Opioids have been regarded for millennia as among the most effective drugs for the treatment of pain. Their use in the management of acute severe pain and chronic pain related to advanced medical...Full Text Available
BackgroundAdequate painassessment is critical for evaluating the efficacy of analgesic treatment in clinical practice and during the development of new therapies. Yet the currently...Full Text Available
A large proportion of patients may develop chronic pain following cancer treatments such as surgery, radiotherapy, or chemotherapy. These patients can experience significant levels of physical and psychological morbidity. Our aim was to investigate a cognitive-behavioral pain management program (PMP) for cancer patients with chronic treatment-related pain. Thirteen patients (1 man, 12 women; mean age 52 yrs) completed the study, 9 of whom had a history of breast cancer and had received extensive medical treatment, including surgery. A combination of physical and psychological techniques were adapted from previous work in chronic benign pain and implemented by two therapists. Interventions included education, relaxation, exercise training, and goal setting. A variety of outcomes were examined to assess general fitness, psychological distress, coping success, ...
Objectives Vietnamese patients? views on healthcare are changing as surgical interventions become more commonplace, but their views on perioperative care have remained largely unstudied during this period of rapid change. This study assesses Vietnamese patients? impression of anesthesia safety and postoperative pain in relation to clinical outcomes with the aim of improving patient-centered perioperative care. Methods The study cohort consisted of 180 hospitalized patients who were followed for 24?h following abdominal surgery. The assessments of these patients on the use of anesthesia and postoperative pain were measured by means of a 5-point Likert scale survey. Perioperative events were recorded on standardized forms by medical staff. The relationship between relevant factors affecting ...
Although previous research suggests that preamputation pain is a risk factor for pain after amputation, little is known about the association between acute postsurgical pain and chronic amputation-related pain. The current prospective study examined the associations of preamputation pain and acute postamputation pain with chronic amputation-related pain. The sample consisted of patients with lower limb amputation (N = 57) who provided both preamputation and postamputation data during a 2-year study period. Preamputation pain intensity and duration were assessed before amputation; acute phantom limb pain (PLP) and residual limb pain (RLP) intensity were assessed on postsurgical days 4 and 5. Acute PLP intensity was the only significant ...
Pain caused by chronic pancreatitis is medically intractable and resistant to conventional interventional or surgical treatment. We report a case of spinal cord stimulation (SCS) for intractable pain...Full Text Available
Psychological illness influences the experience and expression of pain and disability. We tested three null hypotheses: (1) patients with nonspecific pain (medically unexplained and idiopathic) and...Full Text Available
Summary Background Pemphigus vulgaris and pemphigus foliaceus are rare, potentially life-threatening, autoimmune disorders characterized by antibodies to epidermal adhesion molecules. Clinical characteristics are painful chronic erosions of mucous membranes and of the skin. There are only few published studies on the impact of the disease on the health status (HS) of patients with these conditions. Objectives To assess the impact of disease on the HS of patients with pemphigus. Methods Fifty-eight patients enrolled at the Bullous Skin Diseases Unit of IDI-IRCCS in the period January-June 2006 were assessed for their HS using the Medical Outcomes Study 36-item short form health survey (SF-36) questionnaire and for anxiety and depression using the Institute for Personality and Ability Testin...
The interscalenic block technique is widely used for ambulatory shoulder surgery despite a substantial number of failures and adverse effects. We prospectively evaluated satisfaction in 40 consecutive patients who underwent open Bankart repair under a single general anesthesic performed in an ambulatory care unit. The mean age of the patients was 23 years. There were 29 men and 11 women. Patients were evaluated postoperatively with a visual analog scale of pain (in the recovery room, at the time of discharge, and the day after and 1 week after surgery) via a home assessment questionnaire that included the following: effectiveness of oral painmedication, ability to perform activities of daily life, and overall satisfaction. One patient failed to be discharged because of a feeling of faintn...
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
ObjectivesUse of prescription opioids for chronic pain is increasing, as is abuse of these medications, though the nature of the link between these trends is unclear....Full Text Available
The objective of this study was to evaluate the effect of pregabalin in painful cervical or lumbosacral radiculopathy treated in Primary Care settings under routine clinical practice. An observational,...Full Text Available
... Search Help? Coping with Test Pain, Discomfort, and Anxiety Introduction | Be Prepared | Know Your Tests | Relax | Conclusion ... though they may feel some embarrassment, discomfort, or anxiety at the outset. If undergoing medical tests makes ...
The treatment of chronic pain conditions continue to present a challenge to the medical field. Physical therapy treatment needs to approach the management of chronic pain differently than the approach used to resolve acute pain. Patients with chronic pain often have many factors that have perpetuated the pain condition. These factors, as well as pain itself, influence their ability to reactivate and perform functional daily activities. Physical therapists can begin to address some of the factors, including fear and deconditioning, by building confidence and body awareness in a self-care model including a slow graduated reactivation program. There is evidence that patients with chronic pain conditions have altered motor control that may be influencing reoccurrences and possible flares of pa...
Objective:To assess the efficacy of facet joint infiltrations for pain relief in 44 selected patients with chronic nonradicular low back pain (LBP).Materials...Full Text Available
Five methods of personality assessment are evaluated to provide guidance for the psychological treatment of patients with chronic back pain. Patient pain drawings, pentothal pain studies, stress score...Full Text Available
The physical demands of performing on musical instruments can cause pain, sensory loss, and lack of coordination. Five cases illustrate common problems. Knowledge of the interaction between the technique...Full Text Available
Behavioural assessment methods have been used to signal the need for intervention and to evaluate treatment effectiveness. Direct observation and rating scales have been used to assesspain and distress...Full Text Available
The overarching goal of medical training is to nurture the growth of knowledgeable, caring and insightful clinicians guided by the ideals of medical professionalism. Recent definitions of professional...Full Text Available
Inclusion of family members in the assessment of patients with chronic pain can improve outcomes. Family functioning can be assessed in four basic areas: boundaries, power, communication, and intimacy....Full Text Available
Over the years, nurses, doctors and scientists have sought ways of assessing the impact of pain on patients. While many of the instruments devised have been extremely useful in identifying the nature and intensity of pain, defining the effect it has on people's lives and perceptions has proved much more problematic. Based on the work she carried out with patients suffering from chronic benign pain, Karen Rose explores one aspect of these effects--the feeling of isolation. By using a four-step anthropological approach to identify the impact of pain, she argues, nurses can arrive at a realistic and accurate assessment of how patients are coping. PMID:7947167
AbstractBackground Few published data are available on the benefits of aspirin use in patients with unstable angina (UA). Hypothesis Aspirin use carries a mortality benefit in a population-based cohort of patients presenting with UA. Methods All residents of Olmsted County, Minnesota presenting to local emergency departments with acute chest pain from January 1985 through December 1992 having symptoms consistent with UA were identified through medical records. A total of 1628 patients were identified with UA and were stratified by aspirin use in-hospital and at discharge. Cardiovascular mortality and nonfatal myocardial infarction and stroke were assessed over a median of 7.5 years follow-up and all-cause mortality data over a median of 16.7 years. The mean age of patients with UA was 65 y...
The utilization of health care services in children and adolescents with chronic benign pain was studied in a Dutch population sample of 254 chronic pain sufferers aged 0-18 years. Children and adolescents who had reported chronic pain (continuous or recurrent pain >3 months) in our previous prevalence study were asked to keep a 3-week diary on their pain and to fill out questionnaires on background factors, health care use and the impact of pain. Parent ratings were used for children aged 0-11 years, self-report was used in adolescents (12-18 years). In a 3-month period, in 53.4% of the cases medication was used for pain, and general practitioners and specialists were consulted for pain in 31.1% and 13.9% of subjects, respectively. Physiotherapists, psychologists and alternative health providers ...
BackgroundThe objective of this study was to develop and validate a daily electronic Endometriosis Pain and Bleeding Diary (EPBD) for assessing treatment-related changes in endometriosis...Full Text Available
This article reports on an exploratory study of hospice social workers’ assessment and collaborative practices related to pain management; especially caregiver concerns about patient...Full Text Available
Racial and ethnic disparities in healthcare persist in the U.S. Although pain is one of the most prevalent and disabling symptoms of disease, only a few studies have assessed disparities in...Full Text Available
Objectives. To assess the feasibility of treating musculoskeletal pain in the lower back and/or lower extremities in persons with Parkinson's disease (PD) with cranial electrotherapy...Full Text Available
BackgroundThe purpose of our study was to evaluate the clinical value of hybrid SPECT/CT for the assessment of patients with painful total knee arthroplasty (TKA).MethodsTwenty-three...Full Text Available
... Previous Topic Pain Next Topic Scars and wounds Prostheses Prostheses (pross-THEE-sees) are man-made substitutes ... covered by medical insurance (this includes wigs). Breast prostheses: Contact your local chapter of the American Cancer ...
BackgroundAcute low back pain is a very common symptom and reason for many medical consultations. In some unusual circumstances it could be linked to a rare aetiology.Case...Full Text Available
Chronic benign pain is commonly associated with chronic fatigue and depression. Depression and chronic fatigue syndrome are also associated with each other and often include pain. Psychologic factors are prominent in these conditions, and they may share neurobiologic factors as well. Management requires separately addressing each component of patients' distress and usually includes physical rehabilitation, education, administration of nonhabituating medications and often counseling. Depression may be a favorable prognostic sign, as it suggests a treatable condition and provides incentive for recovery. PMID:1876618
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) remains an enigmatic medical condition. Creation of the (NIH) Chronic Prostatitis Collaborative Research Network (CPCRN) funded by...Full Text Available
RationaleProcedures for studying the effects of medications on satiation will assist the development of obesity medications.ObjectivesFull Text Available
Abstract Residual limb pain (RLP) and phantom limb pain (PLP) can be debilitating and can prevent functional gains following amputation. High correlations have been reported between RLP and the stump neuromas following amputation. Many treatment methods including physical therapy, medications, and interventions, have been used with limited success. Pulsed radiofrequency ablation (PRFA) has shown promise in treating neuropathic pain because of the inhibition of evoked synaptic activity. We present 4 amputees who were treated with PRFA after failing conservative management for their RLP and PLP. All 4 patients underwent PRFA and demonstrated at least 80% relief of RLP for over 6 months. One patient reported a complete resolution of phantom sensation while another patient had significantly de...
Percutaneous coronary revascularisation [PCR] improves angina and health related quality of life [HRQOL] compared to standard medical therapy. It is unknown whether PCR has the same benefits for patients with a history of CABG. Over a period of 5?years, we assessed HRQOL of patients undergoing PCR using Part 1 of the Nottingham Health Profile [NHP] at baseline 3, 12 and 24?months. We compared HRQOL after PCR in 255 patients with CABG to 2680 without. There were more males [81.1% v 69.6% p?=?0.002] and older patients [mean age 60.1?years v. 58.0 p?=?0.03] in CABG group. Perceived HRQOL improved at 24?months for pain, energy and emotional reaction but the improvement was less in the CABG group. However, mean NHP scores at 24?months for those with CABG had returned to baseline levels for slee...
We propose new method of assessment of histological images for medical diagnostics. 2-D image is preprocessed to form 1-D landscapes or 1-D signature of the image contour and then their complexity is...Full Text Available
The subjective experience of one's environment is constructed by interactions among sensory, cognitive, and affective processes. For centuries, meditation has been thought to influence such processes by enabling a nonevaluative representation of sensory events. To better understand how meditation influences the sensory experience, we used arterial spin labeling functional magnetic resonance imaging to assess the neural mechanisms by which mindfulness meditation influences pain in healthy human participants. After 4 d of mindfulness meditation training, meditating in the presence of noxious stimulation significantly reduced pain unpleasantness by 57% and pain intensity ratings by 40% when compared to rest. A two-factor repeated-measures ANOVA was used to identify interactions between meditation and pain-related brain activation. Meditation reduced pain-related ...
ObjectivesModernising Medical Careers (MMC) emerged in response to acknowledged problems in training in the Senior House Officer grade. The objective of this study was to assess...Full Text Available
One membrane oxygen enricher (Oxygen Enrichment Company OE-4E) and four molecular sieve (MS) concentrators (Mountain Medical Econo2, De Vilbiss MINI DeVO2, Cryogenic Roomate III, and Mountain Medical...Full Text Available
Choosing a medical device is complex and requires a transparent process based on reason, evidence and assessment of prioritized public health needs. Poor choices lead to inappropriate use or non-use of medical devices and a waste of resources.This report suggests how an agenda to improve access to appropriate medical devices could be devised from applying the crucial 4 components - Availability, Accessibility, Appropriateness, and Affordability, to the 15 global high-burden diseases and some cross-cutting issues. The results of this exercise suggest several areas of research necessary to help
INTRODUCTIONInformatics and automation are important tools for the reduction of work, errors and costs in a hospital pharmacy.OBJECTIVESTo describe...Full Text Available
The aim of this review is to evaluate the role of inflammatory spine disease in patients with chronic back pain. The contribution of imaging modalities for the diagnostic evaluation of back pain is discussed. A systematic literature search based on the classification of seronegative spondyloarthropathies and rheumatoid arthritis was performed. The results of this search and the experiences in a large collective of rheumatological patients are analyzed. The prevalence of rheumatoid arthritis (1-2%) is comparable to that of spondyloarthropathies (1.9%). The etiology of these entities is not fully elucidated. Magnetic resonance imaging is increasingly used for early detection and surveillance of therapy with TNF-#alpha# antagonists. Bone marrow edema, which is only detectable with MRI, represents an early sign of inflammation. Therapy with TNF-#alpha# antagonists is based on clinical and laboratory criteria, and signs of inflammation in MRI. MRI ...
Botulinum neurotoxin is produced by the bacterium, Clostridium botulinum. The neurotoxin inhibits acetylcholine at the neuromuscular junction, thus interfering with overall muscular contraction. Botulinum neurotoxin is commonly used for the following medical conditions: cervical dystonia, upper limb spasticity, blepharospasm, strabismus, and hyperhydrosis. However, the use of botulinum neurotoxin was recently approved for the prophylaxis of headaches in adults with chronic migraines. The proposed mechanism of botulinum neurotoxin is no longer solely limited to the inhibition of acetylcholine. There are new mechanisms emerging that involve inhibition of proinflammatory agents and neuropeptides involved in chronic pain. Consequently, there is a disruption of the overall sensory feedback loop...
Background: Ecchymosis, oedema, haematoma and pain after SMAS-based facelift surgery are all the direct result of the physical trauma of surgery and subsequent inflammatory response. Hilotherapy is a novel form of cryotherapy that purports to minimise these events through single-use face masks circulating cooled, sterile water. This study was performed to assess the validity of Hilotherapy in this population of patients. Methods: Over 14 weeks fifty consecutive patients were randomised to post-operative facial cooling with Hilotherapy or management with standard dressings alone, while fifteen subsequent, consecutive patients were randomised to cooling of one side of the face but not the other. Assessment of ecchymosis, oedema, haematoma and pain was performed independently by clinical staf...
Two experiments used the McGill Pain Questionnaire (MPQ) to examine the affective dimension of pain in patients whose pain was secondary to malignancy. In experiment I, segregating groups of cancer patients on the basis of extreme scores (high versus low) on the MPQ failed to produce segregation on independent measures of affect and infirmity. This outcome contrasts with earlier work with chronic benign pain patients. Experiment II compared cancer pain patients matched with benign pain patients on intensity of pain report on the affective dimension of the MPQ. Cancer pain patients reported a reliably higher affective loading to their pain. These data suggest that cancer pain patients employ different criteria than benign pain patients in selecting affective ...
Studies on the determinants of pain-related support are needed to enhance couples-based treatments for pain. The purpose of this study was to determine the extent to which pain catastrophizing...Full Text Available
To assess the merits of currently available treatment options in the management of patients with low rectal cancer, a review of the medical literature pertaining to the operative and non-operative management...Full Text Available
This study assesses the contribution of smoking to all-cause mortality among a primarily minority cohort of urban transit operators. Survey and medical exam data, obtained from 1,785 workers (61% African...Full Text Available
The noninvasive assessment of cardiac function is of first importance for the diagnosis of cardiovascular diseases. Among all medical scanners only a few enables radiologists to evaluate the local cardiac...Full Text Available
IntroductionThe aim of the study was to assess and classify incidents of electromagnetic interference (EMI) by second-generation and third-generation mobile phones on critical care...Full Text Available
BackgroundThe Emergency Care Summary (ECS) was introduced in 2006 to allow aspects of the general practitioner (GP; family doctor, equivalent to primary care physician) medical record...Full Text Available
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.
DescriptionLameness, commonly referred to as the leg health, in the modern broiler chicken is an emotive issue and the debate surrounding this subject is not helped by the lack of agreement as to how leg health should be assessed. A commonly used tool for scoring leg health is the Bristol Gait Score, a technique used in the recently reported Defra project AW0230 (`Leg Health and Welfare in Commercial Broiler Production`). The authors of the final report for AW0230 noted that for the chickens gait scored [continued...
As medical schools incorporate medical informatics into their curriculum the problems of implementation arise. Because there are no standards regarding a medical informatics curriculum, medical schools...Full Text Available
IntroductionShoulder pain covers a wide range of problems and affects up to 20% of the population. It is not a specific diagnosis. Shoulder pain can be caused by problems with the...Full Text Available
BACKGROUND:In adults, it is well known that high levels of pain catastrophizing are related to increased pain and disability as well as to heightened anxiety and depression. However,...Full Text Available
BACKGROUND:Despite increasing attention to the epidemiology of pain, relatively little is known about the association between pain and health in children. In particular, no studies...Full Text Available
Stabbing paroxysmal pain due to neurological disease can often be controlled by anticonvulsants, whereas steady burning pain is often responsive to tricyclic antidepressants, and to neuroleptics. Overuse...Full Text Available
Despite the existence of effective analgesic drugs, many cancer patients live and die with ineffective pain control. The control of cancer pain is largely achievable with the appropriate use of available...Full Text Available
Abstract Recently, a study of patients with rheumatoid arthritis who developed herpes zoster while taking a tumor necrosis factor (TNF)- inhibitor reported a decreased incidence of postherpetic neuralgia. The objective of this study was to investigate whether patients on TNF- inhibitors who developed herpes zoster have a lower incidence of subsequent development of postherpetic neuralgia. A retrospective review of herpes zoster patients on TNF- inhibitors (infliximab, etanercept, or adalimumab) was conducted in 12 dermatology clinics. Medical records of such patients were reviewed thoroughly to confirm herpes zoster and TNF- inhibitors and any subsequent development of postherpetic neuralgia (pain score -3 out of 10 after 90 days of shingles onset) was noted. A total of 206 cases were revi...
Forty cases of Ewing's sarcoma of various sites had attended the Department of Radiotherapy at the Wanless Hospital and the Miraj Medical Centre, attached to the Government Medical College, Miraj, Maharashtra, from January, 1970 through December, 1979. There were 28 male patients and 12 female patients in the series with a male to female ratio of 2.3:1. The youngest patient in the series was a female of 6 years of age with the tumour in the scapula and the oldest patient was a 32-year-old male with a lesion in the metacarpal bone. Sixty per cent of the cases were seen in the second decade. The average age of the patients was 13.5 years. The bones of the lower extremities were most commonly involved with the highest number (35 per cent) of the cases occurring in the femur. Involvement of the bones of the right side of the body was almost equal to that of the left side. Swelling over the site of the lesion and pain over the ...
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 ...
Proceeding from analysis of the influence of parameters of the target-filter system on radiation-physical characteristics of braking radiation, some recommendations were issued for assessment of the forming systems of medical accelerators of electrons. A new criterion - a coefficient of the forming system efficacy - was introduced, characterizing a beam formation tract with relation to a whole set of radiotherapeutic problems.
Little is known about how sociodemographic factors relate to children’s chronic pain. This paper describes the pain, health, and sociodemographic characteristics of a cohort of children...Full Text Available
Pain and pain-related interference with physical function have not been thoroughly studied in individuals who have undergone knee-disarticulation amputations. The principal aim of this study...Full Text Available
The aim of the study was to determine whether children with chronic benign pain are in contact with their general practitioner (GP) more frequently than those without chronic benign pain. A random sample...Full Text Available
ObjectiveThe aims of the study were to: determine the attitudes of parents, pediatric residents, and medical students from a Turkish population toward childhood disciplinary methods; ascertain the association of participants' abusive childhood history with their attitudes toward discipline; and assess their attitudes about disciplinary actions, which should be reported as abuse.MethodA cross-sectional survey was conducted in Ankara University School of Medicine, Department of Social Pediatrics. Sixty-five parents, 39 pediatric residents, and 106 medical students completed a questionnaire (Survey of Standards of Discipline). This questionnaire was designed to measure sociodemographic characteristics, attitudes toward childhood disciplinary practices, and abusive childhood experiences. There...
Peer assessment provides a powerful avenue for students to receive feedback on their learning. Although student perceptions of peer assessment have been studied extensively in higher education, little qualitative research has been undertaken with medical students in problem-based learning (PBL) curricula. A qualitative study of students' attitudes to, and perceptions of, peer assessment was undertaken within the framework of a larger study of metacognition with first-year medical students at the University of Queensland. A highly structured format for provision of feedback was utilised in the study design. Many recommendations from the higher education literature on optimal implementation of peer-assessment procedures were put into practice. Results indicated the existence of six main themes: (1) increased responsibility for others, (2) improved learning, (3) ...
Aim: To evaluate the role of computed tomography (CT) in needle placement for ganglion impar blocks, and to determine the efficacy of CT-guided ganglion impar blocks in the management of coccydynia. Materials and methods: The results of ganglion impar blockade in eight patients with coccydynia secondary to trauma or unknown cause were reviewed. The diagnosis of coccydynia was based on clinical history, location of pain, and response to previous diagnostic and therapeutic procedures. The eight patients were treated with CT-guided ganglion impar blocks to manage their coccyx pain after conservative procedures, including oral medication and cushions, failed to provide relief. All patients were subjected to ganglion impar blocks under a thin-section CT-guided technique for needle placement, using a mixture of bupivacaine and triamcinolone. The patients were followed-up for a period of 6-months. Results: Eight patients were ...
Pai ALH, Gray E, Kurivial K, Ross J, Schoborg D, Goebel J. The Allocation of Treatment Responsibility scale: A novel tool for assessing patient and caregiver management of pediatric medical treatment regimens. Pediatr Transplantation 2010: 14:993 999. 2010 John Wiley & Sons A/S. Abstract: The purpose of the current study is to report preliminary psychometric properties of the ATR scale, a brief measure of the distribution of treatment tasks across the family members of children with a kidney transplant. Pediatric patients with renal transplants (ages 7 18 yr) and their caregivers completed the ATR and measures of adherence and family functioning. Internal consistency for the ATR (total score and subscales) was strong (range = 0.75 0.93). Validity for the ATR was supported by significant co...
Background: Measurements from pressure biofeedback units (PBUs) can be used to evaluate the activity of the transversus abdominis (TrA) muscle indirectly. These measurements can classify patients or monitor the progress of treatment programmes for people with low back pain. Objective: To systematically review studies on the measurement properties of PBUs for the assessment of TrA activity. Data sources: Eligible studies were identified through searches of PUBMED, CINAHL and BIREME (1990 to 2009). In addition, hand searches of journals and citation tracking were performed. Study selection: Full-text studies involving any type of clinimetric tests of PBU measurement for the assessment of TrA activity were selected. Data extraction: Two independent reviewers selected the studies, extracted th...
The E and P industry has high levels of uncertainty and risk, which oil companies attempt to quantify before embarking on each individual E and P project. However, the actual return on investment often falls well short of the hurdle rate. This discrepancy has been attributed to systemic limitations in decision analysis processes and workflow, which result in repeated underestimation of risk and overestimation of the predicted production of the project. Well designed decision analysis processes in association with clearly defined, multi-scenario analyses of significant technical uncertainties are required. However, simulation of these uncertainties is not realistic given the performance and infrastructure limitations of conventional technology (Begg et al., 2001; Floris and Peersmann, 2000). During the past five years, more than 20 companies have attempted to map the requirements of new technology that is needed to improve uncertainty assessment and decision ...
BackgroundToday, there is a trend towards establishing the medical humanities as a component of medical education. However, medical humanities programs that exist within the context...Full Text Available
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)
One case of esophagitis caused by oral medication of Tetracycline is reported. The cause and factors predisposing to this uncommon complication of oral medication are discussed.
Pain is necessary for survival but chronic pain is disabling and causes significant health and economic problems. This study provides an understanding of the future for spinal cord stimulation. Stimulation by means of chronically implanted electrodes, was carried out in 200 patients with pain of varied benign organic etiology. In 177 of them, pain was confined to the failed back syndrome. Most patients were referred by a Pain Management Service. 226 epidural implants were used: 80 unipolar, 59 Resume, 12 bipolar, and 75 quadripolar. Patients were followed for periods of 6 months to 12 years, with a mean follow-up of 44 months. 84 patients (42%) were able to control their pain by stimulation alone, 22 patients (11%) needed occasional analgesic supplements along with their stimulation program. Pain secondary to failed back syndrome, multiple ...
The University of North Carolina Comprehensive Pain Center, which has been in existence since 1972, is a pain evaluation, treatment and research program based upon individual diagnosis, comprehensive...Full Text Available
Chronic pain patients who show aberrant drug-related behavior often are discontinued from treatment when they are noncompliant with their use of opioids for pain. The purpose of this study was...Full Text Available
While research has shown that patients’ beliefs about their pain are related to pain adjustment and treatment outcomes, little is known about the beliefs of their significant others....Full Text Available
Sex differences in pain are frequently reported in the literature. However, less is known about possible sex differences in the experience of pain secondary to a disability. The current study...Full Text Available
In all mammals, tissue inflammation leads to pain and behavioral sensitization to thermal and mechanical stimuli called hyperalgesia. We studied pain mechanisms in the African naked mole-rat, an unusual...Full Text Available
BACKGROUND:Canadian chronic pain prevalence estimates range from 11% to 66%, are affected by sampling and measurement bias, and largely represent urban settings.OBJECTIVES:To...Full Text Available
Chronic neurogenous pain is often an extremely difficult condition to manage. In the orofacial region, trauma from injury or dental procedures may lead to the development of severe neuralgic pains and...Full Text Available
BACKGROUND:Reports indicate that characteristics of older adults with chronic pain may be different than those of younger persons.OBJECTIVE:To study...Full Text Available
ObjectiveTo examine the longitudinal relationship between depressive symptoms at study entry (T1) on pain intensity (PI) and functional disability over a 1-year period...Full Text Available
Even clinicians who keep up with the research literature on pain mechanisms may find themselves uncertain when trying to bring these new theories down to practical application for a patient with pain....Full Text Available
Idiopathic or functional abdominal pain (FAP) is common in school-age children and typically reflects a functional gastrointestinal disorder (FGID). FGIDs in adults have been distinguished by...Full Text Available
Post amputation pain can be debilitating for patients and families. Chronic pain is a common phenomenon after lower extremity amputation, occurring in up to 80% of this population. The purpose of this...Full Text Available
ObjectiveThe purpose of this study is to identify the factors affecting the failure of trials (<50% pain reduction in pain for trial period) to improve success rate of spinal...Full Text Available
For diagnosis of loosening or infection after implantation of a single-side or double-side total hip endoprosthesis 59 patients being in pain were investigated by a combination of bone scan (Technetium-99m DPD) and leucocyte scan (Indium-111 labelled leucocytes). The correlation between clinical results and scintigraphic findings revealed: bone scintigraphy detects loosening of prostheses with 95% sensitivity (45/47); bone scintigraphy excludes an instable prosthesis with 89% specificity (3/27). 45% of the loosened prostheses revealed an infection (21/47): leucocyte scintigraphy could detect 17 correct positive. Three leucocyte scans of 53 prostheses without clinical signs of infection were false positive. Therefore, leucocyte scintigraphy had a sensitivity of 91% and a specificity of 94% for detecting infection. Bone scintigraphy can detect loosening of prostheses with 93% accuracy, Indium-111 labelled leucocyte scintigraphy can detect infection of the prosthesis ...
BackgroundLow back pain (LBP) is the most prevalent musculoskeletal condition and one the most common causes of disability in the developed nations. Anecdotally, there is a general...Full Text Available
BackgroundNonsteroidal anti-inflammatory drugs are commonly used to treat postoperative and chronic pain. Animal studies suggest these drugs act in part by blocking...Full Text Available
Interest and research into the mechanisms and treatment of neuropathic pain have increased during recent years, but current treatment is still far from satisfactory (Dworkin...Full Text Available
BackgroundStump and phantom pains are debilitating sequelae of amputations that are often resistant to treatment. The efficacy of pharmacologic therapies, including...Full Text Available
The family physician dealing with gynecologic pelvic pain (acute or chronic) enters at the beginning of the problem as diagnostician, refers the patient to a specialist in the interim, and resumes...Full Text Available
Cryoanalgesia, the local application of extreme cold to nerves to produce analgesia, has been used to treat patients with intractable perineal pain. The cryoprobe was inserted percutaneously through...Full Text Available
ObjectiveTo describe the prevalence, intensity, and functional impact of the following types of pain associated with upper-limb loss: phantom limb, residual limb,...Full Text Available
An assessment is made of the biological effects and physical hazards of static and time-varying fields associated with the NMR devices that are being used for clinical imaging and in vivo spectroscopy. A summary is given of the current state of knowledge concerning the mechanisms of interaction and the bioeffects of these fields. Additional topics that are discussed include: (1) physical effects on pacemakers and metallic implants such as aneurysm clips, (2) human health studies related to the effects of exposure to nonionizing electromagnetic radiation, and (3) extant guidelines for limiting exposure of patients and medical personnel to the fields produced by NMR devices. On the basis of information available at the present time, it is concluded that the fields associated with the current generation of NMR devices do not pose a significant health risk in themselves. However, rigorous guidelines must be followed to avoid the physical ...
The aim of the study was to determine whether children with chronic benign pain are in contact with their general practitioner (GP) more frequently than those without chronic benign pain. A random sample of children and adolescents aged between 0 and 18 years of age was drawn from the records of ten general practices. According to their responses to a pain questionnaire, subjects were assigned to the chronic benign pain group (n = 95) if they had pain of more than three months' duration, or to the control group (n = 105) if they had pain of less than three months' duration or no pain at all. All the subjects had an average GP consultation rate of 2.6 contacts per year. No significant age and sex differences were found. Chronic benign pain in childhood and adolescence is not related to increased use of healthcare ...
Objective: To develop software for assessment of dose to thyroid gland in emergencies resulting in the release of radioiodine. Methods: Based on procedures for thyroid monitoring and dose assessment introduced in IAEA publications (IAEA-TECDOC-1092 and EPR-MEDICAL-2005), a software was developed with Visual Basic 6.0 program to computerized the methods of thyroid dose estimation. Results: The intake of radioiodine and committed equivalent dose to thyroid could be estimated rapidly and accurately with the present software. Conclusion: The present software provide a practical and rapid tool for estimating thyroid doses received in emergencies resulting in the release of radioiodine by emergency workers and members of public, which is necessary for recommendation of further actions. (authors)
The long-term health consequences of war service remain unclear, despite burgeoning scientific interest. A longitudinal cohort study of a random sample of Australian Vietnam veterans was designed to assess veterans' postwar physical and mental health 36 years after the war (2005-2006) and to examine its relation to Army service, combat, and post-traumatic stress disorder (PTSD) assessed 14 years previously (1990-1993). Prevalences in veterans (n = 450) were compared with those in the Australian general population. Veterans' Army service and data from the first assessments were evaluated using multivariate logistic regression prediction modeling. Veterans' general health and some health risk factors were poorer and medical consultation rates were higher than Australian population expectatio...
Objective To investigate the impact on life quality of women with traumatic and non-traumatic origin fibromyalgia syndrome [FMS]. Method Women affected with FMS were selected and divided into two groups: those with traumatic origin FMS [Group 1] and those with non-traumatic origin FMS [Group 2]. A standard question form was used for the research, as well as the fibromyalgia impact questionnaire [FIQ] for evaluation of life quality. Results Seventy-two patients, 34 for Group 1 and 38 for Group 2 were analyzed. The main triggering symptoms were divorce [23.5 percent of cases] and death in the family [23.5 percent of cases]. In addition to diffuse pain, the main symptoms presented were poor sleep quality, weariness, and paresthesia, with no difference between the groups; migraine had a greate...
The objective of this study was to examine the effect of a nonsteroidal anti-inflammatory drug (NSAID) plaster for knee osteoarthritis among Japanese patients. An open-labeled, randomized, controlled, multiclinic trial was performed involving outpatient clinic groups. Two comparative groups?plaster NSAIDs and oral NSAIDs?were randomly allocated. The drugs used were limited to the current top three in both groups in Japan. Treatments were assessed after four?weeks and compared with the baseline scores. Outcomes were evaluated by two psychometric measures: Japanese knee osteoarthritis measure, and pain with the visual analogue scale. The total number of patients included in the final evaluation was 165 (87 for the plaster group and 78 for the oral group). Between these two groups there were ...
There are no specific diagnostic tests or a gold standard method for measuring disease activity and outcome in spondyloarthropathies (SpA). Many different methods have been developed to assess the signs and symptoms in SpA. The aim of this study was to evaluate the value of scintigraphy, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and Bath Ankilosing Spondylitis Disease Activity Index (BASDAI) in the evaluation of disease activity in early axial SpA diagnosed with magnetic resonance imaging (MRI). Thirty early MRI-positive axial SpA patients (23 males, 7 females) with a median age of 35 (18?55) years and a median duration of inflammatory low back pain of 24 (8?60) months were included in the study. In the patients with sacroiliitis, the sensitivity, specificity, and pos...
Computed Tomography (CT) of the spine was performed on 17 patients with myeloma in order to assess the role of the technique in recognizing and evaluating the extent of the lesions. Myelomatous lesions followed two patterns at CT: first of all, multiple focal lesions, whose density is either solid, liquid, or fatty; second, an extensive pattern involving the spongiosa of the vertebra, including the posterior arch. CT detected more lesions than conventional radiology; furthermore, the extent of the lesions was much better demonstrated by CT. CT should thus be performed: a) in case of pain and/or neurological findings in negative radiological examinations; b) to evaluate the extent of myelomatous lesions (mainly in the spine); c) in solitary myeloma CT may be performed on different bone segments with clinical symptomatology but normal X-ray findings.
National efforts to improve the quality and safety of health care present challenges for medical education and training. Today's doctors need to be skilled communicators who know how to identify, prevent and manage adverse events and near misses, how to use evidence and information, how to work safely in a team, how to practise ethically, and how to be workplace teachers and learners. These competencies (knowledge, skills and attitudes) are set out in the National Patient Safety Education Framework (NPSF) of the Australian Council for Safety and Quality in Health Care. The NPSF is designed to help medical schools, vocational colleges, health organisations and private practitioners develop curricula to enable health professionals to work safely. The NPSF describes what doctors (depending on their level of knowledge and experience) can do to demonstrate competencies in a range of quality and safety activities. Medical ...
Sex differences in pain are frequently reported in the literature. However, less is known about possible sex differences in the experience of pain secondary to a disability. The current study explored these issues in persons with limb loss (n = 335, 72% men) who were recruited as part of a postal survey. Participants provided ratings of phantom limb pain (PLP), residual limb pain (RLP), and general pain intensity. Participants also completed measures of pain-related interference, catastrophizing, coping, and beliefs. Results indicated that a greater proportion of males than females (86% vs 77%, respectively) reported the presence of PLP; however, this difference was no longer prominent when cause of limb loss was controlled. No sex differences were found in the presence of RLP, or in avera...
The language used by chronic benign pain patients to characterize their pain complaint was analyzed to determine the best predictor of psychiatric disturbance. Using the 78 adjectives provided by the McGill Pain Questionnaire, the number of affective descriptors used was the best predictor of psychiatric disturbance. Addition of sensory descriptors either to augment the total number of descriptors used (magnitude) or as a pattern of sensory greater than affective or sensory less than affective failed to increase predictive strength. PMID:6877847
In response to an earlier published paper by Fordyce, some assumptions underlying the behavior management paradigm of chronic pain are critically discussed. While operant treatment has proved successful, the conclusion that operant factors play an important role in the development and maintenance of chronic benign pain is debated. Some empirical studies, regularly used to demonstrate this role, are re-evaluated. An alternative theory is proposed for chronic pain behavior, in which the role of a lower tolerance to proprioceptive stimuli, which may include more than just pain stimuli, is emphasized. PMID:3313200
Abstract Telecare has become an increasingly common medical service in recent years. However, new service must be close to the market and be market-driven to have a high likelihood of success. This article analyzes the business model of a telecardiology service managed by a general hospital. The methodology of the article is as follows: (1) initially it describes the elements of the service based on the ontology of the business model, (2) then it transfers these elements into the choices for business model dynamic loops and examines their validity, and (3) finally provides an empirical financial analysis of the service to assess the profit-making possibilities.
Objectives1. To establish the present capacity and capability across all the sectors within the UK for - a) Undertaking research in the areas of toxicology and ecotoxicology and environmental hazard and risk assessment work on chemical subtances including emerging containments (e.g. enginerred nanomaterials); and b) Applying these skills in the policy and regulatory context. 2) The range of chemicals involved should include pharmaceutical and medical products, crop protection agents, biocides, vet [continued...]DescriptionThe aim of this project is to identify the current status of the scientific community, areas of expertise, and identify the gaps in skills, knowledge or recruitment. The project will use a questionnaire approach to obtain this information for all sectors of the business community. The analysis will identify the gaps in provision, and areas where investment is needed in future training and/or recruitment.
Innovative therapy may appear to coincide with medical experimentation, raising ethical and legal issues, for instance on informed consent and institutional review. Medical treatments may be classified,...Full Text Available
Patients rely on their primary care physician to manage multiple, often chronic medical conditions that require prescription medications. Balancing the risk to benefit of treatments can be challenging...Full Text Available
The aim of this review is to evaluate the role of inflammatory spine disease in patients with chronic back pain. The contribution of imaging modalities for the diagnostic evaluation of back pain is discussed. A systematic literature search based on the classification of seronegative spondyloarthropathies and rheumatoid arthritis was performed. The results of this search and the experiences in a large collective of rheumatological patients are analyzed. The prevalence of rheumatoid arthritis (1-2%) is comparable to that of spondyloarthropathies (1.9%). The etiology of these entities is not fully elucidated. Magnetic resonance imaging is increasingly used for early detection and surveillance of therapy with TNF-{alpha} antagonists. Bone marrow edema, which is only detectable with MRI, represents an early sign of inflammation. Therapy with TNF-{alpha} antagonists is based on clinical and laboratory criteria, and signs of inflammation in MRI. MRI ...
Forty-one patients were treated with epidural neurolysis using 50 % ethyl alcohol 2 ml. Thirty eight patients were suffering from cancer pain and three patients were complaining of chronic benign pain. Alcohol block was repeated 2.3 times (mean) in the same patient. Thirty patients were followed after the treatment. Forty-seven percent of the patients reported 70 % or greater pain relief and 20 % of the patients reported about 50 % pain relief. Duration of pain relief was from 9 days to 203 days with a mean duration of 54 days. Adverse effects were reported 43 % of the patients. There is no miserable adverse effect. Adverse effect reported most was pain with epidural injection of drugs after the alcohol block had been performed. PMID:8544293
"Pillar pain" is a relatively frequent complication after surgical release of the median nerve at the wrist. Its etiology still remains unknown although several studies highlight a neurogenic inflammation as a possible cause. Pillar pain treatment usually includes rest, bracing and physiotherapy, although a significant number of patients still complain of painful symptoms two or even three years after surgery. The aim of this study was to investigate the efficacy of low-energy, flux density-focused extracorporeal shock wave therapy (ESWT) in the treatment of pillar pain. We treated 40 consecutive patients with ESWT who had pillar pain for at least six months after carpal tunnel release surgery, and to our knowledge, this is the first study that describes the use of ESWT for treating this c...
Background and aims. The multiplicity of vaccine injections during childhood leads to iterative painful and stressful experiences which may lead in turn to anticipated pain and then possibly to a true needle phobia. We aimed at evaluating a multifactorial strategy of pain management combining pharmacological and non-pharmacological approaches during vaccination, as compared to usual care, in 4- to 12-year-old children. Methods. In all, 239 children were enroled by 25 family practitioners in an open-label study. After a pseudo-randomization, usual pain management (n = 132) was compared to a multifactorial strategy (n = 107) associating preliminary application of an anesthesic patch, preferential use of specified vaccines, child education by the parents and the doctor, parental accompaniment...
The effect of 50 Hz and 60 Hz (frequencies of current distribution) and 20 kHz to 50 kHz (frequencies of induction cooktop) magnetic interference on implanted pacemakers have been assessed with the present generation of device technology. Sixty patients implanted in 1998 and 1999 with dual chamber pacemakers from 9 different manufacturers were monitored with telemetry while passing through, and standing between a system of two coils. They generated a 50 Hz or a 60 Hz magnetic field at 50 microT. Then, patients used a cooktop at different power. The recordings were made with the standard setting of "medically correct" sensing parameters chosen for the patients. Then pacemakers were reprogrammed to the unipolar mode, with the highest atrial (A) and ventricular (V) sensitivity that did not induce muscular inhibition while moving. Between each exposure (50 Hz, 60 Hz or 20 kHz to 50 kHz), the pacemaker programmation was controlled. At the end of the ...
Purpose: To develop, test, evaluate and implement effective state-of-the-art teacher training in didactic skills and methods. The training concept should be designed and beneficial for medical teachers' postgraduate medical education (CME). Materials and methods: A 5-day workshop with 12 theoretical and 9 'hands-on' modules was designed and stepwise improved, according to the trainees' feedback. All trainees were trained in small groups (6 to 10 participants per workshop). The workshops consisted of mini-lectures, repeated micro teaching exercises and video-supported feedback concerning the following key-competencies: Communication of goals; methods to trigger interactivity; design of slides in power point presentations; effective feedback-techniques; and use of media, time-management, skills teaching, assessment methods (e.g. OSCE and others), evaluation and general presentation skills. The evaluation was based on two ...
To assess the efficacy and resulting complications of tetracycline sclerotherapy in renal, hepatic, ovarian, and perivesical cysts. We retrospectively reviewed 23 cases of benign cysts (16 renal, 4 hepatic, 2 ovarian, and 1 perivesical) in 22 patients in whom the condition was diagnosed or confirmed by either ultrasound, CT, or cytology, and who underwent percutaneous tetracycline sclerotherapy. Using a 21-gauge Chiba needle, the target cyst was punctured under ultrasound guidance. Prior to the injection of 1500 mg of tetracycline diluted in 5 ml of normal saline, almost all the cystic content was aspirated, and at the end of the procedure the tetracycline was left in the cyst. During a period of between 3 and 22 months, 18 of the 23 cases were followed up. In six of the 18 cases followed up, the cysts either decreased in size by 10%, or collapsed completely. In seven cases a collapse of over 50% was noted, and in the remaining five the cyst recurred. In one of ...
The authors assess the role of Computed Topography in the diagnosis and management of multiple myeloma (MM) and investigate if Computed Tomography findings can influence the clinical approach, prognosis and treatment. 273 multiple myeloma patients submitted to Computed Tomography June 1994, to December, 1996. The patients were 143 men and 130 women (mean age: 65 years): 143 were stage I, 38 stage II and 92 stage III according to Durie and Salomon's clinical classification. All patients were submitted to blood tests, spinal radiography and Computed Tomography, the latter with serial 5-mm scans on several vertebral bodies. Computed Tomography despicted vertebral arch and process involvement in 3 cases with the vertebral pedicle sign. Moreover, Computed Tomography proved superior to radiography in showing the spread of myelomatous masses into the soft tissues in a case with solitary permeative lesion in the left public bone, which facilitated subsequent biopsy. As for ...
Presented here is a case of a young woman, with an undiagnosed osteoid osteoma of the spine, which presented with painful scoliosis in adolescence and was treated by bracing until her accession to adulthood....Full Text Available
BackgroundAnterior knee pain (AKP) is a common musculoskeletal complaint. It has been suggested that one factor that may contribute to the presence of AKP is a delay in the recruitment...Full Text Available
Shoulder pain is a common orthopedic condition seen by physical therapists, with many potential contributing factors and proposed treatments. Although manual physical therapy interventions for the cervicothoracic...Full Text Available
A retrospective study is presented of 83 athletes with tendo Achillis pain (TAP) treated conservatively over a 12-year period from 1976 to 1988. Local steroid injections did not contribute to an earlier...Full Text Available
BackgroundPatients’ general tendency to adhere to health care provider-recommended treatments is associated with a number of health outcomes, but whether it influences pain...Full Text Available
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 development of central neuropathic pain varies among patients with spinal cord injury (SCI). The factors contributing to the development and perpetuation of segmental pain (at-level allodynia)...Full Text Available
BackgroundSeverely disabling chronic pain in the adult population is strongly associated with a range of negative health consequences for individuals and high health care costs,...Full Text Available
Previous studies in several different trigeminal nerve injury/inflammation models indicated that the hyperexcitability of primary afferent neurons contributes to the pain pathway underlying mechanical...Full Text Available
BackgroundControversy exists about how to effectively measure patient reported outcomes in IBS clinical trials. Pain numeric rating scales (NRS) are widely used in...Full Text Available
The frozen shoulder is a common cause of shoulder pain and disability. Most patients slowly improve over 12 to 24 months. Some have prolonged loss of movement, pain, and associated disability. Treatments...Full Text Available
Lumbar epidural anesthesia is useful in a variety of chronic benign pain syndromes, including lumbar radiculopathy, low back pain syndrome, spinal stenosis, and vertebral compression fractures. Given...Full Text Available
BackgroundNeuropathic pain (NP) is partially mediated by neuroinflammatory mechanisms, and also modulates local neurogenic inflammation. Dietary lipids, in particular the total amount...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
BackgroundUntil now only limited research has been done on the prevalence of chronic pain in primary care. The aim of this investigation was to study the health care utilisation...Full Text Available
ObjectivePersons with chronic or recurrent pain frequently visit the emergency department (ED), yet little research examines this experience. We conducted this national survey to...Full Text Available
Approximately 20% to 30% of patients who undergo coronary arteriography for the evaluation of chest pain are found to have normal coronary arteries. These patients have a survival rate comparable to...Full Text Available
BackgroundChronic non-specific musculoskeletal pain (CNSMSP) may develop in childhood and adolescence, leading to disability and reduced quality of life that continues into adulthood....Full Text Available
Functional imaging has revolutionized the neurosciences. In the pain field it has dramatically altered our understanding of how the brain undergoes significant functional, anatomical and chemical changes...Full Text Available
The aim of this study was to investigate whether astroglia in the medullary dorsal horn (trigeminal spinal subnucleus caudalis; Vc) may be involved in orofacial neuropathic pain following trigeminal...Full Text Available
ContextWhile opioids are increasingly used for chronic non-cancer pain (CNCP), we know little about opioid dosing patterns among individuals with CNCP in usual care...Full Text Available
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 clinical practice, and for evaluating bedside auscultation skills. When simulating cardiovascular or pulmonary problems, high-quality lung and heart sounds ...
In the last 40 years, significant advances have been made in the understanding of the neurophysiologic processes involved in the experience of trauma and pain. This knowledge, together with the rapid growth and understanding in the behavioral health sciences, has expanded to include a much better appreciation of how these fields are converging and contribute to a process called neuroplasticity. These basic mechanisms common to all patients have important implications for clinical outcome and for improving clinical practice. This article is written for clinicians who manage patients with sacroiliac joint dysfunction, a specific type of nonspecific low back pain.
BackgroundAδ and C fibers are the major pain-conducting nerve fibers, activate only partly the same brain areas, and are differently involved in pain syndromes....Full Text Available
The purpose of this study was to evaluate the safety and efficacy of TACE with microspheres preloaded with doxorubicin in unresectable intrahepatic cholangiocarcinoma (UCH). Twenty patients with UCH were observed; 9 refused, preferring other palliative care or chemotherapy, and 11 agreed to be treated with one or more cycles of DC beads loaded with doxorubicin (100-150 mg) in a TACE procedure between February 2006 and September 2007. A total of 29 individual TACE procedures were performed. Follow-up imaging was performed on all patients before, immediately after, and 4 weeks after each TACE procedure to evaluate the response and need for further treatment. Each patient received i.v hydration, antibiotics, and medications against nausea and pain before TACE. Survival rate was calculated using Kaplan-Meier survival curve. A response rate of 100% followed RECIST criteria was observed. Eight of eleven patients are alive, with a median survival of ...
A population of female civil servants in Rome, Italy, was investigated to determine the prevalence of symptomatic and asymptomatic gallstone disease and to define the associated factors. Field activities started in February 1981 and concluded in April 1982. Diagnosis was assessed by real time ultrasonography. Prevalence of gallstone disease increased with age from 2.5% in the 20- to 29-year-old age group to 25.0% in the 60- to 64-year-old age group, based on both presence of gallstones and history of cholecystectomy. Only one third of the women with gallstones had complained of at least one episode of biliary pain in the last five years. Frequency of "minor" dyspeptic symptoms was not different between women with and those without gallstones. In a multiple logistic function analysis, a positive association was found between age, body mass index, parity, and prevalence of gallstone disease. No association was demonstrated between the presence of ...
Study Design Best evidence synthesis. Objective To undertake a best evidence synthesis of the published evidence on the burden and determinants of neck pain and its associated disorders in the general population. Summary of Background Data The evidence on burden and determinants of neck has not previously been summarized. Methods The Bone and Joint Decade 2000?2010 Task Force on Neck Pain and Its Associated Disorders performed a systematic search and critical review of literature published between 1980 and 2006 to assemble the best evidence on neck pain. Studies meeting criteria for scientific validity were included in a best evidence synthesis. Results We identified 469 studies on burden and determinants of neck pain, and judged 249 to be scientifically admissible; 101 articles related to...
Psychological distress and postamputation pain were investigated in a sample of 582 males with long-term limb amputations (mean time since amputation 639.3 months, standard deviation 166.1; range 240-784 months). Prevalence of significant depressive symptoms (Hospital Anxiety and Depression Scale [HADS]-D score?8) was 32.0%, and 34.0% of respondents met the screening criterion for clinical anxiety (HADS-A score?8). Nearly one quarter (24.6%) of respondents reported significant post-traumatic psychological stress symptoms (Impact of Event Scale scores?35). In total, 87.8% experienced either phantom or residual limb pain. Affective distress scores differed according to the respondents' type of pain experience. Respondents who experienced residual limb pain reported significantly hig...
Environmental scanning electron microscopy (ESEM) allows the examination of hydrated and dried specimens without a conductive metal coating which could be advantageous in the imaging of biological and medical objects. The aim of this study was to assess the performance and benefits of wet-mode and low vacuum ESEM in comparison to high vacuum scanning electron microscopy (SEM) using the choroid plexus of chicken embryos as a model, an organ of the brain involved in the formation of cerebrospinal fluid in vertebrates. Specimens were fixed with or without heavy metals and examined directly or after critical point drying with or without metal coating. For wet mode ESEM freshly excised specimens without any pre-treatment were also examined. Conventional high vacuum SEM revealed the characterist...
An expert system was developed which helps maintenance personnel diagnose the condition of rotor and stator windings and their cores, in motors and generators rated 2300 V and above. The expert system, called MICAA[TM], used an approach which has been found to be effective for diagnosing medical problems. The program required the user to input machine nameplate information, operating status, and any past test data available. In addition, the program would suggest tests that may be useful, as well as provide guidance to maintenance personnel on what to look for in visual inspections of the machine. The expert system stored and correlated all this information, calculated the overall condition of the component in question, and identified the most likely specific causes of any deterioration. The basic methodology of motor and generator condition assessment, and the architecture and processing performed by MICAA to obtain these capabilities were ...
Water?rock interaction is one of the prime factors affecting the fluoride contents of surface and groundwater. If fluoride concentration of drinking water has been neglected, excess fluoride can cause serious dental and medical problems on human health, which is well known at Golcuk-Isparta region. In the research area, Egirdir lake, Golcuk lake and surrounding springs have been utilized as drinking water sources. Golcuk lake water and surrounding groundwaters have high fluoride content (1.4?4.6?mg/l), which is above the WHO standards. Fluoride is predominantly supplied by dissolution of fluoride within the fluormicas of volcanics during the circulation of water. Fluoride concentrations of waters have shown variations for dry and rainy seasons depending on the degree of interaction between...
Summary Objective- Gamma-glutamyltransferase (GGT) has been reported to be useful in predicting cardiovascular disease. Arterial stiffness measured by brachial-ankle pulse wave velocity (baPWV) is not only a marker of vascular damage but a significant predictor of cardiovascular events. Gender difference has been reported in the association between GGT and baPWV. We assessed, therefore, the association between GGT and baPWV in a large population and determined whether there was gender difference. Design- This cross-sectional study was conducted at the Asan Medical Centre, Seoul, Republic of Korea. Subjects and measurements- Serum GGT, baPWV and conventional risk factors were measured in 10 988 apparently healthy subjects (7248 men, 3740 women) who participated in a routine health screening...
Deltombe T, Gustin T. Selective tibial neurotomy in the treatment of spastic equinovarus foot in hemiplegic patients: a 2-year longitudinal follow-up of 30 cases. Objective To assess the long-term efficacy of selective tibial neurotomy in the treatment of spastic equinovarus foot in hemiplegic patients. Design Intervention study (before-after trial) with an observational design and 2-year follow-up. Setting Spasticity group in a university hospital. Participants Hemiplegic patients (N=30) with spastic equinovarus foot. Intervention A selective neurotomy was performed at the level of the motor nerve branches of the tibial nerve. Main Outcome Measures Spasticity (Ashworth scale), muscle strength (Medical Research Council scale), passive ankle dorsiflexion, gait parameters (6 min walking test...
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...
Background: Incidence, characteristics and predictive factors of transient ST-segment changes after DC shock are poorly known. Methods: 91 consecutive pts referred for external cardioversion of atrial fibrillation (AF) (61 men, 69+/-10yo) were prospectively included. The presence of ST elevation or depression was assessed on 12 lead-ECG immediately after the first DC shock. Correlations with DC shock characteristics (monophasic/biphasic and energy), clinical variables, echocardiographic parameters, biological parameters, medications, anesthesic drugs as well with morphological features were made. Results: 18 and 20 pts underwent 200J or 300J monophasic and 53 pts 200J biphasic DC shocks. We found an incidence of 48% for ST-segment changes: 35% for ST elevation and 13% for ST depression. ST...
Abstract The aim was to utilize data from a study of occupational indoor environments to analyze symptoms and physiological signs in relation to the home environment. A medical investigation was performed at the workplace among university staff (n = 173) from four university buildings in Bergen, in March 2004. Tear film break up time (BUT) was measured by two methods. Nasal patency was measured by acoustic rhinometry. Nasal lavage fluid analysis (NAL) included eosinophilic cationic protein (ECP); myeloperoxidase (MPO), lysozyme and albumin. Atopy was assessed by total serum IgE and specific IgE (Phadiatop). Totally 21%, 21%, 18%, 11%, and 27% had weekly ocular, nasal, facial dermal symptoms, headache and tiredness, respectively, 15% had a damp dwelling, and 20% had a cat or dog. Multiple l...
A 2-year-old, female spayed, domestic shorthair cat presented to the University of Missouri-Veterinary Medical Teaching Hospital (UMC-VMTH) with an approximately 11-month history of fluid-draining pockets along her ventral thorax and axillae. The skin in these regions was erythematous, and multiple areas drained a serous to serosanguinous fluid. Fluid-filled, nodules formed along the ventrum, but these nodules disappeared as fluid drained spontaneously. Histologic assessment of skin biopsies revealed areas of vascular proliferation extending along the deep margin of the section and rare instances of invasion into the superficial dermis. These vascular channels were devoid of cells, lined by variably pleomorphic endothelial cells which had a low mitotic index. Based on the mild to moderate ...
Objectives Our purpose was to evaluate interaction of green tea consumption and abdominal obesity as related factors for lacunar infarction in Korean women. Designs A hospital-based, incident case-control study. Settings The Prevention and Managements of Stroke in Women study. Participants Cases (n=233) of first incident lacunar infarction were enrolled and matched by age to stroke-free hospital controls (n=204). Measurements The data were collected through face-to-face interviews by well trained research assistants to assess demographic, medical, lifestyle, marital status, religions status, green tea consumptions, family history of stroke, smoking status, alcohol consumption, meat and vegetable intake frequency, and past history of hypertension. Biochemical analysis, fasting blood specime...
The objective of this study was to evaluate the association between the number of blood cultures collected and the appropriateness of care for suspected bacteremic community-acquired urinary tract infection (UTI) in the elderly. We retrospectively evaluated the medical records of 129 patients with UTI >65?years old admitted to a large community-based training hospital in Japan from 1 January 2006 to 31 December 2009. We assessed the association between the number of blood cultures collected and the appropriateness of care received, as well as other factors. Two-thirds of the patients were women, and patients >85?years old accounted for 45.0% of the cases. Most of the organisms isolated from the urine and blood were Escherichia coli (65.4?67.0%). More than two blood cultures were collected ...
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 ...
In the process of forming a new medical malpractice reinsurance company, the authors analyzed thousands of medical malpractice cases, settlements, and verdicts. The evidence of those analyses indicated...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
Nearly every drug may cause changes to ocular tissues through a variety of mechanisms. Medication overdoses, drug–drug interactions but also chronic administration of medications at...Full Text Available
In 18 months the Canadian Medical Discoveries Fund (CMDF) has attracted investments worth $180 million to spend on biotechnology and medical research. Although eight initial investments totalled only...Full Text Available
PurposePrevious studies suggest that some common medications alter prostate-specific antigen (PSA) levels. It remains unclear whether these reported medication effects are due to...Full Text Available
ObjectiveWhile essential for patient care, information related to medication is often written as free text in clinical records and, therefore, difficult to use in computerized systems....Full Text Available
BACKGROUND. Diabetes can be effectively treated and monitored in general practice. Postgraduate medical education at a local level is required to support this strategic shift of medical care from hospital...Full Text Available
Purpose: To assess the relationship between large intracranial vessel occlusive vasculopathy (vasculopathy) and radiation therapy, and to clarify the clinical efficacy of magnetic resonance (MR) imaging in the diagnosis and screening of the vasculopathy. Methods and Materials: We retrospectively evaluated the medical records and serial MR images for 32 pediatric patients, in whom radiation therapy had been given to fields including the circle of Willis and major cerebral arteries. All children had periodically undergone follow-up neurologic assessment and MR imaging examinations at Kanagawa Children's Medical Center for more than one year after radiation therapy (range 1.3-14 years). Patients who had not remained free of tumor progression up to the time of final evaluation were excluded. Results: Vasculopathy developed in 6 of 32 patients 2-13 years after radiation therapy. Three of them presented with ...
BackgroundNatural disasters result in significant numbers of disabling impairments. Paradoxically, however, the traditional health system response to natural disasters largely neglects health-related rehabilitation as a strategic intervention.ObjectivesTo examine the role of health-related rehabilitation in natural disaster relief along three lines of inquiry: (1) epidemiology of injury and disability, (2) impact on health and rehabilitation systems, and (3) the assessment and measurement of disability.DesignQualitative literature review and secondary data analysis.ResultsAbsolute numbers of injuries as well as injury to death ratios in natural disasters have increased significantly over the last 40 years. Major impairments requiring health-related rehabilitation include amputations, traumatic brain injuries, spinal cord injuries (SCI), and long bone fractures. Studies show that persons with pre-existing disabilities are more likely to die in a natural disaster. ...
In this article, transhumanism is considered to be a quasi‐medical ideology that seeks to promote a variety of therapeutic and human‐enhancing aims. Moderate conceptions are distinguished...Full Text Available
... Harbor Township Vineland Voorhees Pediatric Partner Hospitals AtlantiCare Regional Medical Center- City Campus, Atlantic City AtlantiCare Regional Medical Center - ...
BackgroundAs long-term nursing home care is likely to increase with the aging of the population, identifying chronic medical conditions is of particular interest. Although need factors...Full Text Available
... an endocrinologist here and am part of the Diabetes and Endocrinology Associates here at Shawnee Mission Medical ... also an endocrinologist and a member of the Diabetes and Endocrinology Associates here at Shawnee Mission Medical ...
MD, Chief, Division of Endocrinology, Diabetes and Metabolism, Trinitas Regional Medical Center, Elizabeth, NJ. Review provided by VeriMed Healthcare Network. Also reviewed...
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
SummaryNineteenth-century Vienna is well known to medical historians as a leading centre of medical research and education, offering easy access to patients and corpses to students...Full Text Available
The organizational structure of medical record departments in Iran is not appropriate for the efficient management of healthcare information. In addition, there is no strong information management division...Full Text Available
Postamputation pain (PAP) affects over 60% of major limb amputees. One of the main challenges in treating PAP is the difficulty involved in identifying pain mechanism(s), which pertains to both residual limb pain (RLP) and phantom limb pain (PLP). In this study, sympathetic blocks were performed on 17 major limb amputees refractory to treatment, including 2 placebo-controlled blocks done for bilateral amputations. One hour postinjection, mean RLP scores at rest declined from 5.2 (SD 2.8) to 2.8 (SD 2.6) (P = .0002), and PLP decreased from 5.3 (SD 3.1) to 2.3 (SD 2.1) (P = .0009). By 1 week, mean pain scores for RLP and PLP were 4.3 (SD 2.9) and 4.2 (SD 3.0), respectively. Overall, 8 of 16 (50%) patients experienced ?50% reduction in RLP 1-hour postinjection, with the beneficial effects ...
The utilization of nuclear medicine bone scanning examinations early in the diagnostic process allows physicians to render prompt and correct treatment in urgent or difficult athletic cases. Bone scanning should be performed for athletic injuries whenever (1) x-rays are normal but bone or joint pain persists; (2) x-rays are positive but it cannot be determined if the findings are acute or chronic; (3) soft-tissue injuries present and x-rays are not useful; and (4) bone pain or joint impairment present without a history of trauma.89 references.
Objective: The aim of this study was to obtain an overview of the methodological quality of studies on the measurement properties of neck pain and disability questionnaires and to describe how well various aspects of the design and statistical analyses of studies on measurement properties are performed. Methods: A systematic review was performed of published studies on the measurement properties of neck pain and disability questionnaires. Two reviewers independently rated the quality of the studies using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. This checklist was developed in an international Delphi consensus study. Results: A total of 47 articles were included on the measurement properties of 8 different questionnaires. The meth...
Back pain from osteoporosis is commonly related to compression fractures. The patient with vertebral compression fractures additionally suffers from an ongoing risk of recurrent fractures and postural abnormalities that can result in impaired respiratory function, leading to increased risk of morbidity. Weakened back muscles, especially the back extensor group, are felt to contribute significantly to this risk. The combination of pharmacologic and nonpharmacologic interventions, through physical activity, exercise, and modalities, are potential interventions that could be used to help reduce the pain of osteoporotic compression fractures as well as potentially reducing recurrent fracture rates.
To determine the demographics, imaging findings, clinical symptoms, and prognosis of primary vertebral Ewing's sarcoma (PVES). A retrospective review of medical records and radiological studies of patients diagnosed with PVES from 1936 through 2001 in our institution and Department of Pathology consultation files was undertaken. Metastatic and soft tissue Ewing's sarcoma cases were excluded. From a total of 1,277 cases of Ewing's sarcoma, 125 (9.8%) had a primary vertebral origin. There were 48 females and 76 males. Patient ages ranged from 4 to 54 (mean 19.3, standard deviation 10.7, median 16) years. Vertebral column distribution was four cervical (3.2%), 13 thoracic (10.5%), 31 lumbar (25%), and 67 sacrum (53.2%). More than one vertebral segment was involved in ten cases (8%). Satisfactory imaging studies were available in 51 patients: 49 radiographs, 27 computerized tomography (CT), and 23 magnetic resonance imaging (MRI) studies. The majority of tumors were ...
A new method of administration of an opioid was recently registered: fentanyl transdermal (brand name: Durogesic), intended particularly for the indication range 'pain in cancer'. Fentanyl is lipid-soluble so that deposition in the skin takes place and the biological half-life is approximately 20 hours after removal of the plaster. It is safe to start on a basis of an equianalgesic conversion of 100:1 in relation to oral morphine, although this may entail some risk of fentanyl under dosage. The dose adjustment time is 12-24 hours before a constant fentanyl level is reached; therefore, after attaching the first sticking plaster, the original morphine dose should be continued for another 12 hours. In addition, the patient may, if necessary, be given supplementary morphine preferably as a short-acting drug. There seems to be no clear indication for transdermal fentanyl either in neuropathic pain or in chronic benign pain. ...
Dengue, a major public health problem throughout subtropical and tropical regions, is an acute infectious disease characterized by biphasic fever, headache, pain in various parts of the body, prostration,...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
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
Opinion statementCritical limb ischemia (CLI), defined as chronic ischemic rest pain, ulcers, or gangrene attributable to objectively proven arterial occlusive disease, is the most advanced...Full Text Available
The antinociceptive effects of honokiol and magnolol, two major bioactive constituents of the bark of Magnolia officinalis, were investigated on animal paw licking responses and thermal...Full Text Available
OBJECTIVE: To evaluate the interobserver agreement of ultrasonographic assessment of finger and toe joints in patients with rheumatoid arthritis (RA) by 2 investigators with different medical backgrounds. METHODS: Ultrasonography and clinical examination were performed on 150 small joints of 30 patients with active RA. A General Electric LOGIQ 500 ultrasound unit with a 7-13-MHz linear array transducer was used. In each patient, 5 preselected small joints (second and third metacarpophalangeal, second proximal interphalangeal, first and second metatarsophalangeal) were examined independently on the same day by 2 ultrasound investigators (an experienced musculoskeletal radiologist and a rheumatologist with limited ultrasound training). Joint effusion, synovial thickening, bone erosions, and power Doppler signal were evaluated in accordance with an introduced 4-grade semiquantitative scoring system, on which the investigators had reached consensus ...
The Health Physics, Safety and Medical Services Report for Harwell Laboratory for 1989 includes data on the monitoring of the working environment, personnel monitoring, radiological incidents, disposal of radioactive waste and protection of the public. Work on emergency planning, non-radiological health and safety, occupational hygiene, operations support is also discussed. Finally the medical services available and the medical examinations performed are described. (UK).
BackgroundGeneralized anxiety disorder (GAD) is the most frequent anxiety disorder in primary care patients. It is known that painful physical symptoms (PPS) are associated with...Full Text Available
1. Ro 15-8081 (Hoffmann-La Roche, Basle, Switzerland) is a novel mixed 5-HT/noradrenaline uptake inhibitor producing potent antinociceptive effects in animal pain models. 2. In healthy man, two models...Full Text Available
Radiotherapy recent development in cancer treatment needs strong procedures and quality assessment to improve safety both for patients and professionals. In Ile de France territory, a coordinated action between ASN inspectors and medical doctors specialized in public health (MISP), working as civil servants in health administration, was initiated at the end of 2007. An inspection guideline was implemented in a workshop between ASN and Regional Hospital Agency (ARH). The MISP as health administrator has to verify if care organisation responds to treatment cancer regulatory framework: as a doctor he is authorized to access to patient records to know which treatment was chosen. He has to assure if the therapeutic guidelines are respected. His comprehensive approach is essentially patient-oriented. The MISP inspection coordinated with ASN inspectors is a very pertinent pluri-disciplinary approach, undeniably necessary in such a ...
Radiotherapy recent development in cancer treatment needs strong procedures and quality assessment to improve safety both for patients and professionals. In Ile de France territory, a coordinated action between ASN inspectors and medical doctors specialized in public health (MISP), working as civil servants in health administration, was initiated at the end of 2007. An inspection guideline was implemented in a workshop between ASN and Regional Hospital Agency (ARH). The MISP as health administrator has to verify if care organisation responds to treatment cancer regulatory framework: as a doctor he is authorized to access to patient records to know which treatment was chosen. He has to assure if the therapeutic guidelines are respected. His comprehensive approach is essentially patient-oriented. The MISP inspection coordinated with ASN inspectors is a very pertinent pluri-disciplinary approach, undeniably necessary in such a ...
Morphine sulfate (MS Contin), a proven analgesic in the treatment of cancer pain and chronic benign pain, seems to be a good analgesic for the treatment of burn pain. MS Contin is morphine sulfate incorporated in a wax cellulose matrix delivery system. This wax cellulose delivery system gives MS Contin its duration of action. Ten patients were enrolled in an open-labeled, nonrandomized study. The study was designed to examine the analgesic efficacy of MS Contin in the burn population. Each patient remained in the study for 6 days. The efficacy of the analgesic regimen was subjectively measured by the visual pain scale. The MS Contin group was retrospectively compared with a group of patients who were given continuous intravenous infusions of morphine. The two groups were matched according to age, burn size, surgical procedures, and hospital stay. The analgesic qualities of MS Contin were comparable to ...
Purpose. To evaluate injection-associated pain, safety, and efficacy with the isotonic contrast medium iodixanol (Visipaque 270 mg I/ml) compared with iopromide (Ultravist 300 mg I/ml) in femoral arteriography. Methods. A multicenter, double-blind, randomized, parallel-group clinical investigation was carried out in 54 hospitals in Europe. Of the patients evaluated, 1225 received iodixanol and 1227 iopromide in conventional and/or digital subtraction angiography. Results. The iodixanol group reported statistically significantly less injection-associated pain (0.9%) than the iopromide group (9.5%) (p<0.001). Further, 4.1% in the iodixanol group experienced pain and/or severe heat sensation vs 19.8% in the iopromide group (p<0.001). In the iodixanol group, 1.8% of the patients experienced contrast-related adverse events vs 2.4% in the iopromide group (p=NS). Overall diagnostic information was optimal for 94.1% in the ...
Studies of the effectiveness of operant, relaxation, cognitive, and multimodal behavioural approaches to the treatment of chronic benign pain other than headache were evaluated. In general, the quality of the studies was poor, and most investigations lacked appropriate and adequate control conditions, outcome measures, and/or follow-ups. While outcome reports for all four behavioural treatments have been mainly positive, few data were found which conclusively demonstrate that any of the approaches are effective or that they are the treatment of choice. The data do, however, imply that behavioural approaches may help patients lead more normal and productive lives. Specifically, the literature suggests that: (1) the operant method leads to increased activity levels and decreased pain and drug intake, (2) the relaxation approach results in decreased EMG levels and some pain reductions, (3) the cognitive techniques are ...
Purpose We assess the outcome in 46,XX men with congenital adrenal hyperplasia who were born with Prader 4 or 5 genitalia and assigned male gender at birth. Materials and Methods After receiving institutional review board approval and subject consent we reviewed the medical records of 12 men 35 to 69 years old with 46,XX congenital adrenal hyperplasia, of whom 6 completed social and gender issue questionnaires. Results All subjects were assigned male gender at birth, were diagnosed with virilizing congenital adrenal hyperplasia at age greater than 3 years and indicated a male gender identity with sexual orientation to females. Ten of the 12 subjects had always lived as male and 2 who were reassigned to female gender in childhood subsequently self-reassigned as male. Nine of the 12 men had ...
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 ...
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 and present ...
The genetically significant dose (GSD) is an index variable which exclusively allows to describe the genetic risk in the progeny of a population due to the application of ionizing radiation and radioactive substances in one part of this population. It may result in wrong interpretation of population exposure at increasing incidence of examinations in a population involving ionizing radiation and radioactive drugs at simultaneously increasing application of alternative methods in children and adolescents owing to the fact that it indicates a downward trend although somatic exposure of this population has increased. Therefore, it is recommended to state both the GSD and the level of somatic radiation exposure of the population taken from the individual sources for the comparison and assessment of radiation exposure from various sources in future. Although the somatically significant dose constitutes the suitable variable complementary to GSD in thus context, it is ...
The paper investigates the functional endoscopic sinus surgery with the Messer-linger's technique which treats benign or inflammatory diseases of paranasal sinuses resistant to medical therapy. The goal of this type of surgery is to open the obstructed sinus ostia and restore normal aeration and mucociliary clearance. The computerized tomography permits an accurate assessment of extension and results of functional endoscopic sinus surgery. [Italian] L'articolo discute l'uso della tecnica di Messerklinger nella chirurgia funzionale endoscopica dei seni paranasali per il trattamento delle malattie benigne e delle infiammazioni croniche. Essa disostruisce gli osti sinusali ripristinando la normale areazione e la pulizia mucociliare. La tomografia computerizzata consente di valutare l'estensione e i risultati del trattamento chirurgico funzionale, soprattutto nel caso di insuccesso terapeutico, rilevando malattia ...
To establish test specific normal limits for quantitative analysis of uptake and washout of /sup 201/Tl after dipyridamole infusion combined with low level exercise, 20 healthy volunteers were studied with low likelihood of coronary artery disease (CAD) assessed by a stepwise probability analysis based on age, sex, symptoms, resting electrocardiogram, and exercise electrocardiography. Likelihood of CAD in these volunteers was calculated as less than or equal to 1%. After dipyridamole infusion combined with low level exercise, one volunteer complained of headache; no other side effects were observed. There were no chest pain complaints. Maximal hemodynamic changes were achieved during the 6th and 7th min of the test. No ST segment depression was recorded. Visual analysis of the /sup 201/Tl scintigrams was normal in all volunteers. Mean regional washout at 4 h was 44.37%+-2.11%. The regional washout in the 70/sup 0/ LAO view (46.65%+-1.10%) was ...
Objective: To assess dynamic MRI with Gd-DTPA enhancement for evaluating inflammatory changes in the subacromial bursa. Design and patients: We detected the signal intensity changes in dynamic MRI of the subacromial bursa, and confirmed these macroscopically by arthroscopy and histologically. The signal intensity was measured using built-in software, and the enhancement ratio (E ratio) was calculated from dynamic MR images. In addition, as a parameter of the rate of the increase in the signal intensity from 0 to 80 s, the mean increase per second in the E ratio was obtained as the coefficient of enhancement (CE). The correlation was studied of the E ratio and CE with the arthroscopic findings (redness, villous formation, thickening and adhesion), and of the E ratio and CE with the histological findings (capillary proliferation, papillary hyperplasia, fibrosis and inflammatory cell infiltration) of the subacromial bursa. Of patients with shoulder ...
Knee osteoarthritis (OA) is a common degenerative joint disorder and a major cause of pain and disability. The hypothesis tested in this study was that the passion fruit peel extract (PFP), a flavonoid-rich dietary supplement, would reduce symptoms due to knee OA. Thirty-three OA patients were enrolled in a randomized, double-blind, placebo-controlled trial with parallel-group design. Patients received either placebo or PFP pills (150 mg, daily) in a double-blinded fashion for 2 months. The OA clinical symptoms were evaluated monthly with Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index. In the PFP group, there was a significant improvement in total WOMAC score and WOMAC subscale score of physical function after 30 days and pain after 60 days. At 60 days, reductions o...
... be able to watch the many intricate steps Dr. Richard Alexander must accomplish to remove the cancer. ... door to informed medical care. Now let's join Dr. Richard Alexander at the University of Maryland Medical ...
The study examines the question of whether or not civilian marketing practices and principles can be applied in the military care setting. Using the NRMC Great Lakes as a basis, the answer is yes--consumers of military medical care are ready to be the rec...
This paper describes how a computerized MIS is used to assist HMO management to conduct utilization and quality of care review activities in a prepaid medical care network. The HMO is a ‘network’...Full Text Available
What do we mean when we say that a mental condition is a medical disorder rather than a normal form of human suffering or a problem in living? The status of psychiatry as a medical discipline depends...Full Text Available
By analyzing the data of 459 patients who completed the Supportive Care Needs Survey (SCNS), the prevalence, medical and non-medical predictors of unmet needs were investigated. Breast cancer patients...Full Text Available
As the Medical Library Association (MLA) enters its second century, its role in providing leadership and focus for the education of health information professionals in a changing environment will be...Full Text Available
Patient-centered interdisciplinary health care for children with chronic medical disorders represents an evolution from the traditional “stop and go” treatment for acute illnesses. This...Full Text Available
There is a pressing need for medical graduates to be fully prepared to take on the responsibilities of prescribing and to be able to respond to continual inevitable rapid changes in therapeutics. The...Full Text Available
A theoretical framework centering on four classes of self-referent constructs is offered as a device for integrating the diverse areas constituting medical sociology. Guidance by this framework...Full Text Available
OJECTIVEThis study seeks to identify practices of self-medication in the treatment of ocular emergencies. We examine patients’ use of both homemade preparations and manufactured...Full Text Available
ObjectiveComputerized physician order entry with clinical decision support has been shown to improve medication safety in adult inpatients, but few data are available regarding its...Full Text Available
The paper demonstrates several ways that medical language processing can be combined with emerging display technologies to facilitate the extraction of data from free-text patient documents. The techniques...Full Text Available
The strong value in American medical practice placed on the disclosure of terminal illness conflicts with the cultural beliefs of many recent refugees and immigrants to the United States, who often...Full Text Available
In the information age, information utilities like libraries are as sensitive to the stresses of change as any other organization. This article is a case study of a small, specialized medical library...Full Text Available
BackgroundEstablishing an evidence-based method of improving knowledge and attitudes concerning depression has been identified as a priority in Chinese medical education. The purpose...Full Text Available
PURPOSE This study was designed to evaluate the impact of electronic medical record (EMR) implementation on quality of diabetes care.METHODS We conducted a 5-year longitudinal...Full Text Available
Few data exist about the impact of computerized prescribing systems on outpatient medication errors (MEs) and adverse drug events (ADEs). We compared the rates of MEs and ADEs in handwritten sites versus...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
... different personal wellness goals for you. HIV Health Management With a good medical team and a desire to reach wellness goals , people with HIV can have a virtually normal lifespan. Take the HIV Wellness Quiz Test your knowledge and find out where you need to learn ...
The development of the Multimedia Electronic Medical Record System (MEMRS) promises new opportunities to significantly reduce the routine use of film as the medium for viewing radiological medical images....Full Text Available
BackgroundProfessionalism is a difficult construct to define in medical students but aspects of this concept may be important in predicting the risk of postgraduate misconduct. For...Full Text Available
It is usually very complex to design an Integrated Information System in a hospital that includes both in-patient and out-patient medical care data. The difficulty appears because each department...Full Text Available
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
BackgroundThe purpose of the study was to compare the knowledge scores of medical students in Problem-based Learning and traditional curriculum on public health topics.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 mass casualty situation, medical personnel at the disaster site and other field treatment settings may need to monitor the vital signs of hundreds of seriously injured patients with minimal staffing....Full Text Available
Realization of Pharmacological Tests, Development of the Specifications and Technical Documentation and Registration in the Russian Federation of Medical Products as Soluble Tablets of Acetylsalicylic Acid/Calcium Carbonate in Two Dosages Intended for use as Medical Products Smoothing, Febrifugal and Antiaggregation Action and Development of Technology of Tableting the Above-Stated Preparations
BackgroundErrors have been the concern of providers and consumers of health care services. However, consumers' perception of medical errors in developing countries is rarely explored....Full Text Available
... military medical education, environmental security activities, and provides e-mail capabilities and other basic information management capabilities. ...
... Title : Mental Health and Resilience: Soldiers' Perceptions about Psychotherapy, Medications, and Barriers to Care in the United States Military. ...
Only a small number of radiation accidents in the United States have been severe enough to result in multi-organ failure (MOF). Medical details of selected medical misadministration and criticality cases are reviewed, with an emphasis on pathophysiology. The four criticality cases are particularly relevant for analysis of MOF, since medical treatment was supportive and did not appreciably alter the clinical evolution of radiation injury. PMID:15975871
This study mainly concerns medical explorations by radioisotopes. Detectors with medical exams and applications are described. Ionisation chambers, semiconductor detectors and scintillation counters are also presented. Uses of radioisotopes in medicine in vivo and in vitro techniques are explained. Examples of scintiscanning are given like: angiography, nuclear cardiography and thyroid scintiscanning. The importance of the study is to present a panorama of nuclear medicine laboratories -at the time- in hospitals in Lebanon.
Information technology plays an important role in medicine because of the advanced decision support systems (DSS) it can provide. We provide an overview of the building blocks necessary for a medical decision support system and introduce seven research articles in this special issue that describe the development and evaluation of individual medical DSS building blocks or complete medical DSS.
Osteoporotic vertebral fractures often lead to pain and disability. They can be successfully treated, and possibly prevented, by injecting cement into the vertebral body, a procedure known as vertebroplasty....Full Text Available
Femur fractures typically affect elderly patients with multiple co-morbidities. Pain control can be difficult, requiring intensive nursing and physician care as elderly patients may manifest cardiovascular...Full Text Available
Frozen shoulder (adhesive capsulitis) is a common, painful and disabling condition which is typically slow to resolve. Patients with this condition will be seen in every musculoskeletal practitioner’s...Full Text Available
In recent years RNA interference (RNAi) has rapidly become the most widely used tool for gene knockdown due to its high specificity and potency. RNAi is an evolutionarily conserved mechanism...Full Text Available
According to the International Headache Society, idiopathic stabbing headache (ISH), an indomethacin-responsive headache syndrome, is a paroxysmal disorder of short duration manifested as head pain...Full Text Available
Cryoanalgesia (the use of cold to provide anesthesia or analgesia) is the oldest anesthetic and analgesic still in current clinical use. Its intraoperative use in providing postoperative analgesia for...Full Text Available
We describe a case of sacral perineural cyst presenting with complaints of low back pain with neurological claudication. The patient was treated by laminectomy and excision of the cyst. Tarlov cysts...Full Text Available
When attempting to feed on their hosts, ticks face the problem of host hemostasis (the vertebrate mechanisms that prevent blood loss), inflammation (that can produce itching or pain and thus...Full Text Available
BackgroundAdhesive capsulitis is a common, painful, and disabling condition that has been managed with corticosteroid injections for over 50 years. There is debate over the use of...Full Text Available
BackgroundDistraction osteogenesis is the standard treatment for the management of lower limb length discrepancy of more than 3 cm and bone loss secondary to congenital anomalies,...Full Text Available
ObjectivesThe updated Rome III criteria for pediatric functional gastrointestinal disorders (FGIDs) include new FGID categories and changes to the Rome II criteria...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.
Indomethacin, a potent nonsteroidal anti-inflammatory drug, has been used in the treatment of various kinds of pains, inflammation and arthritis. However, oral administration of indomethacin produces...Full Text Available
Osteoid osteoma of the spine is a relatively rare bone-forming tumor. Pain that is worse at night and relieved by aspirin and muscle contracture are the most characteristic symptoms of spinal osteoid...Full Text Available
Antagonists for kainate receptors (KARs), a family of glutamate-gated ion channels, are efficacious in a number of animal models of neuropathologies, including epilepsy, migraine pain, and anxiety....Full Text Available
The inflammatory process has direct effects on normal and abnormal wound healing. Hypertrophic scar formation is an aberrant form of wound healing and is an indication of an exaggerated function of...Full Text Available
A 63-year-old man was admitted to our hospital with a complaint of right lateroabdominal pain. He was diagnosed with metastatic colon cancer, and then developed multiple brain embolic infarctions 7...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
Pericardial fat necrosis is an infrequent cause of acute chest pain and this can mimic acute myocardial infarction and acute pericarditis. We describe here a patient with the magnetic resonance imaging...Full Text Available
BackgroundThe analgesic effect of perioperative low doses intravenous lidocaine has been demonstrated after abdominal surgery. This study aimed to evaluate whether...Full Text Available
The somatic sensory system responds to stimuli of distinct modalities, including touch, pain, itch, and temperature sensitivity. In the past century, great progress has been made in understanding the...Full Text Available
BackgroundWe have recently reported successful treatment of patients with chronic pain syndromes using human pooled intravenous immunoglobulin (IVIG) in a prospective, open-label...Full Text Available
Local anesthetics are able to induce pain relief by binding to the sodium channels of excitable membranes, blocking the influx of sodium ions and the propagation of the nervous impulse. Ropivacaine...Full Text Available
The indications, contra-indications and technique of caudal epidural injections in the treatment of low back pain and sciatica are described. Of 201 patients treated by epidural injection, about 56%...Full Text Available
The first case of human sparganosis in Canada is reported in a 23-year-old woman who emigrated from Greece in 1969. Examination of a ribbon-like worm removed from a painful swelling in the neighbourhood...Full Text Available
The purpose of this investigation was to determine the association between gender and the prevalence and incidence of patellofemoral pain syndrome (PFPS). One thousand five hundred and twenty-five participants from the United States Naval Academy (USNA) were followed for up to 2.5 years for the development of PFPS. Physicians and certified athletic trainers documented the cases of PFPS. PFPS was defined as retropatellar pain during at least two of the following activities: ascending/descending stairs, hopping/jogging, prolonged sitting, kneeling, and squatting, negative findings on examination of knee ligament, menisci, bursa, and synovial plica, and pain on palpation of either the patellar facets or femoral condyles. Poisson and logistic regressions were performed to determine the association between gender and the incidence and prevalence of PFPS, respectively. The incidence rate for PFPS was 22/1000 person-years. Females ...
Background & objectives:Acanthamoeba keratitis (AK) is a painful and vision-threatening ocular infection. The differentiation of Acanthamoeba...Full Text Available
BackgroundLeukotrienes (LTs) belong to the large family of lipid mediators implicated in various inflammatory conditions such as asthma and rheumatoid arthritis. Four distinct types...Full Text Available
This case describes a 10-year-old girl who developed a Ewing's sarcoma in her proximal fibula. The radiologic features mimicked those of a unicameral bone cyst. The presence of pain and the atypical location led to a prompt biopsy and the correct diagnosis. The mechanism of this unusual radiographic presentation is discussed. (orig.)
Examination of a painful hip is fairly concise and reliable at detecting the presence of a hip joint problem. Hip joint disorders often go undetected, leading to the development of secondary disorders....Full Text Available
Low back pain is common during pregnancy. However, the prevalence of symtomatic lumbar disc herniation is rare, and cauda equina syndrome due to disc herniation during pregnancy is even rarer. We report...Full Text Available
BackgroundChronic rotator cuff pathology (CRCP) is a common shoulder condition causing pain and disability. Physiotherapy is often the first line of management for CRCP yet there...Full Text Available
Multiple disease-specific systematic reviews on the effectiveness of physical therapy intervention for shoulder dysfunction have been inconclusive. To date, there have been two systematic reviews that...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
Biliary obstructions are rarely caused by a foreign body and have received sparse attention. We present an unusual case with pruritis and abdominal pain caused by impacted full length surgical gauze...Full Text Available
A 23-year-old woman presented to our hospital with nonspecific pain in the abdomen. She underwent radiological investigations, which revealed a solid and cystic mass in the tail end of the pancreas....Full Text Available
BackgroundBlood sampling through heel lancing is the most common invasive painful procedure performed on newborn infants.Case PresentationWe report...Full Text Available
Seventy seven patients with soft tissue shoulder lesions including adhesive capsulitis and disorders of the rotator cuff and acromioclavicular joint were admitted to a trial comparing two different...Full Text Available
Snapping or grating scapula is a condition of the shoulder girdle in which the patient complains of pain and an audible snapping sound which may be associated with pain. We evaluated the diagnostic value of the computed tomography (CT) scans using the clinical diagnosis of a grating scapula as the gold standard. This retrospective study reports the sensitivity, specificity, likelihood ratio and receiver operator characteristic curve for the CT scans and the k value as a measure of the interobserver agreement. None of the parameters validated the examination. We therefore concluded that CT scans are inappropriate for differentiation between a grating scapula and a normally functioning shoulder except in cases where bony abnormalities are present. (orig.)
Lumbar epidural anesthesia is useful in a variety of chronic benign pain syndromes, including lumbar radiculopathy, low back pain syndrome, spinal stenosis, and vertebral compression fractures. Given the increased number of epidural nerve blocks being performed, some have reported unexplained complications of a transient or permanent nature and with varying degrees of severity. However, no case has been reported of a broken epidural needle tip retained in the lumbar facet joint area. This represents the first reported case presentation of foraminal stenosis developing in a patient after a retained epidural needle tip. PMID:21286465
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 ...
BACKGROUND: The urgent need for patient safety education for healthcare students has been recognised by many accreditation bodies, but to date there has been sporadic attention to undergraduate/graduate medical programmes. Medical students themselves have identified quality and safety of care as an important area of instruction; as future doctors and healthcare leaders, they must be prepared to practise safe healthcare. Medical education has yet to fully embrace patient safety concepts and principles into existing medical curricula. Universities are continuing to produce graduate doctors lacking in the patient safety knowledge, skills and behaviours thought necessary to deliver safe care. A significant challenge is that patient safety is still a relatively new concept and area of study; thus, many medical educators are unfamiliar with the literature and unsure how to integrate ...
BACKGROUND: The urgent need for patient safety education for healthcare students has been recognised by many accreditation bodies, but to date there has been sporadic attention to undergraduate/graduate medical programmes. Medical students themselves have identified quality and safety of care as an important area of instruction; as future doctors and healthcare leaders, they must be prepared to practise safe healthcare. Medical education has yet to fully embrace patient safety concepts and principles into existing medical curricula. Universities are continuing to produce graduate doctors lacking in the patient safety knowledge, skills and behaviours thought necessary to deliver safe care. A significant challenge is that patient safety is still a relatively new concept and area of study; thus, many medical educators are unfamiliar with the literature and unsure how to integrate ...
Numerous laboratory investigations have shown that sulfur dioxide (SO/sub 2/) induces bronchoconstriction and respiratory symptoms in exercising asthmatics. These effects appear to depend on dose rate (the product of exposure concentration and ventilation rate), and may occur at dose rates attainable during outdoor exercise in SO/sub 2/-polluted communities. Effects are rapid in onset, requiring no more than 5 min of exercise during exposure. Thus they may be induced by transient elevations of SO/sub 2/ levels, which may occur near large pollution sources even when longer-term average concentrations meet existing air quality standards. Even very mild asthmatics typically are far more sensitive to SO/sub 2/ than healthy volunteers. The authors discuss an investigation designed to expand and improve the dose-response information on SO/sub 2/. In comparison to earlier work it employed a larger, clinically more diverse population of volunteer subjects. Comparatively severe, ...
BACKGROUND AND CASE STUDY: Surgical fires are rare but preventable. During facial surgery for a 68-year-old man, a fire broke out, resulting in first- and second-degree burns after a nasal cannula ignited in an oxygen-rich environment because of improper draping and tenting. DISCUSSION: Operating room (OR) fires can be prevented if any component of the "fire triangle"-fuels, ignition sources, and oxidizers-is reduced or eliminated. The use of supplemental oxygen in the OR via nasal cannulae, nebulizers, and oxygen cylinders must always considered a potential source of fire. Deficits in knowledge among the surgical team with respect to the prevention and management of surgical fires were apparent. A plan was put into place to improve fire safety education, entailing an educational program that is included in intern and resident orientation. Surgical fire safety training was also put into place for anesthesia and surgical faculty. The anesthesia preoperative evaluation was modified to ...
Radioiodinated 15-(p-iodophenyl)-3,3-dimethylpentadecanoic acid (DMIPP) has been prepared as a new terminal iodophenyl-substituted fatty acid containing dimethyl-branching at the beta-position. Iodine-125-labeled DMIPP showed rapid, high myocardial uptake (min, mean % injected dose/g) in fasted rats (5, 4.67; 30, 5.06; 60, 4.79; 120, 4.37), and also exhibited high heart:blood ratios (min, ratio) 5, 3:1; 30, 12:1; 60, 12:1; 120, 13:1. These data demonstrate an unanticipated much longer myocardial residence time with DMIPP (+/sub 1/2/ 7-8 h) than observed with either the 3-monomethyl (BMIPP) analogue (+/sub 1/2/ 30-45 min) or the rapidly metabolized straight-chain (IPP) analogue (+/sub 1/2/ 10-15 min). The (/sup 123/I)DMIPP is thus an excellent candidate for clinical evaluation of regional fatty acid metabolism under conditions where the uptake of energy substrates can be assessed independent of regional blood delivery. Studies with the new activated carbon-based ...
The OASIS Registry started annual collection of longitudinal data on patients on home parenteral nutrition (HPN) in 1984. This report describes outcome profiles on 1594 HPN patients in seven disease categories. Analysis showed clinical outcome was principally a reflection of the underlying diagnosis. Patients with Crohn's disease, ischemic bowel disease, motility disorders, radiation enteritis, and congenital bowel dysfunction all had a fairly long-term clinical outcome, whereas those with active cancer and acquired immunodeficiency syndrome (AIDS) had a short-term outcome. The long-term group had a 3-year survival rate of 65 to 80%, they averaged 2.6 complications requiring hospitalization per year, and 49% experienced complete rehabilitation. The short-term group had a mean survival of 6 months; they averaged 4.6 complications per year and about 15% experienced complete rehabilitation. The registry data also indicated HPN was used for 19,700 patients in 1987 with therapy growth ...
PURPOSE We wanted to examine how coordinated care is implemented in primary care practices to address patients' health behavior change needs. METHODS Site visit notes, documents, interviews, and online implementation diaries were collected from July 2005 to September 2007 from practice-based research networks (PBRNs) participating in Prescription for Health: Promoting Healthy Behaviors in Primary Care Research Networks (P4H). An iterative group process was used to conduct a cross-case comparative analysis of 9 interventions. Published patient outcomes reports from P4H interventions were referenced to provide information on intervention effectiveness. RESULTS In-practice health risk assessment (HRA) and brief counseling, coupled with referral and outreach to a valued and known counseling resource, emerged as the best way to consistently coordinate and encourage follow-through for health behavior counseling. Findings from published P4H outcomes suggest that this ...
Hepatocellular carcinoma (HCC) is the most common primary liver cancer and has very limited therapeutic options. Recently, it has been found that hyaluronic acid (HA) shows selective binding to CD44 receptors expressed in most cancer histotypes. Since the trend in cancer treatment is the use of targeted radionuclide therapy, the aim of this research was to label HA with rhenium-188 and to evaluate its potential use as a hepatocarcinoma therapeutic radiopharmaceutical. Methods: {sup 188}Re-HA was prepared by a direct labelling method to produce a ReO(O-COO){sub 2}-type coordination complex. {sup 188}Re-HA protein binding and its stability in saline, phosphate buffer, human serum and cysteine solutions were determined. Biokinetic and dosimetric data were estimated in healthy mice (n=60) using the Medical Internal Radiation Dose methodology and mouse model beta-absorbed fractions. To evaluate liver toxicity, alanine aminotranferase (AST) and aspartate aminotranferase ...
To compare the accuracy in the detection and staging of various malignant tumors with high resolution whole-body MRI using parallel imaging with whole-body dual-modality PET-CT. Preliminary results of an interim analysis from a prospective, blinded study are presented, in which 20 patients (mean age 59 years, range 27-77 years) with different oncological diseases underwent whole-body dual modality FDG-PET-CT screening for tumor search or staging in case of confirmed or suspected metastatic disease. All patients also underwent whole-body MRI imaging with the use of parallel imaging (iPAT). High-resolution coronal T1w- and STIR-sequences of 5 body levels with 512 x 512 matrix, axial fast T2w imaging of lung and abdomen (HASTE), contrast-enhanced dynamic and static T1w-sequences of liver, brain, abdomen, and pelvis were performed. Using a 32-channel whole-body MRI scanner (Magnetom Avanto, Siemens Medical Solutions) with a total field of view of 205 cm and free table ...
Weakly absorbing materials, such as biological, soft tissues, can be imaged by generating contrast due to the phase shift of X-rays. In the past decade, several methods for X-ray phase imaging were proposed and demonstrated. The performance of X-ray phase imaging is attractive in the field of medical imaging technology, and its development for practical use is expected. Many methods, however, have been developed under the assumption of the use of synchrotron radiation, which is an obstacle to practical use. The method based on Talbot (-Lau) interferometry enables us to use a compact X-ray source, and its development is expected as a breakthrough for medical applications. (author)
The book is intended as a source of information for general practioners and for medical students doing their practical training. Efficient application of imaging methods is explained with great emphasis on practical aspects, concentrating on typical tasks to be solved for adult patients with internal disease or surgical problems. The material is arranged by various organic systems of the body. Graded diagnostics for a stepwise approach to the final diagnosis is the concept described, and is shown to be of advantage to the patient and in terms of cost and time.
During the 1990s, a debate took place in Sweden concerning Conductive Education. Proponents of this method focused their critique on the role and methods of physiotherapists but this profession was not active in the debate. Instead, the medical profession came out as defenders of habilitation services and methods. Departing from sociology of the professions, our objective in this article is to analyze the physiotherapists' silence in relation to the profession's position and its relation to the medical profession. The analysis is based on data from interviews with members of habilitation teams and other key persons, and on documents. The relative silence of physiotherapists is found to be related to both interprofessional factors (the subordination under the medical profession paired with ...
Radiology departments often underestimate the importance of protecting medical data during transmission, including the precautions taken to ensure data protection. In teleradiology, transmitted as well as stored patient data have to be signed digitally according to the currently valid regulation (Roentgenverordnung, RoeV). The DICOM standard facilitates a digital signature. So far, medical image manufacturers only announced to support this security feature. We introduce a solution that extends the feature of digital signing to older modalities. (orig.)
The article examines the contribution of the Military Medical Academy as an educational, research and medical institutions in the establishment and development of the national Russian manned spaceflight. Lists the names of the Academy's scientists, working in laboratories and in the Cosmonaut Training Center. In 1958 the academy was formed Department of Aviation Medicine from the research laboratories of aviation medicine, psychophysiology, and encephalography, a division of pressure chambers and furnaces. Direct contribution to the preparation of the first manned space flight made by graduates of the academy, E.A. Karpov (the first chief of Cosmonauts Training Center. Yuri Gagarin) and I.A. Kolosov. Over the half century history of the Russian Space Military Medical Academy, prepared and sent to the CPC Gagarin more than 110 of its graduates. PMID:21770320
Aim:To present three patients with ocular disease who developed a range of complications following use of traditional medications.Settings...Full Text Available
BackgroundProfessionalism is a critical quality for physicians to possess. Physician professionalism has received increased attention in recent years, with many authorities suggesting...Full Text Available
Abstract The authors provide a survey of how images are used in radiation therapy to improve the precision of radiation therapy plans, and delivery of radiation treatment. In contrast...Full Text Available
Though notes in electronic medical record systems (EMRs) have advantages, they are often criticized for their unattractive and unprofessional appearance. We sought to identify notes regarded by physicians...Full Text Available
The WHO Expert Committee on Biological Standardization authorized the National Institute for Medical Research to establish an International Reference Preparation of Erythropoietin on the basis of the...Full Text Available
PurposeTo describe etiologies and clinical characteristics of corneal opacities leading patients to seek cosmetic treatments.MethodsThe medical records...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
Abstract An important aspect of Chinese academic health science libraries is their involvement in teaching medical information retrieval courses as part of the medical curriculum. Health science librarians in China have a more formal teaching role than is generally found in Western countries, including many full time teaching positions. This article provides a case study of Kunming Medical University Library, where courses are provided as credit units at both undergraduate and postgraduate levels. The teaching practices of Chinese health science libraries are compared with teaching experiences reported in Western countries. It is noted that Chinese government s educational policy is similar to that of the United States in promoting the role of the library in teaching subjects as part of th...
High-throughput technologies for DNA sequencing and for analyses of transcriptomes, proteomes and metabolomes have provided the foundations for deciphering the structure, variation and function of the...Full Text Available
In the wake of the 2010 earthquake in Haiti, medical relief organizations and individual practitioners mobilized to provide assistance. Here, an emergency medicine physician who worked with a Louisiana-based...Full Text Available
Securing the co-operation of persons supplying information required for medical statistics is essentially a problem in human relations, and an understanding of the motivations, attitudes, and behaviour...Full Text Available
AIM: To analyze the contribution of Orvosi Hetilap (Hungarian Medical Journal) to the field of gastroenterology.METHODS: All issues of the journal between 1857 and 2008 and identified...Full Text Available
ROBOT-ASSISTED RADICAL LAPAROSCOPIC PROSTATECTOMY WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER WINSTON-SALEM, NC 00:00:08 ANTHONY ATALA, MD: I would like ...
Objectives:Myocardial infarction (MI) is a leading cause of death in both the industrialized and developing countries globally. The economic evaluation of MI is undertaken...Full Text Available
... as the difference between date of birth and date of ... Final model selections were based on the ... approval by the Naval Submarine Medical Research ...
The practice of medical tourism depends on successfully informing potential patients about procedure options, treatment facilities, tourism opportunities, travel arrangements, and destination countries. The promotion of medical tourism includes a wide range of marketing materials such as flyers, booklets, and websites. Yet, there is a paucity of knowledge about the dissemination, content, and reception of these promotional materials. Drawing on a thematic content analysis of the promotional print material distributed at the first medical tourism trade show in Canada in 2009, the main purpose of this article is to identify and understand the messages and images that companies use to market India as a global destination. While researchers and news media frequently cite low cost procedures as...
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
brain Printer-friendly version Email this page to a friend Share Primary lymphoma of the brain is cancer of the lymph cells that starts in the brain. Causes The cause of primary...
BackgroundMedication errors are common among inpatients and many are preventable with computerized prescribing. Relatively little is known about outpatient prescribing errors or...Full Text Available
Selected applications of novel techniques in Agricultural Biotechnology, Health Food formulations and Medical Biotechnology are being reviewed with the aim of unraveling future developments and policy changes that are likely to open new markets for Biotechnology and prevent the shrinking or closing of existing ones. Amongst the selected novel techniques with applications in both Agricultural and Medical Biotechnology are: immobilized bacterial cells and enzymes, microencapsulation and liposome production, genetic manipulation of microorganisms, development of novel vaccines from plants, epigenomics of mammalian cells and organisms, and biocomputational tools for molecular modeling related to disease and Bioinformatics. Both fundamental and applied aspects of the emerging new techniques are being discussed in relation to their anticipated, marked impact on future markets and present policy changes that are needed for success in either ...
Neuroleptic malignant syndrome is a life-threatening reaction of neuroleptic medication. The estimated incidence rate of neuroleptic malignant syndrome is between 1% and 1.5% of patients treated with...Full Text Available
... with the symptoms of MS have MS. Diagnosis Physical examination and medical history are very important in diagnosing MS. Physical exams include a variety of tests to check ...
ObjectiveFamily-centered bedside rounds (FCBR) are recommended to improve trainee education, patient outcomes, and family satisfaction. However, bedside teaching...Full Text Available
The Department of Defense (DOD) will soon issue a directive to test all incoming military personnel for the presence of hemoglobin S. The military testing program for hemoglobin S is an occupational...Full Text Available
... The AAT Z mutation involves a single amino acid substitution (glutamine for lysine) at position 342, resulting in abnormal folding and polymerization of the ...
BackgroundLymphangioleiomyomatosis (LAM) is a rare lung disease characterised by progressive airflow obstruction. No effective medical treatment is available but therapy with sirolimus...Full Text Available
Hyperglycemia frequently occurs with acute medical illness, especially among patients with cardiovascular disease, and has been linked to increased morbidity and mortality in critically ill patients....Full Text Available
This study was carried out to determine the rate and types of injuries experienced by boardsailors. Results derive from: (a) a review of hospital medical records for water sports injuries, and (b) a...Full Text Available
... objective of this research work were to 1 ... function of experimentally manipulated dogs to define ... Escherichia coli; Sepsis; Military medicine; Medical ...
Invasive fungal infections can be devastating, particularly in immunocompromised patients, and difficult to treat with systemic drugs. Furthermore, systemic administration of those medications...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
PurposeHealth information technology (HIT) and physician career satisfaction are associated with higher-quality medical care. However, the link between HIT and physician...Full Text Available
The invention of the microscope disclosed a whole new world, that of the hitherto invisibly small. Histologic evidence as revealed by the microscope has become a cornerstone of medical diagnosis, and...Full Text Available
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 equipment' which ...
Privacy-preserving machine learning algorithms are crucial for the increasingly common setting in which personal data, such as medical or financial records, are analyzed. We provide general...Full Text Available
BackgroundAlthough advances in rehydration therapy have made cholera a treatable disease with low case-fatality in settings with appropriate medical care, cholera continues...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
CESAREAN SECTION SHAWNEE MISSION MEDICAL CENTER MERRIAM, KANSAS March 13, 2008 00:00:09 ANNOUNCER: Tonight you will experience the miracle of birth during ...
CESAREAN SECTION SHAWNEE MISSION MEDICAL CENTER MERRIAM, KANSAS March 13, 2008 00:00:09 ANNOUNCER: Tonight you will experience the miracle of birth during a live ...
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
Cholera is a severe diarrheal disease caused by specific serogroups of Vibrio cholerae that are pathogenic to humans. Cholera can become epidemic and deadly without adequate medical...Full Text Available
... in MEDCAP "the level of interface was left up ... of these patients had peripheral nerve injuries, head ... with poorly constructed prosthesis or waiting for ...
Malformations of the cerebral cortex are recognized as a common cause of developmental delay, neurological deficits, mental retardation and epilepsy. Currently, the diagnosis of cerebral cortical...Full Text Available
Chinese and Chumash traditional medical approaches are similar in terms of disease causation, use of acupuncture or healing touch, plants, spiritual and philosophical approaches. This article provides...Full Text Available
This bibliography of nonserial publications consists of 610 annotations. It is intended as a guide to the development of a collection for librarians and for health professionals in research and education....Full Text Available
Instructions and control measures related to enteric contagious diseases at the Veterinary Medical Teaching Hospital (VMTH) of the Faculty of Veterinary Medicine of the University of Montreal are presented....Full Text Available
Bone metastases at the thoracic and lumbar segment of the spine are usually presented with painful sensation and medullar compression. The treatment is based on the clinical and neurological conditions of the patient and the degree of tumor invasion. In the present study, 32 patients with spinal metastasis of thoracic and lumbar segment were prospectively analyzed. These patients were treated by decompression and internal stabilization followed by radiotherapy or irradiation with external immobilization. The election of the groups was in accordance with the tumor radiotherapy sensitivity, clinical conditions, spinal stability, medullar or nerve compression and patient's decision. The Frankel scale and pain visual test were applied at the moment of diagnosis and after 1 and 6 months. The surgical group had better results with preserving the ambulation longer and significant reduction of pain.(author)
We aimed to investigate the effects of local anesthetics soaked in Merocel nasal packs on hemorrhage and pain after septoplasty. The methodology includes a prospective double-blind study that was conducted in patients undergoing septoplasty because of nasal septal deviation. The study included 143 patients. The patients were divided into four groups. Each group received 1% lidocaine?+?0.000625% adrenalin, 0.375% ropivacaine, 0.25% bupivacaine as study groups or 0.9% sodium chloride as a control group in their Merocel packs postoperatively. The local anesthetics or sodium chloride were reapplied at the eighth postoperative hour. Each patient was given a questionnaire where verbal analog score and amount of postoperative hemorrhage was noted. The statistical analysis was performed using two ...
Abstract Introduction: Transduodenal ampullectomy (TDA) can be performed for benign and premalignant tumors of the ampulla of Vater (AOV) as an alternative to pancreaticoduodenectomy. However, the laparoscopic approach has rarely been attempted. In this report 2 cases of benign ampullary tumor that were treated by totally laparoscopic TDA. Patients and Methods: Case 1 was of a 75-year-old female who was admitted with left knee pain and underwent arthroscopic debridement. On postoperative day 6, she showed elevated levels of alkaline phosphatase, aspirate aminotransferase, alanine transaminase, and gamma-glutamyl transpeptidase, without any other laboratory test abnormality. She had no complaint of abdominal pain, and physical examinations were unremarkable. Computed tomography (CT), magnet...
Background: This study was conducted to examine the effects of prophylactic misoprostol prior to intrauterine device (IUD) placement in nulliparous women. Study Design: Nulliparous, reproductive-aged women desiring an IUD for contraception were randomized to receive 400 mcg of buccal misoprostol or placebo 90 min prior to IUD insertion. Subjects completed a series of 100-mm visual analogue scales (VAS, anchors: 0=none, 100 mm=worst imaginable) to measure their perceived pain at several times points (anticipated pain, leg positioning, speculum placement, tenaculum placement, IUD insertion, equipment removal and 5 min postinsertion). Secondary outcomes included provider ''ease of placement'' (100-mm VAS, anchors: 0=easy, 100 mm=extremely difficult), side effects and retention of the IUD afte...
SummaryBackground Persistent Lyme Disease Symptoms (PLDS) have included fatigue, headaches, poor concentration and memory, lightheadedness, joint pain, and mood disturbances. Evidence-based guidelines committees disagree over the severity of PLDS. The 2004 International Lyme and Associated Diseases Society (ILADS) concluded that PLDS are severe. The 2006 Infectious Disease Society of America (IDSA) guidelines committee concluded that PLDS are nothing more than the "aches and pains of daily living" and an ad hoc International Lyme group concluded that PLDS are "symptoms common in persons who have never had Lyme disease." Hypothesis Clinical trials validate the severity of persistent Lyme disease symptoms. Evaluation of the Hypothesis There are 22 standardized instruments used to measure the...
Pyogenic sacroiliitis is a rare entity in children. Diagnosis is often delayed because of its variable clinical presentation, low suspicion by the examining physician, and rare findings on radiographs. Delayed diagnosis, however, results in complications such as iliopsoas abscess. We report the case of a 12-year-old girl hospitalized with a 21-day history of fever, pain in the left iliac fossa, and flexion contracture of the hip. On examination, she had fever (38.9 ^oC), psoitis, localized tenderness at the left sacroiliac joint, and pain elicited by lateral compression of the pelvis. The abdominal examination was normal. The erythrocyte sedimentation rate was 130mm in the first hour, C-reactive protein was 186mg/l, and the white blood cell count was 18,400/mm^3, with 79% neutrophils. Urin...
On the basis of legally provided area dose measurements and time records of fluoroscopic examinations during the operation, radiation doses to medical personnel and patients are evaluated. Adequate radiation protection measures and a careful behaviour in the operating room keep the radiation exposure to the personnel below the maximum permissible exposure. Taking into account the continuous personnel radiation monitoring and medical supervision, radiation hazards in the operating room can be considered low.
An introduction is presented on the radiation hazards connected with biomedical radiography and nuclear medicine. The frequency of radiodiagnostic efforts was rather high in the Netherlands. This was reduced considerably by abolishing the thorax screening of the population. About diagnostic nuclear medicine less can be said because far fewer numerical data are available. An exposition of genetically and somatically significant doses and how to compute them is given. The drawing up of a profit versus risk evaluation for medical applications of ionizing radiations is recommended. (Auth.).
... orthopaedics, waiting times, NHS, private hospitals,health news, medical news, health services, medical treatments, health tips NHS ...be sent to private hospitals for surgery in a bid to bring orthopaedic waiting times under control. Plan to send NHS patients for ...
Neutron activation of nitrogen and hydrogen in the body, the isotope dilution technique and the measurement of naturally radioactive potassium in the body are among the new nuclear methods, now under collaborative development by the Australian Nuclear Scientific and Technology Organization and medical specialists from several Sydney hospitals. These methods allow medical specialists to monitor the patient's response to various diets and dietary treatments in cases of cystic fibrosis, anorexia nervosa, long-term surgical trauma, renal diseases and AIDS. ills.
We describe the architecture of LifeCode® (A-Life Medical, Inc.), a natural language processing system for free-text clinical information extraction, our methodology in applying LifeCode®...Full Text Available
This report is a brief review of biological and medical applications of ion-track membranes. The review aims at informing nuclear physicists about alternative (i.e. non-fundamental-science) use of heavy ion accelerators such as production of micro- and nano-porous materials. The ion-track membranes produced this way are employed in life sciences and numerous technological applications. The author focuses on recent results from the Flerov laboratory in co-operation with other scientific institutions and industrial partners.
We have investigated the detection performance of GaAs detectors made with different thickness and contact geometries. A comparison is made between these detection capabilities and the imaging requirements for the following medical applications: digital mammography, digital chest radiography and nuclear medicine. Experimental results and preliminary images are presented and discussed. (author)
This paper describes the research and development activities in three areas of radiation processing, namely: food irradiation, medical product sterilization and wood plastic combination. Plans and efforts exerted to acquire a larger gamma source to augment our present 5,000 curie source are discussed. Cost estimates for a radiation facility are presented on the basis of the market potential of food irradiation and medical product sterilization. Existing local industries that can benefit from the adaptation of irradiation technology in their processing requirements are described.
A team of physicians, pharmacists, and informatics professionals developed a CDSS added to a commercial electronic medical record system to provide prescribers with patient-specific maximum dosing recommendations...Full Text Available
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
BackgroundHamstring injuries are the most common injury in Australian Rules football. It was the aims to investigate whether a sports chiropractic manual therapy intervention protocol...Full Text Available
AbstractIn a previous study using male rats, a correlation was found between the development of “at-level” allodynia in T6-7 dermatomes following severe T8 spinal contusion...Full Text Available
During their life, intervertebral discs undergo degenerative changes which need not necessarily become lesions. Conventional X-rays do not provide information on the condition of the intervertebral discs, so MRT or CT are recommended as primary techniques as they are non-invasive. Invasive methods like myelography and especially discography should not be used unless a case is highly problematic. In infants with pains in the back, MRT should be carried out as early as possible as there is nearly always an organic cause. (orig.)
... 03/08/2011 Professor named Chair at Epworth Hospital Professor Nilmini Wickramasinghe from the College of Business at RMIT University has been named Epworth Chair, Health Information Management , by Epworth HealthCare. 26/07/2011 Study investigates drug-free relief for tension headaches As Australia marks its first National Pain Week ...
An 8-year-old child presented with severe chest pain and respiratory distress after he accidentally bit an automobile tyre tube which burst into his mouth. The chest radiograph revealed left-sided pneumothorax....Full Text Available
BackgroundPostherpetic neuralgia (PHN) is a painful and difficult to treat complication of acute herpes zoster. Current treatment options provide only partial relief and are often...Full Text Available
Primary peritoneal malignant mixed mullerian tumors are very rare. We report the case of a patient presenting with pain in the right upper quadrant of the abdomen and in whom the physical examination demonstrated a peritoneal mass. Computed tomography (CT) confirmed the presence of a mass, with invasion of adjacent organs.
NASA cost-risk assessment is composed of cost estimating relationship (CER) and technical risk assessment plus cost element correlation assessment; ...
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 Lawrence Livermore National Laboratory (LLNL) Management Pre-Start Review (MPR) Team was formed to independently verify the operational readiness of Building 368 (B368) Biosafety Level III (BSL-3) Facility to conduct research with biological pathogens and toxins including those considered Select Agents. Review objectives and criteria were developed from the DOE/NNSA and LLNL requirements. These were provided in the Implementation Plan for the Biosafety Level III (BSL-3) Facility Management Pre-Start Review (BSL-3 MPR) at Lawrence Livermore National Laboratory that was reviewed and approved by DOE/NNSA-LSO. The formal part of the LLNL MPR for the BSL-3 Facility was begun in August of 2005 but work on the MPR was stopped in October of 2005 due to the need for LLNL to reassess organizational and operational controls and respond to Centers for Disease Control and Prevention inquiries related to a shipping incident involving select agents. The MPR was restarted in mid-June of 2006. ...
In areas where radiation dose monitoring has not been performed, it is essential to use material available in the environment be able to rapidly assess doses to individuals for immediate emergency medical care or for general estimation of the radiological consequences. It was shown that certain types of telephone cards containing microchips have the potential to be used as individual radiation dosimeters in emergency situations to detect doses over 250 mGy by luminescence measurements. In order to understand the dosimetric properties of chip cards, the components obtained from INFINIEON Company at various stages of production were used for luminescence measurements. It is found that the protecting layer used above the chips so called 'globe top' is the main source of radiation induced signal in chip cards. The globe top produced by INFINIEON at that stage is found to contain SiO2 and Epoxy. In order to improve the dosimetric properties of the ...
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 ...
Objectives: Acupuncture has served as a major complementary and alternative therapy that supplements conventional medicine and is the subject of growing public interest. This study was conducted to estimate the usage rate of acupuncture as a supplemental treatment in acute ischaemic stroke patients and to identify factors associated with the choice to use this therapy. Methods: Using the registry of stroke patients admitted to an academic medical centre in Korea, the use of acupuncture therapy was recorded and analysed, along with the patients' socio-demographic characteristics, hospital access variables, risk factors for ischaemic stroke and clinical characteristics. The data were analysed using descriptive statistics, chi-square tests and multiple logistic regression analyses. Results: O...
This book examines the applications of Monte Carlo (MC) calculations in therapeutic nuclear medicine, from basic principles to computer implementations of software packages and their applications in radiation dosimetry and treatment planning. It is written for nuclear medicine physicists and physicians as well as radiation oncologists, and can serve as a supplementary text for medical imaging, radiation dosimetry and nuclear engineering graduate courses in science, medical and engineering faculties. With chapters is written by recognised authorities in that particular field, the book covers the entire range of MC applications in therapeutic medical and health physics, from its use in imaging prior to therapy to dose distribution modelling targeted radiotherapy. The contributions discuss the fundamental concepts of radiation dosimetry, radiobiological aspects of targeted radionuclide therapy and the various components and ...
The first part of the study contains a literature compilation of more than 50 original publications reporting the radiation induced effects in 17 different high polymer materials and glass which are relevant in the manufacturing of medical devices or packing materials. The results collected demonstrate that high energy radiation, i.e. gamma- or X-rays, causes various physical and chemical alterations in high polymer materials. A detailed summary and discussion of the results of the original publications is not included in the present report, it will be presented in the second part of the study. Furthermore, the second part of the study will refer to the aspect of wholesomeness of irradiated medical devices or packing materials in a more general manner of representation. (orig.).
When evaluating the risks of oncogenesis and cancer mortality following exposure to the radiations of the atomic bombs (A-bombs), the medical X-ray doses received by the A-bomb survivors must also be estimated and considered. Using a human phantom, dosimetry was performed to estimate the X-ray doses received by A-bomb survivors during medical examinations at the Radiation Effects Foundation (RERF) as part of the long-term follow-up on the Adult Health Study (AHS). These examinations have been estimated to represent nearly 45% of the survivors' cumulative medical irradiation dose. Doses to the salivary glands, thyroid gland, lung, breast, stomach and colon were measured using thermoluminescent dosemeters. The results, which are reported here, will aid in estimating organ doses received by individual AHS participants. (Author).
When evaluating the risks of oncogenesis and cancer mortality following exposure to the radiations of the atomic bombs (A-bombs), the medical X-ray doses received by the A-bomb survivors must also be estimated and considered. Using a human phantom, dosimetry was performed to estimate the X-ray doses received by A-bomb survivors during medical examinations at the Radiation Effects Foundation (RERF) as part of the long-term follow-up on the Adult Health Study (AHS). These examinations have been estimated to represent nearly 45% of the survivors' cumulative medical irradiation dose. Doses to the salivary glands, thyroid gland, lung, breast, stomach and colon were measured using thermoluminescent dosemeters. The results, which are reported here, will aid in estimating organ doses received by individual AHS participants. (Author).
Medical Science Liaison (MSL) teams are a well-recognized function within the pharmaceutical and medical products industries. While in most organizations, MSLs have focused on the development of relationships with individual Key Opinion Leaders, progressive companies have realized the value that MSLs can also bring to Key Account Management (KAM). This article discusses the five steps that should be followed in order to successfully integrate the support of Key Accounts into an MSL function. These include understanding the business approach to KAM, identifying what MSL resources are available, developing a comprehensive strategic plan, implementing the plan, and evaluating and making any necessary adjustments. Finally, a case example outlining the experience of a small pharmaceutical compa...
One of the goals of the DARPA Virtual Soldier Project is to aid the field medic in the triage of a casualty. In Phase I, we are currently collecting 12 baseline experimental physiological variables and a cardiac gated Computed Tomography (CT) imagery for use in an prototyping a futuristic electronic medical record, the "Holomer". We are using physiological models and Kalman filtering to aid in diagnosis and predict outcomes in relation to cardiac injury. The physiological modeling introduces another few hundred variables. Reducing the complexity of the above into easy-to-read text to aid in the triage by the field medic is the challenge with multiple display solutions. A description of the possible techniques follows. PMID:15718701
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...
Most standard accounts of human anatomy and physiology are designed to meet the requirements of medical education and therefore consider their subject matter from the standpoint of typical rather than...Full Text Available
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
BackgroundStrategies to accurately identify the occurrence of specific health care events in administrative data is central to many quality improvement and research efforts. Many...Full Text Available
ObjectiveThis report provides updated estimates on use of electronic medical records (EMRs) in US home health and hospice (HHH) agencies, describes utilization of EMR functionalities,...Full Text Available
Thoracic aortic aneurysms (TAAs) are potentially devastating, and due to their asymptomatic behavior, pose a serious health risk characterized by the lack of medical treatment options and high...Full Text Available
Technology is now available to allow a complete haemodynamic analysis; however this is only used in a small proportion of patients and seems to occur when the medical staff have the time and inclination....Full Text Available
In a new approach to medical computer based education (CBE) students at several U.S. and Canadian health professions schools have been using an optical videodisc under computer control to study basic...Full Text Available
BackgroundIt remains unclear if certain antiretroviral medications, particularly abacavir, compromise response to hepatitis C virus (HCV) therapy. Such data can inform...Full Text Available
BackgroundThe National Consortium for Multicultural Education for Health Professionals (Consortium) comprises educators representing 18 US medical schools, funded by the National...Full Text Available
Oxidative stress contributes to the pathophysiology of exposure to heavy metals/metalloid. Beneficial renal effects of some medications, such as chelation therapy depend at least partially on the ability...Full Text Available
This paper describes the deliverables framework developed by Vanderbilt University Medical Center (VUMC) in its IAIMS planning process. The key deliverables include: visions for the future; mission,...Full Text Available
Embryonic stem cells have the ability to develop into virtually any cell in the body, and may have the potential to treat medical conditions such as diabetes and Parkinsons disease. On August 9, 2001, President Bush announced that for the first time feder...
Papers are presented in the areas of: Medical Technologies; Non-Destructive Evaluation; Applications of Signal/Image Processing; Laser Guide Star and Adaptive Optics; Computational Electromagnetic, Acoustics and Optics; Micro-Impulse Radar Processing; Optical Applications; TANGO Space Shuttle.
BackgroundPostoperative delirium is a topic of great importance in the geriatric surgical specialty. Although antipsychotic drugs are the medications most frequently used to treat...Full Text Available
The most publicly justifiable application of human cloning, if there is one at all, is to provide self-compatible cells or tissues for medical use, especially transplantation. Some have argued that...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
BackgroundDiscovery of biomarkers that are correlated with therapy response and thus with survival is an important goal of medical research on severe diseases, e.g. cancer. Frequently,...Full Text Available
In May 2002, the United States Department of Energy (DOE) signed Assistance Instrument Number DE-FC09-02CH11109 with the Medical University of South Carolina (MUSC) to support the Environmental Biosciences Program (EBP). This funding instrument replaces DOE Assistance Instrument Number DE-FC02-98CH10902. EBP is an integrated, multidisciplinary scientific program, employing a range of research initiatives to identify, study and resolve environmental health risk issues. These initiatives are consistent with the Medical University's role as a comprehensive state-supported health sciences institution and the nation's need for new and better approaches to the solution of a complex and expansive array of environment-related health problems. The intrinsic capabilities of a comprehensive health sciences institution enable the Medical University to be a national resource for the scientific investigation of ...
Lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) are highly prevalent in older men. Medical therapy is the first-line treatment for LUTS associated with BPH. Mainstays...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.
Atypical antipsychotic medications have assumed growing importance for the treatment of bipolar disorder, an illness that affects approximately 1.2%–3.7% of the general population in a given...Full Text Available
SummaryBackgroundThe US FDA has been collecting information on medical devices involved in significant adverse advents since 1984. These reports have...Full Text Available
ObjectiveTo test whether a disclosure intervention improves subjective health and reduces medical consumption and sick leave in somatising patients in general practice.DesignNon-blind...Full Text Available
The achievements made in the field of radiation protection over the past 20 years are outlined. Risk analysis as applied to medicine is considered and genetic significant doses, genetic risks, somatic effective doses and somatic risks are discussed. (C.F.).
... His work has been recognised with numerous honours, including Fellow of the Australian Academy of Science; International Research Scholarships from the Howard Hughes Medical Institute ; a Wellcome Trust Fellowship; the Glaxo-Wellcome Australia Medal; the Australian Academy of Science Gottschalk Medal; the Boehringer Mannheim Medal;...
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
Medical treatment of heroin addiction with methadone and other pharmacotherapies has important benefits for individuals and society. However, regulatory policies have separated this treatment from the...Full Text Available
OBJECTIVE: To determine the common types of injuries among children (0-14 years) in Al-Ain, United Arab Emirates (UAE). DESIGN: A retrospective descriptive hospital based study. SETTING: Al-Ain Medical...Full Text Available
Nowadays, percutaneous pulmonary valve implantation is a successful alternative to surgery for patients requiring treatment of pulmonary valve dysfunction. However, owing to the wide variety of implantation...Full Text Available
Academy of Neurology and the American Epilepsy Society. Neurology. 2007;69:1991-2007. Rubin DH, Kornblau DH, Conway Jr EE, et al. Neurologic Disorders. In: Marx, JA, ed. Rosen's...
Background: Health information technologies (HIT) such as electronic medical records (EMR), computerized physician order entry (CPOE), and clinical decision support systems (CDSS) have...Full Text Available
The outcome of patients admitted to intensive care units is known to be influenced by such factors as age, previous health status, severity of disease, and diagnosis. To estimate the outcome of such...Full Text Available
... Biomedical Engineering Optical and Photonic Materials and Devices Fundamental Optical Interactions ... of Texas Medical School OPTICAL AND PHOTONIC MATERIALS AND DEVICES Gary Bjorklund, IBM, Chair Nan ...
This article describes the new Health Sciences Library at the University of Virginia Medical Center in Charlottesville, Virginia. The library was under construction for about two years and opened in...Full Text Available
The developing Integrated Academic Information System (IAIMS) at Columbia-Presbyterian Medical Center provides data sharing links between two separate corporate entities, namely Columbia University...Full Text Available
Objective:Parkinson disease (PD) may affect the autonomic nervous system and may cause constipation; however, few studies have explored constipation preceding the motor onset of...Full Text Available
Driving buses in London is an occupation in which the standards of fitness have been defined and in which the frequency of, and clinical reason for, exclusion from the occupation have been recorded.The...Full Text Available
The prognosis for patients with newly diagnosed malignant gliomas remains poor; however there have been some recent advances in treatment that have generated optimism. Medical management usually includes...Full Text Available
Multimodality imaging with PET/CT and SPECT/CT has become commonplace in clinical practice and in preclinical and basic medical research. Do other combinations of imaging modalities have a similar...Full Text Available
Less than half of older adults with depression achieve remission with antidepressant medications, and rates of remission are even poorer for those with comorbid conditions. Psychosocial interventions...Full Text Available
... of the American Medical Association JAMA PATIENT PAGE Cardiopulmonary Resuscitation W hen the heart stops beating (cardiac arrest), ... circulation (blood flow) returns or is restored. Providing cardiopulmonary resuscitation ( CPR ) is a way to keep some circulation ...
An ex-employee's claims that inadequate enforcement of radiation safety regulations allowed excess radiation exposure thereby causing his deteriorating health was not substantiated by a thorough investigation.
Objectives:Despite its impact on health policy, the relationship between geographical proximity and health care seeking has received scant attention in the medical literature. This...Full Text Available
Homeopathy was born as an experimental discipline, as can be seen from the enormous amount of homeopathic data collected over more than two centuries. However, the medical tradition of homeopathy has...Full Text Available
This paper describes Image Engine, an object-oriented, microcomputer-based, multimedia database designed to facilitate the storage and retrieval of digitized biomedical still images, video, and text...Full Text Available
More than 30 years of experience in developing a computer-based patient record system, The Medical Record (TMR), in multiple settings, in multiple specialty groups, and at multiple sites has taught...Full Text Available
AimsTo identify the completeness of documentation of Complementary And Alternative Medicine (CAM) use in hospital medical records of patients before and after an education programme.Full Text Available
BackgroundHerbs and other dietary supplements are among the most commonly used complementary medical therapies. However, clinicians generally have limited knowledge, confidence and...Full Text Available
Contemporary Western medicine has witnessed a fragmentation of our conceptualization of the medical endeavor into ‘traditional medicine’ and ‘non-traditional medicine’....Full Text Available
Porous Nitinol (PNT) has found vast applications in the medical industry as interbody fusion devices, synthetic bone grafts, etc. However, the tendency of the PNT to corrode is anticipated to...Full Text Available
...comply with funding body archiving policies, including the policies put in place by the National Institutes of Health, The Wellcome Trust and the Howard Hughes Medical Institute . Delayed Access Select journals provide content to some or all of a journalrsquo;s backfile. For example, articles in ...
Current methods of detecting confidentiality breaches in electronic medical record systems are inadequate, partially due to the lack of necessary information at the point of audit trail analysis. In...Full Text Available
Journal editorials are an important medium for communicating information about medical innovations. Evaluative statements contained in editorials pertain to the innovation's technical merits, as well...Full Text Available
BackgroundWebsites of many rogue sellers of medications are accessible through links in email spam messages or via web search engines. This study examined...Full Text Available
BackgroundThis study investigated the knowledge of depression and preference for professional help, medications and treatment methods among Australians of Chinese-speaking background,...Full Text Available
In summer 2000, the Cushing/Whitney Medical Library at Yale University began a demonstration project to digitize classic articles in neurosurgery from the late 1800s and early 1900s. The objective of...Full Text Available
BackgroundInvestigation of the functioning of the brain in living systems has been a major effort amongst scientists and medical practitioners. Amongst the various disorder of the...Full Text Available
child becomes unresponsive, stops breathing, or turns blue: Shout for help. Give infant CPR. Call 911 after one minute of CPR. If you can SEE the object blocking the airway, try...
Carotid artery stenosis is a major risk factor for stroke, and treatments for this condition to decrease the risk of stroke include medical therapy, carotid endarterectomy (CEA), and, more recently,...Full Text Available
Drownings in Recreational Water Settings - United States, 2001-2002 While immediate CPR can save someone's life, often medical care in the hospital cannot prevent serious...
- flushing Chemotherapy - what to ask your doctor Dry Mouth Oral mucositis Peripherally inserted central catheter Radiation therapy - what to ask your doctor Safe drinking during...
SUMMARYThis article looks at medical approaches to women’s fertility in Argentina in the 1930s and explores the ways in which eugenics encouraged the reproduction of the...Full Text Available
... Since then he has pursued an academic career at the University of Bristol with a one year Fellowship at the the Howard Hughes Medical Institute in the USA. Through his work with ProXara (a biotechnology company) and committee work within Bristol University, Jeremy has amassed ...
The devastating earthquake in Sichuan, China on 12 May 2008 left thousands of survivors requiring medical care and intensive rehabilitation. In view of this great demand, the Chinese Speaking Orthopaedic...Full Text Available
Described and discussed in this paper are radiation processes and their advantages over the conventional techniques. Radiation sterilization of medical products, food irradiation, wood plastic composites, and radiation treatment of sewage and waste waters are presented. The Philippine experience in using these technologies, its problems and barriers are also given. (ELC).
Very few areas of medical science have experienced more rapid development of new and beneficial treatment approaches during the past two decades than the disciplines required for total care of patients...Full Text Available
CONTEXTThe impact of residents on hospital finance has been studied; there are no data describing the economic effect of residents on attending physicians.OBJECTIVEIn...Full Text Available
OBJECTIVE: To increase cost-efficiency while maintaining the standard of medical care, an accelerated surgical stay program for patients having breast surgery was instituted. SUMMARY BACKGROUND DATA:...Full Text Available
Sensitivity and specificity measure inherent validity of a diagnostic test against a gold standard. Researchers develop new diagnostic methods to reduce the cost, risk, invasiveness, and time. Adequate...Full Text Available
IntroductionA rare side effect of antipsychotic medication is neuroleptic malignant syndrome, mainly characterized by hyperthermia, altered mental state, haemodynamic dysregulation,...Full Text Available
Image enhancement is of great importance in medical imaging where image resolution remains a crucial point in many image analysis algorithms. In this paper, we investigate brain hallucination...Full Text Available
BackgroundInsurance coverage of tobacco cessation medications increases their use and reduces smoking prevalence in a population. However, uncertainty about the impact of this coverage...Full Text Available
... York, 7/15/2008) Cancers Adrenal Gland Cancer Laparoscopic Adrenalectomy (Shawnee Mission Medical Center, Shawnee Mission, KS, ... MN, 1/24/2007) Colorectal Cancer Advances in Laparoscopic Colorectal Surgery (Charles E. Schmidt College of Biomedical ...