.Full Text Available
BackgroundAgricultural practices such as the use of irrigation during rice cultivation, the use of ponds for fish farming and the storage of water in tanks for livestock provide...Full Text Available
BACKGROUND: The experience from general practice fundholding suggests that financial incentives may influence prescribing; guidelines and hospital prescribing are two other suggested influences. AIM:...Full Text Available
Certain structural and environmental factors other than technical combination of resources and firm size are hypothesized to affect medical practice output. Four groups of variables related to physician...Full Text Available
BackgroundAlthough the health benefits of breastfeeding are well established, early introduction of formula remains a common practice. Cultural beliefs and practices can have an...Full Text Available
This paper describes the development of an interactive internet-based cost-estimating tool for commonly used urban storm runoff best management practices (BMP), including: retention and detention ponds, grassed swales, and constructed wetlands. The paper presents the cost data, c...
BackgroundThis study assessed the level of knowledge, attitudes, and practice regarding disinfection procedures among nurses in Italian hospitals.MethodsA...Full Text Available
ObjectiveTo estimate the joint effect of a multifaceted access intervention on primary care physician (PCP) productivity in a large, integrated prepaid group practice.Data...Full Text Available
Clinical questionWhat is the best treatment for bacterial conjunctivitis?ResultsTopical antibiotics expedite recovery from bacterial conjunctivitis....Full Text Available
... from theory to practice will be significantly reduced while intrinsically revolutionizing the approach to engineering network security architectures. ...
Biomedical science researchers often express frustration that health physics practices vary widely between individual institutions. A survey examining both internal and external dose assessment practices was devised and mailed to fifty institutions supporting biomedical science research. The results indicate that health physics dose assessment practices and policies are highly variable. Factors which may contribute to the degree of variation are discussed. 2 tabs.
The philosophy of work management in radiation protection puts emphasis on the following up and management of overall process from work selection, planning, preparation, implementation till experience feedback, and overall optimization of production and safety management. This paper reports practices and experiences of Daya Bay nuclear power plant in the implementation of the philosophy during operational radiation protection through the practical examples
Government should model good practice in social inclusion and diversity.Apply a social inclusion test ...Government should model good practice in social inclusion and diversity.Apply a social inclusion test ...Government should model good practice in social inclusion and diversity.Apply a social inclusion test
Negligent hazardous waste management has resulted in real threats to public health. The Federal Government has responded to the situation with laws and regulations aimed at the producers of hazardous waste, including clinical laboratories. The Resources Conservation and Recovery Act (RCRA) imposes controls on hazardous waste management through the Code of Federal Regulations (CFR). The Environmental Protection Agency (EPA) and the Department of Transportation (DOT) regulate these activities through 40 CFR and 49 CFR. Most clinical laboratories can operate satellite accumulation points and accumulate, store, transport, and dispose of waste in accordance with EPA and DOT regulations. Regulations pertaining to infectious waste, sure to affect many clinical laboratories, are being developed now by he EPA. The cradle to grave tracking system mandated by the Federal Government can be supplemented by state and local authorities ...
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...
A practical hands-on course encompassing enzyme purification, biochemical characterization, and crystallization that completed the course work of 350 second-year bachelor students enrolled in molecular biology/biochemistry was given at the Universite Louis Pasteur of Strasbourg (France). The experimental part of the practical dealt entirely with the model protein lysozyme isolated from hen egg-white. It was designed as a research project to give students the possibility to practice biochemical methods such as chromatography, electrophoresis, and spectrophotometry. It also included enzyme activity assay and protein crystal growth that are usually taught in master-level courses. The organization of the practical work and the related experimental procedures are described and discussed.
''The LLNL Site-Specific Advanced Simulation and Computing (ASCI) Software Quality Engineering Recommended Practices VI.I'' document describes a set of recommended software quality engineering (SQE) practices for ASCI code projects at Lawrence Livermore National Laboratory (LLNL). In this context, SQE is defined as the process of building quality into software products by applying the appropriate guiding principles and management practices. Continual code improvement and ongoing process improvement are expected benefits. Certain practices are recommended, although projects may select the specific activities they wish to improve, and the appropriate time lines for such actions. Additionally, projects can rely on the guidance of this document when generating ASCI Verification and Validation (VSrV) deliverables. ASCI program managers will gather information about their ...
This article provides an historical look at how programs and practices for students with emotional or behavior disorders (E/BD) have been evaluated since 1964, leading to a codified, although not universally recognized, set of recommendations for evaluating best practices for students with E/BD set out by The Peacock Hill Working Group (1991). The authors contend that, in addition to the programmatic features of best practice, the addition of the quality indicators and standards for research in special education add a critical dimension for examining the quality of the scientific research of identified best practices. Taken together, these set of recommendations and quality indicators represent the state of the art in program evaluation for best practice and programs for students with E/BD. The goal of this article is to outline the current recommendations and apply them to current ...
To determined precisely a possible connection between the amount of copper in tap-water and the risk of early childhood liver disease, it was attempted through an epidemiological survey, to determine the extent of excessive concentrations of copper in the tap-water of households with copper pipes. Water samples from 956 households were tested for copper, and the state of health of the infants in these households was documented. Infants who had been fed using water with a copper concentration of 0.8 mg/l or more received a paediatric examination with a blood serum analysis to rule out any liver damage. A copper level greater than 0.8 mg/l was found in only 2% of the households examined. Eight infants were examined by a paediatrician and their serum was analysed. These infants had either been breast-fed to the 12th week or had received more than 200 ml of tap water per day during first 12 months. None of the infants examined showed any signs of liver malfunction. ...
To determine clinical predictors and accuracy of {sup 123}I-FP-CIT SPECT imaging in the differentiation of drug-induced parkinsonism (DIP) and Parkinson's disease (PD). Several clinical features and {sup 123}I-FP-CIT SPECT images in 32 patients with DIP, 25 patients with PD unmasked by antidopaminergic drugs (PDu) and 22 patients with PD without a previous history of antidopaminergic treatment (PDc) were retrospectively evaluated. DIP and PD shared all clinical features except symmetry of parkinsonian signs which was more frequently observed in patients with DIP (46.9%) than in patients with PDu (16.0%, p<0.05) or PDc (4.5%, p<0.01). Qualitatively {sup 123}I-FP-CIT SPECT images were normal in 29 patients with DIP (90.6%) and abnormal in all patients with PD, and this imaging technique showed high levels of accuracy. DIP and PD are difficult to differentiate based on clinical ...
Eliminating anterior tooth contact is paramount when treating combination syndrome. It is possible to do so through the use of linear occlusion with a non-interceptive arrangement and the bilateral fulcrum of protrusive stability. The presence of mandibular anterior teeth often complicates this procedure. When establishing the horizontal plane of occlusion, clinical circumstances often necessitate modifications; nevertheless, certain principles must be incorporated into the design of the prostheses. Clinical circumstances may dictate altering the approach but these principles must be maintained to eliminate anterior hyperfunction. PMID:15055634
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.
Interferons, a group of cytokines with antiangiogenic, direct antitumour and immunostimulating properties, have shown significant activity against osteosarcoma in vitro and in xenograft models. They have also been used in osteosarcoma clinical trials as a single adjuvant to surgery, with an apparent increase in relapse-free survival. In the ongoing EURAMOS 1 clinical trial, interferon a-2b is evaluated as an adjuvant treatment in osteosarcoma. This article reviews the rationale for the use of interferon in cancer with special reference to the treatment of osteosarcoma, including all published data of clinical efficacy in this disease. Pediatr Blood Cancer 2010;54:350-354. Copyright 2009 Wiley-Liss, Inc.
The current role of magnetic resonance imaging (MRI) in different organ systems is discussed and compared to nuclear medicine and to other available clinical diagnostic modalities. The value of optimizing radiofrequency pulse sequence selection to provide additional tissue characterization is also described. The results of nuclear medicine and MRI studies in 56 patients are compared to evaluate the clinical diagnostic contribution of each imaging modality for various pathological processes. In addition, the state-of-the-art MRI systems and future development in MRI technology with its potential contribution is defined.
A practical method to determine the ionic diffusion coefficient and activation energy by using quasielastic light scattering (QELS) is presented. It is shown that a temperature dependence curve of the QELS intensity at a fixed frequency can be well fitted by Jonscher's formula and that the diffusion parameters can be obtained from this curve fitting. This method is successfully applied not only to crystals with high optical quality, as reported earlier, but also to opaque ceramics, which are more important than the crystals from a practical point of view. The composition dependence of the ionic diffusion coefficient is studied in sintered YbSZ to show the usefulness of this method.
This talk will present an overview of the use of mathematical programming techniques in manufacturing management practice. The emphasis is on applied contributions in three areas: conceptual and qualitative results, modelling, and algorithms. The discussion will be limited to methods that have found or are likely to find application in practice. Overall the picture is not heartening and many promising directions have not resulted in practical applications. Yet there are several areas where significant opportunities exist, though they seem to be better for heuristics than for highly structured traditional models. Time will be available for discussion of topics that interest the participants.
In this paper the reader is asked to engage in some simple problem-solving in classical pure number theory and to then describe, on the basis of a series of questions, what it is like to solve the problems. In the recent philosophy of mind this ?what is it like? question is one way of signaling a turn to phenomenological description. The description of what it is like to solve the problems in this paper, it is argued, leads to several morals about the epistemology and ontology of classical pure mathematical practice. Instead of simply making philosophical judgments about the subject matter in advance, the exercise asks the reader to briefly engage in a mathematical practice and to then reflect on the practice.
Ontologies ? a form of structured and logically related knowledge or classification hierarchy embedded in a computer system ? are regarded by many scientists as having enormous promise for the consistent use and re-use of data. To realise this promise, however, is not straightforward. In this paper, based on ethnographic observation, we argue that the challenges for ontology building are ?social? as much as they are technical. By this we mean the routine work undertaken in the building process and the problems and difficulties entailed can be understood in terms of the practices of knowledge workers and the practical nature of ?sorting things out?. Getting a better sense of how, in practise, this work gets done gives a sense of the main challenges of building successful ontologies and how ...
Clinical and hormonal indices of androgenic activity were compared in 118 males chronically intoxicated with alcohol. The population was divided into two groups with respect to their clinical and hormonal androgenic indices: 76 patients with (Group 1), and 46 patients without (Group 2) androgenic insufficiency. Distinct signs and syndromes of alcohol addiction were shown to correlate with the extent of cross-regulation impairment within hypothalamo-hypophyseo-gonadal system. This was particularly derived from comparison of clinical picture of chronic alcohol intoxication and hormone activity in the groups. Conventional therapy failed to restore the neuroendocrine indices that was apparently due to inhibition of cross-regulation links in the hypothalamo-hypophyseo-gonadal system at several stages of alcohol addiction. PMID:3223149
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
BackgroundOxidative stress has been proposed as a mechanism linking the poor placental perfusion characteristic of preeclampsia with the clinical manifestations of...Full Text Available
Background. The role of vitamin D in the body's ability to fight influenza and URI's may be dependent on regulation of specific cytokines that participate in the host inflammatory...Full Text Available
Exponentially growing biological and bioinformatics data sets present a challenge and an opportunity for researchers to contribute to the understanding of the genetic basis of phenotypes. Due to breakthroughs in microarray technology, it is possible to simultaneously monitor the expressions of thousands of genes, and it is imperative that researchers have access to the clinical data to understand the genetics and proteomics of the diseased tissue. This technology could be a landmark in personalized medicine, which will provide storage for clinical and genetic data in electronic health records (EHRs). In this paper, we explore the computational and ethical challenges that emanate from the intersection of bioinformatics and healthcare informatics research. We describe the current situation of the EHR and its capabilities to store clinical and genetic data and then discuss the Genetic Information Nondiscrimination Act. ...
Assessment of the results of laminectomy for lumbar disc lesions is unsatisfactory, but it seems that some degree of recurrent pain is virtually inevitable. The clinical features and incidence of the...Full Text Available
Selection of the appropriate radiation quality is an important aspect of optimisation for every clinical imaging task in radiology, since it affects both image quality and patient dose. Spreadsheet...Full Text Available
The Johns Hopkins Hospital has initiated an ambitious program to apply modern technologies to the development of a new, comprehensive clinical information system. One component of this system is a...Full Text Available
PurposeTo describe etiologies and clinical characteristics of corneal opacities leading patients to seek cosmetic treatments.MethodsThe medical records...Full Text Available
Hyaluronan (HA), a non-sulfated glycosaminoglycan, is widely used in the clinic for viscosurgery, viscosupplementation, and treatment of osteoarthritis. Four decades of chemical modification...Full Text Available
... was associated with at least some 360 intent to ... herself, at least to 366 some degree, can be ... As prospective assessment instruments for suicidality are created ...
BackgroundTo identify the differential tuberculosis (TB) characteristics within the immigrant population with respect to natives in Spain.Methodology/Principal...Full Text Available
The early and precise diagnosis, the prognosis, and the clinical management of multiple sclerosis, remain a considerable challenge. In recent years, the development of novel and powerful proteomic...Full Text Available
BackgroundPreclinical models of pediatric cancers are essential for testing new chemotherapeutic combinations for clinical trials. The most widely used ...Full Text Available
The purpose of this article is to review the literature for clinical presentation, treatment, outcome and complications of using radiotherapy for the treatment of orbital lymphoma. For this, MEDLINE,...Full Text Available
Purpose. To describe the characteristics of idiopathic macular holes (MH) on optical coherence tomography (OCT) and correlate OCT with clinical assessment. Design....Full Text Available
We review the cases of 19 successfully treated plague patients, with emphasis on the clinical and epidemiologic features of the disease. Proper staining and culturing of bubo aspirates; prompt institution...Full Text Available
Schizophrenia is a heterogeneous psychiatric disorder in which multiple neurotransmitter systems have been implicated. Increased and decreased dopamine transmission in the subcortical meso-limbic and...Full Text Available
ObjectiveNeuralgic amyotrophy (NA) is a distinct clinical syndrome that is characterized by the acute onset of shoulder and arm pain, weakness, and sensory loss. The purpose of this...Full Text Available
Necrotizing sialometaplasia, is a benign inflammatory lesion primarily involving the minor salivary glands of the hard palate. The lesion often presents itself as a deep-seated palatal ulcer with clinical...Full Text Available
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
A case of intraocular coenurosis was clinically diagnosed and treated with praziquantel. The drug destroyed the coenurus, but vision was lost through toxic endophthalmitis and retinal detachment. There...Full Text Available
The need for material standards in the field of clinical immunology, together with the mode of operation of the combined World Health Organization/International Union of Immunological Societies programme...Full Text Available
PurposeClinical trials have commenced to evaluate the feasibility of targeting malignant gliomas with genetically engineered cytolytic T-cells (CTLs) delivered directly...Full Text Available
To discuss and share knowledge around advances in the care of patients with thrombotic disorders, the Third International Symposium of Thrombosis and Anticoagulation was held in S?o Paulo, Brazil, from October 14?16, 2010. This scientific program was developed by clinicians for clinicians, and was promoted by four major clinical research institutes: the Brazilian Clinical Research Institute, the Duke Clinical Research Institute of the Duke University School of Medicine, the Canadian VIGOUR Centre, and the Uppsala Clinical Research Center. Comprising 3?days of academic presentations and open discussion, the symposium had as its primary goal to educate, motivate, and inspire internists, cardiologists, hematologists, and other physicians by convening national and international visionaries, th...
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
This Memorandum describes the following aspects of legionellosis: clinical presentations of legionella infection, general epidemiology (including nosocomial outbreaks and travel-associated legionnaires'...Full Text Available
BackgroundThe aim of this report was to describe duodenal obstruction caused by a rubber foreign body in a cow.Case PresentationThe clinical, biochemical...Full Text Available
Cutaneous scarring can cause patients symptoms ranging from the psychological to physical pain. Although the process of normal scarring is well described the ultimate cause of pathological scarring...Full Text Available
138 unselected head tomographies of children by computer are reported and analysed. The major aspect stressed by the authors is the excellent precision of this radiological technique.
The importance of designating criteria for diagnosing dementia lies in its implications for clinical treatment, research, caregiving, and decision-making. Dementia diagnosis in Huntington's...Full Text Available
The purpose of this study was to compare the clinical outcomes and wound complications in coccygectomy with or without subperiosteal resection. This retrospective study included 25 patients who underwent...Full Text Available
In general, the etiologic factors of chronic paranasal sinusitis are systemic conditions such as nutrition, predisposition, allergy, and local factors such as nasal anatomic conditions. Among these...Full Text Available
Primary cardiac angiosarcoma is a rare cardiac tumor. The initial clinical course is often asymptomatic, and metastatic disease is present in a majority of affected patients at diagnosis. We present...Full Text Available
This book discusses the procedures applied for the clinical nuclear medicine laboratory. The procedures are presented as proven guidelines. The chapters are included on quality assurance, radionuclide handling, and radiation safety.
Experience gained with a wide variety of missile injuries of the brain is presented. Clinical signs and intracranial pressure (ICP) studied in the early post-injury period have been correlated with...Full Text Available
Breast cancer in the elderly has attracted considerable interest in recent years for three main reasons. Firstly, information concerning the profile (clinical and biological) of the disease in the geriatric...Full Text Available
In eight patients with Ewing's sarcoma bone scans were performed using "9"9"mTc-MDP. This procedure rendered possible the diagnosis of clinically or radiologically silent metastases. (orig.).
BackgroundThe metagenomic analysis of microbial communities holds the potential to improve our understanding of the role of microbes in clinical conditions. Recent, dramatic improvements...Full Text Available
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
... radiation during clinical therapy and exposures due to radiation accidents or attacks, in which the doses are uncontrolled ... only be used off-label in victims of radiation accidents or attacks. The idea...
Training of health professionals commonly involves multiple sites in order to best utilize the available clinical material. However, this makes it difficult to achieve continuity in the presentation...Full Text Available
The stable introduction of therapeutic transgenes into human cells can be accomplished using viral and nonviral approaches. Transduction with clinical-grade recombinant viruses offers the potential...Full Text Available
The avermectins were introduced in 1981 and constitute a potent new class of anthelmintic agents. They are naturally-derived products of microbial action displaying an exceptionally wide range of antiparasitic...Full Text Available
Raeder described five patients with mixed features of trigeminal nerve pathology and oculosympathetic impairment, with or without other cranial nerve lesions. This constellation of clinical features...Full Text Available
The fundamental recommendations of the ICRP issued in its publication of 1990 stipulate the general principle of performance of dose measurements at regular intervals in the field of diagnostic radiology, for the purpose of equipment performance checking and optimization of radiological protection. In response to this requirement, the Federal Ministry, in cooperation with experts and the competent supervising authorities, has issued an order to install dose-area-product meters in angiographic examination systems, imaging systems and fluoroscopic screen devices primarily used for examining infants and children up to the age of 12. This is done in response to reported cases of adverse effects of radiation exposure and the high priority given to radiological protection in the examination of infants and children. In 1992, an expert group was convened to discuss and elaborate instructions for including dose-area product measurement in the dosimetry activities in medical diagnostic ...
The purpose of this study was to use high-resolution magnetic resonance (MR) imaging combined with image analysis to investigate the three-dimensional (3D) trabecular structure, anisotropy, and connectivity of human vertebral, femoral, and calcaneal specimens. The goal was to determine whether: (a) MR-derived measures depict known skeletal-site-specific differences in architecture and orientation of trabeculae; (b) 3D architectural parameters combined with bone mineral density (BMD) improve the prediction of the elastic modulus using a fabric tensor formulation; (c) MR-derived 3D architectural parameters combined with BMD improve the prediction of strength using a multiple regression model, and whether these results corresponded to the results obtained using higher resolution depictions of trabecular architecture. A total of 94 specimens (12 x 12 x 12 mm cubes) consisting of trabecular bone only were obtained, of which there were 7 from the calcaneus, 15 from distal femur, 47 from the ...
BackgroundThe WINPEPI computer programs for epidemiologists are designed for use in practice and research in the health field and as learning or teaching aids. The programs are free,...Full Text Available
A guide to practical astronomy. It introduces the reader to some basic (and some not-so-basic) astronomical concepts, and discusses the stars and their evolution, the planets, nebulae, and distant galaxies
The interaction between two metals, which can be either synergistic or antagonistic, implies that the behavior of one is changed by the presence of the other. Possible mechanisms of these interactions,...Full Text Available
The practice of urology is changing, not only from a medical and technological standpoint, but also from a business standpoint. New and improved computer technology and enhanced databases have allowed...Full Text Available
The publication gives the basic information needed by growers of syrup sugarcane. It includes descriptions of the sugarcane plant characteristics needed in syrup varieties, the best varieties, cultural requirements and practices, and the diseases and inse...
Improving patient compliance with physicians’ treatment or prescription recommendations is an important goal in medical practice. We examine the relationship between treatment progress...Full Text Available
The concept of plant intelligence, as proposed by Anthony Trewavas, has raised considerable discussion. However, plant intelligence remains loosely defined; often it is either perceived as practically...Full Text Available
Physician reimbursement and the coding to support it are critically important to the sustained health of any physician's practice. This article reviews the recent history of physician reimbursement...Full Text Available
OBJECTIVE: This study evaluated, in a large, heterogeneous population, the outcome of open cholecystectomy as it is currently practiced. SUMMARY BACKGROUND AND DATA: Although cholecystectomy has been...Full Text Available
The report gives a summary of important developments in numerical weather prediction and discusses their relationship to, and effect on, the practice of synoptic meteorology.
The solution of the continuity equation in practical applications is examined, and the values needed for approximate solutions are indicated. Models are adequate for investigating what could happen,...Full Text Available
Because the proportion of Hispanic patients is increasing rapidly, most physicians are now coming into daily contact with Hispanics. In addition to obvious difficulty with oral communication, Hispanics...Full Text Available
The economics of medical computer networks are presented in context with the patient care and administrative goals of medical networks. Design alternatives and network topologies are discussed with...Full Text Available
Lifespan can be extended by reduction of dietary intake. This practice is referred to as dietary restriction (DR), and extension of lifespan by DR is evolutionarily conserved in taxonomically diverse...Full Text Available
This article reports research findings related to converging formats, media, practices, and ideas in the process of academics' interaction with electronic texts during a research project. The findings are part of the results of a study that explored interactions of scholars in literary and historical studies with electronic texts as primary materials. Electronic texts were perceived by the study participants as fluid entities because the electronic environment promotes seamless interactions with a variety of media and formats. Working with electronic texts combines some traditional information and research practices into new patterns of information behavior. The practice called "netchaining" combines aspects of networking with information-seeking practices to establish and shape online information chains, which link sources and people. Different forms of exploration of participants' research questions ...
... Except for isolated radiation accidents over the ensuing years, little practical experience has been gained in the treatment of thermal injuries ...
OBJECTIVE AND DESIGNThis study used qualitative and quantitative methods to examine the reasons primary care physicians and nurses offered for their inability to initiate guideline-concordant...Full Text Available
... Stone, CR & Grover, CC Practice Readers ... Tolbert, M., Withers, S. & Watkins, HT, Good Workers All State Department of Education, Columbia, South ...
SummaryA microreactor for electrochemical synthesis has been designed and fabricated. It has been shown that different reactions can be carried out successfully using simple protocols.
OBJECTIVE: To evaluate the effectiveness of a program to improve hypertension control practices in primary care. DESIGN: Retrospective quasi-experimental study. SETTING: Three hospital-based family...Full Text Available
In this article is reviewed the role of Computed Tomography (CT) in thoracic complications following ortho topic liver transplantation (OLT). In a post-OLT population of 567 patients transplanted in the Italian institutions, 100 patients (17.6%) were examined with chest CT. It was reviewed data relative to the total number of examinations, clinical and/or radiographic indications, the CT technique-i.e., conventional (with (out) intravenous, i.v., contrast material) or high-resolution (HRCT). It also reviewed the radiologic patterns and their correlation with the other clinical, bronchoscopic and/or laboratory results. Of 152 chest CT examinations, 45 (29.6%) were performed because of clinical indications, 31 (20.4%) because of a radiographic abnormality, 64 (42.1%) because of clinical and radiographic abnormality, 64 (42.1%) because of clinical and radiographic indications, while in ...
BackgroundThe purpose of this study was to analyze the radiotherapy (RT) quality assurance (QA) assessment in Japan Clinical Oncology Group (JCOG) 0202, which was the first trial...Full Text Available
Seventeen clinical isolates of Staphylococcus aureus (from the United States and Europe) selected for low (borderline)-level methicillin resistance (MIC of methicillin, 2 to 4 micrograms/ml; MIC of...Full Text Available
The "1"3"1I-labelled monoclonal antibodies 791T/36 and 79IT/36 Fab fragments have been evaluated in the imaging of patients with colorectal cancer, with benign colorectal tumours, and with malignant tumours of other parts of the gastrointestinal tract. The results of clinical imaging have been carefully correlated with clinical findings and direct measurement of the preferential uptake of antibody by the tumours. (UK).
The clinical feasibility of using interventional examination techniques was tested with an equipment combining fluoroscopy and MR imaging. This hybrid system showed to be of advantage in a great number of interventional examinations. The 1.5 Tesla magnet proved to be superior to open MR scanning systems in terms of image quality and scanning times. (orig.).
Comprehensive geriatric care should receive nation-wide attention in order to realize its objectives. An analysis of patient problems at the Geriatirc Clinic, Tygerberg Hospital and Goodwood Aftercare Hospital is presented. The training of personnel, with full motivation of the community, to render health services to the aged is discussed. PMID:7368010
Lysozyme chloride was administered to 84 patients of laryngeal cancer and the clinical effect was discussed. Lysozyme chloride delayed the appearance of swelling and white plaque while it accelerated that of inflammatory erythema in radiotherapy. No difference of the local inflammation was found between lysozyme administered groups and not administered groups when irradiation and chemotherapy were combined. Any side effect was not seen in blood picture of all cases by using lysozyme chloride.
BackgroundLimited information has been published regarding how specific processes for event adjudication can affect event rates in trials. We reviewed nonfatal myocardial infarctions...Full Text Available
The non-invasiveness of autofluorescence technology may reduce sampling error and time delay for histopathology diagnosis. We establish biophotonic methods and guidelines to visualize and interpret early epithelial tissue changes that signify disease. Flexible and rigid fiber endomicroscopy instrumentation design parameters feasible for translation towards clinical use are in development.
The diagnostic value of the portable chest radiography obtained with Fuji computed radiography (FCR) was evaluated in comparison with conventional images in 23 patients who were admitted to ICU in Yokohama City University Hospital. On the whole , FCR produced more exellent images than conventional screen-film radiographs. Especially the evaluation for the demonstration of the catheters, the endotracheal tubes and the tracheal shadows obtained high score. We discuss the clinically utility of FCR for the portable chest radiographs in ICU. (author).
The diagnostic value of the portable chest radiography obtained with Fuji computed radiography (FCR) was evaluated in comparison with conventional images in 23 patients who were admitted to ICU in Yokohama City University Hospital. On the whole , FCR produced more exellent images than conventional screen-film radiographs. Especially the evaluation for the demonstration of the catheters, the endotracheal tubes and the tracheal shadows obtained high score. We discuss the clinically utility of FCR for the portable chest radiographs in ICU. (author).
The clinical and metabolic effects of two regimens of total parenteral nutrition delivering the same amino-acid (2·8 g/kig per 24 h), fat (4·8 g/kg per 24 h), and glucose (12 g/kg per...Full Text Available
Divided into diagnostic and treatment sections, this book provides a comprehensive overview of the most common medical procedures performed in modern clinical settings. Each section presents common names for the procedure; an outline of the disease or injury for which the procedure is performed; a brief review of the anatomical structures and physiological processes that are involved; staffing, equipment, and pre-procedure requirements; a detailed description of the procedure itself; and, a discussion of expected outcomes as well as potential complications. Each chapter includes a summary and
Fifteen strains of CDC group 1 coryneform and biochemically similar bacteria were isolated from clinical specimens. Of the 15 strains isolated, 11 were derived from abscesses and purulent lesions, mostly...Full Text Available
BackgroundPaclitaxel-eluting stents decrease angiographic and clinical restenosis following percutaneous coronary intervention compared to bare metal stents. TAXUS Element is a third-generation...Full Text Available
Topics of this proceedings are: DNA damage and repair; Space research; Cell and tissue radiobiology; Treatment planning 1: The role of clinical RBEs; Treatment planning 2: Dose optimization and inverse planning; Dosimetry; Clinical results of particle therapy and new techniques; Status reports and future developments. Separate abstracts were prepared for 79 chapters. (orig./SR)
This study examined preliminary psychometric properties of the Teaching Practices Observation Scale (TPOS), a newly developed observational taxonomy for assessing teacher behaviors during free play with young children. Behaviors of 42 child caregivers and junior kindergarten teachers were coded using a combination of time-sampling, event-sampling, and behavior ratings. Findings support the validity of observational coding scheme. (Author/KB)
In Hungary, legislation for nuclear power plants was developed at the end of the 1970s, among which is the quality assurance code for nuclear power plants. Hungarian practice is presented, including discussion of the requirements for quality assurance, qualification of the suppliers and inspection practices. The general requirements of quality assurance in the course of construction of a nuclear power plant are presented: quality assurance of technological equipment, fuel, electrical equipment, automatic instrumentations, building structures and technology.
Daya Bay Nuclear Power Station has made a series of tries and efforts on radiation source control and benefited from them since it was put into commercial operation. Some of them were introduced from experience feedbacks of foreign nuclear power industry and others came from our own good practices
Effective barrier pillar design is essential for safe and productive underground coal mining. This U.S. Bureau of Mines report presents an overview of available barrier pillar design methodologies that incorporate sound engineering principles while remaining practical for everyday usage. Nomographs and examples are presented to assist in the determination of proper barrier pillar sizing. Additionally, performance evaluation techniques and criteria are included to assist in determining the effectiveness of selected barrier pillar configurations.
Accidents from three main practices: medical applications, industrial radiography and industrial irradiators are used to illustrate some common causes of accidents and the main lessons to be learned. A brief description of some of these accidents is given. Lessons learned from the described accidents are approached by subjects covering: safety culture, quality assurance, human factors, good engineering practice, defence in depth, security of sources, safety assessment and monitoring and verification compliance. (author)
This article will highlight the experiences of two baccalaureate Health Information Administration (HIA) programs in the adoption of the American Health Information Management Association's (AHIMA) e-HIM Virtual Laboratory (Virtual Lab) into the Professional Practice Experience (PPE). Information is provided describing the implementation of the Virtual Lab, issues that were encountered, and subsequent feedback from students and faculty regarding this new technology.
This environmental review of right-of-way clearing for transmission projects has been undertaken by the Environmental Analysis Branch for the Division of Land Resources in BPA's Office of Engineering and Construction. It is intended to review the present practices and results of selective clearing, and to make recommendations toward improvements in environmental practices and procedures in mitigation development for impacts associated with right-of-way clearing. 29 figs.
DescriptionFollowing publication of the Curry report, DEFRA have made a commitment to establish a number of pilot projects supporting a network of demonstration and development farms. These 'farms' are intended to support the process of technology transfer by giving free access to information on the practical application of new, emerging and best practice technologies. Protected Horticulture has been identified as a sub-sector requiring the establishment of one of these projects. One of the major pressures [continued...
A reciprocal relationship informing both research and practice is one of the primary goals in the emerging field of Mind, Brain, and Education (MBE), yet the field has little documentation and analysis of such collaborations. In this article, we present case studies of three research-practice partnerships taking place between scientists and educators. By comparing and contrasting these three partnerships we expect to illuminate common characteristics, challenges, and benefits that come with doing MBE work.
Theoretical and practical aspects of anodic protection for control of corrosion by a wide range of acidic and alkaline solutions are discussed. Chapters are included concerning strategic importance of metals and alloys in modern industry, applications to industrial equipment, descriptions of equipment used in the technique; design, operation and maintenance; economics, scientific principles, characteristics of potentiostats, laboratory tests and procedures, selected application examples and projected future uses. A section is devoted to electrochemical principles.
The usefulness and clinical applicability of computed radiography(FCR) in X-ray examination of the stomach were evaluated in comparison with film-screen (FS) radiography by both phantom experiments and clinical studies. Receiver operating characteristic (ROC) curve analysis consisting of 25 normal and 25 artificially created simulated lesions on an orginally created Styrofoam phantom showed no difference in lesion detectability between FCR and FS radiography. Both were also equal in evaluation of the internal structure and margin of the 25 lesions by visual ranking. ROC curve analysis of clinical cases was performed in 30 cases, 20 normal and 10 abnormal, while evaluation by visual ranking was performed on 18 lesions. There was no significant difference between FCR and FS radiography either with ROC curve analysis or visual ranking, although the variations were somewhat greater in the clinical cases ...
The usefulness and clinical applicability of computed radiography(FCR) in X-ray examination of the stomach were evaluated in comparison with film-screen (FS) radiography by both phantom experiments and clinical studies. Receiver operating characteristic (ROC) curve analysis consisting of 25 normal and 25 artificially created simulated lesions on an orginally created Styrofoam phantom showed no difference in lesion detectability between FCR and FS radiography. Both were also equal in evaluation of the internal structure and margin of the 25 lesions by visual ranking. ROC curve analysis of clinical cases was performed in 30 cases, 20 normal and 10 abnormal, while evaluation by visual ranking was performed on 18 lesions. There was no significant difference between FCR and FS radiography either with ROC curve analysis or visual ranking, although the variations were somewhat greater in the clinical cases ...
The background for this paper is a growing interest during the past decade in Denmark in the concepts of ?situated learning?, ?social theory of learning? and ?learning in communities of practice? developed by the American social anthropologist Jean Lave and the Californian Research Scientist Etienne Wenger. The work by Jean Lave from 1988 (Lave, 1988) based on anthropological field studies in Brazil and Liberia as well as later works by Lave & Wenger (Lave and Wenger, 1991; Chaiklin and Lave, 1993; Wenger, 1998; Wenger, McDermott, R. and W. Snyder, 2002) on situated learning and social learning theory have provoked considerable response in anthropological studies, in learning theories as well asin considerations about practical implementation of concepts like ?lifelong learning? in Denmark in recent decades. The European concept of ?lifelong learning? has had a big impact on educational thinking, including teacher education. In addition to ...
Background: Recent series describing the clinical presentation, response to therapy, and long-term outcome of Zollinger-Ellison syndrome are limited. Aims: To assess the clinical characteristics and long-term outcome of patients with Zollinger-Ellison syndrome. Methods: Over a 20-year period, patients with Zollinger-Ellison syndrome were enrolled in a prospective trial evaluating the efficacy of lansoprazole. Following dose stabilization, patients were followed on a 6-monthly basis with interval history, physical examination, endoscopy with gastric biopsies, gastric acid analysis and laboratory studies. Results: 72 patients (mean age 54+/-12 years, % male 58%, % Caucasian 69%) were prospectively enrolled. The clinical presentation was stereotypical for Zollinger-Ellison syndrome. Symptoms ...
Wound dressings impregnated with silver have a role to play in aiding to reduce both the dressing and wound microbial bioburden. It is therefore imperative that antimicrobial wound dressings have efficacy on a broad range of clinical significant microorganisms. Accordingly, this study aimed to determine the antimicrobial efficacy of a silver alginate dressing against 115 wound isolates that had been isolated routinely from patients at West Virginia University Hospital. Standardised corrected zones of inhibition (CZOIs) were performed on all clinical isolates. It was found that the silver alginate dressing was able to inhibit the growth of all microorganisms tested. In particular, the silver alginate dressing inhibited the growth of Candida albicans and yeasts with CZOI of 3-115 mm. All met...
We investigated 161 children under 24 months of age by CT of the skull and reviewed the anamnestic and clinical history. 87 children showed subdural effusions, and 74 did not. There were 33 patients with other pathological findings in CT, and 41 had normal scans. Age and sex distribution as well as localization of the subdural effusions were consistent with the literature. The 87 children with subdural effusions represented 17% in a sample of about 5000 CT scans. CT was the most reliable method for diagnosis of subdural effusions, compared to other techniques. There was a preponderance of small subdural effusions from 1 to 7 mm thickness (51%). Other CT abnormalities accompanying subdural effusions were found. Most frequently the interhemispheric sulcus was dilated and an internal hydrocephalus was present. Also in our group there were 7 anamnestical and 6 clinical symptoms highly diagnostic of subdural effusions.
Paraquat is a nonselective contact herbicide of great toxicological importance, being associated with high mortality rates, mainly due to respiratory failure. We report the case of a 22-year-old male admitted to the emergency room with a sore throat, dysphagia, hemoptysis, and retrosternal pain after the ingestion of 50 mL of a paraquat solution, four days prior to admission. Chest CT scans revealed pulmonary opacities, pneumomediastinum, pneumothorax, and subcutaneous emphysema. The patient was submitted to two cycles of immunosuppressive therapy with cyclophosphamide, methylprednisolone, and dexamethasone. The pulmonary gas exchange parameters gradually improved, and the patient was discharged four weeks later. The clinical and tomographic follow-up evaluations performed at four months after discharge showed that there had been further clinical improvement. We also present a brief review of the literature, as well as a discussion of the ...
Paraquat is a nonselective contact herbicide of great toxicological importance, being associated with high mortality rates, mainly due to respiratory failure. We report the case of a 22-year-old male admitted to the emergency room with a sore throat, dysphagia, hemoptysis, and retrosternal pain after the ingestion of 50 mL of a paraquat solution, four days prior to admission. Chest CT scans revealed pulmonary opacities, pneumomediastinum, pneumothorax, and subcutaneous emphysema. The patient was submitted to two cycles of immunosuppressive therapy with cyclophosphamide, methylprednisolone, and dexamethasone. The pulmonary gas exchange parameters gradually improved, and the patient was discharged four weeks later. The clinical and tomographic follow-up evaluations performed at four months after discharge showed that there had been further clinical improvement. We also present a brief review of the literature, as well as a discussion of the ...
Two patients who developed large intracranial vessel occlusion after standard radiation therapy for brain tumor are described. This form of vascular occlusion is usually seen in patients who have previously been treated by radiotherapy for intracranial tumor who then develop a relatively acute change in neurologic status. Histology of the lesion mimics accelerated focal arteriosclerosis. The clinical and radiographic manifestations of one case were highly atypical. The vasculopathy became evident shortly after termination of radiation therapy for a fourth ventricular ependymoma, and the angiographic picture stimulated a diffuse arteritis. The second patient was more typical, with clinical symptoms developing 12 years after radiation therapy for an oligodendroglioma. Occlusion of a proximal vessel that had been included in the radiation port was demonstrated radiographically and confirmed by pathologic examination. The ...
Two patients who developed large intracranial vessel occlusion after standard radiation therapy for brain tumor are described. This form of vascular occlusion is usually seen in patients who have previously been treated by radiotherapy for intracranial tumor who then develop a relatively acute change in neurologic status. Histology of the lesion mimics accelerated focal arteriosclerosis. The clinical and radiographic manifestations of one case were highly atypical. The vasculopathy became evident shortly after termination of radiation therapy for a fourth ventricular ependymoma, and the angiographic picture stimulated a diffuse arteritis. The second patient was more typical, with clinical symptoms developing 12 years after radiation therapy for an oligodendroglioma. Occlusion of a proximal vessel that had been included in the radiation port was demonstrated radiographically and confirmed by pathologic examination. The ...
The use of meta-analysis has become increasingly useful for clinical and policy decision making. A recent development in meta-analysis, multiple treatment comparison (MTC) meta-analysis, provides inferences on the comparative effectiveness of interventions that may have never been directly evaluated in clinical trials. This new approach may be confusing for clinicians and methodologists and raises specific challenges relevant to certain areas of medicine. This article addresses the methodological concepts of MTC meta-analysis, including issues of heterogeneity, choice of model, and adequacy of sample sizes. We address domain-specific challenges relevant to disciplines of medicine, including baseline risks of patient populations. We conclude that MTC meta-analysis is a useful tool in the context of comparative effectiveness and requires further study, as its utility and transparency will likely predict its uptake by the research and ...
Background The Committee for the Standardization of Renal Pathological Diagnosis and the Working Group for Renal Biopsy Database of the Japanese Society of Nephrology started the first nationwide, web-based, and prospective registry system, the Japan Renal Biopsy Registry (J-RBR), to record the pathological, clinical, and laboratory data of renal biopsies in 2007. Methods The patient data including age, gender, laboratory data, and clinical and pathological diagnoses were recorded on the web page of the J-RBR, which utilizes the system of the Internet Data and Information Center for Medical Research in the University Hospital Medical Information Network. We analyzed the clinical and pathological diagnoses registered on the J-RBR in 2007 and 2008. Results Data were collected from 818 patien...
IntroductionMost clinical studies on the outcome of apical surgery concentrate on periapical healing based on radiographic and clinical characteristics (signs and symptoms). This study focuses on long-term changes in periodontal parameters after apical surgery. MethodsPeriodontal parameters (ie, probing depth [PD], level of gingival margin [GM], and calculated clinical attachment level [CAL]) were collected at baseline and at 1 and 5 years after apical surgery. Changes in PD, GM, and CAL were calculated over time and were also evaluated in relation to patient-, tooth-, and treatment-related covariables. ResultsOne hundred eighty-six of 242 initially identified teeth could be evaluated. Significant changes in GM and CAL were observed at facial sites during the first year after surgery (mean...
Abstract This study explored the demographic and diagnostic features of children who were currently receiving antipsychotics compared to children who were receiving other psychotropics in a cohort of children with and without elevated symptoms of mania (ESM). Participants were recruited from 10 child outpatient mental health clinics associated with four universities. Guardians with children between 6?12 years who presented for new clinical evaluations completed the Parent General Behavior Inventory-10 Item Mania Scale (PGBI-10M). All children who scored ?12 on the PGBI-10M and a select demographically matched comparison group of patients who scored ?11 were invited to participate. Children were divided into two groups: those receiving at least one antipsychotic medication and those receivi...
Anaphylaxis is a serious allergic reaction that is rapid in onset and sometimes leads to death. Understanding mechanisms, triggers, and patient-specific risk factors for severe or fatal anaphylaxis is critically important. Diagnosis of anaphylaxis is currently based on established clinical criteria. Epinephrine (adrenaline) is the first-line medication for anaphylaxis treatment and delay in injecting it contributes to biphasic reactions, hypoxic-ischemic encephalopathy, and fatality. Here, we focus on four important areas of translational research in anaphylaxis: studies of potential new biomarkers to support the clinical diagnosis of anaphylaxis, laboratory tests to distinguish allergen sensitization from clinical risk of anaphylaxis, the primary role of epinephrine (adrenaline) in anaphylaxis treatment, and strengthening the overall evidence base for anaphylaxis treatment. PMID:21668849
The aim of the study was to assess the usefulness of artificial neural networks (ANN) application in evaluation of scintimammography in the context of clinical data in the diagnosis of breast cancer. The results produced by ANN were compared with the diagnosis of two independent observers, nuclear medicine specialists. Material and methods: The clinical data and the numerical values derived from scintimammograms of 103 patients were the material for the study. The reference method was the result of histopathology study (core biopsy and /or FNB). Results: The overall sensitivity of physician diagnosis was 78% with specificity of 72%. The ANN produced 71% sensitivity and specificity of 73%. The physicians and ANN results were not significantly different (p=0.4619). Conclusions: Artificial neutral networks are useful tool in clinical diagnosis of breast cancer. (authors)
Attention-deficit/hyperactivity disorder (ADHD) is a chronic neurobehavioral disorder afflicting adults worldwide. This article is an update on the evidence supporting medications for adult ADHD, with particular emphasis on cardiovascular implications. Relevant clinical literature was sought using PubMed searches, with an emphasis on new reports from April 2009 to April 2011. This review describes the efficacy and general tolerability of stimulant and nonstimulant medications for adults with ADHD as seen in contemporary clinical trials. Cardiovascular response to medications for ADHD is primarily seen in heart rate and blood pressure elevations, while less is known about the etiology of rare cardiovascular events or long-term sequelae. Further research is indicated to delineate clinical an...
Magnesium fructose-1,6-diphosphate is a novel agent of antimyocardial ischaemia. In the present study, the subchronic toxicity of magnesium fructose-1,6-diphosphate was investigated after 13-week repeated intravenous administration in beagle dogs. The animals received doses of 0, 75, 150 and 300 mg/kg/day (three males and three females for each dose). During the study period, clinical signs, mortality, body weights, food consumption, electrocardiogram, urinalysis, haematology, clinical biochemistry, macroscopic findings, organ weights and histopathology were examined. The administration of magnesium fructose-1,6-diphosphate resulted in increased incidence of clinical signs, including salivation and emesis. These effects were transient and were noted in almost all dogs given 300 mg/kg/day a...
The paper seeks to illuminate everyday work practices in the economic spaces of Malaysia's business process outsourcing (BPO) industry. It draws upon empirical evidence from call centre staff and promotes analytical sensitivity to the experience of labour and spatiotemporal relations within the offshore back offices of multinational corporations located in Cyberjaya, Malaysia. The analysis provides an empirical snapshot of how IT-facilitated work practices in the global information economy are embedded and socially reproduced in everyday settings. To this end, the paper engages anthropologically with BPO labour, and critiques -globalist- representations of economic and social transformation frequently articulated through an abstract, dehumanized space of networks and flows often seen to wa...
ERDMANN A.L., DE ANDRADE S.R., FERREIRA DE MELLO A.L., KLOCK P., DO NASCIMENTO K.C., SANTOS KOERICH M. & STEIN BACKES D. (2011) Practices for caring in nursing: Brazilian research groups. International Nursing Review58, 379-385 Background:- The present study considers the production of knowledge and the interactions in the environment of research and their relationships in the system of caring in nursing and health. Aim:- To elaborate a theoretical model of the organization of the practices used for caring, based on the experiences made by the research groups of administration and management in nursing, in Brazil. Methods:- The study is based on grounded theory. Twelve leaders of research groups, working as professors in public universities in the south and the south-east of Brazil, distri...
Variability in production is one of the largest factors that negatively impacts construction project performance. A common construction practice to protect production systems from variability is the use of buffers (Bf). Construction practitioners and researchers have proposed buffering approaches for different production situations, but these approaches have faced practical limitations in their application. A multiobjective analytic model (MAM) is proposed to develop a graphical solution for the design of Work-In-Process (WIP) Bf in order to overcome these practical limitations to Bf application, being demonstrated through the scheduling of repetitive building projects. Multiobjective analytic modeling is based on Simulation?Optimization (SO) modeling and Pareto Fronts concepts. Simulation...
Abstract Aim- According to the revised Bethesda Guidelines, colorectal cancer (CRC) occurring under age 50-years should be screened to exclude Lynch syndrome. However, in current practice in East Anglia, tumour screening is initiated only after genetics referral, reserved for those with a strong pedigree. This study aimed to determine how many patients with young-onset CRC undergo tumour screening in hospitals in East Anglia. Method- A retrospective case notes review over 5-years in four hospitals was undertaken to determine what proportion of those with young-onset CRC underwent referral for tumour screening and to assess local practices in terms of patient counselling and management. Results- One hundred and twenty-two patients were included. There was an average yearly caseload of 6-9 p...
Many organizations are challenged with the tasks of identifying customer needs and expectations for their products, anticipating future product needs, communicating a future product vision to clients, and designing with today's technology to bring a future vision to successful realization. The design evolution of plant control centres is one aspect of CANDU development that faces such challenges. The Disney Corporation is an example of an organization that has been successful in consistently meeting these challenges for over fifty years; and some of the design practices proven in moviemaking, theme park and resort layout, and vacation experience organization may be helpful and effective when applied in other domains. This paper summarizes the findings from an examination of Disney Corporation design practices, and suggests how some practices could be used to simplify and enhance the design of future CANDU control ...
Riparian zones of streams in northwestern Mississippi have been impacted by agriculture, channelization, channel incision, and gully erosion. Riparian gully formation has resulted in the fragmentation of remnant riparian zones within agricultural watersheds. One widely used conservation practice for controlling gully erosion is the installation of drop pipes. This practice involves placing earthen dams across eroding gullies and embedding a metal standpipe within the dam to convey water from the field to stream level. Installation of this structure halts gully erosion and incidentally replaces eroding gullies with riparian habitats. Previous research evaluating gully erosion control structures have not considered the ecological impacts of these conservation practices on amphibian and repti...
We investigated gathering and cultivating practices and how they complement each other in a rural population of Northwestern Patagonia. We analyzed plant diversity, species similarity, biogeographic origin, and plant use by means of semi-structured interviews and field visits. Pichi Leufu inhabitants used 173 species: 138 cultivated plants, mainly for edible purposes, and 45 wild species principally for medicinal use. Most cultivated species were exotic (91.3%), whereas gathered plants were both native and exotic. While locals maintained vegetable gardens, the adoption of greenhouses improved conditions for certain crops. The integration of novel practices with ancestral knowledge suggests resilient processes in this community, probably reflected in the dynamics of current horticultural an...
There are many differences between industrial CT and industrial radiography, such as imaging principle, inspection time, radiation dose and the requirements for operators etc. The national standards for radiation protection of industrial detection are not applicable to the requirements of protection and safety for #gamma#-ray industrial CT to some extent now. In order to standardize the production and use for #gamma#-ray industrial CT, protect the safety of operators and the public, and to promote the popularization and application of #gamma#-ray industrial CT, it is significant to establish the national standards for radiation protection of #gamma#-ray industrial CT as soon as possible. The purpose of this paper is to introduce the contents of this standard, and specify some important terms. Then there is a brief discussion on the existing problems during establishing such standards. At last, the paper summarize the practice of the standards passed over the past ...
The French agency of environment and energy mastery (Ademe) and Deutsche Energie Agentur (DENA) organised in Berlin on November 22 and 23, 2001, the first seminar and forum of ideas and exchanges on the implementation of energy efficiency and renewable energy policies in France and in Germany. On this occasion, Ademe asked Energie-Cites - an association of European cities with a long practical experience in 'good practice' exchanges - to prepare a publication describing the experience of about ten French cities or local energy agencies in energy management issues. The case studies presented in this document concern the following cities: Besancon, Dole, Dunkerque, Lille, Montpellier, and the local energy agencies of Clermont-Ferrand (Aduhme), Grenoble, Montreuil-Vincennes, Mulhouse and Rennes. (J.S.)
The Department of Energy (DOE) policy requires that all DOE activities be conducted in a manner that protects the safety of the public and provides a safe and healthful workplace for employees. DOE has also prescribed that all personnel be protected in any explosives operation undertaken. The level of safety provided shall be at least equivalent to that of the best industrial practice. The risk of death or serious injury shall be limited to the lowest practicable minimum. DOE and contractors shall continually review their explosives operations with the aim of achieving further refinements and improvements in safety practices and protective features. This manual describes the Department's explosive safety requirements applicable to operations involving the development, testing, handling, and processing of explosives or assemblies containing explosives. It is intended to reflect the state-of-the-art in explosives ...
Climate change is one of the main global issues of modern time. Ever increasing demand for food/feed and the need for higher environmental standards require shaping of the agricultural activities toward ecological and more sustainable efficient systems. One of the principal ways of attaining higher productivity and environmental standards is identification and adoption of beneficial management practices (BMP) by reviewing the conventional agricultural activities. The BMP are agricultural practices that promote sustainable land stewardship and maintain/increase profitability of farms. The BMP are from both crop and animal production systems and tradeoffs between the two systems could provide several opportunities in reducing, removing and/or avoiding of greenhouse gases (GHG) emissions. Des...
Special education researchers have made noteworthy progress toward conceptualizing literacy research questions, designing quality studies, and disseminating the results of their research. These advancements have been made through the establishment and refinement of quality research indicators. Unfortunately, this progress has mostly eluded the arena of juvenile justice special education research. The purpose of this article is to review juvenile justice literacy studies and provide juvenile justice personnel and researchers with methodological and practical considerations for improving the quality of juvenile justice literacy research. The focus is on advancing group designs. Practical concerns are based on the first-year experiences of researchers who implemented an Institute of Education Sciences Goal 3 study with the aim of determining the efficacy of literacy instructional programs in a juvenile justice setting.
Bloodstream infection by highly antibiotic-resistant bacteria, such as vancomycin-resistant Enterococcus (VRE), is a growing clinical problem that increasingly defies medical intervention....Full Text Available
Borrelial infection may manifest with a wide range of clinical signs, and in many cases, microbiological findings are essential for a proper diagnosis. This study included 48 patients with a working...Full Text Available
Oligonucleotide DNA probes complementary to the hypervariable region of the 16S rRNA of Bacteroides forsythus were tested for their specificity and sensitivity against reference and clinical isolates...Full Text Available
BackgroundThe presence of enthesitis (insertional inflammation) in patients with juvenile idiopathic arthritis (JIA) is difficult to establish clinically and may influence classification...Full Text Available
SummaryTwo Caucasian males (57 and 70 years old) were referred to our attention with parasinus mucoceles, maxillary and frontal mucocele, respectively, that had eroded the orbital rim...Full Text Available
Uterine sarcomas are a rare group of neoplasms with aggressive clinical course and poor prognosis. They are classified into four main histological subtypes in order of decreasing incidence: carcinosarcomas,...Full Text Available
BackgroundTobacco smokers are more susceptible to periodontitis than non-smokers but exhibit reduced signs of clinical inflammation. The underlying mechanisms are unknown. We have...Full Text Available
Strategies to combine aspirated marrow cells with scaffolds to treat connective tissue defects are gaining increasing clinical attention and use. In situations such as large defects where initial...Full Text Available
The functional outcome after stroke is unpredictable; it is not accurately predicted by clinical pictures upon hospital admission. The presence of apoptotic neurons in the ischemic penumbra and perihematoma...Full Text Available
The morphological appearance, incidence and prognostic significance of human chorionic gonadotrophin (HCG)-containing cells in seminomas were examined in a retrospective series of 228 orchidectomy specimens,...Full Text Available
Pseudomonas aeruginosa, a common inhabitant of soil and water, is an opportunistic pathogen of growing clinical relevance. Its genome, one of the largest among bacteria [5570 open reading...Full Text Available
BackgroundCharacterizing infectious disease burden in Africa is important for prioritizing and targeting limited resources for curative and preventive services and monitoring the...Full Text Available
The Brain Database is an information tool designed to aid in the integration of clinical and research results in neuroanatomy and regional biochemistry. It can handle a wide range of data types including...Full Text Available
The activities of some semisynthetic penicillins and cephalosporins have been tested against clinical strains of Staphylococcus aureus. The apparent activity in vitro varies with the method of testing...Full Text Available
Surge capacity is the ability to rapidly mobilize to meet an increased demand. While large amounts of federal funding have been allocated to public health laboratories, little federal funding has been...Full Text Available
SUMMARYThe biologic and clinical significance of KIT overexpression that associates with KIT gain-of- function mutations occurring in subsets...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
BackgroundTo determine male outpatient attenders' sexual behaviours, expectations and experience of talking about their sexuality and sexual health needs with a doctor.MethodsA...Full Text Available
Serratia odorifera biogroup 1 was isolated from the blood and urine of an alcoholic male with cirrhosis and signs of septic shock. The organism is rarely reported to occur in clinical specimens. This...Full Text Available
We describe the interactions of two benzimidazole derivatives, astemizole (AST) and lansoprazole (LNS), with anomalous aggregates of tau protein (neurofibrillary tangles). Interestingly, these...Full Text Available
Clinical salmonellosis in cattle is infrequently recorded in Botswana, the majority of salmonella isolations being made from apparently healthy animals. A salmonella carrier rate of 6·7% was...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
Human cytomegalovirus (HCMV) in clinical material cannot replicate efficiently in vitro until it has adapted by mutation. Consequently, wild-type HCMV differ fundamentally from the passaged strains...Full Text Available
ObjectivesWe have developed an image-guided surgery system based on invisible near-infrared (NIR) fluorescent light. Presently, the only clinically-available NIR...Full Text Available
The polymerase chain reaction (PCR) was investigated as a means of diagnosing Mycoplasma pneumoniae infections. The target DNA sequence was a 375-bp segment of the P1 virulence protein. This DNA segment...Full Text Available
This study identified clinical (e.g., etiology) and demographic factors related to prosthesis use in persons with upper- and lower-limb amputation (ULA and LLA, respectively) and the effect...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
Background:The non-surgical management of non-melanoma skin cancers is an area requiring clinical investigation. Radiotherapy has a role in treatment for a defined subset...Full Text Available
Mucopolysaccharidosis type IIIB (MPS IIIB; Sanfilippo syndrome type B) is a metabolic disorder with devastating clinical characteristics starting in early childhood and leading to premature death. A...Full Text Available
A 42% (70 of 167 isolates) incidence of resistance to 20 micrograms of trimethoprim per ml was found among clinical isolates of coagulase-negative staphylococci from two hospitals. A specific trimethoprim...Full Text Available
Out of nearly 900 women in a research study of human immunodeficiency virus infection in pregnancy, 8 were subsequently found not to be infected. Misdiagnoses could have resulted from (a) laboratory...Full Text Available
Therapeutic hypothermia is a promising method for controlling intracranial pressure (ICP) in severely brain-injured patients. However, clinical data regarding the effect of brain hypothermia on overall outcome of these patients is limited. This may be because there are specific pitfalls associated with the clinical management of induced hypothermia in patients with severe traumatic brain injury (TBI). These pitfalls may be avoided by preventing specific risk factors when cooling is induced and with rewarming. However, these risk factors have not been well systematically discussed in the literature. In this paper, three categories of clinical issues regarding the management of brain hypothermia are discussed: (1) stress-induced secondary brain injury mechanisms; (2) technical aspects of intensive care unit (ICU) cooling management; and (3) rewarming rates and methods. For patients with a Glasgow Coma Scale (GCS) score of ...
Over the last two centuries, there has been a significant increase in average lifespan expectancy in the developed world. One unambiguous clinical implication of getting older is the risk of experiencing...Full Text Available
Posterior spinal ligament pathology is becoming increasingly recognized as a significant cause of low back pain. Despite the growing clinical importance of interspinous ligament degeneration in low...Full Text Available
BackgroundApproximately 80% of all new HIV-1 infections are acquired through sexual contact. Currently, there is no clinically approved microbicide, indicating a clear and...Full Text Available
Empirical treatment is best guided by current surveillance of local resistance patterns. The goal of this study is to characterize the prevalence of antimicrobial nonsusceptibility within pneumococcal...Full Text Available
Dementia with Lewy bodies (DLB) is the second most common cause of degenerative dementia after Alzheimer's disease (AD), and is clinically characterized by the progressive cognitive decline with fluctuations...Full Text Available
The concept of "one-stop information shopping" is becoming a reality at Columbia-Presbyterian Medical Center. Our goal is to provide access from a single workstation to clinical, research, and library...Full Text Available
Previous studies have documented diagnostic bias and noted that its reduction could eliminate misdiagnosis and improve mental health service delivery. Few studies have investigated clinicians'...Full Text Available
SynopsisEarly detection of late onset neonatal sepsis, prior to obvious and potentially catastrophic clinical signs, is an important goal in neonatal medicine. Sepsis causes a...Full Text Available
SummaryBlastomycosis is a serious and potentially fatal infection by the thermally dimorphic fungus Blastomyces dermatitidis. PCR assays targeting the BAD-1 virulence...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
Extraosseous Ewing's sarcoma (EES) is an uncommon lesion included in the group of soft tissue tumors. We present a case in a 19-year-old woman in which the diagnosis was not initially suspected because of the absence of clinical and radiological evidence. (Author).
Ewing's sarcoma is the second most common malignant bone tumor in children and young adults. It is most prevalent between the ages of 10 and 15 years. There are present two cases of Ewing's sarcoma of the chest wall. The clinical, radiological and pathological features are described and the therapeutic options are discussed. (Author)
We compared MRSA Select to mannitol-salt agar with 8 μg/ml cefoxitin for the detection of methicillin-resistant Staphylococcus aureus (MRSA) from 6,199 clinical...Full Text Available
ObjectivesThe aim of this study was to investigate the effect of cigarette smoking on clinical parameters and signs anemia of chronic disease in chronic periodontitis patients.Full Text Available
1 The long term safety and efficacy of vigabatrin has been studied in 254 patients with refractory epilepsy (82% with partial seizures) in 23 different clinics in eight European countries....Full Text Available
Objectives:The study was planned to evaluate the efficacy and safety of Livwin (polyherbal formulation) in acute viral hepatitis.Materials...Full Text Available
Periodontal diseases are infections of the tissues supporting the dentition. Recognition that relatively specific microfloras are associated with distinct clinical forms of periodontal disease has prompted...Full Text Available
ET-743 (trabectedin; Yondelis) is approved in Europe for the treatment of soft tissue sarcomas. Emerging phase 1 and 2 clinical data have shown high response rates in myxoid liposarcoma in part owing...Full Text Available
BackgroundOne-stage implant placement has clinically acceptable treatment outcomes. Among other advantages, it may allow investigation of early wound healing. The...Full Text Available
IntroductionChest pain with ST-segment elevation is a rare clinical problem during dobutamine stress testing. Although beta-agonists treatment prior to dobutamine stress testing...Full Text Available
A case of multifocal Langerhans cell histiocytosis in a two-year-old child is presented where fine needle aspiration was helpful in achieving a rapid and accurate diagnosis in an appropriate clinical...Full Text Available
Various physico-chemical tissue optical clearing (TOC) methods have been suggested to maximize photon density in tissue. In order to enhance photon density, a compression-controlled low-level...Full Text Available
Accurate prediction of the pathogenic effects of specific genotypes is important for the design and execution of clinical trials as well as for meaningful counseling of individual patients. However,...Full Text Available
Curcumin is a natural product currently in human clinical trials for a variety of neoplastic, preneoplastic, and inflammatory conditions. We previously observed that, in cultured cells, curcumin exhibits...Full Text Available
BACKGROUNDPediatric transfusion medicine (PTM) is a subspecialty of transfusion medicine (TM) with no formal training program and few specialists. The Pediatric Transfusion...Full Text Available
Objective:To estimate the prevalence of insulin resistant syndrome (IRS) among newly diagnosed patients with type 2 diabetes and to test their validity against two indices...Full Text Available
The in vitro antibacterial activities of the newly developed 7 alpha-methoxy cephalosporins and 7 beta-methoxyiminoacetamido cephalosporins against 67 clinical isolates of Bacteroides fragilis and their...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
AIM: To investigate the relation of Fas and Fas ligand (FasL) protein expression with carcinogenesis and metastasis of gastric carcinoma.METHODS: Immunohistochemistry was used to detect Fas and...Full Text Available
The ethical dimension of treating the elderly, including risk–benefit analysis, focuses mainly on quality of life and end-of-life issues. These include arguments on advance directives and the...Full Text Available
Background With the increasing use of cineless diagnostic angiography laboratories, modern telecommunication networks provide an excellent opportunity to transfer dynamic cardiac...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
Objective: To further delineate the clinicopathological and radiological features of solid pseudopapillary tumor (SPT) of the pancreas and summarize the surgical therapy strategy for this tumor. Methods:...Full Text Available
A mild stress such as brief ischemic episodes may protect the heart from a successive and more prolonged myocardial ischemia (ischemic preconditioning). This phenomenon is considered a typical “hormetic...Full Text Available
BackgroundMultiple sclerosis (MS) is the endpoint of a complex and still poorly understood process which results in inflammation, demyelination and axonal and neuronal degeneration....Full Text Available
The cytogenetic findings were analysed in a series of 500 pregnancies in which chorionic villi sampling was performed. In all cases a direct method was used, karyotyping being successful in 481 cases...Full Text Available
Ligature-induced periodontitis was monitored for 6 months in eight Macaca mulatta monkeys to examine clinical status, radiographic bone level, and crevicular fluid (CF) levels of prostaglandin E2 (PGE2),...Full Text Available
A total of 150 strains of staphylococci, clinically isolated, were tested for sensitivity to ovotransferrin (conalbumin). Among these, all the 50 coagulase-positive, mannitol-positive, and deoxyribonuclease-positive...Full Text Available
PurposeTo establish normative values for macular light sensitivity and to determine the intrasession fluctuation of perimetric responses using the OPKO/OTI microperimeter.Full Text Available
vaccination card during trial enrollment at the KEMRI/CDC site in Kenya. (Alan Rubin, KEMRI) KEMRI Clinical Officer Paul Ogai reviews a prospective participant's...
Nitric oxide (NO)-based therapies effectively inhibit neointimal hyperplasia in animal models of arterial injury and bypass grafting, but are not available clinically. We created a simple, effective,...Full Text Available
In Iran, microscopic examination of skin scrapings from 2202 individuals with clinically diagnosed cutaneous leishmaniasis (CL) lesions revealed the presence of amastigotes in 1123 cases (51.0%). Bacteriological...Full Text Available
A clinical laboratory evaluation was conducted on the Clinitek Auto 2000, the Super Aution Analyzer and the Urotron RL9 for the determination of glucose, protein, pH, blood, ketone-bodies and bilirubin....Full Text Available
A survey was conducted at 15 textile plants with dyehouses in western Sweden. Employees with a history of work related rhinitis, asthma, or skin symptoms were offered a clinical and immunological investigation...Full Text Available
This study was performed to investigate the association between hair mineral levels and nutrient intakes, age, and BMI in female adults who visited a woman's clinic located in Seoul. Dietary intakes...Full Text Available
Lack of understanding about workflow can impair health IT system adoption. Observational techniques can provide valuable information about clinical workflow. A pilot study using direct observation was...Full Text Available
Currently there is considerable interest among oncologists to find anticancer drugs in Chinese herbal medicine (CHM). In the past, clinical data showed that some herbs possessed anticancer properties,...Full Text Available
ObjectivesThis study was designed to evaluate the normal development of the nasal septum in Koreans using sagittal MRI for the valuable clinical information on septal procedures.MethodsTwo...Full Text Available
ObjectiveThis study sought to determine whether differential treatment effects in the targeted mechanisms of change and eating disorder (ED) symptoms are associated...Full Text Available
OBJECTIVE—To validate the accuracy of the prognostic significance of non-invasive clinical diagnostic indices as predictors of sustained ventricular tachycardia (sVT) or fibrillation...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 sensitivities to cefuroxime and cephradine of potentially pathogenic bacteria isolated in two British general hospitals comprising 900 beds have been assessed. In a three-month period 2537 strains...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
IntroductionVarious multigene predictors of breast cancer clinical outcome have been commercialized, but proved to be prognostic only for hormone receptor (HR) subsets overexpressing...Full Text Available
SummaryHeadache due to the pressure of nasal mucosa in the absence of inflammation of the nose and paranasal sinuses is a clinical entity that has gained wide acceptance. Concha bullosa...Full Text Available
Several widely recognized sources of nomenclature regarding the bovine external digit were reviewed, compared, and utilized in a clinical survey of bovine digital disease. During this process, some...Full Text Available
Thiamin(e), also known as vitamin B1, is now known to play a fundamental role in energy metabolism. Its discovery followed from the original early research on the ‘anti-beriberi factor’...Full Text Available
In this era of complete genomes, our knowledge of neuroanatomical circuitry remains surprisingly sparse. Such knowledge is critical, however, for both basic and clinical research into brain function....Full Text Available
This paper presents the design and implementation of a clinical picture archiving and communication system (PACS) module within the radiology department of a 700-bed teaching hospital. The system is...Full Text Available