Sample records for 3-year clinical evaluation

  1. Clinical evaluation of Xive implants 3-year after placement

    Institute of Scientific and Technical Information of China (English)

    Ruixia Wang; Hua Yuan; Ning Chen; Guoping Wang; Zhaoping Fang; Guoxing Zhou


    Objective: The main purpose of this retrospective study is to evaluate clinical outcomes of Xive implants 3-year after insertion. Methods: 219 Xive implants were placed in 139 patients and their clinical effects were evaluated using the Albrektsson Standard. Results:The 3-year survival rate of the Xive implants is 97.26%(213/219). Eleven cases of immediate implants and 15 cases of implant insertion after maxillary sinus lifting all succeeded. The failure ratio is 6/219(2.74%) with failures resulting from excess bone loss in the implant region, peal-implant mucosal inflammation or continuous pain caused by some unknown reasons. Conclusion: Xive implants are clinically effective for the restoration of missing teeth. Immediate implant and implant following maxillary sinus lifting were also successful.

  2. Practice-based clinical evaluation of metal-ceramic and zirconia molar crowns: 3-year results. (United States)

    Rinke, S; Schäfer, S; Lange, K; Gersdorff, N; Roediger, M


    This practice-based study evaluates the clinical performance of conventionally luted metal-ceramic and zirconia molar crowns fabricated with pronounced anatomical core design and a prolonged cooling period of the veneering porcelain. Fifty-three patients were treated from 07/2008 until 07/2009 with either metal-ceramic crowns (MCC) (high-noble alloy + low-fusing porcelain) or zirconia crowns (Cercon System, DeguDent, Germany). Forty-nine patients (30 women/19 men) with 100 restorations (metal-ceramic: 48/zirconia: 52, mean observational period: 36·5 ± 6 months) participated in a clinical follow-up examination and were included in the study. Time-dependent survival (in situ criteria), success (event-free restorations) and chipping rates (defects of the veneering ceramics) were calculated according to the Kaplan-Meier method and analysed in relation to the crown fabrication technique, using a Cox regression model (P zirconia: 2) were recorded (survival rate after 3 years: metal-ceramic: 97·6%, zirconia: 95·2%). Of the metal-ceramic restorations, 90·9% remained event-free (two ceramic fractures, one endodontic treatment), whereas the success rate for the zirconia was 86·8% (two ceramic fractures, one endodontic treatment, one secondary caries). No significant differences in survival (P = 0·53), success (P = 0·49) and ceramic fracture rates (P = 0·57) were detected. The combination of a pronounced anatomical core design and a modified firing of the veneering porcelain for the fabrication of zirconia molar crowns resulted in a 3-year survival, success and chipping rate comparable to MCC.

  3. Zirconia dental implants : a clinical, radiographic, and microbiologic evaluation up to 3 years

    NARCIS (Netherlands)

    Brüll, Felix; van Winkelhoff, Arie Jan; Cune, Marco S.


    PURPOSE: To retrospectively evaluate the clinical performance of zirconia endosseous implants. MATERIALS AND METHODS: Partially edentulous patients with adequate bone volume to fit yttria tetragonal zirconia polycrystal (Y-TZP) implants at least 3.5 mm wide and 8.0 mm long were included. Full-mouth

  4. Clinical Evaluation of Silorane and Nano-hybrid Resin Composite Restorations in Class II Cavities up to 3 Years. (United States)

    Öztürk-Bozkurt, F; Toz, T; Kara-Tuncer, A; Gözükara-Bağ, H; Özcan, M

    In this study, the clinical performance of a silorane-based resin composite (SC) vs a nano-hybrid resin composite (NHC) was evaluated in Class II cavities. From January 2012 to February 2013, a total of 29 patients (eight men, 21 women; mean age, 24 ± 5 years) received 29 pairs of restorations using both SC (Filtek Silorane, 3M ESPE) and NHC (Filtek Z550, 3M ESPE) materials. Patients were followed until February 2015. One operator performed all restorations using the corresponding adhesive resins according to the manufacturers' instructions. Two calibrated independent examiners evaluated the restorations at one week, six months, and then annually using the modified United States Public Health Service (USPHS) criteria for anatomic form, marginal adaptation, color match, surface roughness, marginal discoloration, secondary caries, and postoperative sensitivity. Changes in the USPHS parameters were analyzed with the McNemar test (α=0.05). The mean observation period was 31.2 months. Marginal adaptation was the only parameter that showed a significant difference and was worse for SC than NHC (p=0.012). At the final recall, 17 restorations from the SC group and five from the NHC group received a score of 1 (explorer catches). These scores were significantly different between baseline and final recall for SC (p0.05). Both NHC and SC performed similarly in Class II restorations up to three years except for marginal adaptation, for which the latter demonstrated significant deterioration at the final recall compared with baseline.

  5. A randomized, controlled clinical evaluation of a synthetic gel membrane for guided bone regeneration around dental implants: clinical and radiologic 1-and 3-year results

    NARCIS (Netherlands)

    Ramel, C.F.; Wismeijer, D.A.; Hämmerle, C.H.F.; Jung, R.E.


    PURPOSE: The objective of this study was to determine whether a synthetic bioresorbable polyethylene glycol (PEG) hydrogel membrane could provide similar clinical and radiographic outcomes as a standard collagen membrane, both in combination with a membrane-supporting material, during follow-up peri

  6. Clinical evaluation of the marginal gingiva as a donor tissue to augment the width of keratinized gingiva: Series of 2 cases with 3-year follow-up

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    Palka Kaur Khanuja


    Full Text Available The indications to increase the width of keratinized gingiva have not been proven beyond doubt; however it becomes indispensable in certain clinical situations. Inspite of frequently encountered complications, palate is considered most preferred area to harvest the free gingival graft (FGG. This procedure aimed at investigating the potential of buccal marginal gingiva as a donor to augment keratinized gingiva. To the best of our knowledge, no such cases have been documented in the literature. FGG harvested from maxillary buccal marginal gingiva was used to augment gingiva in the mandibular anterior region for two patients. This not only improved plaque control but also resulted in acceptable esthetic results over 3 years. Furthermore, gingiva at donor sites gained its normal form and was in harmony with the neighboring teeth. It may be concluded that buccal marginal gingiva may provide a predictable substitute to other donor tissues to augment gingiva.

  7. Randomized 3-year Clinical Evaluation of Class I and II Posterior Resin Restorations Placed with a Bulk-fill Resin Composite and a One-step Self-etching Adhesive

    DEFF Research Database (Denmark)

    van Dijken, Jan Wv; Pallesen, Ulla


    ). Each patient received at least two extended Class I or Class II restorations that were as similar as possible. In all cavities, a one-step self-etching adhesive (XenoV+) was applied. One of the cavities of each pair was randomly assigned to receive the flowable bulk-fill resin composite SDR......PURPOSE: To evaluate the 3-year clinical durability of the flowable bulk-fill resin composite SDR in Class I and Class II restorations. MATERIALS AND METHODS: Thirty-eight pairs of Class I and 62 pairs of Class II restorations were placed in 44 male and 42 female patients (mean age 52.4 years...... evaluated using slightly modified USPHS criteria at baseline and then annually for 3 years. Caries risk and bruxing habits of the participants were estimated. RESULTS: No post-operative sensitivity was reported. At the 3-year follow-up, 196 restorations - 74 Class I and 122 Class II - were evaluated. Seven...

  8. Clinical evaluation of 860 anterior and posterior lithium disilicate restorations: retrospective study with a mean follow-up of 3 years and a maximum observational period of 6 years. (United States)

    Fabbri, Giacomo; Zarone, Fernando; Dellificorelli, Gianluca; Cannistraro, Giorgio; De Lorenzi, Marco; Mosca, Alberto; Sorrentino, Roberto


    This study aimed to assess the clinical performance of lithium disilicate restorations supported by natural teeth or implants. Eight hundred sixty lithium disilicate adhesive restorations, including crowns on natural teeth and implant abutments, veneers, and onlays, were made in 312 patients. Parafunctional patients were included, but subjects with uncontrolled periodontitis and gingival inflammation were excluded. Veneers up to 0.5 mm thick were luted with flowable composite resin or light curing cements, while dual-curing composite systems were used with veneers up to 0.8 mm thick. Onlays up to 2 mm in thickness were luted with flowable composite resins or dual-curing composite cements. Crowns up to 1 mm in thickness were cemented with self-adhesive or dual-curing resin cements. The observational period ranged from 12 to 72 months, with a mean follow-up of 3 years. The mechanical and esthetic outcomes of the restorations were evaluated according to the modified California Dental Association (CDA) criteria. Data were analyzed with descriptive statistics. Twenty-six mechanical complications were observed: 17 porcelain chippings, 5 fractures, and 4 losses of retention. Structural drawbacks occurred mainly in posterior segments, and monolithic restorations showed the lowest number of mechanical complications. The clinical ratings of the successful restorations, both monolithic and layered, were satisfactory according to the modified CDA criteria for color match, porcelain surface, and marginal integrity. The cumulative survival rates of lithium disilicate restorations ranged from 95.46% to 100%, while cumulative success rates ranged from 95.39% to 100%. All restorations recorded very high survival and success rates. The use of lithium disilicate restorations in fixed prosthodontics proved to be effective and reliable in the short- and medium-term.

  9. 287件 CAD/CAM二氧化锆全瓷修复体3年临床疗效观察%Clinical evaluation of 287 CAD/CAM zirconia ceramic restorations:A 3-year follow up

    Institute of Scientific and Technical Information of China (English)

    赵云; 张少锋; 高婧; 李玲; 郑晓娟; 蔚劲涛; 杨雪薇


    目的:探讨 CAD/CAM氧化锆全瓷修复体的临床疗效及失败原因。方法:对206例患者、287件 CAD/CAM氧化锆全瓷修复体进行3年前瞻性随访研究,按照美国加州牙科协会(CDA)制定的标准,通过 Kaplan-Meier 生存分析、Log-Rank 检验及卡方检验,统计累积生存率,分析修复体类型、修复牙位、基牙桩核与否等因素对全瓷修复体生存率的影响。结果:观察期内CAD/CAM二氧化锆修复体有5件发生瓷崩裂,4件出现明显牙龈炎症,3件基牙发生根尖周炎;修复体3年累积生存率为95.7%。其中单冠、联冠、固定桥的3年累积生存率分别为96.3%、93.6%、95.7%(P >0.05),前牙组与后牙组的3年累积生存率分别为94.5%、96.3%(P >0.05),基牙桩核组与非桩核组3年累积生存率分别为95.0%、96.1%(P >0.05)。结论:CAD/CAM二氧化锆修复体3年累积生存率较高,修复体类型、修复牙位及基牙桩核与否对其生存率影响均无显著性差异;瓷崩裂是最常见的失败原因。%Objective:To evaluate the clinical performance of CAD/CAM zirconia all-ceramic restorations.Methods:287 all-ce-ramic Zirconia restorations in 206 patients were included in a 3-year prospectively survey with California Dental Association Standard (CDA)as a reference.The effects and the related factors such as restoration type,tooth region,fiber reinforced composite application on survival rate were analyzed.Kaplan-Meier survival analysis and Log-Rank test were used for data analysis.Results:Chipping frac-tures in 5 restorations,intense gingivitis at 4 restorations and periapical inflammation for 3 restorations were observed during the obser-vation period.The 3-year cumulative survival rate (CSR)of CAD/CAMzirconia restorations was 95.7%,The differences among the CSR of single crowns(96.3%),linked crowns (93.6%)and fixed partial dentures(95.7%)were not

  10. A 3-year clinical follow-up study of a ceramic (Optec) inlay system. (United States)

    Molin, M; Karlsson, S


    To evaluate the clinical quality of ceramic (Optec) inlays, the inlay production of 10 dentists, served by 3 dental laboratories, was examined independently by 2 calibrated examiners. Of the 57 patients with 205 inlays participating in the first examination, 47 patients with 145 remaining inlays participated in the 3-year follow-up reexamination. For 14 of the participants in the reexamination, altogether 21 inlays had fractured. The mean time in service before fracture was 26.4 months (range, 12-53 months). The inlays were rated using the California Dental Association (CDA) quality evaluation system. This examination showed that the mismatch of color had increased from the first examination to the reexamination and registered slightly roughened surfaces. As to anatomic form, a reduced number of inlays did not receive an excellent CDA rating at the reexamination. Visible evidence of ditching along the margin had increased by almost 50%, and an apparent discoloration of the margin between the restoration and the tooth structure was seen in 73% of the reexamined inlays, compared with 7% at the first examination.

  11. A bioactive dental luting cement--its retentive properties and 3-year clinical findings. (United States)

    Jefferies, Steven R; Pameijer, Cornelis H; Appleby, David C; Boston, Daniel; Lööf, Jesper


    A clinical validation study was conducted to determine the performance of a new bioactive dental cement (Ceramir C&B, Doxa Dental AB) for permanent cementation. The cement is a new formulation class, which is a hybrid material comprised of calcium aluminate and glass-ionomer components. A total of 38 crowns and bridges were cemented in 17 patients; 31 of the abutment teeth were vital and seven were non-vital. Six restorations were bridges with a total of 14 abutment teeth (12 vital/ two non-vital). One fixed splint comprising two abutment teeth was also included. Preparation parameters were recorded, as well as cement characteristics such as working time, setting time, seating characteristics, and ease of cement removal. Baseline data were recorded for the handling of the cement, gingival inflammation, and pre-cementation sensitivity. Post-cementation parameters included post-cementation sensitivity, gingival tissue reaction, marginal integrity, and discoloration. All patients were seen for recall examinations at 30 days and 6 months. Fifteen of 17 subjects and 13 of 17 patients were also available for subsequent comprehensive 1- and 2-year recall examination, and 13 patients were available for a 3-year recall examination. Restorations available for the 3-year recall examination included 14 single-unit full-coverage crown restorations, four three-unit bridges comprising eight abutments, and one two-unit splint. Three-year recall data yielded no loss of retention, no secondary caries, no marginal discolorations, and no subjective sensitivity. All restorations rated excellent for marginal integrity. Average visual analogue scale (VAS) score for tooth sensitivity decreased from 7.63 mm at baseline to 0.44 mm at 6-month recall, 0.20 mm at 1-year recall, and 0.00 mm at 2- and 3-year recall. Average gingival index (GI) score for gingival inflammation decreased from 0.56 at baseline to 0.11 at 6-month recall, 0.16 at 1-year recall, 0.21 at 2-year recall, and 0.07 at 3

  12. SU-E-T-03: 3 Year Clinical Experience with the IBA Proton Eyeline

    Energy Technology Data Exchange (ETDEWEB)

    Kryck, E; Mamalui-Hunter, M; Li, Z; Slopsema, R [University of Florida/Radiation Oncology, Jacksonville, FL (United States)


    Purpose: Over the past 3 years, more than 50 patients with ocular disease have been treated with a prototype commercial eyeline developed by Ion Beam Applications (IBA). It is particularly crucial for the dosimetry of the machine to be accurate, precise, and reproducible because of the small treatment volumes and several surrounding critical structures. A quality assurance (QA) program has been developed in order to regularly check and record the machine’s dosimetry over time. In this study we have summarized and evaluated three years of patient and system QA data for the eyeline prototype. Methods: In order to accurately deliver the prescribed dose to the patient’s treatment site, an output model was created based on several machine parameters. This output model, along with the requested system parameters, are regularly checked and recorded by a QA program. 10 standard proton fields have been created which have regular QA performed monthly with a water tank and parallel-plate chamber, and recorded in a database. QA has additionally been performed for each patient-specific treatment field. This is to verify and evaluate the patient output model as well as the system parameters for range&modulation combinations different than the standard QA fields. Results: 140 beam measurements have been analyzed for range, modulation, and output. The range is typically within tolerance, although there are about 6 cases where the system did not perform as expected. The modulation appears to be very stable, always being within tolerance. Output for the standard QA fields are typically within 2.5% from the baseline value. The patient output measurements agree within 2.5% from the model. Conclusion: Overall the eyeline performs well within the tolerances set, and the patient output measurements agree within 2% of the model.

  13. Clinical and demographic characteristics of patients with occupational contact dermatitis: A 3-year single center experience

    Directory of Open Access Journals (Sweden)

    Aslı Aytekin


    Full Text Available Background and Design: Occupational contact dermatitis (OCD is responsible for 80-90% of the occupational dermatoses. The aim of this work was to evaluate the clinical features of patients with OCD admitted to our hospital. Materials and Methods: The records of patients, who were admitted to our hospital with OCD between December 2009 and January 2013, were evaluated retrospectively. One hundred fifty-nine patients, who were diagnosed with OCD according to the Mathias criteria, were included in the study. Age, sex, location of the lesions, atopic status, glove use, occupational exposure time and total IgE levels of the patients were assessed. Patients with positive allergic reaction with "European Standard Series Skin Patch Test" were identified as allergic OCD and patients with negative test results as "irritant OCD". The clinical features and patch results of patients are evaluated. Results: One hundred fifty-nine patients with a mean age of 39±7.9 years consisted of 151 men and 8 women. The hands were the most common site of OCD; the palms were the most common affected areas of hand eczema. Eighty-one patients (50.1% were identified to have allergic OCD and 78 (49.9% as irritant OCD. Irritant OCD was most commonly seen in dental technicians, whereas allergic OCD was most commonly seen in tailors. The top 3 most frequent allergens were potassium dichromate (15.1%, nickel sulfate (9.11% and cobalt chloride (10.7%. Conclusion: In our country, there has been no comprehensive study presenting the clinical and descriptive characteristics of OCD. For preventing OCD and reducing sick leave we need to have data that belong to our country. Consequently, multicenter studies should be performed for establishing our own database on OCD.

  14. Implementing the objective structured clinical examination in a geriatrics fellowship program-a 3-year experience. (United States)

    Avelino-Silva, Thiago J; Gil, Luiz A; Suemoto, Claudia K; Kikuchi, Elina L; Lin, Sumika M; Farias, Luciana L; Jacob-Filho, Wilson


    The Objective Structured Clinical Examination (OSCE) appears to be an effective alternative for assessing not only medical knowledge, but also clinical skills, including effective communication and physical examination skills. The purpose of the current study was to implement an OSCE model in a geriatrics fellowship program and to compare the instrument with traditional essay examination. Seventy first- and second-year geriatric fellows were initially submitted to a traditional essay examination and scored from 0 to 10 by a faculty member. The same fellows subsequently underwent an OSCE with eight 10-minute stations covering a wide range of essential aspects of geriatric knowledge. Each OSCE station had an examiner responsible for its evaluation according to a predefined checklist. Checklist items were classified for analysis purposes as clinical knowledge items (CKI) and communication skills items (CSI); fellow responses were scored from 0 to 10.Although essay examinations took from 30 to 45 minutes to complete, 180-200 minutes were required to evaluate fellows using the proposed OSCE method. Fellows scored an average of 6.2 ± 1.2 on the traditional essay examination and 6.6 ± 1.0 on the OSCE (P OSCE scores indicated that average performance on CKI was lower than the average on CSI (6.4 ± 1.1 vs. 8.4 ± 1.1; P examination was similar to their performance on CKI (P = .13). Second-year fellows performed better than first-year fellows on the essay examination (P OSCE was successfully implemented as an educational strategy during a geriatrics fellowship program. Combining different testing modalities may provide the best assessment of competence for various domains of knowledge, skills, and behavior.

  15. Community vs. Clinic-based modular treatment of children with early-onset ODD or CD: A clinical trial with 3-year follow-up (United States)

    Kolko, David J.; Bukstein, Oscar G.; Padini, Dustin; Holden, Elizabeth A.; Hart, Jonathan; Dorn, Lorah D.


    This study examines the treatment outcomes of 144, 6–11 year-old, clinically referred boys and girls diagnosed with Oppositional Defiant Disorder (ODD) or Conduct Disorder (CD) who were randomly assigned to a modular-based treatment protocol that was applied by research study clinicians either in the community (COMM) or a clinic office (CLINIC). To examine normative comparisons, a matched sample of 69 healthy control children was included. Multiple informants completed diagnostic interviews and self-reports at six assessment timepoints (pretreatment to 3-year follow-up) to evaluate changes in the child’s behavioral and emotional problems, psychopathic features, functional impairment, diagnostic status, and service involvement. Using HLM and logistic regression models, COMM and CLINIC showed significant and comparable improvements on all outcomes. By 3-year follow-up, 36% of COMM and 47% of CLINIC patients no longer met criteria for either ODD or CD, and 48% and 57% of the children in these two respective conditions had levels of parent-rated externalizing behavior problems in the normal range. We discuss the nature and implications of these novel findings regarding the role of treatment context or setting for the treatment and long-term outcome of behavior disorders. PMID:19221871


    Directory of Open Access Journals (Sweden)



    Full Text Available Sigmoid volvulus is abnormal rotation of sigmoid colon along it’s mesenteric axis which may results in effects ranging from partial to complete obstruction of bowel to vascular compromise, culminating in gangrene of bowel. Sigmoid volvulus is responsible for about 4 - 24% of all acute intestinal obstruction. Retrospectiv ely for last 3 years all cases of acute intestinal obstruction admitted to surgery were reviewed and study of sigmoid volvulus cases done. We analysed 247 cases of acute intestinal obstruction retrospectively over a period of 3 years . 50 cases are due to s igmoid volvulus. Most of cases are around 41 - 60 years. Most of cases present with pain abdomen , abdominal distention , constipation. Diagnosis is made by plain x - ray abdomen. Most cases treated with Derotation , resection and anastomosis. Out of 50 cases 6 d eaths occurred.

  17. Clinical investigation of traumatic injuries in Yeditepe University, Turkey during the last 3 years. (United States)

    Sandalli, Nuket; Cildir, Sule; Guler, Nurhan


    The aim of this study was to evaluate etiology, types of traumatic dental injuries, treatment and to determine the incidence of complications according to dental injuries in patients who referred to Yeditepe University, Faculty of Dentistry, Istanbul, Turkey. The study was based on the clinical data of the 161 traumatized teeth in 92 patients. WHO classification slightly modified by Andreasen & Andreasen for dental trauma was used. The causes and localization of trauma, traumatized teeth classification, treatment and complications were evaluated both primary and permanent teeth. The distribution of complications according to diagnosis and treatment of the injured teeth were evaluated. Of 35 (38%) girls and 56 (72%) boys with a mean age 7.6 +/- 3.5 (ranging 1-14.2) participated to study and the mean followed up was 1.72 +/- 1.28 years (ranging 0.10-3.8 years). From the 161 affected teeth, 69 (42.9%) were in primary teeth and 92 (57.1%) in permanent teeth. The highest frequency of trauma occurred in the 6-12 year age group. Overall boys significantly outnumbered girls by approximately 1:1.6. The most common type of injury in the primary and permanent teeth was seen as luxation (38%) and enamel fracture (20%) of the maxillary central incisors, respectively. Falls were the major sources of trauma both the primary (90%) and the permanent teeth (84%). In the primary dentition, the most common type of soft tissue injury is contusion (62.5%) and in the permanent dentition, it is laceration (49%). The most of the treatment choice was determined as examination only and extraction in primary teeth (58 and 24.6%, respectively) while it was applied as restoration and pulpectomy in permanent teeth (31.5 and 18.5%, respectively). Complications were recorded on 37 teeth (23%) with a most common type of necrosis (10.5%) and dental abscess (7.4%). Necrosis was more frequent in luxation whereas dental abscess were in crown fracture with pulpal involvement in both dentitions. The

  18. The Safety of Sino-implant——3-year Clinical Observation

    Institute of Scientific and Technical Information of China (English)

    刘晓瑷; 毛建平; 陈希珍; 王志倩; 金毓翠; 吴学浙; 李慧沁; 张静君; 朱惠斌; 苏昭仪; 俞美英; 李丽蝉; 李晓露


    A total of 315 women who had Sino implant Ⅱ implantation and 302 healthy women were recruited and followed-up for 3 years in order to observe the effect of Sino implant Ⅱ on myoma of uterus and ovarian cysts.The blood pressure,bodyweight,vaginal ultrasonic examination and smear of cervix were measured once a year.The results show that Sino implant Ⅱ does not influence the blood pressure and body weight obviously.There are more ovarian cysts in Sino-implant group than in the control group,but they are all found to disappear when reexamined after menstrua-tion.These ovarian cysts may be follicular cysts.There are fewer myomas of uterus in Sino-implant group than in the control group,and these myomas develop slowly.The results suggest that Sino-implant is a safe contraceptive method.

  19. Reforming the Israeli health system: findings of a 3-year evaluation. (United States)

    Gross, R; Rosen, B; Shirom, A


    Israel, like many other European countries, has recently reformed its health care system. The regulated market created by the National Health Insurance (NHI) law embodies many of the principles of managed competition. The purpose of this paper is to present initial findings from an evaluation of the first 3 years of the reform (1995-1997) regarding the implementation of the reform and the extent to which it has achieved its main goals. The evaluation was conducted using multiple quantitative and qualitative research tools: interviews with key informants; analysis of documents and sick fund financial statements; analysis of trends in sick fund membership; and population surveys conducted in 1995 and 1997 to assess the impact of the reform on outcome measures related to level of services to the public. Data from the evaluation show that the NHI law achieved a considerable number of its goals: to provide insurance coverage for the entire population, to ensure freedom of movement among sick funds, and to standardize the way resources are allocated to sick funds. The incentives that are embodied in the law have encouraged the sick funds to improve the level of services provided to the average insuree, and to develop services in the periphery and for some of the weaker populations. From the financial perspective, concerns that NHI would lead to a rise in the national health expenditure were not realized as of 1997. In the wake of NHI, there has been a decline in the age adjusted per capita expenditure in three sick funds, with no reports by insurees, at least through 1997, on a decline in satisfaction or level of service. However, the Israeli experience shows that regulating competition does not necessarily lead to economic stability and equality. Regulating the competition also did not solve some of the major policy issues in the Israeli health system including level of resources allocated to health, organizational structure of the hospital system, manpower planning and

  20. Clinical success and survival of indirect resin composite crowns: results of a 3-year prospective study

    NARCIS (Netherlands)

    Jongsma, L.A.; Kleverlaan, C.J.; Feilzer, A.J.


    Objectives The aim of this study was to test the new resin composite "NECO" as a material for indirect restorations clinically. Methods Forty-five patients were selected, of which 12 men and 33 women, with a mean age of 53. A total of 91 post-canine indirect resin composite NECO (Heraeus Kulzer, Gmb

  1. Clinical 3-year follow-up of uterine fibroid embolization; Klinische 3-Jahres-Ergebnisse nach Uterusmyomembolisation

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    Radeleff, B.A.; Satzl, S.; Eiers, M.; Fechtner, K.; Hakim, A.; Kauffmann, G.W.; Richter, G.M. [Universitaetsklinikum Heidelberg (Germany). Abt. Radiodiagnostik; Rimbach, S. [Klinikum Konstanz (Germany). Frauenklinik


    Purpose: The purpose of this study was to evaluate the clinical long-term success of uterine artery embolization (UAE) in patients with symptomatic fibroids using spherical particles (Embosphere). Materials and Methods: 34 consecutive patients treated with UAE were initially enrolled in the study which had the following study goals (1) 1-year follow-up MRI evaluation of the fibroid behavior and (2) clinical long-term success due to standardized assessment of the main fibroid-related symptoms (hypermenorrhoea, dysmenorrhoea and dysuria) of the patients' individual overall health status and their therapy satisfaction at 1-year, 2- year and 3-year intervals after UAE. Results: Technical success was achieved in all procedures. Four patients had to be excluded from the long-term evaluation schedule: one because of a hysterectomy due to bleeding after 6 weeks, 3 patients were not available for the designated minimum follow-up interval. The preinterventional severe hypermenorrhoea (n = 27) with a score of 4.4 {+-} 0.7 (5 = extreme menstrual bleeding) decreased after one year to 2.1 {+-} 0.5 (p = 0.0001), after two years to 1.7 {+-} 0.5 (p = 0.0042) and after three years to 1.3 {+-} 0.6 (p = 0.0001). The preinterventional dysmenorrhoea (n = 15) with a score of 3.1 {+-} 1.5 (3 = distinctly increased dysmenorrhoea) decreased after one year to 1.1 {+-} 0.3 (p = 0.0001), after two years to 1.2 {+-} 0.2 and after three years to 1.2 {+-} 0.4 (p = 0.148). The pretreatment dysuria (n = 12) with a preinterventional score of 3.1 {+-} 1.5 (3 = distinctly increased dysuria) decreased after one year to 1.1 {+-} 0.3 (p = 0.0069) and remained after two years at 1.1 {+-} 0.2 and after three years at 1.2 {+-} 0.4 (p = 0.905). The initial overall health status was 54.7 {+-} 20.1 (maximal value 100). After one year it rose to 90.5 {+-} 15.4 (p = 0.0001), was 91.8 {+-} 5.6 after two years and was 91.3 {+-} 8.5 (p = 0.8578) after three years. The satisfaction with the therapy was 2

  2. Socio-demographic and clinical variables associated with psychological distress 1 and 3 years after breast cancer diagnosis

    DEFF Research Database (Denmark)

    Alfonsson, Sven; Olsson, Erik; Hursti, Timo


    Purpose A large group of women (20–30 %) report psychological distress shortly after breast cancer diagnosis, and some experience continued or increased symptoms over time. The aim of this study was to investigate socio-demographic and clinical variables associated with sustained psychological...... distress in this patient group. Methods Women with breast cancer (n = 833) completed self-report questionnaires regarding socio-demographic and clinical variables shortly after (T1) and 3 years after diagnosis (T2) while data on illness severity were collected from a quality register. The Hospital Anxiety...... and Depression Scale was used as a measure of psychological distress at both time points. Results The number of participants who reported elevated levels of anxiety was 231 (28 %) at T1 and 231 (28 %) at T2 while elevated depressive symptoms was reported by 119 (14 %) women at T1 and 92 (11 %) at T2. Despite non...

  3. Evaluation of bacteremias in a Turkish university hospital: 3-year outcomes. (United States)

    Demirdal, Tuna; Demirturk, Nese; Cetinkaya, Zafer; Tufan, Gulnihal


    In this retrospective study, the investigators examined blood cultures from patients that had been diagnosed with bacteremias over a 3-y period. The study was conduced at Kocatepe University Hospital (Middle Anatolia, Turkey). Blood samples that arrived at the university's microbiology laboratory between 2002 and 2005 were evaluated retrospectively. These samples were classified as contamination, false positivity, community-acquired bacteremia (CAB), or hospital-acquired bacteremia (HAB). Patient age and sex, foci of bacteremia, present comorbidities, predisposing factors, pathogens, and mortality rates were evaluated. A total of 1783 blood cultures that had been drawn from 1441 patients during this 3-y period were examined retrospectively. Of 354 positive isolates, 61 (17.2%) were CABs and 293 (82.8%) were HABs. In HABs, the most commonly isolated microorganisms were Staphylococcus aureus (37.5%), coagulase-negative staphylococci (29.7%), and Escherichia coli (10.2%); in CABs, the most commonly isolated microorganisms were S aureus (29.5%), Brucella spp (26.2%), and E coli (24.6%). Crude mortality rates were determined to be 15.2% for HABs and 12.7% for CABs. This study yielded data on the most common foci of bacteremia, microbiologic factors, and the epidemiology associated with HABs and CABs. It is hoped that these data will enhance empirical antibiotic therapeutic approaches, thereby preventing delays in treatment and decreasing mortality rates associated with bacteremias.

  4. Effect of External Quality Assurance Evaluation for Chest Radiography: 3-Year Follow-Up in the Medical Institution for Pneumoconiosis

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    Lee, Won Jeong; Choi, Soon Byung [Clinical Research Team, Occupational Lung Diseases Institute, Korea Worker' s Compensation and Welfare Service, Ansan (Korea, Republic of)


    The aim of this study was to determine the effect of external quality assurance (QA) evaluation for chest radiography in the medical institution for pneumoconiosis (MIP). The chest radiography of the MIPs were evaluated for a radiological technique (RT), image quality (IQ), and reading environment (RE), during a 3-year follow up according to the Korean guidelines. Same methods were implemented each year to ensure that the results are reliable. RT, IQ, and RE were compared between examination and medical care (EMP), and only medical care (MCP) for pneumoconiosis, film-screen (FSR) and digital (DR) radiography. Uneducated and educated for QA during a 3-year follow up referencing with 2008 were realized. RT and IQ of the MIPs showed a significantly higher score in 2009 and 2010 compared with 2008 (p < 0.01). However, RE was not significantly improved. The score of RT, IQ, and RE of the EMPs were higher than those of MCPs every year, and FSR showed a lower score in all evaluations, although, more improvement was seen than the DR. The chest radiography of the MIPs showed a significant effect as a result of a repeated external QA evaluation. However, the MIPs need to transfer from FSR to DR, and maintain a continuous QA evaluation for the MCPs.

  5. Clinical features of GH deficiency and effects of 3 years of GH replacement in adults with controlled Cushing's disease

    DEFF Research Database (Denmark)

    Höybye, Charlotte; Ragnarsson, Oskar; Jönsson, Peter J;


    Patients in remission from Cushing's disease (CD) have many clinical features that are difficult to distinguish from those of concomitant GH deficiency (GHD). In this study, we evaluated the features of GHD in a large cohort of controlled CD patients, and assessed the effect of GH treatment....

  6. Randomized Clinical Trial of Indirect Resin Composite and Ceramic Veneers : Up to 3-year Follow-up

    NARCIS (Netherlands)

    Gresnigt, Marco M. M.; Kalk, Warner; Ozcan, Mutlu


    Purpose: This randomized controlled split-mouth clinical trial evaluated the short-term survival rate of indirect resin composite and ceramic laminate veneers. Materials and Methods: A total of 10 patients (mean age: 48.6 years) received 46 indirect resin composite (Estenia; n = 23) and ceramic lami

  7. Phase I clinical trial of cell therapy in patients with advanced chronic obstructive pulmonary disease: follow-up of up to 3 years

    Directory of Open Access Journals (Sweden)

    Talita Stessuk


    Full Text Available BACKGROUND Chronic obstructive pulmonary disease is a major inflammatory disease of the airways and an enormous therapeutic challenge. Within the spectrum of chronic obstructive pulmonary disease, pulmonary emphysema is characterized by the destruction of the alveolar walls with an increase in the air spaces distal to the terminal bronchioles but without significant pulmonary fibrosis. Therapeutic options are limited and palliative since they are unable to promote morphological and functional regeneration of the alveolar tissue. In this context, new therapeutic approaches, such as cell therapy with adult stem cells, are being evaluated. OBJECTIVE This article aims to describe the follow-up of up to 3 years after the beginning of a phase I clinical trial and discuss the spirometry parameters achieved by patients with advanced pulmonary emphysema treated with bone marrow mononuclear cells. METHODS Four patients with advanced pulmonary emphysema were submitted to autologous infusion of bone marrow mononuclear cells. Follow-ups were performed by spirometry up to 3 years after the procedure. RESULTS The results showed that autologous cell therapy in patients having chronic obstructive pulmonary disease is a safe procedure and free of adverse effects. There was an improvement in laboratory parameters (spirometry and a slowing down in the process of pathological degeneration. Also, patients reported improvements in the clinical condition and quality of life. CONCLUSIONS Despite being in the initial stage and in spite of the small sample, the results of the clinical protocol of cell therapy in advanced pulmonary emphysema as proposed in this study, open new therapeutic perspectives in chronic obstructive pulmonary disease. It is worth emphasizing that this study corresponds to the first study in the literature that reports a change in the natural history of pulmonary emphysema after the use of cell therapy with a pool of bone marrow mononuclear cells.

  8. Phase I clinical trial of cell therapy in patients with advanced chronic obstructive pulmonary disease: follow-up of up to 3 years (United States)

    Stessuk, Talita; Ruiz, Milton Artur; Greco, Oswaldo Tadeu; Bilaqui, Aldemir; Ribeiro-Paes, Maria José de Oliveira; Ribeiro-Paes, João Tadeu


    Background Chronic obstructive pulmonary disease is a major inflammatory disease of the airways and an enormous therapeutic challenge. Within the spectrum of chronic obstructive pulmonary disease, pulmonary emphysema is characterized by the destruction of the alveolar walls with an increase in the air spaces distal to the terminal bronchioles but without significant pulmonary fibrosis. Therapeutic options are limited and palliative since they are unable to promote morphological and functional regeneration of the alveolar tissue. In this context, new therapeutic approaches, such as cell therapy with adult stem cells, are being evaluated. Objective This article aims to describe the follow-up of up to 3 years after the beginning of a phase I clinical trial and discuss the spirometry parameters achieved by patients with advanced pulmonary emphysema treated with bone marrow mononuclear cells. Methods Four patients with advanced pulmonary emphysema were submitted to autologous infusion of bone marrow mononuclear cells. Follow-ups were performed by spirometry up to 3 years after the procedure. Results The results showed that autologous cell therapy in patients having chronic obstructive pulmonary disease is a safe procedure and free of adverse effects. There was an improvement in laboratory parameters (spirometry) and a slowing down in the process of pathological degeneration. Also, patients reported improvements in the clinical condition and quality of life. Conclusions Despite being in the initial stage and in spite of the small sample, the results of the clinical protocol of cell therapy in advanced pulmonary emphysema as proposed in this study, open new therapeutic perspectives in chronic obstructive pulmonary disease. It is worth emphasizing that this study corresponds to the first study in the literature that reports a change in the natural history of pulmonary emphysema after the use of cell therapy with a pool of bone marrow mononuclear cells. PMID:24255620

  9. Results of a Multidisciplinary Treatment Program in 3-Year-Old to 5-Year-Old Overweight or Obese Children A Randomized Controlled Clinical Trial

    NARCIS (Netherlands)

    Bocca, Gianni; Corpeleijn, Eva; Stolk, Ronald P.; Sauer, Pieter J. J.


    Objective: To assess the effects of a multidisciplinary intervention program for 3-year-old to 5-year-old overweight and obese children compared with a usual-care program. Design: Randomized controlled clinical trial conducted from October 2006 to March 2008. Setting: Groningen Expert Center for Kid

  10. A 3-year review of cranial nerve palsies from the University of Port Harcourt Teaching Hospital Eye Clinic, Nigeria

    Directory of Open Access Journals (Sweden)

    Chinyere Nnenne Pedro-Egbe


    Conclusion: This is the first study in the literature on ocular cranial nerve palsies in Southern Nigeria. Third and sixth cranial nerve palsies were the most common cases to present to the University of Port Harcourt Teaching Hospital Eye Clinic. There was a statistically significant association to systemic disorders such as hypertension and DM and majority of cases with 6 th cranial nerve palsy.

  11. Evaluation of Clinical Competence. (United States)

    Newble, David I.

    In Australia the usual evaluation of whether a student will perform adequately as a doctor is a subjective evaluation of his clinical performance, usually at the completion of five or six years at medical school. The evaluation is performed on an inadequate and uncontrolled patient sample and appears to be subject to many errors. Recent work…

  12. Clinical investigation of mucosal thickness stability after soft tissue grafting around implants: A 3-year retrospective study


    Speroni Stefano; Cicciù Marco; Maridati Paolo; Grossi Giovanni; Maiorana Carlo


    Purpose: To assess the long-term stability of gingival grafts placed around dental implants at the time of second surgery uncovering and to further investigate the association between mucosal thickness (MTh) by demographic variables and clinical investigation. Materials and Methods: Fourteen patients with submerged dental implants covered by inadequate keratinized mucosa were studied. The subjects underwent a periimplant plastic surgery (PPS) at the second-stage dental implant surgery and fr...

  13. Species distribution and in vitro fluconazole susceptibility of clinical Candida isolates in a Brazilian tertiary-care hospital over a 3-year period


    Márcia Cristina Furlaneto; Juliana Frasnelli Rota; Regina Mariuza Borsato Quesada; Luciana Furlaneto-Maia; Renne Rodrigues; Silas Oda; Marcelo Tempesta de Oliveira; Rosana Serpa; Emanuele Júlio Galvão de França


    INTRODUCTION: In this study, we aimed at identifying Candida isolates obtained from blood, urine, tracheal secretion, and nail/skin lesions from cases attended at the Hospital Universitário de Londrina over a 3-year period and at evaluating fluconazole susceptibilities of the isolates. METHODS: Candida isolates were identified by polymerase chain reaction (PCR) using species-specific forward primers. The in vitro fluconazole susceptibility test was performed according to EUCAST-AFST reference...

  14. Species distribution and in vitro fluconazole susceptibility of clinical Candida isolates in a Brazilian tertiary-care hospital over a 3-year period

    Directory of Open Access Journals (Sweden)

    Márcia Cristina Furlaneto


    Full Text Available INTRODUCTION: In this study, we aimed at identifying Candida isolates obtained from blood, urine, tracheal secretion, and nail/skin lesions from cases attended at the Hospital Universitário de Londrina over a 3-year period and at evaluating fluconazole susceptibilities of the isolates. METHODS: Candida isolates were identified by polymerase chain reaction (PCR using species-specific forward primers. The in vitro fluconazole susceptibility test was performed according to EUCAST-AFST reference procedure. RESULTS: Isolates were obtained from urine (53.4%, blood cultures (19.2%, tracheal secretion (17.8%, and nail/skin lesions (9.6%. When urine samples were considered, prevalence was similar in women (45.5% and in men (54.5% and was high in the age group >61 years than that in younger ones. For blood samples, prevalence was high in neonates (35% and advanced ages (22.5%. For nail and skin samples, prevalence was higher in women (71.4% than in men (28.6%. Candida albicans was the most frequently isolated in the hospital, but Candida species other than C. albicans accounted for 64% of isolates, including predominantly Candida tropicalis (33.2% and Candida parapsilosis (19.2%. The trend for non-albicans Candida as the predominant species was noted from all clinical specimens, except from urine samples. All Candida isolates were considered susceptible in vitro to fluconazole with the exception of isolates belonging to the intrinsically less-susceptible species C. glabrata. CONCLUSIONS: Non-albicans Candida species were more frequently isolated in the hospital. Fluconazole resistance was a rare finding in our study.

  15. Clinical Evaluation of Tinnitus. (United States)

    Hertzano, Ronna; Teplitzky, Taylor B; Eisenman, David J


    The clinical evaluation of patients with tinnitus differs based on whether the tinnitus is subjective or objective. Subjective tinnitus is usually associated with a hearing loss, and therefore, the clinical evaluation is focused on an otologic and audiologic evaluation with adjunct imaging/tests as necessary. Objective tinnitus is divided into perception of an abnormal somatosound or abnormal perception of a normal somatosound. The distinction between these categories is usually possible based on a history, physical examination, and audiogram, leading to directed imaging to identify the underlying abnormality.

  16. The presence of anti-citrullinated protein antibodies (ACPA) and rheumatoid factor on patients with rheumatoid arthritis (RA) does not interfere with the chance of clinical remission in a follow-up of 3 years. (United States)

    da Mota, Licia Maria Henrique; Dos Santos Neto, Leopoldo Luiz; de Carvalho, Jozélio Freire; Pereira, Ivânio Alves; Burlingame, Rufus; Ménard, Henri A; Laurindo, Ieda Maria Magalhães


    Autoantibodies in early rheumatoid arthritis (RA) have important diagnostic value. The association between the presence of autoantibodies against cyclic citrullinated peptide and the response to treatment is controversial. To prospectively evaluate a cohort of patients with early rheumatoid arthritis (peptide antibodies (anti-CCP) and citrullinated anti-vimentin (anti-Sa) with the occurrence of clinical remission, forty patients diagnosed with early RA at the time of diagnosis were evaluated and followed for 3 years, in use of standardized therapeutic treatment. Demographic and clinical data were recorded, disease activity score 28 (DAS 28), as well as serology tests (ELISA) for RF (IgM, IgG, and IgA), anti-CCP (CCP2, CCP3, and CCP3.1) and anti-Sa in the initial evaluation and at 3, 6, 12, 18, 24, and 36 months of follow-up. The outcome evaluated was the percentage of patients with clinical remission, which was defined by DAS 28 lower than 2.6. Comparisons were made through the Student t test, mixed-effects regression analysis, and analysis of variance (significance level of 5%). The mean age was 45 years, and a female predominance was observed (90%). At the time of diagnosis, RF was observed in 50% of cases (RF IgA-42%, RF IgG-30%, and RF IgM-50%), anti-CCP in 50% (no difference between CCP2, CCP3, and CCP3.1) and anti-Sa in 10%. After 3 years, no change in the RF prevalence and anti-CCP was observed, but the anti-Sa increased to 17.5% (P = 0.001). The percentage of patients in remission, low, moderate, and intense disease activity, according to the DAS 28, was of 0, 0, 7.5, and 92.5% (initial evaluation) and 22.5, 7.5, 32.5, and 37.5% (after 3 years). There were no associations of the presence of autoantibodies in baseline evaluation and in serial analysis with the percentage of clinical remission during follow-up of 3 years The presence of autoantibodies in early RA has no predictive value for clinical remission in early RA.

  17. Clinical outcomes of guided tissue regeneration with Atrisorb membrane in the treatment of intrabony defects: a 3-year follow-up study. (United States)

    Sakallioglu, Umur; Yavuz, Umit; Lütfioglu, Müge; Keskiner, Ilker; Açikgöz, Gökhan


    In this controlled clinical trial, initial and long-term treatment outcomes of guided tissue regeneration (GTR) were investigated for a synthetic absorbable membrane (Atrisorb) in intrabony defects. Eighteen defects in 16 patients received GTR with Atrisorb (test), with the membrane applied by an indirect method, and 15 defects in 15 patients were treated with open flap debridement (control). Probing pocket depth (PPD), gingival recession (GR), clinical attachment level (CAL), and linear alveolar bone level (ABL) were recorded at baseline and at 1 and 3 years following the treatment procedures and were assessed as the therapeutic outcome parameters. Both groups demonstrated significant PPD reduction and CAL and ABL gain after 1 year. Among these parameters, alterations in PPD and CAL were statistically significantly greater in the test group than the control group 1 year postsurgery. No significant changes were noted in the parameters of the first year between and within the study groups after 3 years. The results suggest that GTR performed with Atrisorb membrane via an indirect application method may provide favorable clinical outcomes for intrabony defects, and these outcomes may be maintained at least as well as open flap debridement over an extended period.


    Directory of Open Access Journals (Sweden)

    Arabela Maria Barbosa Sampaio


    Full Text Available In a world experiencing profound technological and socio-political changes in areas of knowledge and capacity, healthcare can not remain static. A new kind of professional is required, whose practice is based on ethics, scientific standards, integrity, citizenship, and health promotion, who develops skills beyond healthcare, such as decision making, communication,leadership, management, and continuing education. No single method can assess all of these elements (knowledge, skills, and attitudes, and only a combination of methods is able to produce a valid evaluation. An alternative method exists: structured clinical assessments based on observation of "to do, or how to do" that aim to complete this evaluation by focusing attention on the performance of specific skills. In order to broaden the scope of evaluation methods that have been used in health education, this article, a literature review, intends to offer readers an overview of the diverse types of structured clinical evaluation, emphasizing Objective Structured Clinical Examination, the most widely used in Brazil, with a goal of advancing opportunities for health professionals to make use of this evaluative tool.

  19. Community vs. Clinic-Based Modular Treatment of Children with Early-Onset ODD or CD: A Clinical Trial with 3-Year Follow-Up (United States)

    Kolko, David J.; Dorn, Lorah D.; Bukstein, Oscar G.; Pardini, Dustin; Holden, Elizabeth A.; Hart, Jonathan


    This study examines the treatment outcomes of 139, 6-11 year-old, clinically referred boys and girls diagnosed with Oppositional Defiant Disorder (ODD) or Conduct Disorder (CD) who were randomly assigned to a modular-based treatment protocol that was applied by research study clinicians either in the community (COMM) or a clinic office (CLINIC).…

  20. Preparation and Evaluation of SKI-HI: A Parent-Infant Auditory Training Program for under 3- Year -Old Hearing Impaird Children

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    Jaleh Samadi


    Full Text Available Background and Aim: Lack of early detection of and intervention for infants hearing loss results in a significant delay in speech and language development. So auditory rehabilitation plays an important role in improving the diminished communication ability. One of the most successful auditory training approaches is the SKI-HI parent-infant program. The purpose of this study was preparation and evaluation of Farsi-language SKI-HI program for under 3-year-old hearing impaired children. Materials and Methods: After translation and modification of the text of the program, fifteen under 3-year-old children with bilateral severe sensory hearing loss who were fitted with appropriate behind the ear hearing aids received intervention for 6 months. The levels of the auditory skills were measured pre and post intervention. Intervention Efficiency Index (IEI, Pretest Developmental Rate (PDR and Proportional Change Index (PCI were computed. Results: The data indicated that there was a significant difference between means of IEI and PDR which were 0.87 and 0.31, respectively. PCI was 3.38 indicated that the children's auditory skills developed at about 2.38 times higher rate after SKI-HI intervention than they did before. PCI confidence interval showed that development in the population is 1.46 to 3.30 times higher after SKI-HI intervention (with 95% probability the rate of auditory skills. Conclusion: The auditory training with Farsi-language SKI-HI parent-infant program may efficiently affect development of auditory skills of hearing impaired children.

  1. Epidemiology and Clinical Presentation of Parainfluenza Type 4 in Children: A 3-Year Comparative Study to Parainfluenza Types 1–3


    Frost, Holly M.; Robinson, Christine C.; Dominguez, Samuel R.


    Background. Human parainfluenza viruses (HPIVs) are among the most common causes of respiratory tract infections in children. Little is known about the epidemiology and clinical presentation of HPIV type 4.

  2. A prospective study of cow milk allergy in Danish infants during the first 3 years of life. Clinical course in relation to clinical and immunological type of hypersensitivity reaction

    DEFF Research Database (Denmark)

    Høst, A; Halken, S


    elimination/milk challenge procedures in a hospital setting, and continued clinical sensitivity to cow milk (CM) was assessed by rechallenging every 6-12 months until the age of 3 years. Further, in infants with CMA, the clinical course of adverse reactions to other foods and the development of allergy...... than or equal to 2 organ systems. Based on a positive skin prick test (greater than or equal to 2+) and/or AL-RAST class greater than or equal to 2 to CM 16 infants at the time of diagnosis, and at reinvestigation at 1 year, a further five infants giving a total of 21, were classified as having Ig......E-mediated CMA, 19 infants showed "immediate reactions" to CM (within 1 h after intake of 2.3 g milk protein) and 20 infants were "late reactors". No significant correlation between IgE-mediated CMA and "immediate reactions" to CM was demonstrated. The overall prognosis of CMA was good with a total recovery...

  3. Betamethasone: A dermatological clinical evaluation. (United States)



    The purpose of this study was to determine under carefully controlled clinical conditions the relative anti-inflammatory and anti-pruritic action of betamethasone as compared with prednisone and a placebo. A total of 130 consecutive patients with atopic dermatitis, primary irritant dermatitis, nummular eczema, allergic eczematous contact dermatitis, sweat retention, seborrheic dermatitis and pruritus were selected for study. Under the conditions of this clinical trial, the samples indicated a difference in anti-inflammatory and anti-pruritic response to the therapeutic agents used. The difference between betamethasone and the placebo was highly significant, and the difference in these measured responses was studied on the basis of a careful evaluation and statistically. The result of this study corroborates statistically our clinical impression regarding the therapeutic effect of betamethasone.

  4. Contract grading in clinical evaluation. (United States)

    Schoolcraft, V; Delaney, C


    The use of contracts in grading clinical performance has provided faculty with a solution to two important problems. One has been how to ensure that students are graded consistently among the various faculty who are grading the same clinical component of a course. The second has been to increase the opportunity for individualized attention to student learning needs. We have been pleased to see all the faculty members increase their input and involvement in the continuing modifications of the contract. Although we have taken the major responsibility for the semi-annual revisions of the contract, other faculty members have been increasingly more explicit in their evaluations and suggestions as their experience with the contract has expanded. Their confidence in this method of clinical evaluation has increased with each semester of use. We plan to continue in the refinement of the instrument and will develop materials for the use of other faculty groups who are interested in developing similar contracts. We are also designing a survey to attempt to discover how widespread is the use of contract grading in clinical areas.

  5. Clinical evaluation of functional dysphonia. (United States)

    Monday, L A


    Functional dysphonia is a voice impairment without any organic lesion of the phonating system. It may be classified into two categories: functional dysphonia itself where no lesions are found and functional laryngopathies where vocal cord lesions may be attributed to vocal abuse or misuse. The clinical evaluation of a dysphonic patient is performed in three steps: history taking, vocal evaluation, and examination. History taking helps the diagnosis and may be considered also as a therapeutic procedure. Vocal evaluation is oriented toward the voice itself and how it is produced. Then an ENT examination is performed with special attention to the larynx. In functional dysphonia, usually, everything looks normal but there may be signs of inflammation, hyperkinetism, hypokinetism, excessive laryngeal movements, etc. Functional laryngopathies include vocal nodules, laryngitis, polyps, and contact ulcer.

  6. Evaluation of Actiheart and a 7 d activity diary for estimating free-living total and activity energy expenditure using criterion methods in 1·5- and 3-year-old children. (United States)

    Henriksson, Hanna; Forsum, Elisabet; Löf, Marie


    Accurate and easy-to-use methods to assess free-living energy expenditure in response to physical activity in young children are scarce. In the present study, we evaluated the capacity of (1) 4 d recordings obtained using the Actiheart (mean heart rate (mHR) and mean activity counts (mAC)) to provide assessments of total energy expenditure (TEE) and activity energy expenditure (AEE) and (2) a 7 d activity diary to provide assessments of physical activity levels (PAL) using three sets of metabolic equivalent (MET) values (PALTorun, PALAdolph and PALAinsworth) in forty-four and thirty-one healthy Swedish children aged 1·5 and 3 years, respectively. Reference TEE, PALref and AEE were measured using criterion methods, i.e. the doubly labelled water method and indirect calorimetry. At 1·5 years of age, mHR explained 8 % (P= 0·006) of the variation in TEE above that explained by fat mass and fat-free mass. At 3 years of age, mHR and mAC explained 8 (P= 0·004) and 6 (P= 0·03) % of the variation in TEE and AEE, respectively, above that explained by fat mass and fat-free mass. At 1·5 and 3 years of age, average PALAinsworth values were 1·44 and 1·59, respectively, and not significantly different from PALref values (1·39 and 1·61, respectively). By contrast, average PALTorun (1·5 and 3 years) and PALAdolph (3 years) values were lower (Penergy expenditure above that explained by body composition variables, and our activity diary produced mean PAL values in agreement with reference values when using MET values published by Ainsworth.

  7. Early management of type 2 diabetes based on a SMBG strategy: the way to diabetes regression--the St Carlos study : a 3-year, prospective, randomized, clinic-based, interventional study with parallel groups. (United States)

    García de la Torre, Nuria; Durán, Alejandra; Del Valle, Laura; Fuentes, Manuel; Barca, Idoya; Martín, Patricia; Montañez, Carmen; Perez-Ferre, Natalia; Abad, Rosario; Sanz, Fuencisla; Galindo, Mercedes; Rubio, Miguel A; Calle-Pascual, Alfonso L


    The aims are to define the regression rate in newly diagnosed type 2 diabetes after lifestyle intervention and pharmacological therapy based on a SMBG (self-monitoring of blood glucose) strategy in routine practice as compared to standard HbA1c-based treatment and to assess whether a supervised exercise program has additional effects. St Carlos study is a 3-year, prospective, randomized, clinic-based, interventional study with three parallel groups. Hundred and ninety-five patients were randomized to the SMBG intervention group [I group; n = 130; Ia: SMBG (n = 65) and Ib: SMBG + supervised exercise (n = 65)] and to the HbA1c control group (C group) (n = 65). The primary outcome was to estimate the regression rate of type 2 diabetes (HbA1c 4 kg was 3.6 (1.8-7); p < 0.001. This study shows that the use of SMBG in an educational program effectively increases the regression rate in newly diagnosed type 2 diabetic patients after 3 years of follow-up. These data suggest that SMBG-based programs should be extended to primary care settings where diabetic patients are usually attended.

  8. Evaluation of Practical Clinical Examinations. (United States)

    Berrong, Joseph M.; And Others


    The effectiveness of practical examinations in assessing the clinical competence of dental students is discussed. A grading system that derives a significant portion of the senior student's grade from this type of examination is described. The impact of practical clinical examinations on two consecutive graduating classes was analyzed. (Author/MLW)

  9. Evaluating the veterinary clinical teacher

    NARCIS (Netherlands)

    Boerboom, T.B.B.


    Introduction Providing clinical teachers with student feedback is an important part of faculty development. The current literature provides a range of instruments developed to generate student rating feedback. However, these instruments often lack a theoretical framework and evidence concerning thei

  10. Clinical evaluation of a highly wear resistant composite. (United States)

    Dickinson, G L; Gerbo, L R; Leinfelder, K F


    The purpose of this clinical study was to determine the long-term potential of a resin composite restorative material. A total of 62 restorations of a modified Herculite Incisal formulation were inserted into Class I and Class II preparations. A control group of the conventional Herculite formulation was also placed into Class I and Class II cavity preparations at an earlier date. The cavity preparations for both formulations were standardized to conform to that of conventional conservative amalgams. Deep portions of the preparations were lined with calcium hydroxide. The enamel margins were etched per manufacturers' directions followed by a dentin bonding agent. After application of the appropriate matrix, the restorations were placed incrementally. Each restoration was independently evaluated by two clinicians at baseline, 6-months, 1, 2 and 3 years in accordance with the USPHS criteria. In addition, all restorations were evaluated for wear using a series of optical standards (M-L). The color matching ability of the material never fell below 96%. The percent of restorations exhibiting a surface texture similar to enamel never fell below 90% Alfa. At the end of 3 years, the total average loss of material was only 28 microns. No clinical evidence of bulk fracture was detected with the modified Herculite formulation at 3 years. The wear rate of the modified formulation of Herculite was essentially one-half that of conventional Herculite XR. Marginal ditching, which is characteristic of most posterior resin composites in which the filler particle is 1 micron or less, was exhibited.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Clinical evaluation of Graves ophthalmopathy

    Directory of Open Access Journals (Sweden)

    Janićijević-Petrović Mirjana A.


    Full Text Available Introduction. Graves ophthalmopathy is an autoimmune disease, which is the consequence of thyroid dysfunction. Ocular manifestations occur in 50% of patients with Graves disease. The changes occur due to the inflammatory cell infiltration of retrobulbar fat tissue and extraocular muscles. Ultrasonography of eye orbit provides important information about the condition of retrobulbar adipose tissue and the thickness of extraocular muscles. Objective. The aim of our study was to show the clinical significance of orbital ultrasonography in the diagnostics and follow-up of patients with Graves disease. Methods. The authors examined 154 patients with Graves ophthalmopathy at the Clinic of Ophthalmology of the Clinical Centre in Kragujevac during the period 2008–2010. Ophthalmological examination included visual acuity testing (Snellen chart, biomicroscopy and applanation tonometry, direct and indirect ophthalmoscopy, dry eye testing and exophthalmometry (Hertel. Orbital ultrasonography examination and extraorbital muscle measurement was done by ultrasound B-scan. Results. The disease was more frequent in women (79.87% aged from 36–45 years. Most patients had hyperthyreoidism (54.55%. In relation to the duration of the disease, the most frequent clinical signs were bilateral ptosis, conjunctival chemosis and periorbital edema. According to our data the highest number of patients had enlarged medial straight muscle. Conclusion. Graves ophthalmopathy is the most frequent sign of thyroid disease. By orbital ultrasonography we detected extended echogram and measured the thickness of the extraocular muscle. Computerized tomography and magnetic resonance scan were utilized for cases of insufficiently manifested clinical signs of the disease. The advantages of ultrasonography lie in easy handling, patients’ comfort, short time of examination and possibilities of repetition.

  12. Three-year randomised clinical trial to evaluate the clinical performance, quantitative and qualitative wear patterns of hybrid composite restorations. (United States)

    Palaniappan, Senthamaraiselvi; Elsen, Liesbeth; Lijnen, Inge; Peumans, Marleen; Van Meerbeek, Bart; Lambrechts, Paul


    The aim of the study was to compare the clinical performance, quantitative and qualitative wear patterns of conventional hybrid (Tetric Ceram), micro-filled hybrid (Gradia Direct Posterior) and nano-hybrid (Tetric EvoCeram, TEC) posterior composite restorations in a 3-year randomised clinical trial. Sixteen Tetric Ceram, 17 TEC and 16 Gradia Direct Posterior restorations were placed in human molars and evaluated at baseline, 6, 12, 24 and 36 months of clinical service according to US Public Health Service criteria. The gypsum replicas at each recall were used for 3D laser scanning to quantify wear, and the epoxy resin replicas were observed under scanning electron microscope to study the qualitative wear patterns. After 3 years of clinical service, the three hybrid restorative materials performed clinically well in posterior cavities. Within the observation period, the nano-hybrid and micro-hybrid restorations evolved better in polishability with improved surface gloss retention than the conventional hybrid counterpart. The three hybrid composites showed enamel-like vertical wear and cavity-size dependant volume loss magnitude. Qualitatively, while the micro-filled and nano-hybrid composite restorations exhibited signs of fatigue similar to the conventional hybrid composite restorations at heavy occlusal contact area, their light occlusal contact areas showed less surface pitting after 3 years of clinical service.

  13. Evaluation standards for clinical coder training. (United States)

    Bramley, Michelle; Reid, Beth


    This paper reports on an evaluation of clinical coder training programs, recently carried out in Ireland. In building an evaluation framework, the literature was reviewed to identify best practice standards, current practice, and professional opinion against which a sound judgment could be made. The literature was variable but nevertheless useful for the identification of evaluation standards. These standards are reproduced here in order to add to the literature. We also discuss the areas that would benefit from further research, thus contributing to the discourse on best practice in evaluating clinical coder training programs.

  14. A Clinical Evaluation System for Anesthesiology Residents. (United States)

    Viets, J. L.; Foster, Scot D.


    Baylor College of Medicine's system for evaluating the clinical progress of anesthesiology residents, developed in response to problems of standards, staff cooperation, and student dissatisfaction with evaluation, assesses resident progress in terms of performance levels based on case complexity and degree of staff intervention. (Author/MSE)

  15. Developments in statistical evaluation of clinical trials

    CERN Document Server

    Oud, Johan; Ghidey, Wendimagegn


    This book describes various ways of approaching and interpreting the data produced by clinical trial studies, with a special emphasis on the essential role that biostatistics plays in clinical trials. Over the past few decades the role of statistics in the evaluation and interpretation of clinical data has become of paramount importance. As a result the standards of clinical study design, conduct and interpretation have undergone substantial improvement. The book includes 18 carefully reviewed chapters on recent developments in clinical trials and their statistical evaluation, with each chapter providing one or more examples involving typical data sets, enabling readers to apply the proposed procedures. The chapters employ a uniform style to enhance comparability between the approaches.

  16. How Grammatical Are 3-Year-Olds? (United States)

    Eisenberg, Sarita L.; Guo, Ling-Yu; Germezia, Mor


    Purpose: This study investigated the level of grammatical accuracy in typically developing 3-year-olds and the types of errors they produce. Method: Twenty-two 3-year-olds participated in a picture description task. The percentage of grammatical utterances was computed and error types were analyzed. Results: The mean level of grammatical accuracy…

  17. Clinical evaluation of leg ulcers in elderly patients

    Directory of Open Access Journals (Sweden)

    Jordana Prado Benevides


    Full Text Available The aim of this work was to perform a clinical evaluation of leg ulcers in elderly patients in a specialized clinic. An Exploratory-descriptive, cross-sectional research was carried out from August to November 2010, and the population consisted of elderly patients with leg ulcers assisted in the wound dressing room of the Surgery Ambulatory of a University Hospital in Fortaleza-CE, Brazil. Data were collected through interviews using a form. The study included 53 elderly, average age 69.3 years, 27 (51.0% time of ulcer ≥ 1 year, 34 (64.1% with ulcer location in Zone I, 53 (100 % with tissue loss, 40 (75.5% with necrosis, 43 (81.1% with infection and 32 (60.4% of those with exudate and odor, and 50.0% with 29 (54.7 % presence of pain. It was concluded that clinical assessment of leg ulcers is an important step during the approach to the patient and the choice of treatment what should be performed by a professional with competence on the subject.

  18. Clinical Evaluation: Issues of Examination Format. (United States)

    Blumberg, Phyllis


    The utility of general or select response formats for evaluating certain types of clinical competence is studied. Consideration of the suitability of an examination format to fulfill its intended purpose and the appropriateness of the questions included is recommended when designing an examination. (Author/AL)

  19. 3岁前儿童口腔疾病综合防治项目终期效果评价%Terminal effectiveness evaluation of comprehensive intervention on oral health in 0-3 years' old kids

    Institute of Scientific and Technical Information of China (English)

    施春梅; 周嫣; 韦惠平; 江蕙芸; 樊青会; 陈红慧; 王少英; 曹秀芳; 钟秀芬


    目的:评价3 岁前儿童口腔疾病综合防治措施的效果.方法:随机纳入孕妇100 名为试验组,从孕期开始实施口腔健康教育,孩子出生后定期口腔检查并进行母亲个体化健康教育,采取局部涂氟、窝沟封闭等干预措施;随机设置对照组.试验组儿童分别于1、2、3 岁进行口腔检查,与对照组儿童患龋率、龋均、牙面软垢指数、咬合关系相比较,并评估2 组3 岁幼儿的母亲问卷调查结果.数据采用EpiData 3.0录入,应用SPSS 12.0 完成数据分析.结果:2 组幼儿口腔检查结果比较:1 岁年龄段儿童2 组牙面软垢指数差异有统计学意义;2 岁年龄段儿童患龋率、牙面软垢指数2 组差异均无统计学意义; 3 岁年龄段儿童患龋率、牙面软垢指数2 组差异均有统计学意义; 3 个年龄段试验组儿童的龋均较对照组均降低;而3 个年龄段咬合关系2 组差异无统计学意义.2 组3 岁幼儿母亲口腔保健知晓情况比较,试验组正确率达66.3%,对照组为48.9%,13 项指标中有9 项 2 组差异有统计学意义(P<0.05).结论:该项目健康教育与行为干预模式对幼儿防龋效果明显,值得推广应用.%Objective: T6 evaluate the effectiveness of comprehensive intervention on pediatric oral health in 0- 3 years'old kids.Methods: 100 pregnant women were enrolled into experiment group and oral health education were carried out for them. After birth,the children had oral health check periodically,and their mothers got advices about their childrens' oral health individually. Preventive measures were given to the children if necessary. The control subjects were enrolled randomly from those who came to the Preventive Health Branch in our hospital at 1 and 2 year old respectively, and at 3 years'old from primary classes of one kindergarten. Children in the experiment group were checked for oral health including caries incidence,draft index, debris index-simplified and ocelusal relationship

  20. Evaluating student performance in clinical dietetics. (United States)

    Novascone, M A


    The focus of this study was on the development and field-testing of a set of behaviorally anchored rating scales for evaluating the clinical performance of dietetic students. The scales emphasized the application of skills and knowledge. A variation of the Smith-Kendall technique was used to develop the scales. The 42 participants involved in instrument development included dietetic students, didactic and clinical instructors, and dietetic practitioners. The completed instrument contained 8 dimension statements and 70 behavioral anchors. The instrument was field-tested in 16 clinical rotations within 8 dietetic education programs. Evaluators not only rated student performance but also critiqued the format and content of the scales. The mid-to-upper portions of each scale were used most frequently, and little score variation within or across programs was noted. The scales were deemed appropriate for formative evaluation; however, some evaluators who had to grade students' performance expressed a desire for performance standards defined in terms of grades. Because the process used to develop the instrument facilitated the articulation of performance criteria, it is recommended as a practical approach to setting performance standards.

  1. The clinical information system implementation evaluation scale. (United States)

    Gugerty, Brian; Maranda, Michael; Rook, Dona


    Measurement instruments to assess user satisfaction with Clinical Information Systems (CIS) and with the implementation of CIS are needed as part of multi-faceted evaluation of CIS. Seven years of experience in developing measurement instruments to assess staff satisfaction with CIS preceded the development effort that created the Clinical Information System Evaluation Scale (CISIES). The scale was developed using precursors of the CISIES and it was guided by an expert panel. Following its construction the 37-item measurement instrument was piloted as part of the assessment of a Critical Care Clinical Information System implementation at a medical center in Florida, USA. Results indicated satisfaction with the implementation, although not strong, at the time of administration. The results of the CISIES administration were used by informaticians at the research site to plan and execute an intervention to improve satisfaction with the implementation. Re-administration of the CISIES at the site to evaluate the success of this intervention is planned. The CISIES was found to be a useful instrument, easy to administer, acceptable to respondents, easy to score and understandable by non-researcher at the study site. Early indications are that it will be useful in the formative and summative evaluation of CIS implementations.

  2. [Elaboration and critical evaluation of clinical guidelines]. (United States)

    García Villar, C


    Clinical guidelines are documents to help professionals and patients select the best diagnostic or therapeutic option. Elaborating guidelines requires an efficient literature search and a critical evaluation of the articles found to select the most appropriate ones. After that, the recommendations are formulated and then must be externally evaluated before they can be disseminated. Even when the guidelines are very thorough and rigorous, it is important to know whether they fulfill all the methodological requisites before applying them. With this aim, various scales have been developed to critically appraise guidelines. Of these, the AGREE II instrument is currently the most widely used. This article explains the main steps in elaborating clinical guidelines and the main aspects that should be analyzed to know whether the guidelines are well written.

  3. Polycystic ovary syndrome: clinical and laboratory evaluation


    Marcos Yorghi Khoury; Edmund Chada Baracat; Dolores Perovano Pardini; Mauro Abi Haidar; Eduardo Leme Alves da Motta; Geraldo Rodrigues de Lima


    OBJECTIVE: To evaluate clinically, and with laboratory, tests, women with polycystic ovary syndrome (PCO). PATIENTS: One hundred and twelve women with PCO were studied. METHODS: The following data was recorded: Current age; age at menarche; menstrual irregularity, occurrence of similar cases in the family; fertility, obstetric history; body mass index (BMI); and presence of hirsutism. Serum measurements of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin, free testoster...

  4. Ultrareliable PACS: design and clinical evaluation (United States)

    Goble, John C.; Kronander, Torbjorn; Wilske, Nils-Olof; Yngvesson, Jonas T.; Ejderholm, Henrik; Ekstrom, Marie


    We describe our experience in the design, installation and clinical evaluation o fan ultra-reliable PACS - a system in which the fundamental design constraint was system availability. This syste has ben constructed using commercial, off-the-shelf hardware and software, using an open system, standards-based approach. The system is deployed in the film-free Department of Pediatric Radiology at the Astrid Lindgren Barnsjukhus a nit of the Karolinska Institute in Stockholm, Sweden.

  5. Clinical and radiographic evaluation of narrow- vs. regular-diameter dental implants: a 3-year follow-up. A retrospective study

    NARCIS (Netherlands)

    J. Zweers; A. van Doornik; E.A.H. Hogendorf; M. Quirynen; G.A. van der Weijden


    Objectives Narrow-diameter implants (NDIs) are used in severely resorbed mandibles. The reduced implant diameter means a reduction in the total contact surface between the implant and bone. The question arises whether the implant can be sufficiently osseointegrated to withstand loading forces. If no

  6. Clinical presentation and evaluation of dermatomyositis

    Directory of Open Access Journals (Sweden)

    Umaima Marvi


    Full Text Available Dermatomyositis (DM is a chronic inflammatory disorder of the skin and muscles. Evidence supports that DM is an immune-mediated disease and 50-70% of patients have circulating myositis-specific auto-antibodies. Gene expression microarrays have demonstrated upregulation of interferon signaling in the muscle, blood, and skin of DM patients. Patients with classic DM typically present with symmetric, proximal muscle weakness, and skin lesions that demonstrate interface dermatitis on histopathology. Evaluation for muscle inflammation can include muscle enzymes, electromyogram, magnetic resonance imaging, and/or muscle biopsy. Classic skin manifestations of DM include the heliotrope rash, Gottron′s papules, Gottron′s sign, the V-sign, and shawl sign. Additional cutaneous lesions frequently observed in DM patients include periungual telangiectasias, cuticular overgrowth, "mechanic′s hands", palmar papules overlying joint creases, poikiloderma, and calcinosis. Clinically amyopathic DM is a term used to describe patients who have classic cutaneous manifestations for more than 6 months, but no muscle weakness or elevation in muscle enzymes. Interstitial lung disease can affect 35-40% of patients with inflammatory myopathies and is often associated with the presence of an antisynthetase antibody. Other clinical manifestations that can occur in patients with DM include dysphagia, dysphonia, myalgias, Raynaud phenomenon, fevers, weight loss, fatigue, and a nonerosive inflammatory polyarthritis. Patients with DM have a three to eight times increased risk for developing an associated malignancy compared with the general population, and therefore all patients with DM should be evaluated at the time of diagnosis for the presence of an associated malignancy. This review summarizes the immunopathogenesis, clinical manifestations, and evaluation of patients with DM.

  7. Clinical evaluation of genito-urinary fistula

    Directory of Open Access Journals (Sweden)

    Companywala Rashida


    Full Text Available Clinical evaluation of 50 cases of genito-urinary fistula from January 1969 to March 1917 is presented. In 84% of the cases the aetiological factor was obstetric injury while in 12% it followed hysterectomy. Sixty per cent of the patients had come within one year of the development of symptoms. Eighty per cent of the cases were operated upon by vaginal route while 14% were operated upon by abdominal route and 6% by pereineo-abdominal route. The operative management is discussed. The success rate was 72%. The literature on this subject is reviewed.

  8. Clinical evaluation of disc battery ingestion in children. (United States)

    Mirshemirani, AliReza; Khaleghnejad-Tabari, Ahmad; Kouranloo, Jaefar; Sadeghian, Naser; Rouzrokh, Mohsen; Roshanzamir, Fatolah; Razavi, Sajad; Sayary, Ali Akbar; Imanzadeh, Farid


    BACKGROUND The purpose of this study was to evaluate the characteristics, management, and outcomes of disc battery ingestion in children. METHODS We reviewed the medical records of children admitted to Mofid Children's Hospital due to disc battery ingestion from January 2006 to January 2010. Clear history, clinical symptoms and results of imaging studies revealed diagnosis of disc battery ingestion in suspected patients. The clinical data reviewed included age, gender, clinical manifestation, radiologic findings, location of disc battery, duration of ingestion, endoscopic results and surgical treatment. RESULTS We found 22 cases (11 males and 11 females) of disc battery ingestion with a mean age of 4.3 years (range: 9 months to 12 years). Common symptoms were vomiting, cough, dysphagia, and dyspnea. The mean duration of ingestion was 2.7 days (4 hours to 1.5 months). A total of 19 patients had histories of disc battery ingestion, but three cases referred with the above symptoms, and the batteries were accidentally found by x-ray. Only three cases had batteries impacted in the esophagus. Twelve batteries were removed endoscopically, 6 batteries spontaneously passed through the gastrointestinal (GI) tract within 5 to 7 days, and 4 patients underwent surgery due to complications: 3 due to tracheo-esophageal fistula (TEF) and 1 due to intestinal perforation. There was no mortality in our study. CONCLUSION Most cases of disc battery ingestion run uneventful courses, but some may be complicated. If the battery lodges in the esophagus, emergency endoscopic management is necessary. However, once in the stomach, it will usually pass through the GI tract.

  9. Evaluation of clinical and laboratory correlates of sickle leg ulcers. (United States)

    Madu, Anazoeze Jude; Ubesie, Agozie; Madu, Kenechi Anthony; Okwor, Bismarck; Anigbo, Chukwudi


    The exact mechanism for the occurrence of sickle leg ulcers (SLUs) has not been fully explained, although, popular opinion supports a multifactorial etio-pathogenetic process. Leg ulceration in sickle cell is a chronic and debilitating condition which is difficult to treat and may worsen the psychosocial impact of this illness. This study aims to evaluate the laboratory and clinical correlates of SLUs. One hundred sixty-seven patients who had been diagnosed with sickle cell anemia (homozygous S) had their steady-state hemoglobin concentration (Hb), hematocrit, white cell count, platelet count, serum bilirubin, and aspartate transaminase (AST) as well as frequency of crisis per annum evaluated with respect to their relationship to the occurrence of leg ulcers. They were aged 6-53 years (mean age 24.3 years), and prevalence of leg ulcer was found to be 2.75 per 1000 (2.54 per 1000 in females and 2.83 per 1000 in males). The independent sample t-test showed a significant difference in the serum AST levels in those with SLU (p = 0.029), though a positive correlation did not exist. Other predictors of disease severity found to have positive relationship with each other were the AST and total serum bilirubin 0.207 (p = 0.012); Hb and age 0.130 (p = 0.035); Hb and white cell count -0.159 (p = 0.010), white cell count and age -0.113 (p = 0.018). SLUs do not occur in patients with severe disease in sickle cell. The clinical and laboratory indicators of severe sickle cell disease do not correlate positively with the occurrence of SLU. Serum AST may have a relationship with leg ulceration in these patients. Environmental factors most likely play a major part in the etiopathogenesis of leg ulcer and this may require further studies in different sociocultural settings.

  10. Clinical assessment of language development in children at age 3 years that were born preterm Avaliação da evolução dos aspectos linguísticos em crianças que nasceram prematuras aos 3 anos de idade

    Directory of Open Access Journals (Sweden)

    Carolina Rizzotto Schirmer


    Full Text Available OBJECTIVE: To evaluate the influence of gestational age and birth weight on language development and neurodevelopmental outcome at age 3 years in children born preterm. METHOD: Cross sectional study including 69 children followed in our developmental outpatient clinic. Patients were consecutively included at the time of the 3 years of age appointment and stratified for birth weight (OBJETIVO: Avaliar influência da idade gestacional (IG e peso ao nascimento na aquisição da linguagem e neurodesenvolvimento em crianças de 3 anos que nasceram prematuras. MÉTODO: Estudo transversal incluindo 69 crianças acompanhadas no Ambulatório de Seguimento Neonatal. Pacientes incluídos tinham 3 anos e foram estratificados por peso ao nascimento (>1500 gramas e entre 1500-2500 gramas. Todos foram avaliados com relação ao neurodesenvolvimento incluindo avaliação neurológica clínica, Denver II, Bayley II e avaliação da linguagem. Para a analise dividimos em dois grupos com e sem alteração na aquisição de linguagem. RESULTADOS: Crianças com DAL apresentam melhores índices nos escores de desenvolvimento no Bayley II (p=1500 gramas tiveram escores menores no Bayley II na idade de 36 m (p=0.002, p=0.007 e p<0.001. Análise multivariada sugere uma associação da IG (p=0,032 e alteração comportamental (p=0,001 com atraso na aquisição da linguagem. Denver II alterado tanto aos 12 m quanto aos 24 m, correlaciona-se com significância estatística a atraso na aquisição de linguagem receptiva e expressiva aos 3 anos de idade (p=<0.01 e p=<0.01. CONCLUSÃO: Crianças nascidas prematuras e com baixo peso ao nascimento, apresentam maior risco de ter um atraso no desenvolvimento da linguagem. Sendo que as crianças que tem atraso no desenvolvimento de linguagem apresentaram um desempenho cognitivo e psicomotor inferior ao das com desenvolvimento normal.

  11. Convergent and discriminant validity of psychiatric symptoms reported in The Norwegian Mother and Child Cohort Study at age 3 years with independent clinical assessment in the Longitudinal ADHD Cohort Study

    Directory of Open Access Journals (Sweden)

    Guido Biele


    Full Text Available Epidemiological studies often use parent questionnaires to assess children's development and mental health. To date, few studies have investigated the validity of parent questionnaires with standardized clinical assessments as criterion. The current study examines discriminant and convergent validity of parent questionnaires for symptoms of Attention Deficit Hyperactivity Disorder (ADHD, Oppositional Defiance Disorder (ODD, and Conduct Disorder (CD as well as symptoms of Separation Anxiety employed in the Norwegian Mother and Child Cohort Study by using structured clinical interviews performed 5 months later in the Longitudinal ADHD Cohort Study as a criterion. The comparison of confirmatory factor analysis models and examination of factor correlations indicate convergent and discriminant validity of MoBa parent questionnaires for preschool children, especially for the assessment of ADHD and ODD/CD. Future research should attempt to further improve parent questionnaires, examine their validity in representative samples, and explicitly test their utility for screening.

  12. Body Composition at 3-years of Age

    DEFF Research Database (Denmark)

    Ejlerskov, Katrine Tschentscher

    are physiologically plausible and should be investigated in other study settings. Results from paper III showed that total and free IGF-I at both 9 and 36 months were positively related to most measures of anthropometry and body composition at 3 years. We found no clear associations between IGF-I levels and early...... development of obesity. It is possible that IGF-I levels are related to later risk of obesity through increased tempo of weight gain and linear growth leading to early adiposity rebound but this was not visible at 3 years. We had expected that intake of protein and cow’s milk was positively associated...... obesity risk is speculative. A continuation of the SKOT cohort with a follow-up visit when the children have reached 7 - 8 years of age would be highly relevant and enable further elaboration on the findings presented in paper II and III. At this age most children have passed the adiposity rebound...

  13. Intra-stent tissue evaluation within bare metal and drug-eluting stents > 3 years since implantation in patients with mild to moderate neointimal proliferation using optical coherence tomography and virtual histology intravascular ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Kitabata, Hironori; Loh, Joshua P.; Pendyala, Lakshmana K.; Omar, Alfazir; Ota, Hideaki; Minha, Sa’ar; Magalhaes, Marco A.; Torguson, Rebecca; Chen, Fang; Satler, Lowell F.; Pichard, Augusto D.; Waksman, Ron, E-mail:


    Objective: We aimed to compare neointimal tissue characteristics between bare-metal stents (BMS) and drug-eluting stents (DES) at long-term follow-up using optical coherence tomography (OCT) and virtual histology intravascular ultrasound (VH-IVUS). Background: Neoatherosclerosis in neointima has been reported in BMS and in DES. Methods: Thirty patients with 36 stented lesions [BMS (n = 17) or DES (n = 19)] > 3 years after implantation were prospectively enrolled. OCT and VH-IVUS were performed and analyzed independently. Stents with ≥ 70% diameter stenosis were excluded. Results: The median duration from implantation was 126.0 months in the BMS group and 60.0 months in the DES group (p < 0.001). Lipid-laden intima (58.8% vs. 42.1%, p = 0.317), thrombus (17.6% vs. 5.3%, p = 0.326), and calcification (35.3% vs. 26.3%, p = 0.559) did not show significant differences between BMS and DES. When divided into 3 time periods, the cumulative incidence of lipid-laden neointima from > 3 years to < 9 years was similar between BMS and DES (42.9% vs. 42.1%, p = 1.000). Furthermore, it continued to gradually increase over time in both groups. OCT-derived thin-cap fibroatheroma (TCFA) was observed in 17.6% of BMS- and 5.3% of DES-treated lesions (p = 0.326). No stents had evidence of intimal disruption. The percentage volume of necrotic core (16.1% [9.7, 20.3] vs. 9.7% [7.0, 16.5], p = 0.062) and dense calcium (9.5% [3.8, 13.6] vs. 2.7% [0.4, 4.9], p = 0.080) in neointima tended to be greater in BMS-treated lesions. Intra-stent VH-TCFA (BMS vs. DES 45.5% vs. 18.2%, p = 0.361) did not differ significantly. Conclusion: At long-term follow-up beyond 3 years after implantation, the intra-stent neointimal tissue characteristics appeared similar for both BMS and DES.

  14. Clinical evaluation of postradiation dental extraction

    Energy Technology Data Exchange (ETDEWEB)

    Kusukawa, Jingo; Ohisi, Shinichiro; Kameyama, Tadamitsu; Yoshizumi, Munehiro; Hayabuchi, Naofumi [Kurume Univ., Fukuoka (Japan). School of Medicine


    Twenty-one patients who had undergone postradiation dental extraction were evaluated clinically. All patients had received irradiation for primary head and neck malignancies at doses ranging from 8 to 60 Gy (mean, 51.6 Gy). Time to dental extraction after irradiation ranged from 8 to 156 months (mean, 57.9 months). Of the 21 patients (80 teeth extracted, including 33 maxillary teeth and 47 mandibular teeth), one had delayed healing after wisdom tooth extraction due to postextraction irradiation. Thus, osteoradionecrosis after dental extraction did not develop. These results suggest that dental extraction after radiation is not contraindicated. To prevent complications, patients who have received radiation and require extractions should be cared for by oral and maxillofacial surgeons in close association with radiation oncologists. (author).

  15. Polycystic ovary syndrome: clinical and laboratory evaluation

    Directory of Open Access Journals (Sweden)

    Marcos Yorghi Khoury

    Full Text Available OBJECTIVE: To evaluate clinically, and with laboratory, tests, women with polycystic ovary syndrome (PCO. PATIENTS: One hundred and twelve women with PCO were studied. METHODS: The following data was recorded: Current age; age at menarche; menstrual irregularity, occurrence of similar cases in the family; fertility, obstetric history; body mass index (BMI; and presence of hirsutism. Serum measurements of follicle stimulating hormone (FSH, luteinizing hormone (LH, prolactin, free testosterone, and dehydroepiandrosterone sulfate were taken. RESULTS: All patients presented either oligomenorrhea (31 percent, periods of secondary amenorrhea (9 percent, or both alterations (60 percent. The majority of the patients were infertile (75.6 percent. The LH/FSH ratio was higher than 2:1 in 55 percent of the patients and higher than 3:1 in 26.2 percent. The ultrasonographic aspect of the ovaries was considered to be normal in 31 percent. CONCLUSION: The main clinical feature of the PCO is the irregularity of menses since menarche, and that the laboratory tests would be important to exclude other disorders such as hyperprolactinemia or hyperandrogenemia caused by late-onset congenital adrenal hyperplasia.

  16. The North Staffordshire Osteoarthritis Project – NorStOP: Prospective, 3-year study of the epidemiology and management of clinical osteoarthritis in a general population of older adults

    Directory of Open Access Journals (Sweden)

    Dziedzic Krysia


    Full Text Available Abstract Background The clinical syndrome of joint pain and stiffness in older people is the commonest cause of disability and health care consultation in this age group. Yet there have been few prospective studies of its course over time and its impact on personal and social life. We plan a cohort study in the general population aged 50 years and over to determine the course and prognosis of hand, hip, knee and foot pain, and the impact of these syndromes on participation levels and health care use. Methods All patients aged 50 years and over registered with 3 local general practices are to be recruited to a population-based cohort study through the use of a two-stage mailing process. Participants will initially complete a "Health Survey" questionnaire. This will collect information on several areas of life including socio-demographics, general health, physical function, participation, and bodily pain. Those who state that they have experienced any hand problem or any pain in their hands, hips, knees, or feet in the previous 12 months, and also give permission to be re-contacted, will be mailed a "Regional Pains Survey" questionnaire which collects detailed information on the four selected body regions (hand, hips, knees, feet. Follow-up data for the three-year period subsequent to cohort recruitment will be collected through two sources: i general practice medical records and ii repeat mailed survey.

  17. AID awards 3-year Guatemala contract. (United States)


    The US Agency for International Development (USAID) has awarded a 3-year US$593,036 grant to the Los Angeles firm of Juarez and Associates, Inc. to help implement a contraceptive social marketing project in Guatemala. The firm will provide marketing assistance to the for-profit organization. Importadora de Productos Farmaceuticos (PROFA), an offshoot of the nonprofit International Planned Parenthood Federation affiliate, Asociacion Pro-Bienestar de la Familia de Guatemala (APROFAM), created specifically to conduct the social marketing project. Juarez and Associates has previous market research experience in family planning in Guatemala. Contraceptive social marketing sales are projected to begin in early 1985.

  18. Malnutrition levels among vaccinated and unvaccinated children between 2 and 3 years of age following enrollment in a randomized clinical trial with the pentavalent rotavirus vaccine (PRV) in Bangladesh. (United States)

    Feller, Andrea J; Zaman, K; Lewis, Kristen D C; Hossain, Ilias; Yunus, M; Sack, David A


    A double-masked, individually randomized Phase 3 clinical trial to assess the efficacy, safety and immunogenicity of the pentavalent rotavirus vaccine (PRV), RotaTeq™, was conducted in rural Matlab, Bangladesh (NCT00362648). A total of 1136 infants were enrolled and randomized to receive either vaccine or placebo in a 1:1 ratio administered with the standard EPI vaccines at a mean age of approximately 8, 12, and 16 weeks. Weight was collected at four time points (study vaccine doses 1, 2, and 3, and a close-out visit in March 2009 at 15-26 months of age), and birth weight was retrospectively collected from information contained on the mother's health card when available. Approximately one year following trial completion a separate study was conducted to collect anthropometry measurements, including weight and height. These measurements were linked with Phase 3 trial data and a post hoc analysis was conducted to assess the effects of rotavirus vaccination on malnutrition among enrolled children who could be located when they were between 27 and 38 months old. Among the 1033 (91%) children located, and measured, for this analysis height-for-age and weight-for-height Z scores were calculated and compared between vaccine and placebo recipients at the anthropometry follow-up 1-year post-trial, and weight-for-age Z scores were calculated at four trial time points in addition to the anthropometry follow-up. The data indicated that there was no effect of rotavirus vaccination on malnutrition in this population at any of the measured time points. PRV, estimated to have about 43% efficacy against severe rotavirus gastroenteritis in this population, may not reduce the overall burden of diarrheal illness sufficiently among all vaccinees to appreciably measure impact on growth compared with non-vaccinees. Regardless of the impact on malnutrition indicators, rotavirus vaccines are an important intervention for reducing morbidity and mortality in children in developing

  19. Nosocomial Infections of Inpatients:An 3-year Clinical Investigation and Analysis in Basic-level general hospital%基层综合性医院连续3年医院感染调查分析

    Institute of Scientific and Technical Information of China (English)

    赵中; 谭倩


    目的 探讨基层综合性医院住院患者医院感染的特点,以采取相应有效措施预防和控制医院感染的发生.方法 采用回顾性统计调查分析.结果 医院感染率为1.63%,其中以呼吸道最高,依次为泌尿道、手术切口;临床分离的致病菌为G-菌,占55.45%,G+菌,占20%,真菌,占24.55%,比较本院近3年医院感染,条件致病菌各年构成比差异虽无统计学意义,但仍占主导地位.结论 加强医院感染管理,减少侵袭性操作,及时病原菌监测,合理应用抗菌药物是降低医院感染的有效措施.%Objective To investigate the feature of nosocomial infections in Basic-level general hospital, based on which effective methods are taken to prevent and control the incidence of nosocomial infection. Methods An analysis was made on the basis of the survey, the data came from hospitalized cases in the recent three years. Results The rate of nosocomial fungus infection was 1.63 %,the main infection site was respiratory tract, and followed by urinary tract and surgical incision. Among bacteria isolated from clinical cases, 55.45 % were G-, 20.00 % were G+, and 24.55 % were fungi. However,differences of the proportion of conditional bacteria were insignificantly (P>0.05) during the past three years,the conditional bacteria were the major pathogenic in nosocomial infections. Conclusions Strengthening the nosocomial infection management, Lessing invasive process, supervising towards bacteria, and using antibacterial drug rationally are effective methods to reducing the nosocomial infections.

  20. Anecdotal notes. Effective clinical evaluation and record keeping. (United States)

    Liberto, T; Roncher, M; Shellenbarger, T


    Faculty use numerous techniques to evaluate student nurses' clinical performance. The development of keen observational skills is crucial to evaluating students' performance, but this is only the first step. Fair student evaluations require the faculty member to recall incidents and draw sound conclusions about clinical performance events. There are various tools to assist the nurse educator in evaluating students' clinical performance. The authors describe one such tool, the anecdotal record, used by nursing faculty for clinical record keeping and evaluation. Guidelines for anecdotal record keeping and solutions to common management issues related to anecdotal record keeping are provided.

  1. Clinical evaluation of seven anticalculus dentifrice formulations. (United States)

    Scruggs, R R; Stewart, P W; Samuels, M S; Stamm, J W


    One hundred ninety-two subjects completed a clinical trial to determine the effects of seven dentifrice formulations on calculus inhibition. The double-blind study involved a ten-day control phase and a ten-day experimental phase. For the control phase, subjects were evaluated for calculus present, received a prophylaxis and had pre-weighed mylar strips attached to the lingual surfaces of the mandibular incisors to harvest mineral deposits. Subjects were then assigned the placebo dentifrice for unsupervised twice-daily use and were required to report once a day for a supervised mouthrinse using a 1:3 dilution of the dentrifice. The experimental phase was identical except that subjects were allocated the experimental dentifices using a stratified random assignment based on age, gender and the initial presence of calculus. Simple linear regression analyses of the dry and ash log weights obtained from the strips were performed. The results showed no statistically significant differences among the test products; however, two formulations containing zinc citrate showed some calculus inhibition-potential suggesting that further research and development of such products may be warranted.

  2. Implementing Peer Evaluation of Clinical Teaching (United States)

    Laske, Rita Ann


    Clinical education provides the nursing student opportunities to learn the practice of nursing. In the clinical setting, the nursing student applies classroom knowledge to the real patient care situation. The clinical instructor facilitates this important process by assisting students to integrate knowledge into their practice, improve their…

  3. The Independent Psychodiagnostic Clinic: Maintaining Accountability through Program Evaluation. (United States)

    Knoff, Howard M.


    Describes an evaluation model for the independent psychodiagnostic clinic and outlines an evaluation tool used at the Psychoeducational Teaching Laboratory in Syracuse, New York. Evaluation components include formative and summative product and process evaluations. Suggests program evaluation be part of contract negotiations and individually…

  4. Changes in Strength Abilities of Adolescent Girls: The Effect of a 3-Year Physical Education Curriculum (United States)

    Czarniecka, Renata; Milde, Katarzyna; Tomaszewski, Pawel


    Study aim: To evaluate changes in strength abilities of adolescent girls that underwent a 3-year physical education curriculum. Material and methods: The research participants comprised 141 girls aged 13.3 plus or minus 0.35 years who participated in a 3-year physical education curriculum (PEC). Evaluation was based on the following EUROFIT…

  5. 3D Printing/Additive Manufacturing Single Titanium Dental Implants: A Prospective Multicenter Study with 3 Years of Follow-Up. (United States)

    Tunchel, Samy; Blay, Alberto; Kolerman, Roni; Mijiritsky, Eitan; Shibli, Jamil Awad


    This prospective 3-year follow-up clinical study evaluated the survival and success rates of 3DP/AM titanium dental implants to support single implant-supported restorations. After 3 years of loading, clinical, radiographic, and prosthetic parameters were assessed; the implant survival and the implant-crown success were evaluated. Eighty-two patients (44 males, 38 females; age range 26-67 years) were enrolled in the present study. A total of 110 3DP/AM titanium dental implants (65 maxilla, 45 mandible) were installed: 75 in healed alveolar ridges and 35 in postextraction sockets. The prosthetic restorations included 110 single crowns (SCs). After 3 years of loading, six implants failed, for an overall implant survival rate of 94.5%; among the 104 surviving implant-supported restorations, 6 showed complications and were therefore considered unsuccessful, for an implant-crown success of 94.3%. The mean distance between the implant shoulder and the first visible bone-implant contact was 0.75 mm (±0.32) and 0.89 (±0.45) after 1 and 3 years of loading, respectively. 3DP/AM titanium dental implants seem to represent a successful clinical option for the rehabilitation of single-tooth gaps in both jaws, at least until 3-year period. Further, long-term clinical studies are needed to confirm the present results.

  6. 3D Printing/Additive Manufacturing Single Titanium Dental Implants: A Prospective Multicenter Study with 3 Years of Follow-Up (United States)


    This prospective 3-year follow-up clinical study evaluated the survival and success rates of 3DP/AM titanium dental implants to support single implant-supported restorations. After 3 years of loading, clinical, radiographic, and prosthetic parameters were assessed; the implant survival and the implant-crown success were evaluated. Eighty-two patients (44 males, 38 females; age range 26–67 years) were enrolled in the present study. A total of 110 3DP/AM titanium dental implants (65 maxilla, 45 mandible) were installed: 75 in healed alveolar ridges and 35 in postextraction sockets. The prosthetic restorations included 110 single crowns (SCs). After 3 years of loading, six implants failed, for an overall implant survival rate of 94.5%; among the 104 surviving implant-supported restorations, 6 showed complications and were therefore considered unsuccessful, for an implant-crown success of 94.3%. The mean distance between the implant shoulder and the first visible bone-implant contact was 0.75 mm (±0.32) and 0.89 (±0.45) after 1 and 3 years of loading, respectively. 3DP/AM titanium dental implants seem to represent a successful clinical option for the rehabilitation of single-tooth gaps in both jaws, at least until 3-year period. Further, long-term clinical studies are needed to confirm the present results. PMID:27313616

  7. 3D Printing/Additive Manufacturing Single Titanium Dental Implants: A Prospective Multicenter Study with 3 Years of Follow-Up

    Directory of Open Access Journals (Sweden)

    Samy Tunchel


    Full Text Available This prospective 3-year follow-up clinical study evaluated the survival and success rates of 3DP/AM titanium dental implants to support single implant-supported restorations. After 3 years of loading, clinical, radiographic, and prosthetic parameters were assessed; the implant survival and the implant-crown success were evaluated. Eighty-two patients (44 males, 38 females; age range 26–67 years were enrolled in the present study. A total of 110 3DP/AM titanium dental implants (65 maxilla, 45 mandible were installed: 75 in healed alveolar ridges and 35 in postextraction sockets. The prosthetic restorations included 110 single crowns (SCs. After 3 years of loading, six implants failed, for an overall implant survival rate of 94.5%; among the 104 surviving implant-supported restorations, 6 showed complications and were therefore considered unsuccessful, for an implant-crown success of 94.3%. The mean distance between the implant shoulder and the first visible bone-implant contact was 0.75 mm (±0.32 and 0.89 (±0.45 after 1 and 3 years of loading, respectively. 3DP/AM titanium dental implants seem to represent a successful clinical option for the rehabilitation of single-tooth gaps in both jaws, at least until 3-year period. Further, long-term clinical studies are needed to confirm the present results.

  8. Clinical Evaluation--An Instructor's Dilemma. (United States)

    Meisenhelder, Janice Bell


    Guidelines are presented to assist the clinical nursing instructor in deciding whether to give a nursing student a failing grade. The guidelines discuss teacher support of a student, feedback, documentation, and colleague support. (CT)

  9. Feedback-giving behaviour in performance evaluations during clinical clerkships

    NARCIS (Netherlands)

    Bok, Harold G J; Jaarsma, Debbie A D C; Spruijt, Annemarie; Van Beukelen, Peter; Van Der Vleuten, Cees P M; Teunissen, Pim W


    CONTEXT: Narrative feedback documented in performance evaluations by the teacher, i.e. the clinical supervisor, is generally accepted to be essential for workplace learning. Many studies have examined factors of influence on the usage of mini-clinical evaluation exercise (mini-CEX) instruments and p

  10. Feedback-giving behaviour in performance evaluations during clinical clerkships

    NARCIS (Netherlands)

    Bok, Harold G J; Jaarsma, Debbie A D C; Spruijt, Annemarie; Van Beukelen, Peter; Van Der Vleuten, Cees P M; Teunissen, Pim W


    CONTEXT: Narrative feedback documented in performance evaluations by the teacher, i.e. the clinical supervisor, is generally accepted to be essential for workplace learning. Many studies have examined factors of influence on the usage of mini-clinical evaluation exercise (mini-CEX) instruments and p

  11. Clinical evaluation of 413 Thalassemic patients

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    Korosdari Gh.H


    Full Text Available Thalassemia is the most prevalent genetic disorder in Iran and around the world and these patients need regular careful care. The present study reports results of routine examination of patients visited Thalassemia clinic of Tehran. Data about clinical and laboratory examinations of 413 Thalassemic were extracted and analyzed. The prevalence of heart complications, diabetes, growth retardation, delayed puberty and primary and secondary amenorrhea was 9%, 8%, 21.3%, 3.1% and 6.3%, respectively. 44% didn't have secondary sex characteristics. Splenectomy had been done for 67.2% of cases. HBsAg, HBsAb and HBcAb were positive in 1.9%, 57.4% and 43%, respectively. We concluded that blood transfusion standards in this clinic was acceptable, whereas because of poor knowledge, iron chelating is unfavorable.

  12. The Clinical Evaluation of Parkinson's Tremor. (United States)

    Zach, Heidemarie; Dirkx, Michiel; Bloem, Bastiaan R; Helmich, Rick C


    Parkinson's disease harbours many different tremors that differ in distribution, frequency, and context in which they occur. A good clinical tremor assessment is important for weighing up possible differential diagnoses of Parkinson's disease, but also to measure the severity of the tremor as a basis for further tailored treatment. This can be challenging, because Parkinson's tremor amplitude is typically very variable and context-dependent. Here, we outline how we investigate Parkinson's tremor in the clinic. We describe a simple set of clinical tasks that can be used to constrain tremor variability (cognitive and motor co-activation, several specific limb postures). This may help to adequately characterize the tremor(s) occurring in a patient with Parkinson's disease.

  13. Experimental evaluation of clinical colon anastomotic leakage

    DEFF Research Database (Denmark)

    Pommergaard, Hans-Christian


    has been improved and is now thoroughly validated. If used by researchers worldwide, comparison of results is possible. Pure ischemia/anoxia may be too simple an approach to create a clinical leakage model. Thus, future models could focus on multiple risk factors. Conclusively, large-scale clinical...... mice. The number of sutures in the intervention group was reduced to produce a suitable leakage rate. Moreover, the analgesia and suture material were changed in order to optimize the model. In the final experiment, the four-suture anastomoses resulted in a 40% leakage rate in the intervention groups...

  14. Evaluating clinical librarians: mixing apple merchants and orange sellers? (United States)

    Booth, Andrew


    Clinical librarian services have been in existence for over 40 years. Although three systematic reviews have examined clinical librarian roles they continue to pose a challenge to rigorous evaluation. Difficulties can be articulated around their Population, Intervention, Comparator and Outcome (PICO) characteristics as well as within a wider evaluation framework. This feature suggests that developments within health research aimed at evaluating complex interventions may hold the key to assessing the contribution of such a variety of service models.

  15. Clinical Evaluation of Baccalaureate Nursing Students Using SBAR Format: Faculty versus Self Evaluation (United States)

    Saied, Hala; James, Joemol; Singh, Evangelin Jeya; Al Humaied, Lulawah


    Clinical training is of paramount importance in nursing education and clinical evaluation is one of the most challenging responsibilities of nursing faculty. The use of objective tools and criteria and involvement of the students in the evaluation process are some techniques to facilitate quality learning in the clinical setting. Aim: The aim of…

  16. Rubrics for clinical evaluation: objectifying the subjective experience. (United States)

    Isaacson, Julie J; Stacy, Annette S


    Rubrics have historically been used in secondary and higher education to evaluate specific assignments or tasks. There is little mention of rubrics in the nursing literature, particularly in the area of clinical evaluation. A strong case can be made for expanding the traditional use of a rubric to include its validity with clinical evaluation. Clinical evaluation remains a challenge, even for seasoned faculty. Faculty and students often interpret clinical course objectives differently. Coupled with this concern is the subjectivity of the evaluation. The use of "novice" clinical faculty, who inevitably struggle with discerning and justifying anything but stellar student performance, further compounds these issues. Rubrics also facilitate the grading experience for faculty and students. Faculty often find themselves making repetitive written comments to students. These comments can be incorporated into the rubric, thus shortening grading time while increasing the quality and quantity of instructor feedback. When clarified in a rubric, course objectives become "real". Student benefits include increased critical thinking and a more realistic approach to self-evaluation. Clinical rubrics can be developed from existing course objectives. Though perhaps tedious in initial development, both faculty and student satisfaction with the clinical evaluation process can be enhanced with the use of rubrics.

  17. Pharmacologic and clinical evaluation of posaconazole. (United States)

    Moore, Jason N; Healy, Jason R; Kraft, Walter K


    Posaconazole, a broad-spectrum triazole antifungal agent, is approved for the prevention of invasive aspergillosis and candidiasis in addition to the treatment of oropharyngeal candidiasis. There is evidence of efficacy in the treatment and prevention of rarer, more difficult-to-treat fungal infections. Posaconazole oral suspension solution has shown limitations with respect to fasting state absorption, elevated gastrointestinal pH and increased motility. The newly approved delayed-release oral tablet and intravenous solution formulations provide an attractive treatment option by reducing interpatient variability and providing flexibility in critically ill patients. On the basis of clinical experience and further clinical studies, posaconazole was found to be a valuable pharmaceutical agent for the treatment of life-threatening fungal infections. This review will examine the development history of posaconazole and highlight the most recent advances.

  18. Evaluating developmental screening in clinical practice

    Directory of Open Access Journals (Sweden)

    Peter Dawson


    Full Text Available Objective: To demonstrate a method of evaluating accuracy of developmental screening modeled on the evidence-based medical literature. Method: A retrospective review was performed on 418 children screened with the Denver II by a trained technician. Two models for analyzing screening data were examined, using predictive values and likelihood ratios (LR+ and LR−. Results: The technician, working at 20% time, screened 44% of eligible children. There were 129/418 (31% children with Suspect Denver II results, 115/418 who were referred, 81/115 (70% who were evaluated by Early Intervention, and 64/81 (79% who qualified for services. The uncorrected positive predictive value for the Denver II alone (44% was insufficient to meet the preset standard of 60%, but the LR+ of 4.16 indicated a significant contribution of test information to improving predictive value. Combining test results with information from the parent–technician conference to achieve a referral decision resulted in an uncorrected predictive value of 56%, which rose with correction for children referred but not evaluated to 72% (LR+ 10.33. Negative predictive values and likelihood ratios of a negative test and a non-referral decision achieved recommended levels. Parents who expressed concern were significantly more likely to complete recommended evaluation than those who did not (82% vs 58%, p < .01. Results were in the same range as in published studies with other screening tests but showed three areas for improvement: screening more children, more carefully supervising some referral decisions, and getting more children to evaluation. Conclusion: Levels of predictive accuracy above 60% can be obtained by combining different types of information about development to make decisions about referral for more complete evaluation. Systematic study of such combinations could lead to improved predictive accuracy of screening programs and support attempts to close the gap between referral

  19. Psychotherapy with a 3-Year-Old Child: The Role of Play in the Unfolding Process (United States)

    Salcuni, Silvia; Di Riso, Daniela; Mabilia, Diana; Lis, Adriana


    Few studies have investigated the outcomes and process of psychodynamic psychotherapies with children. Among the limited number of studies, some only paid attention to play and verbal production, as they are fundamental aspects in assessing the psychotherapy process. This paper focuses on an empirical investigation of a 3-year, once-a-week psychodynamic psychotherapy carried out with a 3-year-old girl. A process-outcome design was implemented to evaluate play and verbal discourse in in the initial, middle, and final parts of 30 psychotherapy sessions. Repeated measurements of standardized play categories (the Play Category System and the Affect in Play Scale—Preschool version) and verbal discourse (Verbal Production) were analyzed. To increase the clinical validity of the study, data from the assessment phase and vignettes from the sessions were reported to deepen the patient’s picture during the unfolding therapy process. Parent reports before and after the therapy were also included. Empirically measured changes in play and verbal production were fundamental in evaluating the young patient’s psychotherapy process. Verbal production and discourse ability progressively increased and took the place of play, which instead became more symbolic. Developmental issues as well as psychotherapy’s influence on the patient’s change, were discussed in relation to the role of play in enhancing the development of verbal dialog and the expression of the child’s emotions, needs, and desires. PMID:28101070

  20. Nurse educators’ perceptions of OSCE as a clinical evaluation method

    Directory of Open Access Journals (Sweden)

    MM Chabeli


    Full Text Available The South African Qualifications Authority, and the South African Nursing Council are in pursuit of quality nursing education to enable the learners to practise as independent and autonomous practitioners. The educational programme should focus on the facilitation of critical and reflective thinking skills that will help the learner to make rational decisions and solve problems. A way of achieving this level of functioning is the use of assessment and evaluation methods that measure the learners’ clinical competence holistically. This article is focused on the perceptions of twenty nurse educators, purposively selected from three Nursing Colleges affiliated to a university in Gauteng, regarding the use of OSCE (Objective Structured Clinical Examination as a clinical evaluation method within a qualitative and descriptive research strategy. Three focus group interviews were conducted in different sessions. A descriptive content analysis was used. Trustworthiness was ensured by using Lincoln and Guba’s model (1985. The results revealed both positive and negative aspects of OSCE as a clinical evaluation method with regard to: administrative aspects; evaluators; learners; procedures/instruments and evaluation. The conclusion drawn from the related findings is that OSCE does not measure the learners’ clinical competence holistically. It is therefore recommended that the identified negative perception be taken as challenges faced by nurse educators and that the positive aspects be strengthened. One way of meeting these recommendations is the use of varied alternative methods for clinical assessment and evaluation that focus on the holistic measurement of the learners’ clinical competence.

  1. Clinical evaluation of nedocromil sodium in asthma. (United States)

    Holgate, S T


    The recognition that inflammatory events in the airways play a key role in the pathogenesis of asthma has led to a relentless search for pharmacological agents which modify these processes. Nedocromil sodium (Tilade) represents one such agent. Nedocromil sodium, when inhaled by patients with asthma (0.05-0.50% nebulized, 0.5-4.0 mg m.d.i.), has been shown to inhibit immediate bronchoconstriction provoked by challenges with allergen (10 studies), exercise (five studies), isocapnic hyperventilation, fog and sulphur dioxide (one study each) and adenosine (two studies). With these challenges, inhibition of bronchoconstriction exhibited dose-dependency up to 4 mg, with nedocromil sodium being up to four times more potent than sodium cromoglycate. When inhaled prior to allergen provocation, nedocromil sodium inhibited the late asthmatic reaction; when taken regularly during the pollen season, it attenuated the allergen-induced increase in non-specific bronchial responsiveness. The efficacy of nedocromil sodium (4 mg q.i.d.) in the treatment of clinical asthma was initially shown in four open studies and subsequently confirmed in nine double-blind, placebo-controlled 4-12 week studies on patients with seasonal and perennial asthma. Further clinical trials (eight studies) identified some difficulty in replacing inhaled corticosteroids with nedocromil sodium, especially if the corticosteroids were reduced rapidly (four studies). However, two studies have shown that nedocromil sodium produced further improvement in asthma symptoms when used in addition to bronchodilators and inhaled corticosteroids. Treatment with nedocromil sodium (4 mg q.i.d.) for up to 52 weeks demonstrated a progressive reduction in bronchodilator usage throughout the whole treatment period. During clinical assessment, nedocromil sodium was well tolerated, side-effects being unpleasant taste, nausea and headache. In most cases the adverse reactions were mild and transient, although in approximately 3% of

  2. Clinical Evaluation of Disc Battery Ingestion in Children


    Mirshemirani, Alireza; Khaleghnejad-tabari, Ahmad; Kouranloo, Jaefar; Sadeghian, Naser; Rouzrokh, Mohsen; Roshanzamir, Fatolah; Razavi, Sajad; Sayary, Ali Akbar; Imanzadeh, Farid


    BACKGROUND The purpose of this study was to evaluate the characteristics, management, and outcomes of disc battery ingestion in children. METHODS We reviewed the medical records of children admitted to Mofid Children’s Hospital due to disc battery ingestion from January 2006 to January 2010. Clear history, clinical symptoms and results of imaging studies revealed diagnosis of disc battery ingestion in suspected patients. The clinical data reviewed included age, gender, clinical manifestation,...

  3. Increment of Dental Caries in Infants from the City of Feira de Santana, BA, Brazil: 3-Year-Follow-up

    Directory of Open Access Journals (Sweden)

    Ana Isabel Fonseca SCAVUZZI


    Full Text Available Purpose: To investigate the increment of dental caries and potential clinical risk factors for this increase within a 3-year-period (1998-2001.Method: A prospective longitudinal study on dental caries was performed between 1998 a 2001 in a sample of 136 children aged 12 years and 30 months, in the city of Feira de Santana, BA. The city has fluoridated water supply and the children were evaluated at three different moments: baseline, after 1 year and after 3 years. At the three moments, intraoral examination was performed for detection of dental caries (dmf-t index, dental plaque and white spot lesions on the buccal surfaces of maxillary incisors and presence of molars. Data were analyzed by distribution of absolute and relative frequencies, means, median and standard deviation, and use of chi-square, Wilcoxon test of signalized posts, Mc-Nemar and Fisher’s tests. Significance level was set at 5%. Results: The prevalence of dental caries in the baseline examination was 5.9%, 18.4% after 1 year and 40.4% after 3 years, denoting an increment of 39.7%. It was confirmed the significant association between the variables white spot lesions, visible plaque and previous caries experience with the increment of dental caries after 3 years. There was no association with the presence of primary molars. Conclusions: The prevalence of dental caries after 3 years was approximately 7 times higher than that of the baseline examination and twice as higher as that of the baseline examination. The clinical risk factors identified in this study are important indicators of the increment of dental caries in very young children.

  4. Evaluation of Respiratory Muscle Strength in Mouth Breathers: Clinical Evidences

    Directory of Open Access Journals (Sweden)

    Cunha, Renata Andrade da


    Full Text Available Introduction The child who chronically breathes through the mouth may develop a weakness of the respiratory muscles. Researchers and clinical are seeking for methods of instrumental evaluation to gather complementary data to clinical evaluations. With this in mind, it is important to evaluate breathing muscles in the child with Mouth Breathing. Objective To develop a review to investigate studies that used evaluation methods of respiratory muscle strength in mouth breathers. Data Synthesis  The authors were unanimous in relation to manovacuometry method as a way to evaluate respiratory pressures in Mouth Breathing children. Two of them performed with an analog manovacuometer and the other one, digital. The studies were not evaluated with regard to the method efficacy neither the used instruments. Conclusion There are few studies evaluating respiratory muscle strength in Mouth Breathing people through manovacuometry and the low methodological rigor of the analyzed studies hindered a reliable result to support or refuse the use of this technique.

  5. Instructional Scaffolding to Improve Students’ Skills in Evaluating Clinical Literature (United States)

    Dominguez, Karen D.; Troutman, William G.; Bond, Rucha; Cone, Catherine


    Objective To implement and assess the effectiveness of an activity to teach pharmacy students to critically evaluate clinical literature using instructional scaffolding and a Clinical Trial Evaluation Rubric. Design The literature evaluation activity centered on a single clinical research article and involved individual, small group, and large group instruction, with carefully structured, evidence-based scaffolds and support materials centered around 3 educational themes: (1) the reader's awareness of text organization, (2) contextual/background information and vocabulary, and (3) questioning, prompting, and self-monitoring (metacognition). Assessment Students initially read the article, scored it using the rubric, and wrote an evaluation. Students then worked individually using a worksheet to identify and define 4 to 5 vocabulary/concept knowledge gaps. They then worked in small groups and as a class to further improve their skills. Finally, they assessed the same article using the rubric and writing a second evaluation. Students’ rubric scores for the article decreased significantly from a mean pre-activity score of 76.7% to a post-activity score of 61.7%, indicating that their skills in identifying weaknesses in the article's study design had improved. Conclusion Use of instructional scaffolding in the form of vocabulary supports and the Clinical Trial Evaluation Rubric improved students’ ability to critically evaluate a clinical study compared to lecture-based coursework alone. PMID:21769138

  6. [Clinical evaluation of vertigo in menopausal women]. (United States)

    Owada, Satoko; Yamamoto, Masahiko; Suzuki, Mitsuya; Yoshida, Tomoe; Nomura, Toshiyuki


    Vertigo is one of the usual menopausal symptoms. We have often examined some women under the complaint of vertigo related with the menopause. We diagnosed each disease based on neuro-otological examinations and investigated the characteristics of menopausal-associated vertigo. We studied 413 women aged 40-59 years old who complained of vertigo. There were 73 women with menopause symptoms (14 women introduced from the gynecologist in our medical center, 18 women had undergone treatment at another female clinic, and 41 women visited an otorhinolaryngologist first) compared with 340 women without menopause symptoms. In the menopause group, 41 (56.2%) cases were diagnosed as having benign paroxysmal positional vertigo (BPPV), 13 (17.8%) cases had Meniere's disease, sudden deafness with vertigo accounted 2 cases, one was an acoustic tumor, and so on. The percentage of patients with BPPV was almost same ratio between the menopause group (56.2%) and the non-menopause group (52.9%). The percentage of patients with Meniere's disease was higher markedly in the menopausal group (17.8%). than the non-menopause group (9.7%). Menopausal symptoms are caused not only by hot flashes related to a lack of estrogen but also by psychological factors. The onset of Meniere's disease can also be influenced by psychological factors. As for the diagnosis of Meniere's disease, we supposed the reason for the higher percentage in the menopausal group was its relationship with psychological factors. We could diagnose and treat some menopausal women with vertigo. We believe that joint consultation with a gynecologist and otorhinolaryngologist would be necessary to ensure an optimum quality of life for such patients.

  7. Evaluation of different systems for clinical quantification of varicose veins. (United States)

    Cornu-Thénard, A; De Vincenzi, I; Maraval, M


    One hundred twenty-five lower limbs with varicose veins were studied clinically, essentially by palpation. Two specialists in venous pathology scored the severity of the varicose veins from 0 to 20. Comparison between the different clinical parameters and the scores of the specialists showed that two systems of clinical quantification gave good results and were easy to use. One system is the maximum diameter of the largest varicose vein; the other system is the sum of maximum diameters over 7 sections (3 for thigh, 3 for leg, 1 for foot). This latter system gives a more precise evaluation of the clinical severity of the varicose veins.

  8. Legal Issues in Faculty Evaluation of Student Clinical Performance. (United States)

    Kapp, Marshall B.


    Many faculty members are reluctant to evaluate the clinical performance of medical students because of fear of legal liability and lawsuits. Current methods and uses of evaluation and legal issues are discussed. The Supreme Court's decision in Board of Curators of the University of Missouri v. Horowitz is discussed. (Author/MLW)

  9. Clinical Evaluation of Inpatients with Acute Urticaria

    Directory of Open Access Journals (Sweden)

    Ayşe Serap


    Full Text Available Background and Design: To determine the clinical and etiological features of inpatients with acute urticaria and angioedema and to assess the need for laboratory tests. Material and Methods: We recruited 105 patients with acute urticaria and angioedema who were admitted to our inpatient unit. The lesions and the characteristics of the patients were analyzed. Routine diagnostic tests including complete blood count, thyroid function tests, hepatitis panel, stool parasite, total IgE levels, cultures, erythrocyte sedimentation rate, C-reactive protein, anti-nuclear antibody, and posterior anterior lung X-ray were ordered. A psychiatric consultation was obtained, when needed. The results were analyzed with SPSS 15.0 statistical software.Results: Among 105 patients, 28 (26.7% had urticaria, 7 (6.7% had angioedema, and 70 (66.7% suffered from both urticaria and angioedema. The most common accompanying symptoms were itching (91.4% and burning (34.3%. The most common systemic symptoms were fatigue (15.2% and headache (12.4%. The lesions usually appeared in the evening hours (24.8%. Twenty-five patients were waking up due to itching during the night. Some lesions were associated with physical activities. Systemic diseases accompanied the lesions in 12 patients (11%. In terms of etiological factors, 33 patients (22.5% had infections. Food- related lesions were encountered in 14 (13% patients. Thirty patients (28.5% had history of medication use. Stress was detected in 37.1% of the patients; anxiety was diagnosed in 3% of patients. The stool was positive for parasites in 10 (9% patients. Conclusion: Acute urticaria is a benign disorder. Although the underlying cause of urticaria can not always be identified, infections and medications are the most common causes. A comprehensive and detailed history is very important to discover the underlying cause. The diagnostic tests should be ordered according to the patient’s history. Conducting diagnostic tests

  10. Usefulness of mandibular third molar coronectomy assessed through clinical evaluation over three years of follow-up. (United States)

    Kohara, K; Kurita, K; Kuroiwa, Y; Goto, S; Umemura, E


    The aim of this study was to investigate the 3-year morbidity of coronectomy of the lower third molar and to monitor the behaviour and migration pattern of the retained roots postoperatively. A total of 92 patients (111 teeth) who had undergone a coronectomy between October 2005 and July 2009 were investigated. Patients were followed up at 3 months and 1, 2, and 3 years for clinical evaluation and dental computed tomography imaging of the coronectomy sites. In total, 10 cases (9%) required tooth root extraction within the 3 years after coronectomy. In seven of them, the distal pocket of the lower second molars remained connected to the roots within the first year. Of the cases in whom a pocket did not remain at an early stage, none showed peri-apical lesions on transmission images of the retained roots in the apical area, which usually result from necrosis of the pulp. Root migration increased in the first 2 years after coronectomy but stabilized between the second and third years. In addition, a significant difference was noted in root migration between patients of different ages and sex. Retained roots after coronectomy in the lower third molars led to no complications in terms of infection or the development of pathologies within the first 3 years postoperatively.

  11. Development and evaluation of a clinical note section header terminology. (United States)

    Denny, Joshua C; Miller, Randolph A; Johnson, Kevin B; Spickard, Anderson


    Clinical documentation is often expressed in natural language text, yet providers often use common organizations that segment these notes in sections, such as history of present illness or physical examination. We developed a hierarchical section header terminology, supporting mappings to LOINC and other vocabularies; it contained 1109 concepts and 4332 synonyms. Physicians evaluated it compared to LOINC and the Evaluation and Management billing schema using a randomly selected corpus of history and physical notes. Evaluated documents contained a median of 54 sections and 27 major sections. There were 16,196 total sections in the evaluation note corpus. The terminology contained 99.9% of the clinical sections; LOINC matched 77% of section header concepts and 20% of section header strings in those documents. The section terminology may enable better clinical note understanding and interoperability. Future development and integration into natural language processing systems is needed.

  12. Reporting and evaluation of HIV-related clinical endpoints in two multicenter international clinical trials

    DEFF Research Database (Denmark)

    Lifson, A; Rahme, FS; Belloso, WH;


    PURPOSE: The processes for reporting and review of progression of HIV disease clinical endpoints are described for two large phase III international clinical trials. METHOD: SILCAAT and ESPRIT are multicenter randomized HIV trials evaluating the impact of interleukin-2 on disease progression...

  13. Success Rate of MTA Pulpotomy on Vital Pulp of Primary Molars: A 3-Year Observational Study (United States)

    Tyagi, Rishi


    Introduction Vital pulp therapy is a major contributor in the preservation of primary dentition after caries affliction. Introduction of mineral trioxide aggregate (MTA) has revolutionized such treatment. Aim The aim of our study was to evaluate and correlate the effects of MTA clinically and radiographically on pulpotomized primary molars till their exfoliation or extraction followed by histological evaluation. Study design This is an observational study. Materials and methods A total of 25 teeth were selected from 5- to 8-year-old children requiring pulp therapy on the basis of inclusion and exclusion criterion. The teeth were treated by conventional pulpotomy technique under aseptic conditions using MTA and were immediately restored with stainless steel crown. The teeth were assessed postoperatively till 36 months. The exfoliated or extracted teeth were examined histologically. Results The pulpotomized teeth were vital with no adverse clinical findings during the observation period. After 3 months, one tooth showed internal resorption, but the same was not observed after 12 months. Pulp canal obliteration was seen in three cases. At the end of the study, five teeth were exfoliated and one tooth was extracted for maintaining arch symmetry. The histological examination of extracted tooth revealed the presence of healthy pulp and the area of true calcification. Remaining exfoliated teeth presented dentin bridge formation. Statistics Frequencies and percentages were used for descriptive statistics. Fisher’s exact tests were used to see the difference between clinical and radiological findings. The probability value was fixed at 5% level of significance. Conclusion The response of pulp in primary teeth to MTA was favorable in all cases from clinical and radiographic perspective, and histological evaluation confirmed the observation. How to cite this article Godhi B, Tyagi R. Success Rate of MTA Pulpotomy on Vital Pulp of Primary Molars: A 3-Year Observational Study


    Directory of Open Access Journals (Sweden)

    Wadikar Sujata Surendra


    Full Text Available A Clinical study on "Clinical Evaluation of Selected Colouring Herbals in Savarnikaran" was carried out at shalya tantra dept. of M.A.Podar Hospital, Worli, Mumbai 18. The prime aim of the study is to make available an effective, alternative colouring cosmetic preparations which will be useful in post burn, post acne and post wound colour morbidity.Ayurvedic herbal drugs are abundant, easily available and cost effective but their use is not observed in all forms. The trial drug is prepared in powder-paste, oil and ointment form. Further the efficacy of the different preparation is also evaluated separately. Cosmetic aspect of ayurvedic surgery is neglected, here we attempt to bring this aspect in routine practice.Total number of 40 patients were studied in this clinical study.Observations were documented through specially designed clinical record form and relevant conclusions were drawn.

  15. [Clinical evaluation of thrombo-embolic venous disease]. (United States)

    Chagnon, Isabelle


    Clinical manifestations of venous thromboembolism are often subtle or misleading. Yet it is a potentially fatal condition. Although the symptoms and signs at presentation have a poor sensitivity and specificity when considered singly, the physician can accurately assess a clinical probability based on the history, the risk factors, the physical examination and some simple laboratory exams. This essential step allows us to identify a low risk group of patients which will benefit of a non invasive diagnostic strategy. More recently explicit prediction rules were proposed to offset the lack of standardization of this clinical assessment. These new didactic tools can simplify clinical evaluation. Nevertheless, their comparison to implicit evaluation reveals that they should be complemented by the physician's judgement.

  16. 地拉罗司治疗重型β-地中海贫血铁过载的三年临床试验研究%A 3-year clinical trial of deferasirox in heavily iron-overloaded patients with Beta-thalassemia major

    Institute of Scientific and Technical Information of China (English)

    刘容容; 赖永榕; 马劼; 张新华; 罗建明; 李辉萍; 梁金清; 李喆; 王明月; 苏鹏


    Objective To evaluate the efficacy and safety of deferasirox in heavily iron-overloaded patients with beta-thalassemia major. Methods A single arm, open-label clinical trial was conducted to evaluate the efficacy and safety of deferasirox in the treatment for 23 patients with beta-thalassemia major and heavily iron-overloaded in 3 years follow-up. Results The 23 patients never received regular chelation before enrolling this trial [the mean baseline of serum ferritin was (5433.96 ± 2873.90) μg/L]. In this trial, a deferasirox dose of 20 mg·kg-1·d-1 could stabilize serum ferritin levles,while of ≥30mg·d-1 reduced the levels and achieved negative iron balance. There were no serious adverse events related to the drug.Most common adverse events were mild increases of liver enzyme and serum creatinine levels. Overall, 23 patients could tolerate the drug on schedule and all completed the trial. Conclusion As a new oral iron chelator, deferasirox has a significant efficacy for the treatment of iron overload. The effectiveness is dependent on the courses of treatment and the dose of deferasirox. The single-dose used is safe and tolerated, so deferasirox can remarkably improve life quality of patients.%目的 评价新型口服铁螯合剂--地拉罗司治疗重型β-地中海贫血(β-地贫)患者铁过载的疗效及安全性.方法 采用单组、开放试验设计,观察23例重型β-地贫铁过载患者3年随访中地拉罗司的疗效及安全性.结果 入组的23例重型β-地贫患者治疗前均未规则使用铁螫合剂,铁过载状况严重[血清铁蛋白平均基线值为(5433.96±2873.90)μg/L].20 mg·kg-1·d-1的地拉罗司能维持患者铁过载处于平衡状态,治疗前后血清铁蛋白水平无显著性变化;随治疗时间的延长,服药剂量的增加,≥30 mg·kg-1·d-1的地拉罗司能使患者铁过载达到负平衡状态,治疗前后比较血清铁蛋白水平差异具有统计学意义(P<0.01).3年随访中未出现地拉罗

  17. Clinical evaluation of the Vitek Neisseria-Haemophilus Identification card.


    Janda, W M; Malloy, P J; Schreckenberger, P C


    A clinical evaluation of the Vitek Neisseria-Haemophilus Identification (NHI) card (Vitek Systems, Inc., Hazelwood, Mo.) was performed with 480 clinical isolates and stock strains of Neisseria spp., Haemophilus spp., and other fastidious microorganisms included in the data base of the system. Identifications obtained with the NHI card were compared with those determined by conventional methods. The card identified 83.2% of 244 Neisseria spp. and Branhamella catarrhalis, 54.9% of 164 Haemophil...

  18. A Deliberation for Evaluating Clinical Effects in Chinese Medicine

    Institute of Scientific and Technical Information of China (English)

    WANG Jia-liang


    @@ Chinese medicine (CM) has several thousands of years of history and has made a great contribution to human health and disease prevention in the world.Since there are so many differences between CM and Western medicine (WM) on their theory and methods in disease diagnosis and treatment,how to evaluate the clinical effects exactly and correctly in clinical practice becomes one bottleneck problem in CM.This is also the primary theme of the 369th Xiangshan Seminar,2010,Beijing.

  19. Evaluation of the Olympus AU 400 clinical chemistry analyzer. (United States)

    Bilić, A; Alpeza, I; Rukavina, A S


    The performance of the Olympus AU 400 clinical chemistry analyzer was evaluated according to the guidelines of the European Committee for Clinical Laboratory Standards. The following analytes were tested: glucose, urea, creatinine, calcium, AST, ALT, CK, LDH, ALP and amylase. The Olympus AU 400 was compared with the Olympus AU 800. Coefficients of correlation showed high correlation between the compared analyzers. Other performances (intra- and inter-assay variation, carry-over and interferences) of the analyzer were satisfactory.

  20. Evaluating clinical teachers with the Maastricht clinical teaching questionnaire : How much 'teacher' is in student ratings?

    NARCIS (Netherlands)

    Boerboom, Tobias B. B.; Mainhard, Tim; Dolmans, Diana H. J. M.; Scherpbier, Albert J. J. A.; Van Beukelen, Peter; Jaarsma, A. D. (Debbie) C.


    Background: Students are a popular source of data to evaluate the performance of clinical teachers. Instruments to obtain student evaluations must have proven validity. One aspect of validity that often remains underexposed is the possibility of effects of between-student differences and teacher and

  1. Modular stem fixed-bearing total ankle replacement: prospective results of 23 consecutive cases with 3-year follow-up. (United States)

    Brigido, Stephen A; Galli, Melissa M; Bleazey, Scott T; Protzman, Nicole M


    In the present report, the 3-year outcomes of 23 consecutive patients treated with a modular stem fixed-bearing total ankle replacement are described. Pain, functional impairment, and disability were assessed annually using a visual analog scale. Complications and additional procedures also were recorded. Compared with preoperative pain (8.4 ± 1.4), functional impairment (8.7 ± 2.3), and disability (3.0 ± 2.5), there were statistically significant postoperative improvements at 1 year (pain, 2.6 ± 1.6; functional impairment, 3.1 ± 2.1; disability, 0.9 ± 1.2), 2 years (pain, 1.5 ± 1.3; functional impairment, 1.9 ± 1.4; disability, 0.6 ± 1.4), and 3 years (pain, 1.3 ± 1.3; functional impairment, 1.9 ± 1.9; disability, 0.4 ± 0.9; p ≤ .001). Pain, function, and disability significantly improved postoperatively from 1 to 2 years (p ≤ .008) and from 1 to 3 years (p ≤ .008). The reductions in pain, functional impairment, and disability were maintained from 2 to 3 years (p ≥ .08). Nine complications (39.1%) were encountered: 1 deep infection, 2 pulmonary embolisms, 3 wounds, 1 ectopic bone formation, 1 stiff joint, and 1 talar subsidence. In the 3-year follow-up period, 3 patients (13.0%) required additional procedures after the immediate postoperative phase. Our results have demonstrated that modular stem fixed-bearing prostheses can be implanted in a predictable and consistent fashion with resultant improvements in pain, function, and disability. Future studies evaluating the clinical outcomes after modular stem fixed-bearing total ankle replacement are warranted.

  2. Preparedness for clinical: evaluation of the core elements of the Clinical Immersion curriculum model. (United States)

    Diefenbeck, Cynthia; Herrman, Judith; Wade, Gail; Hayes, Evelyn; Voelmeck, Wayne; Cowperthwait, Amy; Norris, Susan


    The Clinical Immersion Model is an innovative baccalaureate nursing curriculum that has demonstrated successful outcomes over the past 10 years. For those intending to adopt the model, individual components in isolation may prove ineffective. This article describes three core components of the curriculum that form the foundation of preparation for the senior-year clinical immersion. Detailed student-centered outcomes evaluation of these critical components is shared. Results of a mixed-methods evaluation, including surveys and focus groups, are presented. Implications of this curricular evaluation and future directions are explored.

  3. Preliminary Clinical Evaluation: The What, Where, How Approach to Scoring


    Wright, C.; Akimoto, T.


    The SCoR is driving for preliminary clinical evaluation (PCE) however; currently there is no method of quantification to assess quality. FRCR has an approach to quantify comments in the rapid reporting examination (CR2B).The aim of this project was to develop a robust scoring system that enables comprehensive image evaluation regardless of profession. An image test bank was administered using RadBench with equal prevalence of normal /abnormal. A random sample of attempts was selected to pilot...

  4. Caustic Injury In Adults – A Study For 3 Year Period



    The aim of the study is to present the results of a 3-year clinico-epidemiological investigation of caustic injury in adults. The study includes 43 patients with acute corrosive ingestion, hospitalized in the Toxicology Clinic, University Hospital “N. I. Pirogov”, Sofia, Bulgaria, for the period 01.01. 2010-31.12.2012. The methods used include: clinical observation and examination, clinical laboratory, imaging, and psychiatric methods and tests. 43 patients between the ages of 22 and 82 with ...

  5. Development of atopic dermatitis during the first 3 years of life

    DEFF Research Database (Denmark)

    Halkjær, Liselotte Brydensholt; Loland, Lotte; Buchvald, Frederik F;


    OBJECTIVES: To describe the development of atopic dermatitis (AD) during the first 3 years of life and identify the localization of the early skin lesions that predicts the development of AD. DESIGN: Prospective, longitudinal, birth cohort study of children born to mothers with a history of asthma......, followed up for 3 years with scheduled visits every 6 months as well as visits for onset or acute exacerbations of skin symptoms. SETTING: The cohort was recruited from greater Copenhagen, Denmark, and followed up at a clinical research unit, which controlled all diagnoses and treatment of skin diseases...... predicted AD at age 3 years. CONCLUSIONS: Atopic dermatitis begins at the scalp, forehead, ear, and neck in a balaclava-like pattern. Eczema at the arms and joints provides the highest predictive value for the development of AD at age 3 years. This may be used for early prediction and intervention of AD....

  6. Comprehensive clinical evaluation as an outcome assessment for a graduate orthodontics program. (United States)

    Pinskaya, Yuliya B; Hsieh, Tsung-Ju; Roberts, W Eugene; Hartsfield, James K


    To supplement the American Board of Orthodontics (ABO) objective grading system (OGS) for posttreatment dental casts and panoramic radiographs, a comprehensive clinical assessment (CCA) method was developed to assess facial form, dental esthetics, vertical dimension, arch form, periodontium preservation, root resorption, and treatment efficiency. The sum of the CCA and the ABO OGS scores was defined as the clinical outcome. To determine a 3-year baseline for treatment outcomes in a graduate orthodontic program, the posttreatment records of 521 consecutive patients were evaluated. The mean ABO OGS score for the entire sample was 34.4 points: 32.4, 33.1, and 37.8 points for 1998, 1999, and 2000, respectively. The mean CCA score for the entire sample was 4.67 points: 2.96, 5.13, and 6.15 points for 1998, 1999, and 2000, respectively. Corresponding ABO OGS and CCA scores showed a progressive decrease in the quality of finished cases that was associated with a treatment time increase from 28.9 to 39.3 months. Overall, longer active treatment times resulted in a diminished clinical outcome, primarily due to "patient burn-out." Scoring of all finished cases is an effective means for determining clinical outcomes. However, the data suggest that, in initiating a clinical grading program, it is important to establish a multiyear baseline. Patients who are progressing well in treatment tend to be finished by the time the current class graduates, and the problem patients are transferred. Because long treatment times are associated with diminished clinical outcomes, it is often in the best interest of the uncooperative patient to terminate treatment rather than extend active mechanics in an attempt to achieve a better result.

  7. The clinical utility of functional capacity evaluations: the opinion of health professionals working within occupational rehabilitation. (United States)

    James, Carole; MacKenzie, Lynette


    Functional Capacity Evaluations (FCE's) are used within the occupational rehabilitation arena with the aim of assessing an individual's functional abilities in relation to work tasks. Therapists use a variety of different FCE's, both standardized and non standardized. This study aimed to investigate therapists' views on the clinical utility of FCE's in general and to identify if these differed between professional groups. A cross sectional study design was used. Health professionals who conduct FCE's and who worked for WorkCover accredited rehabilitation providers in NSW were surveyed. Surveys were returned from 79 participants working for 65 different rehabilitation providers. Of those who replied, 82\\% (n=63) were occupational therapists, 13% (n=10) physiotherapists and 5% (n=5) exercise physiologists. The mean years of professional experience was 10.9 years and the mean years of FCE experience was 5.3 years. Data were analyzed using STATA [v8.0] and the clinical utility of FCE's was considered relating to: usefulness & relevance; adaptability and flexibility; therapist perceived requirements and issues in practice. No differences were found related to the clinical utility of FCE's between professional groups or years of professional experience. The results suggest consistency and similarities in how FCE's are currently used in practice across NSW (Australia). Limitations of this study and areas for further research are suggested.

  8. Evaluation of clinical ethics support services and its normativity. (United States)

    Schildmann, Jan; Molewijk, Bert; Benaroyo, Lazare; Forde, Reidun; Neitzke, Gerald


    Evaluation of clinical ethics support services (CESS) has attracted considerable interest in recent decades. However, few evaluation studies are explicit about normative presuppositions which underlie the goals and the research design of CESS evaluation. In this paper, we provide an account of normative premises of different approaches to CESS evaluation and argue that normativity should be a focus of considerations when designing and conducting evaluation research of CESS. In a first step, we present three different approaches to CESS evaluation from published literature. Next to a brief sketch of the well-established approaches of 'descriptive evaluation' and 'evaluation of outcomes', we will give a more detailed description of a third approach to evaluation-'reconstructing quality norms of CESS'-which is explicit about the normative presuppositions of its research (design). In the subsequent section, we will analyse the normative premises of each of the three approaches to CESS evaluation. We will conclude with a brief argument for more sensitivity towards the normativity of CESS and its evaluation research.

  9. Evaluation of nursing students about the objective structured clinical examination

    Directory of Open Access Journals (Sweden)

    Jéssica Naiara de Medeiros Araújo


    Full Text Available The Objective Structured Clinical Examination (OSCE is considered a fundamental element to improve teaching and learning. It can be understood as a measurement tool of clinical competencies with adoption of standard procedures. A qualitative study aimed to describe the evaluation of students about the OSCE use as strategy to promote the teaching-learning process in Clinical Nursing. A focus group with 27 students was created for data collection with information extracted from three guiding questions. Data was analyzed using Content Analysis technique. Two categories emerged from the first guiding question: the use of SOP; and learning strategy. Three categories emerged from the second question: main feelings; valid experience; and assessment method. From the third question, two categories were identified: learning from errors; and similarity with practice. The OSCE constitutes an assessment strategy that positively contributed with the teaching-learning process in Clinical Nursing.

  10. The process of clinical assessment: cognitions of the evaluator

    Directory of Open Access Journals (Sweden)

    Carmelo Ibáñez Aguirre


    Full Text Available The cognitive paradigm of the past few decades opens several new possibilities for psychological evaluation.  The objective of this essay is to emphasize the possibilities related to the quality of self-evaluation, specifically professional self-assessment, meaning a critical analysis of one’s own evaluation process. In this essay, metacognition activities and strategies are examined, as are the ways in which these activities and strategies relate to metacognition and cognitive skills. The intent of this theoretical essay is to offer answers to the clinical evaluator’s professional experience. The results indicate that the clinical professional must consider strategies to improve metacognition and cognitive skills through reflection, self-analysis and self-criticism to improve the quality and efficiency of their work.

  11. [Travel diarrhea: attempt at a clinical-epidemiologic evaluation]. (United States)

    Kollaritsch, H; Kremsner, P G; Tobisch, P; Ambrosch, F; Stemberger, H


    Traveller's diarrhea is the most common tourist's disease in the tropics. Therefore epidemiological data for the evaluation of factors influencing the attack rates and the severity of the disease are being required. This paper deals with the data of 1058 Austrian tourists travelling to warm climate countries. 47.3% of all travellers suffered from an episode of traveller's diarrhea during their stay. However, it could be evaluated that besides the destination seasonal influences were very important. Factors like individual hygiene and accommodation did not influence the attack rates. Age and environmental conditions, however, did partially influence the frequency of diarrhea. Furthermore, additional symptoms were interpreted and it could be seen that suspected heterogenicity of etiology leads to a similar pattern of clinical symptoms. Clinical evaluation proves that traveller's diarrhea is commonly not severe, but due to the incidence and duration of the disease it is a major health problem in modern tourism.

  12. Developing an evaluation framework for clinical redesign programs: lessons learnt. (United States)

    Samaranayake, Premaratne; Dadich, Ann; Fitzgerald, Anneke; Zeitz, Kathryn


    Purpose The purpose of this paper is to present lessons learnt through the development of an evaluation framework for a clinical redesign programme - the aim of which was to improve the patient journey through improved discharge practices within an Australian public hospital. Design/methodology/approach The development of the evaluation framework involved three stages - namely, the analysis of secondary data relating to the discharge planning pathway; the analysis of primary data including field-notes and interview transcripts on hospital processes; and the triangulation of these data sets to devise the framework. The evaluation framework ensured that resource use, process management, patient satisfaction, and staff well-being and productivity were each connected with measures, targets, and the aim of clinical redesign programme. Findings The application of business process management and a balanced scorecard enabled a different way of framing the evaluation, ensuring measurable outcomes were connected to inputs and outputs. Lessons learnt include: first, the importance of mixed-methods research to devise the framework and evaluate the redesigned processes; second, the need for appropriate tools and resources to adequately capture change across the different domains of the redesign programme; and third, the value of developing and applying an evaluative framework progressively. Research limitations/implications The evaluation framework is limited by its retrospective application to a clinical process redesign programme. Originality/value This research supports benchmarking with national and international practices in relation to best practice healthcare redesign processes. Additionally, it provides a theoretical contribution on evaluating health services improvement and redesign initiatives.

  13. Clinical Application and Evaluation of Pharmacogenomics in Tumor Chemotherapy

    Institute of Scientific and Technical Information of China (English)

    Feng Jifeng


    In the treatment of tumor patients, how to select the chemotherapy regimen with better efifcacy, less toxicity and expense is a difficult problem that perplexes clinical doctors for a long time. Pharmacogenetics is to study the influence of genetic factors on pharmacokinetics, whereas pharmacogenomics is to study the relationship between various gene mutations and drug efifcacy and safety. With molecular biology developing, pharmacogenetics and pharmacogenomics are considered to be essential in the reduction of adverse reactions, improvement of efficacy and realization of individualized treatment. In this article, the clinical application and evaluation of pharmacogenomics in tumor chemotherapy were primarily investigated.

  14. A survey on needs of fever - related knowledge in parents with 0 ~ 3 years old children in out - patients clinic of pediatric department.%0~3岁儿童家长对儿童发热知识需求的调查

    Institute of Scientific and Technical Information of China (English)

    田艳原; 左力


    目的 了解0~3岁儿童家长对儿童发热知识的需求,为组织和开展儿童发热相关知识的健康教育提供参考依据.方法 对216名0~3岁发热儿童家长用自行设计的儿童发热相关知识需求问卷调查,了解家长一般情况及对发热知识的了解程度、需求程度和健康教育方式的需求.结果 家长对儿童发热知识了解得分均较低在2.38以下,其中得分最低的是小儿高热惊厥时在家中紧急抢救的措施,为1.28±0.48,家长对高热惊厥儿童发热期间的注意事项得分也仅为1.32±0.93;基础知识中,家长需求最高的知识为对小儿高热惊厥的预防措施,得分2.54±0.62,应对措施中,给发热患儿降温的几种方法 项得分最高为2.17±0.62;家长健康教育需求途径得分最高的三项是通过与医护人员沟通获得、通过固定热线电话获得和通过提供健康教育手册.结论 护士应及时补充完善家长对儿童发热的知识,引起家长对儿童发热的重视,根据家长的不同需求程度利用多种途径开展健康教育.%Objective To explore the needs of fever - related knowledge in parents with 0 ~ 3 years old children in out - patients clinic of pediatric department in order to provide reference for health education on fever - related knowledge.Methods Two hundred and sixteen parents of 0 ~3 years old children with fever had been surveyed by questionnaires including general circumstances of parents, degree of understanding and needing on fever - related knowledge and the degree of request for health education.Results The understanding scores of parents to fever - related knowledge were in lower level below 2.38.Among them, the lowest one was salvage measure for convulsion occurring at home and its scores were 1.28 ± 0.48.The term on notice for convulsion during the febrile period of children only got scores of 1.32 ± 0.93.Among basic knowledge, the degree of highest needing was prevention measures for

  15. Long-term effectiveness of four pulpotomy techniques: 3-year randomised controlled trial. (United States)

    Huth, Karin Christine; Hajek-Al-Khatar, Niran; Wolf, Petra; Ilie, Nicoleta; Hickel, Reinhard; Paschos, Ekaterini


    A pulpotomy is the therapy for management of pulp exposures due to caries in symptom-free primary molars. The aim was to longitudinally compare the relative effectiveness of the Er:YAG laser, calcium hydroxide and ferric sulphate techniques with dilute formocresol in retaining symptom-free molars. Two hundred primary molars in 107 healthy children were included and randomly allocated to one technique. The treated teeth were blindly reevaluated after 6, 12, 18, 24 and 36 months. Descriptive data analysis and logistic regression analysis accounting for multiple observations per patient by generalised estimating equation were used. Additionally, various influences including tooth type, upper and lower jaws, type of anaesthesia, operator and the final restoration on treatment success were evaluated (Wald chi-square test). After 36 months, the following total (considering clinical and clinically symptom-free radiographic failures) and clinical success rates were determined (in percent): Formocresol 72 (92), laser 73 (89), calcium hydroxide 46 (75), ferric sulphate 76 (97). No significant differences were detected between formocresol and any other technique after 36 months. However, the odds ratio of failure appeared to be three times higher for calcium hydroxide than for formocresol. No significant differences in total success rates were seen regarding the aforementioned influencing clinical parameters. The correct diagnosis of the pulpal status, bleeding control and the specific technique are highly important for long-term success of pulpotomies in primary molars. According to the presented long-term data, pulpotomies using ferric sulphate revealed the best treatment outcome among the used techniques, while calcium hydroxide resulted in the lowest success rates after 3 years. Therefore, we can recommend ferric sulphate for easy and successful treatment of primary molars with caries-exposed pulps.

  16. Clinical evaluation of two different materials for retrograde root filling


    Dimova, Cena; Papakoca, Kiro; Kovacevska, Ivona; Evrosimovska, Biljana; Georgiev, Zlatko


    BACKGROUND:Retrograde root filling is indicated when periapical inflammation cannot be resolved by conventional endodontic therapy. A retrograde filling should prevent flow of microorganisms and bacterial endotoxins from the root canal into periapical tissues. The aim was to evaluate the clinical and radiographic treatment outcome of two different materials for retrograde root filling (dentin-bonded resin nano composite and glass ionomer cement) using special preparation performance of re...

  17. Clinical evaluation of sodium flouride chewable tablets in dental caries. (United States)

    Maddi, S S; Tandon, S; Aithal, K S


    Chewable tablets containing low dosage flouride content were prepared using two varities of celluloses and their in vitro parameters were evaluated. An eighteen month clinical trial revealed that both these formulations were effective in controlling the caries. However, ethyl cellulose is proved to be superior to methylcellulose as a controlled release matrix material in controlling caries. Thus this study recommends ethylcellulose matrix tablets containing low flouride content is an efficacious and cost effective drug device in controlling dental caries.

  18. Evaluation of a Computerized Clinical Information System (Micromedex).


    Lundsgaarde, H. P.; Moreshead, G. E.


    This paper summarizes data collected as part of a project designed to identify and assess the technical and organizational problems associated with the implementation and evaluation of a Computerized Clinical Information System (CCIS), Micromedex, in three U.S. Department of Veterans Affairs Medical Centers (VAMCs). The study began in 1987 as a national effort to implement decision support technologies in the Veterans Administration Decentralized Hospital Computer Program (DHCP). The specific...

  19. Radiological Evaluation of Temporomandibular Joint Disorders Followed by Clinical Symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Park, Tae Won; You Dong Soo [Dept. of Oral Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)


    The authors analyzed the clinical findings, radiological findings and their correlations in the temporomandibular joint disorders. 1. The most prevalent age group was in the first decade, then the second decade and the third decade. Female were more common with a ratio of 3.4 : 1. 2. The most common clinical findings was the pain on open mouth position (42.43%), then came the clicking and limitation of mouth opening. 3. The most common bone change on the condyle side was the erosion, then came the flattening, the osteopyte and the sclerosis in that orders. 4. In the case of the crepitus, the coarse crepitus showed more radiological change than the fine crepitus. 5. In the case of the mouth opening limitation, the evaluation of the translatory movement by transcranial projection was in accordance with the clinical evaluation. 6. The correlation between the clinical symptom and the condylar position within the mandibular fossa was not present and in the case of diagnosis of disc displacement, the transcranial projection seemed not to be able to substitute for the arthrography. 7. Radiographically, the most prevalent age group which showed the bone change was in the first, the second and the third decade. And the bone change seemed to have no relationship with aging.

  20. Primary Clinical Evaluation of the Joint Replacement for the Treatment of the First Metatarsophalangeal Arthritis

    Institute of Scientific and Technical Information of China (English)

    Qi-yi Li; Jin Jin; Xi-sheng Weng; Jin Lin; Yi-dan Zhang; Gui-xing Qiu


    Objective To retrospectively assess the primary clinical results of a cohort of the first metatarsophalangeal joint replacement with double-stemmed hinge silicone implant. Methods A total of 12 patients (15 feet) received the joint replacement with double-stemmed hinge silicone implant. There were 2 males and 10 females with a mean age of 61.4 (range, 56-75) years old. Of them, 9 cases (11 feet) were hallux valgus with osteoarthritis; 1 case (2 feet) was rheumatic arthritis; 2 cases (2 feet) were traumatic arthritis. The subjective and objective results were evaluated during follow-up.Results All of the patients were followed up regularly with an average of 24.7 months, ranging from 12 to 38 months. Ten patients were completely satisfied with the operation; 1 patient showed partial satisfaction, and 1 patient was not satisfied because of the first matatarsophalangeal joint pain due to severe hyperosteogeny surrounding the cut bone surface 3 years after the operation. Osteolysis around the implant occurred in 2 cases without clinical symptoms, and no special treatment was given.Conclusion The joint replacement is a preferable method in alleviating pain and improving walking function with proper indication.

  1. Evaluation of psychology practitioner competence in clinical supervision. (United States)

    Gonsalvez, Craig J; Crowe, Trevor P


    There is a growing consensus favouring the development, advancement, and implementation of a competency-based approach for psychology training and supervision. There is wide recognition that skills, attitude-values, and relationship competencies are as critical to a psychologist's competence as are knowledge capabilities, and that these key competencies are best measured during placements, leaving the clinical supervisor in an unparalleled position of advantage to provide formative and summative evaluations on the supervisee's progression towards competence. Paradoxically, a compelling body of literature from across disciplines indicates that supervisor ratings of broad domains of competence are systematically compromised by biases, including leniency error and halo effect. The current paper highlights key issues affecting summative competency evaluations by supervisors: what competencies should be evaluated, who should conduct the evaluation, how (tools) and when evaluations should be conducted, and process variables that affect evaluation. The article concludes by providing research recommendations to underpin and promote future progress and by offering practice recommendations to facilitate a more credible and meaningful evaluation of competence and competencies.

  2. Evaluation of medication treatment for Alzheimer's disease on clinical evidence

    Directory of Open Access Journals (Sweden)

    Meng-qiu LI


    Full Text Available Objective To formulate the best treatment plan for Alzheimer's disease patients by evaluating the therapeutic efficacy and side effect of various evidence-based programs. Methods Alzheimer's disease, donepezil, rivastigmine, galantamine, memantine, rosiglitazone, etc. were defined as retrieval words. PubMed, Cochrane Library, Wanfang Data and China National Knowledge Infrastructure (CNKI databases were used with applying of manual searching. Systematic reviews, randomized controlled trials (RCT, controlled clinical trials and case-observation studies were collected and evaluated by Jadad Scale. Results After screening, 33 selected resources included 14 systematic reviews, 14 randomized controlled trials, 4 controlled clinical trials and 1 case-observation study. According to Jadad Scale, total 28 articles were evaluated to be high quality (12 with score 4, 10 score 5, 6 score 7, and 5 were low quality with score 3. It was summarized as follows: 1 Alzheimer's disease is a progressive neurodegenerative disease for which no cure exists. To date, only symptomatic treatments with cholinesterase inhibitors (donepezil, rivastigmine, galantamine and an N-methyl-D-aspartate (NMDA receptor noncompetitive antagonist (memantine, are effective and well tolerated to counterbalance the neurotransmitter disturbance, but cannot limit or impact on disease progression. 2 Disease modifying drug is an potential agent, with persistent effect on slowing the progression of structural damage, and can be detected even after withdrawing the treatment. Many types of disease modifying drugs are undergoing clinical trials. Conclusions Using evidence-based medicine methods can provide best clinical evidence on Alzheimer's disease treatment. doi: 10.3969/j.issn.1672-6731.2014.03.009

  3. Evaluation of a Computerized Clinical Information System (Micromedex). (United States)

    Lundsgaarde, H P; Moreshead, G E


    This paper summarizes data collected as part of a project designed to identify and assess the technical and organizational problems associated with the implementation and evaluation of a Computerized Clinical Information System (CCIS), Micromedex, in three U.S. Department of Veterans Affairs Medical Centers (VAMCs). The study began in 1987 as a national effort to implement decision support technologies in the Veterans Administration Decentralized Hospital Computer Program (DHCP). The specific objectives of this project were to (1) examine one particular decision support technology, (2) identify the technical and organizational barriers to the implementation of a CCIS in the VA host environment, (3) assess the possible benefits of this system to VA clinicians in terms of therapeutic decision making, and (4) develop new methods for identifying the clinical utility of a computer program designed to provide clinicians with a new information tool. The project was conducted intermittently over a three-year period at three VA medical centers chosen as implementation and evaluation test sites for Micromedex. Findings from the Kansas City Medical Center in Missouri are presented to illustrate some of the technical problems associated with the implementation of a commercial database program in the DHCP host environment, the organizational factors influencing clinical use of the system, and the methods used to evaluate its use. Data from 4581 provider encounters with the CCIS are summarized. Usage statistics are presented to illustrate the methodological possibilities for assessing the "benefits and burdens" of a computerized information system by using an automated collection of user demographics and program audit trails that allow evaluators to monitor user interactions with different segments of the database.

  4. Cross-system evaluation of clinical trial search engines. (United States)

    Jiang, Silis Y; Weng, Chunhua


    Clinical trials are fundamental to the advancement of medicine but constantly face recruitment difficulties. Various clinical trial search engines have been designed to help health consumers identify trials for which they may be eligible. Unfortunately, knowledge of the usefulness and usability of their designs remains scarce. In this study, we used mixed methods, including time-motion analysis, think-aloud protocol, and survey, to evaluate five popular clinical trial search engines with 11 users. Differences in user preferences and time spent on each system were observed and correlated with user characteristics. In general, searching for applicable trials using these systems is a cognitively demanding task. Our results show that user perceptions of these systems are multifactorial. The survey indicated eTACTS being the generally preferred system, but this finding did not persist among all mixed methods. This study confirms the value of mixed-methods for a comprehensive system evaluation. Future system designers must be aware that different users groups expect different functionalities.

  5. Clinical Evaluation of Superficial Fungal Infections in Children

    Directory of Open Access Journals (Sweden)

    Ragıp Ertaş


    Full Text Available Objective: This retrospective study was referred to evaluate 51 cases of superficial mycoses, referred to our Pediatric Dermatology outpatient clinic in one year. Methods: We reviewed following data for all patients: age, gender, accompanied diseases, clinical types, localization and treatment. Superficial mycotic infections were diagnosed on the basis of clinical picture, direct microscopy and some of them were confirmed by fungal cultures. Results: Our patients comprised 33 boys (64.7% and 18 girls (35.3%, with an average age of 6.2 years (range 4 months to 17 years. Eighteen patients (35.3% had dermatophytes on the scalp. Clinical forms, in the order of frequency, were: tinea capitis profunda in 10 patients (19.6%, tinea capitis superficialis in 8 patients (15.8%, tinea unguium in 8 patients (15.8%. Tinea capitis (35.3% was the most frequent form of dermatomycosis. The most common symptom was the pruritus. Thirty (58% patients were treated with local antimycotics and 21 (42% patients were treated with systemic terbinafine or itraconazole. Conclusion: In this study it was found that, tinea capitis was the most frequent form of dermatomycosis and onychomycosis in children are not uncommon as it is mentioned. The data also suggest that topical antifungal agents may be effective and well-tolerated in the treatment of onychomycosis and tinea capitis in children.

  6. Modified cementless total coxofemoral prosthesis: development, implantation and clinical evaluation

    Directory of Open Access Journals (Sweden)

    S.A. Arias


    Full Text Available The aim of this study was to modify canine coxofemoral prostheses and the clinical evaluation of the implantation. Fifteen canine hips and femora of cadavers were used in order to study the surface points of modification in prostheses and develop a perforation guide. Femoral stems and acetabular components were perforated and coated with biphasic calcium phosphate layer. Twelve young adult male mongrel dogs were implanted with coxofemoral prostheses. Six were operated upon and implanted with cemented canine modular hip prostheses, establishing the control group. The remaining six were implanted with a novel design of cementless porous tricalcic phosphate-hydroxyapatite coated hip prostheses. Clinical and orthopedic performance, complications, and thigh muscular hypotrophy were assessed up to the 120th post-operatory day. After 120 days, animals with cementless prostheses had similar clinical and orthopedic performance compared to the cemented group despite the increased pain thigh hypotrophy. Animals that underwent cementless hip prosthesis evidenced more pain, compared to animals with cemented hip prosthesis that required longer recuperation time. No luxations, two fractures and two isquiatic neurapraxies were identified in the course of the study. Using both the cemented and the bioactive coated cementless model were suitable to dogs, showing clinical satisfactory results. Osseointegration and biological fixation were observed in the animals with the modified cementless hip prosthesis.

  7. Evaluation of febrile neutropenic patients hospitalized in a hematology clinic

    Institute of Scientific and Technical Information of China (English)

    M ucahit Goruk; Mehmet Sinan Dal; Tuba Dal; Abdullah Karakus; Recep Tekin; Nida Ozcan; Orhan Ayyildiz


    Objective: To evaluate the febrile neutropenic patients with hematological malignancies hospitalized in hematology clinic with poor hygiene standards. Methods: A total of 124 patients with hematological malignancies (69 male, 55 female) hospitalized in hematology clinic with poor hygiene conditions depending on hospital conditions, between January 2007 and December 2010, were evaluated, retrospectively. Results: In this study, 250 febrile neutropenia episodes developing in 124 hospitalized patients were evaluated. Of the patients, 69 were men (56%) and 55 women (44%). A total of 40 patients (32%) had acute myeloid leukemia, 25 (20%) acute lymphoblastic leukemia, 19 (15%) non-Hodgkin's lymphoma, 10 (8%) multiple myeloma, and 8 (8%) chronic myeloid leukemia. In our study, 56 patients (22%) were diagnosed as pneumonia, 38 (15%) invasive aspergillosis, 38 (15%) sepsis, 16 (6%) typhlitis, 9 (4%) mucormy-cosis, and 4 (2%) urinary tract infection. Gram-positive cocci were isolated from 52%(n = 20), while Gram-negative bacilli 42%(n = 16) and yeasts from 6% (n = 2) of the sepsis patients, respectively. The most frequently isolated Gram-positive bacteria were methicillin-resistant coagulase-negative staphylococci (n=18), while the most frequently isolated Gram-negative bacteria was Escherichia coli (n=10). Conclusions: Febrile neutropenia is still a problem in patients with hematological ma-lignancies. The documentation of the flora and detection of causative agents of infections in each unit would help to decide appropriate empirical therapy. Infection control pro-cedures should be applied for preventing infections and transmissions.

  8. Criteria for clinical translucency evaluation of direct esthetic restorative materials (United States)


    The purpose of this review was to suggest practical criteria for the clinical translucency evaluation of direct esthetic restorative materials, and to review the translucency with these criteria. For the evaluation of reported translucency values, measuring instrument and method, specimen thickness, background color, and illumination should be scrutinized. Translucency parameter (TP) of 15 to 19 could be regarded as the translucency of 1 mm thick human enamel. Visual perceptibility threshold for translucency difference in contrast ratio (ΔCR) of 0.07 could be transformed into ΔTP value of 2. Translucency differences between direct and indirect resin composites were perceivable (ΔTP > 2). Universal and corresponding flowable resin composites did not show perceivable translucency differences in most products. Translucency differed significantly by the product within each shade group, and by the shade group within each product. Translucency of human enamel and perceptibility threshold for translucency difference may be used as criteria for the clinical evaluation of translucency of esthetic restorative materials. PMID:27508156

  9. [Clinical diagnosis and standardized evaluation of borderline personality: preliminary report]. (United States)

    Chaine, F; Guelfi, J D; Monier, C; Brun, A; Seunevel, F


    A sample of 36 patients considered by French clinicians as suffering from a borderline personality disorder was evaluated using the International Personality Disorder Examination, the Diagnostic Interview for Borderline-Revised, and the Minnesota Multiphasic Personality Inventory. First, global descriptive analysis of the sample elicited the socio-demographic and standard clinical characteristics of the borderline individuals. After diagnostic evaluation, the sample appeared to be quite homogeneous with 25 of the 36 patients evaluated (69.5%) being defined as borderline by two of the three diagnostic systems: ICD 10, DSM III-R and Gunderson (15/36 = 41.5% of patients were defined as borderline by all three systems). It is the types of BL personality co-diagnoses which differentiated the BL subjects in the sample from those classically described in the international literature, since the most frequent personalities were the Dependent and Avoiding ones, not the Antisocial, Histrionic, Narcissistic or Schizotypic personalities of the DSM III-R. ICD 10 elicited the same significant prevalence of Anxious and Dependent personalities. Lastly, the patients diagnosed as borderline both by clinicians and by all diagnostic systems (forming the sample "core") were compared with the rest of the sample with regard to socio-demographic, clinical and diagnostic characteristics. A few hypotheses are proposed on the type of variables that may permit to discriminate between these two types of patients.

  10. Toward an evaluation of an integrated clinical imaging system: identifying clinical benefits. (United States)

    Kaplan, B; Lundsgaarde, H P


    Integrated clinical imaging systems can provide the foundation for future computer-based patient record systems as recommended by the Institute of Medicine. However, documenting the benefits of such systems is difficult. This paper reports an evaluation of a clinical imaging system that is integrated with an on-line electronic patient record. The evaluation used interviews and observations to identify what physicians thought were the benefits of this system. Reported benefits may be classified into patient care benefits, educational benefits, and productivity and cost-reduction benefits Physicians said that the imaging system provided patient care benefits by: improving clinical communication and decision making, making care more patient-based, reducing the number of procedures and patient risks, and improving record keeping. Educational benefits they reported included: improving communication, providing broad "real" experience, and improving supervision. These benefits may be reflected in increased productivity and cost reduction by increasing time savings, reducing clerical work, improving morale, and reducing the costs of care. The approach described in this study was valuable in identifying potential benefits of a clinical information system. The findings point the way to realization of benefits for other systems, and, ultimately, for computer-based patient records.

  11. Carriage of streptococcus pneumoniae 3 years after start of vaccination program, the Netherlands

    NARCIS (Netherlands)

    Spijkerman, J.; van Gils, E.J.M.; Veenhoven, R.H.; Hak, E.; Yzerman, E.P.F.; van der Ende, A.; Wijmenga-Monsuur, A.J.; van den Dobbelsteen, G.P.J.M.; Sanders, E.A.M.


    To evaluate the effectiveness of the 7-valent pneumococcal conjugate vaccine (PCV7) program, we conducted a cross-sectional observational study on nasopharyngeal carriage of Streptococcus pneumoniae 3 years after implementation of the program in the Netherlands. We compared pneumococcal serotypes in

  12. A 3-year longitudinal analysis of changes in fitness, physical activity, fatness and screen time

    DEFF Research Database (Denmark)

    Aires, L; Andersen, Lars Bo; Mendonça, D


    in fitness. METHODS: This is a 3-year longitudinal study of 345 high school students aged 11-19 years. Students performed curl-ups, push-ups and 20-m shuttle run tests from Fitnessgram. PA and ST were evaluated using a standard questionnaire. Standardized scores of fitness tests were summed. Changes over...

  13. Clinical study of propofol sedation with paedfusor model via target control infusion in dressing operation for 1-3 years old children with burn%Paedfusor模型异丙酚靶控输注用于1~3岁小儿烧伤换药麻醉的研究

    Institute of Scientific and Technical Information of China (English)

    费翔; 孙雪峰; 李萌萌; 郝建华; 米卫东


    Objective:To study the efficacy and safety of propofol sedation via target control infusion (TCI) with paedfusor model during burn dressing change for children of 1-3 years old and to evaluate the use of Narco-trend as a tool for measuring the depth of sedation. Methods:Thirty children scheduled for elective burn dressing change (admitted form January 2013 to June 2013,age 1 to 3 years old,ASA grades I-Ⅱ,burn area<30%TB-SA,burn depthⅡ-Ⅲ degree)were involved in the study. The TCI device was programmed with paedfusor pharmcokinetic model,and Alaris PK TCI pump. The depth of sedation was assayed by Ramsay score. The target plasma concentration of propofol was started at 5μg/ml,till an adequate sedation (Ramsay≥5 )was secured be-fore the dressing change,and 2 μg/ml propofol was inj ected intravenously.Before the operation,target was re-duced to 4μg/ml and adj usted with 0.5 μg/ml if patients had limbs movement,and the upper limit was 6 μg/ml.The blood pressure,heart rate,the Narcotrend,Ramsay,predicted blood propofol concentration(Cp )were monitored at induction period,during operation and after operation. The time of induction,time of makening and complications were observed. The relationship among Cp,Ramsay,and Narcotrend was analyzed. Results:Five minutes after TCI,blood pressure and heart rate lowered and then maintained at stable level.One child showed ap-nea (SpO2<0.90),and 2 children showed agitation.The mean induction time was (3.1 ±0.6)minutes,and the minimum Narcotrend index was 4 2.5 ± 6.1;mean recovery time (Ramsay grade from≥5 to ≤2 )was (1 2.5 ±3.2)minutes,and at the same time,Cp was (1.9±0.2)μg/ml and Narcotrend index was 88.2±4.3. Cp was posi-tively correlated with Ramsay (r=0.968,P<0.001)and negatively correlated with Narcotrend (r=-0.898,P<0.001),while Ramsay was negatively correlated with Narcotrend(r=-0.948,P<0.001).Conclusions:Propofol sedation via TCI programmed with paedfusor pharmacokinetic parameters is safe and effective

  14. SU-E-J-34: Clinical Evaluation of Targeting Accuracy and Tractogrphy Delineation of Radiosurgery

    Energy Technology Data Exchange (ETDEWEB)

    Juh, R; Suh, T; Kim, Y; Han, J; Kim, C; Oh, C; Kim, D [Seoul National University Bundang Hospital (Korea, Republic of)


    Purpose: Focal radiosurgery is a common treatment modality for trigeminal neuralgia (TN), a neuropathic facial pain condition. Assessment of treatment effectiveness is primarily clinical, given the paucity of investigational tools to assess trigeminal nerve changes. The efficiency of radiosurgery is related to its highly precise targeting. We assessed clinically the targeting accuracy of radiosurgery with Gamma knife. We hypothesized that trigeminal tractography provides more information than 2D-MR imaging, allowing detection of unique, focal changes in the target area after radiosurgery. Methods: Sixteen TN patients (2 females, 4 male, average age 65.3 years) treated with Gamma Knife radiosurgery, 40 Gy/50% isodose line underwent 1.5Tesla MR trigeminal nerve . Target accuracy was assessed from deviation of the coordinates of the target compared with the center of enhancement on post MRI. Radiation dose delivered at the borders of contrast enhancement was evaluated Results: The median deviation of the coordinates between the intended target and the center of contrast enhancement was within 1mm. The radiation doses fitting within the borders of the contrast enhancement the target ranged from 37.5 to 40 Gy. Trigeminal tractography accurately detected the radiosurgical target. Radiosurgery resulted in 47% drop in FA values at the target with no significant change in FA outside the target, suggesting that radiosurgery primarily affects myelin. Tractography was more sensitive, since FA changes were detected regardless of trigeminal nerve enhancement Conclusion: The median deviation found in clinical assessment of gamma knife treatment for TN Is low and compatible with its high rate of efficiency. DTI parameters accurately detect the effects of focal radiosurgery on the trigeminal nerve, serving as an in vivo imaging tool to study TN. This study is a proof of principle for further assessment of DTI parameters to understand the pathophysiology of TN and treatment effects.

  15. The effects of aging on clinical vestibular evaluations

    Directory of Open Access Journals (Sweden)

    Maxime eMaheu


    Full Text Available Balance disorders are common issues for aging populations due to the effects of normal aging on peripheral vestibular structures. These changes affect the results of vestibular function evaluations and make the interpretation of these results more difficult. The objective of this article is to review the current state of knowledge of clinically relevant vestibular measures. We will first focus on otolith function assessment methods cVEMP and oVEMP, then the caloric and vHIT methods for semi-circular canals assessment. cVEMP and oVEMP are useful methods, though research on the effects of age for some parameters are still inconclusive. vHIT results are largely independent of age as compared to caloric stimulation and should therefore be preferred for the evaluation of the semi-circular canals function.

  16. Similarity Predicts Liking in 3-Year-Old Children (United States)

    Fawcett, Christine A.; Markson, Lori


    Two studies examined the influence of similarity on 3-year-old children's initial liking of their peers. Children were presented with pairs of childlike puppets who were either similar or dissimilar to them on a specified dimension and then were asked to choose one of the puppets to play with as a measure of liking. Children selected the puppet…

  17. A Study of Differentiated Instructional Change over 3 Years (United States)

    VanTassel-Baska, Joyce; Feng, Annie Xuemei; Brown, Elissa; Bracken, Bruce; Stambaugh, Tamra; French, Heather; McGowan, Susan; Worley, Bess; Quek, Chwee; Bai, Wenyu


    This study examines Title 1 heterogeneous classroom teachers' instructional behavior change through implementing well-designed research-based curriculum units and attending regular professional development activities across 3 years. Employing an experimental design, this study compares experimental and comparison teachers' behavioral changes as…

  18. Ultrasound and clinical evaluation of soft-tissue versus hardware biceps tenodesis: is hardware tenodesis worth the cost? (United States)

    Elkousy, Hussein; Romero, Jose A; Edwards, T Bradley; Gartsman, Gary M; O'Connor, Daniel P


    This study assesses the failure rate of soft-tissue versus hardware fixation of biceps tenodesis by ultrasound to determine if the expense of a hardware tenodesis technique is warranted. Seventy-two patients that underwent arthroscopic biceps tenodesis over a 3-year period were evaluated using postoperative ultrasonography and clinical examination. The tenodesis technique employed was either a soft-tissue technique with sutures or an interference screw technique using hardware based on surgeon preference. Patient age was 57.9 years on average with ultrasound and clinical examination done at an average of 9.3 months postoperatively. Thirty-one patients had a hardware technique and 41 a soft-tissue technique. Overall, 67.7% of biceps tenodesis done with hardware were intact, compared with 75.6% for the soft-tissue technique by ultrasound (P = .46). Clinical evaluation indicated that 80.7% of hardware techniques and 78% of soft-tissue techniques were intact. Average material cost to the hospital for the hardware technique was $514.32, compared with $32.05 for the soft-tissue technique. Biceps tenodesis success, as determined by clinical deformity and ultrasound, was not improved using hardware as compared to soft-tissue techniques. Soft-tissue techniques are equally efficacious and more cost effective than hardware techniques.

  19. Evaluation of Clinical Features of Female Patients with Macroprolactinemia

    Directory of Open Access Journals (Sweden)

    Göksun Ayvaz


    Full Text Available Aim: Macroprolactin is a high-molecular-weight form of prolactin. It has been suggested that macroprolactin has no clinical importance because of its decreased or limited bioactivity. Although screening for macroprolactinemia is recommended especially in patients with idiopathic hyperprolactinemia; recent studies reported that patients with macroprolactinemia may have some hyperprolactinemia symptoms. Currently, the causes of the symptoms as well as the treatment and follow-up of this group of patients are not clear. In our study, we aimed to retrospectively evaluate and compare the clinical characteristics and gonadal hormone levels of patients with macroprolactinemia and hyperprolactinemia.Materials and Methods: Forty patients with macroprolactinemia and 15 patients with hyperprolactinemia who referred to Obstetrics and Gynecology Hospital were examined.Results: We observed that the patients with macroprolactinemia had similar menstrual disturbances (oligomenorrhea/amenorrhea to the patients with hyperprolactinemia. There was no statistically significant difference between the two groups with respect to FSH, LH and estradiol levels. The frequencies of galactorrhea (p=0.002, headache (p=0.04 and positive radiological finding (p=0.001 were higher in patients with hyperprolactinemia. Infertility rate was found to be increased in women with macroprolactinemia (p=0.02.Conclusion: Patients with macroprolactinemia may have very similar clinic symptoms to those with hyperprolactinemia. Therefore, macroprolactin levels should be measured regardless of the symptoms of hyperprolactinemia in patients with elevated prolactin levels. Türk Jem 2011; 15: 62-5

  20. 76 FR 9583 - Draft Guidance for Industry on Clinical Pharmacogenomics: Premarketing Evaluation in Early Phase... (United States)


    ... guidance for industry entitled ``Clinical Pharmacogenomics: Premarketing Evaluation in Early Phase Clinical Studies.'' The draft guidance is intended to assist the pharmaceutical industry and other investigators... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry on Clinical...

  1. Clinical diagnostic potentials of thyroid ultrasonography and scintigraphy; An evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Torizuka, Tatsuo; Kasagi, Kanji; Hatabu, Hiroto; Misaki, Takashi; Iida, Yasuhiro; Konishi, Junji (Kyoto Univ. (Japan). Hospital); Endo, Keigo


    This prospective study was designed to evaluate the potential contributions of high resolution ultrasonography (US) and Tc-99m scintigraphy in the routine diagnosis of thyroid disease. The diagnostic impacts of US and Tc-99m scintigraphy results in 177 patients visiting our thyroid clinic were assessed and scored according to the following criteria: when the information provided by either test supported, confirmed or changed the initial clinical diagnosis, they received scores of 2, 3 and 4 respectively, while score 1 was given when the test itself was useless for the differential diagnosis. US identified focal lesions that both palpation and scintigraphy had failed to detect in 14 (12.1%) of 116 patients with diffuse thyroid diseases, suggesting the necessity of Hashimoto's thyroiditis, adenoma, adenocarcinoma and adenomatous goiter, and vice versa in the diagnosis of hyperthyroid and euthyroid Graves's diseases. Thus, the advantages of US over scintigraphy for morphological evaluation were confirmed. US was particularly useful for the differential diagnosis of adenomatous goiter from Hashimoto's thyroiditis or a single nodular disease. In contrast, scintigraphy gave functional images, being especially helpful for the differential diagnosis of thyrotoxicosis. (author).

  2. Evaluation of the clinical usefulness of modulated Arc treatment

    CERN Document Server

    Lee, Young Kyu; Kim, Yeon Sil; Choi, Byung Ock; Nam, Sang Hee; Park, Hyeong Wook; Kim, Shin Wook; Shin, Hun Joo; Lee, Jae Choon; Kim, Ji Na; Park, Sung Kwang; Kim, Jin Young; Kang, Young-Nam


    The purpose of this study is to evaluate the clinical usefulness of modulated arc (mARC) treatment techniques. The mARC treatment plans of the non-small cell lung cancer (NSCLC) patients were performed in order to verify the clinical usefulness of mARC. A pre study was conducted to find the most competent plan condition of mARC treatment and the usefulness of mARC treatment plan was evaluated by comparing it with the other Arc treatment plans such as Tomotherapy and RapidArc. In the case of mARC, the optimal condition for the mARC plan was determined by comparing the dosimetric performance of the mARC plans with the use of various parameters. The various parameters includes the photon energies (6 MV, 10 MV), optimization point angle (6{\\deg}-10{\\deg} intervals), and total segment number (36-59 segment). The best dosimetric performance of mARC was observed at 10 MV photon energy and the point angle 6 degree, and 59 segments. The each treatment plans of three different techniques were compared with the followin...

  3. Clinical evaluation strategies for a live attenuated tetravalent dengue vaccine. (United States)

    Precioso, Alexander Roberto; Palacios, Ricardo; Thomé, Beatriz; Mondini, Gabriella; Braga, Patrícia; Kalil, Jorge


    Butantan Institute is a public Brazilian biomedical research-manufacturer center affiliated to the São Paulo State Secretary of Health. Currently, Butantan is one of the main public producers of vaccines, antivenoms, and antitoxins in Latin America. The partnership between Butantan and the National Institutes of Health (NIH) of the United Sates has been one of the longest and most successful partnerships in the development and manufacturing of new vaccines. Recently, Butantan Institute has developed and manufactured a lyophilized tetravalent live attenuated dengue vaccine with the four dengue viruses attenuated and licensed from the Laboratory of Infectious Diseases at The National Institutes of Allergy and Infectious Diseases (LID/NIAID/NIH). The objective of this paper is to describe the clinical evaluation strategies of a live attenuated tetravalent dengue vaccine (Butantan-DV) developed and manufactured by Butantan Institute. These clinical strategies will be used to evaluate the Butantan-DV Phase III trial to support the Butantan-DV licensure for protection against any symptomatic dengue caused by any serotype in people aged 2 to 59 years.

  4. 75 FR 79446 - Clinical Science Research and Development Service; Cooperative Studies Scientific Evaluation... (United States)


    ... AFFAIRS Clinical Science Research and Development Service; Cooperative Studies Scientific Evaluation... (Federal Advisory Committee Act) that a meeting of the Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation Committee will be held on January 13, 2011, at The...

  5. Clinical and Radiological Evaluation of Children with Subacute Sclerosan Panencephalitis

    Directory of Open Access Journals (Sweden)

    Ahmet İrdem


    Full Text Available A total of 65 children with Subacute Sclerosing Panencephalitis (SSPE who admittedto our clinic between September 1998 and December 2002 were retrospectively evaluated interms of clinical and radiological findings.The most common symptoms and findings at admission were myoklonia (31 patients, 47%, behaveral changes (18 patients, 27.7 % and convulsion (8 patients, 12 %. There was atrauma history initiating symptoms in 14 patients (21.5 %. Neurological symptoms presentedsignificantly earlier in patients who had measles before 2 years of age compared to others(p0.05. The clinical stage of the patients at admission was determined based on Risk veHaddad classification. The most frequent stage was IIA (21 patients, 32.2%, IIC (17patients, 26.2% and IIB (16 patients, 24.6%. At the follow-up period, 46 (71% patients wasdepended to bed. The mean time interval between SSPE initiation age and bed dependencywas 4.68 ± 4.05 months (1-17 months.Of the 31 patients who underwent cranial magnetic rezonans imaging (MRI, 15patients (48.38% had pathological findings, the most frequent findings were cortical vesubcortical lesions. Of the 24 patients who underwent cranial tomographi, 22 (91.6% werenormal. Of the remaining two, one had atrophy and the other had increase in contrast. All ofthe patients underwent rutine EEG test. Fifty-four (83.1% of these had periodic complexhigh slow wave activity.The clinical findings and Electro Encephalographi results are important parameters inthe diagnosis of SSPE. Cranial tomographi is not useful in the diagnosis of SSPE. However,cranial MRI findings is pathologic only in the half of the patients.

  6. Evaluation of febrile neutropenic patients hospitalized in a hematology clinic

    Institute of Scientific and Technical Information of China (English)

    Mcahit; Grk; Mehmet; Sinan; Dal; Tuba; Dal; Abdullah; Karakus; Recep; Tekin; Nida; zcan; Orhan; Ayyildiz


    Objective:To evaluate the febrile neutropenic patients with hematological malignancies hospitalized in hematology clinic with poor hygiene standards.Methods:A total of 124 patients with hematological malignancies(69 male,55 female)hospitalized in hematology clinic with poor hygiene conditions depending on hospital conditions,between January 2007 and December 2010,were evaluated,retrospectively.Results:In this study,250 febrile neutropenia episodes developing in 124 hospitalized patients were evaluated.Of the patients,69 were men(56%)and 55 women(44%).A total of 40 patients(32%)had acute myeloid leukemia,25(20%)acute lymphoblastic leukemia,19(15%)non-Hodgkin’s lymphoma,10(8%)multiple myeloma,and 8(8%)chronic myeloid leukemia.In our study,56 patients(22%)were diagnosed as pneumonia,38(15%)invasive aspergillosis,38(15%)sepsis,16(6%)typhlitis,9(4%)mucormycosis,and 4(2%)urinary tract infection.Gram-positive cocci were isolated from 52%(n=20),while Gram-negative bacilli 42%(n=16)and yeasts from 6%(n=2)of the sepsis patients,respectively.The most frequently isolated Gram-positive bacteria were methicillin-resistant coagulase-negative staphylococci(n=18),while the most frequently isolated Gram-negative bacteria was Escherichia coli(n=10).Conclusions:Febrile neutropenia is still a problem in patients with hematological malignancies.The documentation of the flora and detection of causative agents of infections in each unit would help to decide appropriate empirical therapy.Infection control procedures should be applied for preventing infections and transmissions.

  7. Ankle tenosynovitis in rheumatoid arthritis: clinical and ultrasonographic evaluation

    Directory of Open Access Journals (Sweden)

    Ana Luiza Naves Pereira


    Full Text Available Objective: To investigate ankle tenosynovitis in rheumatoid arthritis patients, regarding its presence, the kind of tendon involved and the concordance between clinical and ultrasound findings. Methods: Twenty patients with rheumatoid arthritis and pain or swollen ankle joint were evaluated. Tendon involvement was evaluated with ultrasound imaging. The Health Assessment Questionnaire (HAQ was performed for disability evaluation. Age, sex, disease duration, and vocational activity levels were also obtained. The statistical analysis included Fisher’s exact test. The significance level was 0.05. Results: Tenosynovitis was found in 13 of 20 (65.0% patients in 19 joints, in which 6 were bilaterally (46.1% and unilateral in 7 (53.8%. Tibialis posterior tenosynovitis was seen in nine (45.0% patients, Achilles tenosynovitis in seven (35.0%, tibialis anterior tenosynovitis in three (15.0%, and peroneal tenosynovitis in three (15.0% patients. We found concordance between symptomatic ankle and ultrasonographic findings in 92.3% of the patients with tenosynovitis. Association between severe HAQ with tendon involvement was not found (p>0.05. Disease duration was not associated with tenosynovitis. Patients were predominantly older, female, with mean age around 50.8 years. The long disease duration of patients presented a mean of 11.4 years and, most of them, with no vocational activity (65.0%. Conclusions: The results indicate that ankle tenosynovitis is very common in rheumatoid arthritis patients, both unilateral and bilateral. Tibialis posterior was the most common tendon involvement found. Finally, we found concordance between the clinical and ultrasound findings in almost all rheumatoid arthritis patients with ankle tenosynovitis.

  8. Clinical Significance of Evaluating Antihypertensive Effect with Arterial Compliance

    Institute of Scientific and Technical Information of China (English)

    李新立; 倪春辉; 王震震


    Objective To evaluate the clinical significance of antihypertensive effect witharterial compliance. Methods In males, 72 cases were control group, 35 cases were EH-controlled,and 35 cases were EH-uncontrolled groups. Blood pressure and arterial compliance (C1 and C2) weredetected by HDI DO-2020. Results In the EH-uncontrolled group,the values of systolic blood pres-sure (SBP) , diastolic blood pressure (DBP) , mean arterial pressure (MAP), and pulse pressure(PP) were significantly higher than those of the control and the EH-controlled groups (P<0.01),however ,there was no difference between the control and the EH-controlled groups. In the EH-uncon-trolled group,the values of C1 and C2 were lower tlan those of both the control and the EH-controlledgroups (P<0.01) ,again,with no difference between the control and the EH-controlled groups. Con-clttsion Arterial compliance (C1 and C2) measurements may serve as a sensitive indicator of evalu-ating antihypertensive effect.

  9. Occlusal characteristics in 3-year-old children – results of a birth cohort study


    Wagner, Yvonne; Heinrich-Weltzien, Roswitha


    Background Aim of this prospective study was to determine prevalence of malocclusion and associated risk factors in 3-year-old Thuringian children. Methods Subjects (n = 377) were participants in a regional oral health programme, a birth cohort study with the aim to prevent caries (German Clinical Trials Register DRKS00003438). Children received continuous dental care since birth. Occlusal characteristics (overjet, overbite, anterior open bite, canine relationship and posterior crossbite) wer...

  10. Health Blogging and Social Support: A 3-Year Panel Study. (United States)

    Keating, David M; Rains, Stephen A


    The reported study explored the implications of informal computer-mediated social support for the well-being of individuals coping with illness over the course of 3 years. A panel study was conducted in which respondents--bloggers writing about their experiences living with a health condition--reported on their perceptions of social support and well-being during 2010 and again during 2013. Among respondents who completed both questionnaires (n = 49), increases in support availability from family and friends were related to improvements in bloggers' health self-efficacy as well as improvements in bloggers' loneliness, particularly among those who also experienced increased support availability from blog readers. Increased blog reader support availability was associated with improvements in bloggers' health-related uncertainty. Among respondents who completed the initial questionnaire (N = 121), a survival analysis showed that neither support available from family and friends nor support from blog readers predicted continued health blogging over the 3-year period.

  11. Clinical evaluation of clotrimazole. A broad-spectrum antifungal agent. (United States)

    Spiekermann, P H; Young, M D


    The efficacy and safety of the broad-spectrum, topically applied antifungal agent clotrimazole were evaluated in two double-blind, multicentric trials. Ten investigators reported on a total of 1,361 cases in which a 1% solution or a 1% cream formulation was compared with its respective vehicle. Clotrimazole was therapeutically effective, as confirmed by mycological cure (negative microscopy and culture) and clinical improvement, in tinea pedis, tinea cruris, tinea corporis, pityriasis versicolor, and cutaneous candidasis. Furthermore, species identification established the efficacy of clotrimazole against Trichophyton rubrum, T mentagrophytes, Epidermophyton floccosum, Microsporum canis, Malassezia furfur (Pityrosporum orbiculare), and Candida albicans. Safety was demonstrated by the low incidence of possibly drug-related adverse experiences, namely, 19 (2.7%) of 699 patients who were treated with clotrimazole, of whom four (0.6%) discontinued treatment.

  12. DNA Damage in Chronic Kidney Disease: Evaluation of Clinical Biomarkers

    Directory of Open Access Journals (Sweden)

    Nicole Schupp


    Full Text Available Patients with chronic kidney disease (CKD exhibit an increased cancer risk compared to a healthy control population. To be able to estimate the cancer risk of the patients and to assess the impact of interventional therapies thereon, it is of particular interest to measure the patients’ burden of genomic damage. Chromosomal abnormalities, reduced DNA repair, and DNA lesions were found indeed in cells of patients with CKD. Biomarkers for DNA damage measurable in easily accessible cells like peripheral blood lymphocytes are chromosomal aberrations, structural DNA lesions, and oxidatively modified DNA bases. In this review the most common methods quantifying the three parameters mentioned above, the cytokinesis-block micronucleus assay, the comet assay, and the quantification of 8-oxo-7,8-dihydro-2′-deoxyguanosine, are evaluated concerning the feasibility of the analysis and regarding the marker’s potential to predict clinical outcomes.

  13. Clinical evaluation of chlorine dioxide for disinfection of dental instruments. (United States)

    Watamoto, Takao; Egusa, Hiroshi; Sawase, Takashi; Yatani, Hirofumi


    This study aimed to clinically evaluate the disinfection efficacy of chlorine dioxide (ClO2) for used dental instruments. An imprint culture technique demonstrated that ultrasonic cleaning of intraorally applied dental mirrors in 0.02% ClO2 for 10 minutes resulted in compete removal of microorganisms for 10 subjects. Hepatitis C virus (HCV) RNA was detected by real-time polymerase chain reaction on periodontal curettes after subgingival scaling in four HCV-infected patients and was completely removed by the same treatment procedure. Therefore, the combination of ultrasonic cleaning with ClO2 may provide an alternative to toxic disinfectants, such as glutaraldehyde and sodium hypochlorite, for disinfecting dental instruments.

  14. Clinical evaluation of Er:YAG laser caries treatment (United States)

    Dostalova, Tatjana; Jelinkova, Helena; Kucerova, Hana; Krejsa, Otakar; Hamal, Karel; Kubelka, Jiri; Prochazka, Stanislav


    To prepare the enamel, the energy used was mainly 345 mJ and repetition rate 2 Hz, for dentine the optimal energy of Er:YAG drilling machine was 200 mJ and repetition rate from 1 to 2 Hz, depending on cavity depth. Subject of treatment were caries of enamel and dentine and it was possible to remove the old insufficient fillings. The average number of pulses was 111.22, ranging from 16 to 489. During preparation, vibrations of microexplosions were felt by 8 patients, however, neither pain or unpleasant sensations were experienced. The filling materials used were composite resins and glassionomer cements. Their clinical evaluation 6 months post insertion was similar to that of the classical drilling system.

  15. Clinical Evaluation on Several anti- HIV Diagnostic Reagents

    Institute of Scientific and Technical Information of China (English)


    Objective We Joined clinical evaluation on 6 anti - HIV diagnostic reagents which was organized by National Reference Laboratory of National Center for AIDS Prevention and Control. Method 100 sera of known result and 100 sera of unknown result were detected with 6 reagents according to test procedure of the reagents. Result The crude agreement (99.5 % ) of Organon Teknika and Determine reagents were higher than that of the other reagents. No anti - HIV positive serum was detected negative with Organon Teknika and Determine reagents. The sensitivity and specificity of Organon Teknika and Determine reagents were higher than those of the other reagents. The capacity of Organon Teknika reagent to detect the mild positive serum was greater than that of the other reagent. Conclusion Organon Teknika and Determine antiHIV diagnostic reagents were qualified for anti - HIV screening test while the other 4 reagents should be improved on sensitivity and specificity.

  16. [Clinical evaluation of a novel HBsAg quantitative assay]. (United States)

    Takagi, Kazumi; Tanaka, Yasuhito; Naganuma, Hatsue; Hiramatsu, Kumiko; Iida, Takayasu; Takasaka, Yoshimitsu; Mizokami, Masashi


    The clinical implication of the hepatitis B surface antigen (HBsAg) concentrations in HBV-infected individuals remains unclear. The aim of this study was to evaluate a novel fully automated Chemiluminescence Enzyme Immunoassay (Sysmex HBsAg quantitative assay) by comparative measurements of the reference serum samples versus two independent commercial assays (Lumipulse f or Architect HBsAg QT). Furthermore, clinical usefulness was assessed for monitoring of the serum HBsAg levels during antiviral therapy. A dilution test using 5 reference-serum samples showed linear correlation curve in range from 0.03 to 2,360 IU/ml. The HBsAg was measured in total of 400 serum samples and 99.8% had consistent results between Sysmex and Lumipulse f. Additionally, a positive linear correlation was observed between Sysmex and Architect. To compare the Architect and Sysmex, both methods were applied to quantify the HBsAg in serum samples with different HBV genotypes/subgenotypes, as well as in serum contained HBV vaccine escape mutants (126S, 145R). Correlation between the methods was observed in results for escape mutants and common genotypes (A, B, C) in Japan. Observed during lamivudine therapy, an increase in HBsAg and HBV DNA concentrations preceded the aminotransferase (ALT) elevation associated with drug-resistant HBV variant emergence (breakthrough hepatitis). In conclusion, reliability of the Sysmex HBsAg quantitative assay was confirmed for all HBV genetic variants common in Japan. Monitoring of serum HBsAg concentrations in addition to HBV DNA quantification, is helpful in evaluation of the response to lamivudine treatment and diagnosis of the breakthrough hepatitis.

  17. Echocardiographic evaluation of clinically healthy Florida manatees (Trichechus manatus latirostris). (United States)

    Gerlach, Trevor J; Estrada, Amara H; Sosa, Ivan S; Powell, Melanie; Maisenbacher, Herbert W; de Wit, Martine; Ball, Ray L; Walsh, Michael T


    Antemortem studies pertaining to the manatee cardiovascular and cardiopulmonary systems are limited despite reports of cardiac disease in postmortem specimens. The objective of this project was to develop a technique for echocardiography in the Florida manatee (Trichechus manatus latirostris). Because of their unique anatomy, a ventral approach was employed by use of an echocardiography table designed specifically for this study. Fourteen clinically healthy, free-ranging and captive Florida manatees underwent echocardiography between the fall of 2011 and winter of 2012. Eight females and six males of various age categories were included in the study. Clear visualization of all valves and chambers was accomplished, and length and width measurements of the left atrium, peak aortic flow velocity, and ejection fraction percentage were calculated in most animals. Abnormalities observed during the study included atrioventricular regurgitation and severe right-atrial enlargement. Based on the results of this study, echocardiography in the Florida manatee is possible, which has both clinical and research implications in larger epidemiologic studies evaluating diseases of the cardiopulmonary and cardiovascular systems.

  18. [Clinical and pharmacokinetic evaluation of ceftazidime in children]. (United States)

    Fujita, K; Sakata, H; Murono, K; Yoshioka, H; Maruyama, S; Sanae, N; Takimoto, M


    Forty-two pediatric patients were treated with ceftazidime ( CAZ ) in the doses ranging from 45.6 to 120 mg/kg/day for 2 to 10 days, and the clinical efficacy and side effects were evaluated. Among the 37 children with bacterial infections including pneumonia, bronchitis, tonsillitis, croup, cervical lymphadenitis, abdominal abscess and urinary tract infections, the results were excellent in 22, good in 12, fair in 2, and poor in 1 patient with pneumonia. Out of the 42 patients, 5 cases showed eosinophilia, but no clinical sign such as rash, fever or diarrhea, attributable to CAZ was observed during the study. The serum concentrations of CAZ in 4 patients ranged from 60.8 to 71.0 micrograms/ml (mean 66.1 micrograms/ml) at 30 minutes and from 0.5 to 1.2 micrograms/ml (mean 0.8 micrograms/ml) at 8 hours after 20 mg/kg intravenous bolus injection of the antibiotic. The mean serum half-life was 1.42 hours (85 minutes). Patients with impairment of renal function were excluded from this study.

  19. Clinical evaluation of the Vitek Neisseria-Haemophilus Identification card. (United States)

    Janda, W M; Malloy, P J; Schreckenberger, P C


    A clinical evaluation of the Vitek Neisseria-Haemophilus Identification (NHI) card (Vitek Systems, Inc., Hazelwood, Mo.) was performed with 480 clinical isolates and stock strains of Neisseria spp., Haemophilus spp., and other fastidious microorganisms included in the data base of the system. Identifications obtained with the NHI card were compared with those determined by conventional methods. The card identified 83.2% of 244 Neisseria spp. and Branhamella catarrhalis, 54.9% of 164 Haemophilus spp., and 84.7% of 72 fastidious gram-negative species with no further testing required. Some isolates produced good confidence-marginal separation identifications, in which the correct identification was listed with one or two other possible identifications and extra tests were required and suggested. When isolates producing good confidence-marginal separation identifications were included, correct identifications of these organism groups increased to 97.1, 92.7, and 94.4%, respectively. Among the commonly isolated microorganisms, the NHI card identified 99.1% of 110 N. gonorrhoeae, 98.5% of 68 N. meningitidis, 93.9% of 98 H. influenzae, and 95.6% of 46 H. parainfluenzae strains. All of these organisms produced excellent to very good confidence level identifications except for H. influenzae biotypes II, III, and VII, for which hemolytic reactions were required for differentiation from H. haemolyticus. The NHI card reliably identified other fastidious gram-negative species, including H. aphrophilus, Eikenella corrodens, Gardnerella vaginalis, and Kingella denitrificans.

  20. A standardized clinical evaluation of phenotypic diversity in diabetic polyneuropathy. (United States)

    Scholz, Joachim; Rathmell, James P; David, William S; Chad, David A; Broderick, Alithia C; Perros, Stephen G; Shin, Naomi S; Wells, Jenna L; Davis, John B; DiMaggio, Charles J; Wang, Shuang; Tate, Simon N


    Diabetic polyneuropathy (DPN) is a major cause of neuropathic pain and a frequent target condition in analgesic treatment trials. Differences in the clinical symptoms and signs associated with DPN suggest distinct pathophysiological mechanisms underlying nerve damage and dysfunction that are likely to have therapeutic relevance. The aim of this study was to develop a tool for the bedside assessment of painful neuropathies such as DPN that captures the diversity of phenotypes. Sixty-one patients with type 2 diabetes and painful neuropathy, 19 patients with painless DPN, 25 patients with type 2 diabetes but no clinical evidence of neuropathy, and 20 healthy control subjects completed a structured interview (47 items) and a standardized physical examination (39 items). After analyzing critical features of pain and painless symptoms and examining the outcome of physical tests of sensory function, we determined principal components of the phenotypic variance among patients. Increased sensitivity to mechanical or thermal stimuli and, to a lesser extent, the sensory quality of pain or paresthesia were the most discriminating elements of DPN phenotypes. Correlation patterns of symptoms and signs indicated the involvement of functionally distinct nerve fiber populations. We combined interview questions and physical tests identifying these differences in a shortened assessment protocol that we named Standardized Evaluation of Pain and Somatosensory Function (StEPS). The protocol StEPS generates a phenotypic profile of patients with neuropathy. Separate intensity ratings for spontaneous painful symptoms and pain evoked by standard stimuli support a detailed documentation of neuropathic pain and its response to analgesic treatment.

  1. Evaluation of the Konelab 20XT clinical chemistry analyzer. (United States)

    Stojanović, Natasa; Rogić, Dunja; Stavljenić-Rukavina, Ana


    The Konelab 20XT (Thermo Electron Oy, Finland) is a clinical chemistry analyzer for colorimetric, immunoturbidimetric and ion-selective electrode measurements. The aim of our work was to evaluate the analytical performances of the Konelab 20XT according to the European Clinical Chemistry Laboratory Standards Guidelines. A total of 30 analytes including substrates, enzymes, electrolytes and specific proteins were tested. Investigation results showed low imprecision (within-run coefficient of variation was below 3.5% and between-day coefficient of variation was less than 2.5% for most analytes at all three levels studied) and acceptable accuracy of the analyzer. No significant sample- or reagent-related carry-over was found. It was demonstrated that the analytical system operates within the claimed linearity ranges. The results compared well with those obtained by instruments routinely used in our laboratory (Olympus AU2700, Behring Nephelometer II). In general, the data on interference by hemoglobin, hyperbilirubinemia and turbidity are in accordance with known facts. However, slight hemolysis was found to interfere with the alkaline phosphatase (ALP) assay and mild lipemia affected the glucose assay. The Konelab 20XT is an easy-to-use analyzer that is suitable for routine and emergency analyses in small laboratories.

  2. Smith-Magenis syndrome: clinical evaluation in seven Brazilian patients. (United States)

    Gamba, B F; Vieira, G H; Souza, D H; Monteiro, F F; Lorenzini, J J; Carvalho, D R; Morreti-Ferreira, D


    Smith-Magenis syndrome (SMS) is a complex congenital anomaly characterized by craniofacial anomalies, neurological and behavioral disorders. SMS is caused by a deletion in region 17p11.2, which includes the RAI1 gene (90% of cases), or by point mutation in the RAI1 gene (10% of cases). Laboratory diagnosis is through cytogenetic analysis by GTG banding and molecular cytogenetic analysis by FISH. We carried out an active search for patients in Associations of Parents and Friends of Exceptional Children (APAE) of São Paulo and genetic centers in Brazil. Forty-eight patients were screened for mental retardation, craniofacial abnormalities and stereotyped behavior with a diagnosis of SMS. In seven of them, chromosome banding at high resolution demonstrated chromosome 17p11.2 deletions, confirmed by FISH. We also made a meta-analysis of 165 cases reported between 1982 and 2010 to compare with the clinical data of our sample. We demonstrated differences between the frequencies of clinical signs among the cases reported and seven Brazilian cases of this study, such as dental anomalies, strabismus, ear infections, deep hoarse voice, hearing loss, and cardiac defects. Although the gold standard for diagnosis of SMS is FISH, we found that the GTG banding technique developed to evaluate chromosome 17 can be used for the SMS diagnosis in areas where the FISH technique is not available.

  3. A Formative Program Evaluation of Electronic Clinical Tracking System Documentation to Meet National Core Competencies. (United States)

    Smith, Lynette S; Branstetter, M Laurie


    Electronic clinical tracking systems are used in many educational institutions of higher learning to document advanced practice registered nursing students' clinical experiences. Students' clinical experiences are constructed according to the National Organization of Nurse Practitioner Faculties core competencies. These competencies form a basis for evaluation of advanced practice registered nursing programs. However, no previous studies have evaluated the use of electronic clinical tracking systems to validate students' clinical experiences in meeting national core competencies. Medatrax, an electronic clinical tracking system, is evaluated using a formative program evaluation approach to determine if students' clinical documentations meet Family/Across the Lifespan Nurse Practitioner Competencies in a midsouthern family nurse practitioner program. This formative program evaluation supports the use of an electronic clinical tracking system in facilitating accreditation and program outcome goals. The significance of this study is that it provides novel evidence to support the use of an electronic clinical tracking system to assist a midsouthern school of nursing in meeting national core competencies.

  4. Clinical evaluation of dynamic CT scan of the pancreas

    Energy Technology Data Exchange (ETDEWEB)

    Tokuda, Masamichi


    The clinical usefulness of dynamic CT scans (DCT) of the pancreas was evaluated in 62 normal cases, 9 cases of acute pancreatitis, 24 cases of chronic pancreatitis and 43 cases of carcinoma of the pancreas. The normal pancreas was intensely and homogeneously enhanced on DCT, and peripancreatic vessels were clearly demonstrated, especially the gastroduodenal artery (98.4%). DCT was useful to demonstrate vascular lesions, associated with pancreatitis such as pseudoaneurysm. Although the carcinoma of the pancreas showed poor contrast enhancement on conventional enhanced CT (CCT), 37.2% showed intense contrast enhancement on DCT. Visualization of the gastroduodenal artery by DCT is helpful to decide the extent of tumor. DCT is superior to CCT in demonstrating collateral veins caused by tumor invasion to the portal system in carcinoma. DCT was approximately as accurate as angiography (92.6%) in evaluating tumor invasion to the portal system. DCT is a useful and minimally invasive modality in assessing the resectability of pancreatic carcinoma. DCT may eliminate angiography and surgery in unresectable cases. (author).

  5. Clinical and radiographic evaluation of single tantalum dental implants: a prospective pilot clinical study (United States)



    SUMMARY Objective The aim of this prospective pilot clinical case series report was to evaluate, through a clinical and radiographic analysis, the peri-implant bone resorption of the tantalum dental implants (TMT) (Zimmer TMT, Parsippany, NJ, USA) one year after prosthetic rehabilitation. Methods Twenty tantalum dental implants were placed in both maxillas and mandibles of 20 patients. Patients were asked to attend a radiographic and clinical follow-up and their previous clinical records and X-rays were assessed. Bone levels were calculated by digitally measuring the distance from the implant shoulder to the first bone-to-implant on periapical radiographs taken at surgery and after 6 and 12 months of functioning. The Pearson correlation analysis was performed to assess it there was a correlation between the measurement of the marginal bone loss (MBL). The Anova Test with a post-hoc analysis using Bonferroni’s test was used to compare the three group (0, 6 months and 12 months). Results The mean total MBL for the group 0 months was 0.84 mm (SD 0.21), 6 months was 0.87 mm (SD 0.22) and for 12 months was 0.89 mm (SD 0.23). The values of the Pearson’s coefficients showed that the data measurement were positively correlated. The Anova test showed a statistically significant difference between the groups. Conclusion The statistically significant difference in marginal bone loss can be considered physiological. Within the limits of this study it can be concluded that TMT implants have an excellent bone crest’s stability, however, to have most accurate information, will be necessary extend the sample. PMID:28280531

  6. Evaluating dose response from flexible dose clinical trials

    Directory of Open Access Journals (Sweden)

    Baron David


    Full Text Available Abstract Background The true dose effect in flexible-dose clinical trials may be obscured and even reversed because dose and outcome are related. Methods To evaluate dose effect in response on primary efficacy scales from 2 randomized, double-blind, flexible-dose trials of patients with bipolar mania who received olanzapine (N = 234, 5–20 mg/day, or patients with schizophrenia who received olanzapine (N = 172, 10–20 mg/day, we used marginal structural models, inverse probability of treatment weighting (MSM, IPTW methodology. Dose profiles for mean changes from baseline were evaluated using weighted MSM with a repeated measures model. To adjust for selection bias due to non-random dose assignment and dropouts, patient-specific time-dependent weights were determined as products of (i stable weights based on inverse probability of receiving the sequence of dose assignments that was actually received by a patient up to given time multiplied by (ii stable weights based on inverse probability of patient remaining on treatment by that time. Results were compared with those by unweighted analyses. Results While the observed difference in efficacy scores for dose groups for the unweighted analysis strongly favored lower doses, the weighted analyses showed no strong dose effects and, in some cases, reversed the apparent "negative dose effect." Conclusion While naïve comparison of groups by last or modal dose in a flexible-dose trial may result in severely biased efficacy analyses, the MSM with IPTW estimators approach may be a valuable method of removing these biases and evaluating potential dose effect, which may prove useful for planning confirmatory trials.

  7. A 3-year clinical prospective investigation: establishment of anassessment questionnaire for Parkinson's disease with motor complications%三年前瞻性临床研究初步构建帕金森病运动并发症危险评估量表

    Institute of Scientific and Technical Information of China (English)

    万赢; 刘振国; 任肖玉; 魏雅荣; 周明珠; 何海燕; 干静; 陆丽霞; 吴佳英; 陈伟


    Objective To derive a questionnaire to assess the risk of developing motor complications through a 3-year prospective investigation on 71 patients of Parkinson' s disease (PD) in the out clinic at our hospital.Methods Three years after the first assessment,71 PD out patients were reassessed using various scales,including Unified Parkinson Disease Rating Scale,Hoehn-Yahr grade,Mini Mental State Exam,Hamilton Depression Scale and Hamilton Anxiety Scale.Results The incidence of motor complications was 43.6% (31/71).Logistic regression analysis showed that the prognostic factors for motor fluctuation were age of onset ≤ 54 (OR =6.4,95% CI 1.7-24.5,P =0.006),the occurrence of swallowing difficulty (OR =3.8,95 % CI 1.0-14.1,P =0.04) and depression (OR =4.0,95 % CI 1.1-13.7,P =0.03),and the prognostic factors for dyskinesia were age of onset ≤54 (OR =48.5,95% CI 1.9-121.0,P:0.02),the occurrence of falling (OR =64.1,95% CI 2.9-142.2,P =0.008) and the daily levodopa dosage > 600 mg(OR =17.5,95% CI 1.1-276.2,P =0.04).Based on the regression model,the assessment questionnaire for motor complicationsincludes the followings:the questionnaire for motor fluctuations:the age of onset ≤54,2 points; the occurrence of swallowing difficulty,1 point; the occurrence of depression,1 point; the questionnaire for dyskinesia:the onset age ≤54,2 points; the occurrence of falling,3 points; daily levodopa dosage > 600 mg,2 points.In all patients in this study,21.7% (10/46) was asscssed to a total scorc of 0-1 which is associated with a low risk of motor fluctuation,8/16 had a score of 2 which is associated with intermediate risk and 8/9 got a score of 3-4 associated high risk; 10.2% (5/49) had a score of 0-2,a low risk of dyskinesia,4/13 had a score of 3-4,a intermediate risk and 7/9 got a score of 5-7 which is associated with a high risk.Conclusions Age onset ≤54,the occurrence of swallowing difficulty,falling and depression,daily levodopa dosage > 600 mg

  8. [Clinical effectiveness and economical evaluation of preventive vaccination]. (United States)

    Vaz Carneiro, António; Belo, Ana Isabel; Gouveia, Miguel; Costa, João; Borges, Margarida


    The value of mass vaccination as a preventive measure for infectious diseases is one of the most important advances of modern Medicine. The impact on incidence of several infectious diseases, until recently responsible for significant morbidity and mortality at world level, is well proved in a series of high quality epidemiological studies. In this scientific review we aimed firstly to briefly resume the history of mass vaccination and its scientists, responsible for synthesis and marketing of these drugs. In second place we present a group of a few disease preventable by vaccines as well as the Portuguese National Vaccination Plan and its benefits. In third place we identified groups of subjects in which a well structured vaccination plan is particularly important, as well as the correspondent diseases to be covered by vaccination. Fourthly, we discussed the ethical considerations of vaccination, and its tensions between subject autonomy and society advantages in com pulsive programs. Fifthly, we analyzed clinical effectiveness of vaccines through the concept of herd immunity, clinical evaluation of immune response to vaccines and some examples of systematic reviews on three relevant diseases (influenza, meningococcal and pneumococcal infections). In sixth place we discussed vaccine safety presenting monitoring methods of vaccination risks, as well as discussing the public myths concerning vaccines. Finally we present a economic analysis of preventive vaccination with a review of some published literature on specific diseases. We conclude that mass vaccination is a efficacious preventive measure, as well as a economic rational choice, and that this public health intervention should be a pillar of a modern preventive system.

  9. Acute myeloid leukemia with basophilic differentiation in a 3-year-old Standardbred gelding (United States)

    Furness, Mary Catherine; Setlakwe, Emile; Sallaway, John; Wood, Darren; Fromstein, Jordan; Arroyo, Luis G.


    A 3-year-old Standardbred gelding with a history of pyrexia, persistent hemorrhage from the oral cavity, and a large, soft swelling at the junction of the caudal aspect of the mandibular rami and proximal neck was evaluated. The horse had neutropenia and anemia, with atypical granulated cells in a blood smear. Additional tests confirmed acute myeloid leukemia with basophilic differentiation, which has been reported in humans, cats, dogs, and cattle but not horses. PMID:27708445

  10. Azithromycin for episodes with asthma-like symptoms in young children aged 1-3 years

    DEFF Research Database (Denmark)

    Stokholm, Jakob; Chawes, Bo L; Vissing, Nadja H;


    Prospective Studies on Asthma in Childhood 2010 cohort; a birth cohort consisting of the general Danish population of Zealand, including Copenhagen. Exclusion criteria were macrolide allergy, heart, liver, neurological, and kidney disease, and, before each treatment, one or more clinical signs of pneumonia...... children with recurrent asthma-like symptoms, hypothesising that it reduces the duration of the symptomatic period. METHODS: In this randomised, double-blind, placebo-controlled trial, we recruited children aged 1-3 years, who were diagnosed with recurrent asthma-like symptoms from the Copenhagen...... masked until the youngest child turned 3 years of age and throughout the data validation and analysis phases. The primary outcome was duration of the respiratory episode after treatment, verified by prospective daily diaries and analysed with Poisson regression. Analyses were per protocol (excluding...

  11. Evaluation of a novel electronic genetic screening and clinical decision support tool in prenatal clinical settings. (United States)

    Edelman, Emily A; Lin, Bruce K; Doksum, Teresa; Drohan, Brian; Edelson, Vaughn; Dolan, Siobhan M; Hughes, Kevin; O'Leary, James; Vasquez, Lisa; Copeland, Sara; Galvin, Shelley L; DeGroat, Nicole; Pardanani, Setul; Gregory Feero, W; Adams, Claire; Jones, Renee; Scott, Joan


    "The Pregnancy and Health Profile" (PHP) is a free prenatal genetic screening and clinical decision support (CDS) software tool for prenatal providers. PHP collects family health history (FHH) during intake and provides point-of-care risk assessment for providers and education for patients. This pilot study evaluated patient and provider responses to PHP and effects of using PHP in practice. PHP was implemented in four clinics. Surveys assessed provider confidence and knowledge and patient and provider satisfaction with PHP. Data on the implementation process were obtained through semi-structured interviews with administrators. Quantitative survey data were analyzed using Chi square test, Fisher's exact test, paired t tests, and multivariate logistic regression. Open-ended survey questions and interviews were analyzed using qualitative thematic analysis. Of the 83% (513/618) of patients that provided feedback, 97% felt PHP was easy to use and 98% easy to understand. Thirty percent (21/71) of participating physicians completed both pre- and post-implementation feedback surveys [13 obstetricians (OBs) and 8 family medicine physicians (FPs)]. Confidence in managing genetic risks significantly improved for OBs on 2/6 measures (p values ≤0.001) but not for FPs. Physician knowledge did not significantly change. Providers reported value in added patient engagement and reported mixed feedback about the CDS report. We identified key steps, resources, and staff support required to implement PHP in a clinical setting. To our knowledge, this study is the first to report on the integration of patient-completed, electronically captured and CDS-enabled FHH software into primary prenatal practice. PHP is acceptable to patients and providers. Key to successful implementation in the future will be customization options and interoperability with electronic health records.

  12. Clinical evaluation of the infertile male: new options, new challenges

    Institute of Scientific and Technical Information of China (English)

    Robert I McLachlan; Csilla Krausz


    Male reproductive dysfunction is the sole or contributory cause of infertility in half of couples making the systematic clinical and laboratory evaluation of the male,and the application of costeffective management strategies tailored to the individual patient's need,vital parts of fertility practice.1,2 Male infertility has a wide range of etiologies and effective approaches to initiate,restore or preserve natural fertility are available in some settings.But the most striking development in the past 20 years has been in the area of assisted reproductive technologies (ART),especially intracytoplasmic sperm injection (ICSI);the latter provides an extraordinarily effective bypass of the natural processes involved such that a single viable sperm,obtained from any part of the reproductive tract,will often successfully fertilize an oocyte and has allowed many previously sterile men to father healthy children.However,our understanding of the genetic and environmental factors causing male factor infertility has lagged behind these technological advances and still for a significant minority,no options exist other than adoption,donor sperm or abandonment of their aspirations for a family.

  13. Evaluation of clinical, biochemical and hematological parameters in macrocytic anemia

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    Aarthi Kannan


    Results: Primary bone marrow disorders were the most common cause of macrocytosis (46%. The other causes in decreasing order of frequency were megaloblastic anaemia (38%, hemolytic anemia (6%, drug induced (5%, alcoholism and liver disease (4% and idiopathic thrombocytopenic purpura (1%. There was a significant difference in the mean values of MCV and serum LDH between megaloblastic and non and ndash; megaloblastic macrocytosis. When serum LDH >1345.2 IU/L or MCV>121fl (criterion values of ROC curve with reticulocyte count <2% was taken as criteria, the sensitivity was 92.1% and specificity was 93.5% for diagnosing megaloblastic anemia. Conclusions: Systematic evaluation of macrocytosis will help us to distinguish megaloblastic and non and ndash; megaloblastic macrocytosis. The blood and biochemical parameters especially CBC, RC, and serum LDH along with supporting clinical features help us in diagnosing megaloblastic anemia in a setup where vitamin and metabolite levels are difficult to obtain. [Int J Res Med Sci 2016; 4(7.000: 2670-2678

  14. Clinical evaluation of therapeutic success in rabbits with suspected encephalitozoonosis. (United States)

    Sieg, Jessica; Hein, Jutta; Jass, Ariane; Sauter-Louis, Carola; Hartmann, Katrin; Fischer, Andrea


    Between 2000 and 2008, 95 rabbits with suspected encephalitozoonosis and neurological symptoms were treated at the Clinic of Small Animal Medicine, Ludwig Maximilian University Munich. Standard treatment consisted of oxytetracycline (from 2000 to 2003; n=50) or fenbendazole and oxytetracycline (from 2004 to 2008; n=45), and the rabbits were randomly assigned to treatment groups with or without dexamethasone. Each therapeutic regime was given for 10 days, with fluids, B vitamins and nutritional support added as needed. Therapeutic success was evaluated by assessing the survival rate on day 10, the neurological score of the surviving rabbits and Kaplan-Meier curves for long-term survival past 10 days. Inclusion of fenbendazole in the treatment protocol was associated with increased survival rates on day 10 (p=0.043), better neurological scores (p=0.008), and improved long-term survival (p=0.025) based on the results of univariate analyses. Treatment with dexamethasone showed no effect on neurological score or on short- or long-term survival. The study did not provide any evidence that dexamethasone is an effective component of the treatment scheme.

  15. Clinical evaluation of desensitizing treatments for cervical dentin hypersensitivity

    Directory of Open Access Journals (Sweden)

    Ana Cecilia Corrêa Aranha


    Full Text Available The aim of this study was to compare different treatments for dentin hypersensitivity in a 6-month follow-up. One hundred and one teeth exhibiting non carious cervical lesions were selected. The assessment method used to quantify sensitivity was the cold air syringe, recorded by the visual analogue scale (VAS, prior to treatment (baseline, immediately after topical treatment, after 1 week, 1, 3 and 6 months. Teeth were randomly assigned to five groups (n = 20: G1: Gluma Desensitizer (GD; G2: Seal&Protect (SP; G3: Oxa-gel (OG; G4: Fluoride (F; G5: Low intensity laser-LILT (660 nm/3.8 J/cm²/15 mW. Analysis was based on the non-parametric Kruskal-Wallis test that demonstrated statistical differences immediately after the treatment (p = 0.0165. To observe the individual effects of each treatment, data was submitted to Friedman test. It was observed that GD and SP showed immediate effect after application. Reduction in the pain level throughout the six-month follow-up was also observed. In contrast, LILT presented a gradual reduction of hypersensitivity. OG and F showed effects as of the first and third month respectively. It can be concluded that, after the 6-month clinical evaluation, all therapies showed lower VAS sensitivity values compared with baseline, independently of their different modes of action.


    Directory of Open Access Journals (Sweden)

    Jangle Vidya Muralidhar


    Full Text Available Urolithiasis, a presence of calculi single or multiple in renal or urinary tracks is a clinical entity which has been universally accepted as problematic condition regarding its treatment in all systems of medical science. There is no known drug therapy at present which dissolves or fragments the calculi by changing lithogenic potential of particular person. Urinary calculi disease has been described in detail under the heading of Ashmari in Ayurvedic texts. Ashmari is one of the few surgical conditions which have been given very prominent place in Ayurveda by Acharya Sushruta and Various herbs like Kulattha (Dolicos Biflorus, Gokshura (Tribulus Terrestris, Apamarga (Achyranthes Aspera, Pashanbheda (Berginia Lingulata and Varuna (Crataeva Nurvela etc. and herbomineral compounds are described which are effective against urolithiasis by dissolving calculi thus facilitating their expulsion. This study was aimed to evaluate Ashmaribhedana property of “Kulatthadi yoga” in Mutrashmari to make an effective, long lasting, cost effective, authentic alternative & easily available conservative management of Mutrashmari. After observation, it was found that Kulatthadi Yoga is effective in Kapha-Vataja Mutrashmari & control group shows significant result in Mutrashmari.

  17. European multicentre evaluation of the ABBOTT Spectrum clinical chemistry analyzer. (United States)

    Blijenberg, B G; Braconnier, F; Vallez, J M; Burlina, A; Plebani, M; Celadin, M; Haeckel, R; Römer, M; Hänseler, E; De Schrijver, G


    The analytical performance of the selective multitest ABBOTT Spectrum analyser was studied according to the ECCLS guidelines and partly the CERMAB protocol in a multicentre evaluation involving laboratories from six European countries. Fifteen analytes, including the electrolytes sodium, potassium and chloride, were measured each in at least 3 laboratories, all at 37 degrees C, except the electrolytes, which are measured at room temperature. The trial lasted approximately three months and involved the collection of over 60,000 data points. It yielded the following results: 1. The precision was at least as good as the precision obtained with the comparison instruments. The majority of the coefficients of variation were between 1 and 4%. 2. The recovery for method assigned control sera values was, with few exceptions, within 10%. 3. Good agreement with respect to the method assigned values of control materials and method comparison with patient specimens to different instruments (e.g. SMAC, Hitachi 737, RA 1000) was found. 4. No drift was observed. 5. Reagent-related carry-over was not found. Specimen-related carry-over was detected in some cases, the deviation being of little or no clinical significance. 6. The manufacturer's claims regarding method linearity were as stated or exceeded. 7. The open system capability was tested and rated as very convenient. 8. The practicability of the instrument was very good.

  18. Axon clinical chemistry analyzer evaluated according to ECCLS protocol. (United States)

    Brenna, S; Prencipe, L


    We assessed the analytical performance of the Axon system (Bayer Diagnostici), according to the European Committee for Clinical Laboratory Standards guidelines, for assay of 12 analytes: cholesterol, creatinine, glucose, total protein, urea, uric acid, alkaline phosphatase, alpha-amylase, aspartate aminotransferase, creatine kinase, sodium, and potassium. The field evaluation lasted approximately 5 months and involved the collection of approximately 10,000 data points with the Axon. The following results were obtained: The highest CVs for controls and human sera at different concentration/activity values were 2.2% for within-run imprecision (n = 60; 3 days, pooled estimate) and 3.5% for the between-day imprecision (n = 20 days). Close correlation was found with results for patients' specimens assayed with comparative instruments (Hitachi 717 for substrates and enzymes, Beckman Synchron EL/E4A for electrolytes). No drift was observed during 8 h of operation. The linearity range was broad, sometimes exceeding the manufacturer's claims. No sample-, reagent-, or cuvette-related carryover was found. Measurement of control sera gave results within +/- 5% of the assigned values. We conclude that good reliability and practicability make the Axon system suitable for laboratories with various needs.

  19. Economic evaluation in long-term clinical trials. (United States)

    Hlatky, Mark A; Boothroyd, Derek B; Johnstone, Iain M


    Economic endpoints have been increasingly included in long-term clinical trials, but they pose several methodologic challenges, including how best to collect, describe, analyse and interpret medical cost data. Cost of care can be measured by converting billed charges, performing detailed micro-costing studies, or by measuring use of key resources and assigning cost weights to each resource. The latter method is most commonly used, with cost weights based either on empirical regression models or administratively determined reimbursement rates. In long-term studies, monetary units should be adjusted to reflect cost inflation and discounting. The temporal pattern of accumulating costs can be described using a modification of the Kaplan-Meier curve. Regression analyses to evaluate factors associated with cost are best performed on the log of costs due to their typically skewed distribution.Cost-effectiveness analysis attempts to measure the value of a new therapy by calculating the difference in cost between the new therapy and the standard therapy, divided by the difference in benefit between the new therapy and the standard therapy. The cost-effectiveness ratio based on the results of a randomized trial may change substantially with longer follow-up intervals, particularly for therapies that are initially expensive but eventually improve survival. A model that projects long-term patterns of cost and survival expected beyond the end of completed follow-up can provide an important perspective in the setting of limited trial duration.

  20. [Process and key points of clinical literature evaluation of post-marketing traditional Chinese medicine]. (United States)

    Liu, Huan; Xie, Yanming


    The clinical literature evaluation of the post-marketing traditional Chinese medicine is a comprehensive evaluation by the comprehensive gain, analysis of the drug, literature of drug efficacy, safety, economy, based on the literature evidence and is part of the evaluation of evidence-based medicine. The literature evaluation in the post-marketing Chinese medicine clinical evaluation is in the foundation and the key position. Through the literature evaluation, it can fully grasp the information, grasp listed drug variety of traditional Chinese medicines second development orientation, make clear further clinical indications, perfect the medicines, etc. This paper discusses the main steps and emphasis of the clinical literature evaluation. Emphasizing security literature evaluation should attach importance to the security of a comprehensive collection drug information. Safety assessment should notice traditional Chinese medicine validity evaluation in improving syndrome, improveing the living quality of patients with special advantage. The economics literature evaluation should pay attention to reliability, sensitivity and practicability of the conclusion.

  1. Evaluation of Clinical Outcome after Laparoscopic Antireflux Surgery in Clinical Practice: Still a Controversial Issue

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    Sandro Contini


    Full Text Available Background. Laparoscopic antireflux surgery has shown to be effective in controlling gastroesophageal reflux (GERD. Yet, a universally accepted definition and evaluation for treatment success/failure in GERD is still controversial. The purpose of this paper is to assess if and how the outcome variables used in the different studies could possibly lead to an homogeneous appraisal of the limits and indications of LARS. Methods. We analyzed papers focusing on the efficacy and outcome of LARS and published in English literature over the last 10 years. Results. Symptoms scores and outcome variables reported are dissimilar and not uniform. The most consistent parameter was patient's satisfaction (mean satisfaction rate: 88.9%. Antireflux medications are not a trustworthy outcome index. Endoscopy and esophageal manometry do not appear very helpful. Twenty-four hours pH metry is recommended in patients difficult to manage for recurrent typical symptoms. Conclusions. More uniform symptoms scales and quality of life tools are needed for assessing the clinical outcome after laparoscopic antireflux surgery. In an era of cost containment, objective evaluation tests should be more specifically addressed. Relying on patient's satisfaction may be ambiguous, yet from this study it can be considered a practical and simple tool.

  2. Clinical evaluation of a novel herbal dental cream in plaque formation: a double-blind, randomized, controlled clinical trial


    amrutesh, sunita; Malini, J; Tandur, Prakash S; Pralhad S. Patki


    Background The aim of this study was to evaluate the efficacy and safety of herbal dental cream in comparison to fluoride dental cream. Objectives Clinical evaluation of a novel herbal dental cream in plaque formation: a double-blind, randomized, controlled clinical trial. Methods One hundred and two patients with established dental plaque were randomly assigned to either herbal dental group or fluoride dental group for six weeks in a double-blind design. Improvement in plaque index, oral hyg...

  3. Outcome of pregnancy in one Norwegian county 3 years prior to and 3 years subsequent to the Chernobyl accident

    Energy Technology Data Exchange (ETDEWEB)

    Ulstein, M.; Skeie Jensen, T.; Irgens, L.M.; Lie, R.T.; Sivertsen, E. (Univ. of Bergen (Norway). Dept. of Obstetrics and Gynecology, and Medical Birth Registry)


    Pregnancy outcome was studied in a county in Norway 3 years prior to and 3 years subsequent to the Chernobyl nuclear plant accident on 26th April 1986. More detailed analyses have been performed for the 12 months prior to and subsequent to the accident. A significant increase in the spontaneous abortion rate the first year after the accident was followed by a slight decrease during the second and third years, but figures were still higher than the period prior to the accident. The rate of legal abortions was unchanged. During the entire observation period the number of births increased continuously, with the exception of a decrease in the last 2 months of 1986 and the first month of 1987. A higher incidence of spontaneous abortions was found for pregnancies conceived during the first 3 months after the accident. This increase in the spontaneous abortion rate is noteworthy, and more especially its long-term persistence, which cannot be the results of external radiation. The internal radiation from food polluted by radioactive fallout is a possible explanation. Changes in nutrition in order to avoid polluted food may also be of importance. (authors).

  4. 75 FR 28686 - Clinical Science Research and Development Service; Cooperative Studies Scientific Evaluation... (United States)


    ... AFFAIRS Clinical Science Research and Development Service; Cooperative Studies Scientific Evaluation... Research and Development Service on the relevance and feasibility of proposed projects and the scientific... (Federal Advisory Committee Act) that a meeting of the Clinical Science Research and Development...

  5. Ceramage 聚合瓷嵌体修复牙体缺损3年的临床疗效观察%3-year observation of the clinical efficacy of Ceramage polymeric porcelain inlay in the repair of tooth defect

    Institute of Scientific and Technical Information of China (English)



    用 Ceramage 聚合瓷嵌体和铸瓷嵌体分别修复大面积牙体缺损104例和94例。修复后1年复查2组各项指标差异无统计学意义(P >0.05)。修复后3年复查修复体折裂发生于聚合瓷嵌体(3.1%)铸瓷嵌体10.6%(P <0.05),其他指标组间无差异(P>0.05)。%104 teeth with large defect were repaired by Ceramage polymeric porcelain inlay(Ceramage group)and 94 by casting porcelain inlay(casting group).After 1 year there was no statistical significance in all indexes between two groups(P >0.05).After 3 year,Restora-tion fracture was observed in 3.1% of Ceramage group and 10.6% of casting group(P <0.05).No statistical significance was found in other indexes between the two groups.

  6. Subcutaneous scrotal dirofilariasis in a 3- year- old boy

    Directory of Open Access Journals (Sweden)

    Biserka Pigac


    Full Text Available Dirofilariasis is a zoonosis caused by parasites the genus Dirofilaria, most common species are D. repens and D. immitis. This parasitosis rarely affects humans and it is usually asymptomatic. Canines are considered to be the reservoir of the parasite, yet the parasite is transmitted via mosquito bite. We present a case of subcutaneous scrotal dirofilariasis in a 3-year-old boy from north- western part of Croatia, where this zoonosis's not endemic, which characterizes this entity as rarity in this part of the country. In this case, parasitic infestation was manifested as painless scrotal nodule up to 1 cm in its largest diameter. Surgical excision revealed a thread- like material exiting the incision site. According to well –preserved morphologic characteristics, the specimen was characterized as a helminth of the genus Dirofilaria. We emphasize the importance of dirofilariasis in patients with subcutaneous nodules. And increase the awareness level of these parasites among clinicians and pathologists.

  7. Extrinsic Rewards Diminish Costly Sharing in 3-Year-Olds. (United States)

    Ulber, Julia; Hamann, Katharina; Tomasello, Michael


    Two studies investigated the influence of external rewards and social praise in young children's fairness-related behavior. The motivation of ninety-six 3-year-olds' to equalize unfair resource allocations was measured in three scenarios (collaboration, windfall, and dictator game) following three different treatments (material reward, verbal praise, and neutral response). In all scenarios, children's willingness to engage in costly sharing was negatively influenced when they had received a reward for equal sharing during treatment than when they had received praise or no reward. The negative effect of material rewards was not due to subjects responding in kind to their partner's termination of rewards. These results provide new evidence for the intrinsic motivation of prosociality-in this case, costly sharing behavior-in preschool children.

  8. 3-year experience with US QML: lessons learned (United States)

    Leseur, M.


    Based on its 20 years experience in manufacturing semiconductor devices, Atmel Nantes has chosen to apply QML concept to move from Product Qualification to Technology Qualification. Defense Supply Center Colombus granted Atmel Nantes QML Q & V (class Q = military quality level , class V = space quality level), in December 1999. A demonstration phase is on-going with draft ESA/SCC 25400 and 2549000 basic specifications for the definition of a European QML. Atmel is a candidate as an integrated microcircuits manufacturer. After 3 years producing QML devices, some optimisations of screening tests have been implemented. This appears to be a valid solution for reducing both cost and cycle time with no impact on product reliability.

  9. ISS ECLSS: 3 Years of Logistics for Maintenance (United States)

    Shkedi, Brienne; Thompson, Dean


    The International Space Station (ISS) Environmental Control and Life Support System (ECLSS) is designed to be maintainable. During the 3 years since the ISS US Lab became operational, there have been numerous ECLSS Orbital Replacement Units (ORUs) launched and returned to Maintain the ECLSS operation in the US segments. The maintenance logistics have provided tools for maintenance, replaced limited life ORUs and failed ORUs, upgraded ECLSS hardware to improve reliability and placed critical spares onboard prior to need. In most cases, the removed ORUs have been returned for either failure analysis and repair or refurbishment. This paper describes the ECLSS manifesting history and maintenance events and quantifies the numbers of ECLSS items, weights, and volumes.

  10. Clinical evaluation of efonidipine hydrochloride in angina pectoris. Evaluation in exercise {sup 201}Tl myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Hori, Masatsugu; Nishimura, Tsunehiko [Osaka Univ., Suita (Japan). Medical School


    Clinical usefulness of once-daily administration of 20 to 60 mg of efonidipine hydrochloride and coronary hemodynamics during exercise {sup 201}Tl myocardial scintigraphy were investigated in patients with angina pectoris. Out of 11 patients enrolled in this study, 9 patients were included in the evaluation of patients` impression, in improvement rating in subjective symptoms, in the analysis of the exercise test, in the improvement rating of images on {sup 201}Tl myocardial scintigraphy, and in the global improvement rating, while 10 patients were included in the overall safety rating. Four patients in improvement rating in subjective symptoms, 2 in improving rating in the exercise test, and 5 in the global improvement rating were rated `improved` or better. In the improvement rating on the exercise {sup 201}Tl myocardial scintigraphy image, reduction of the image was observed in 5 patients, 3 out of which were evaluated as `improved` or better. A distinctive reduction of ischemic regions was observed in 2 patients out of the 3. A significant decrease in the number of angina pectoris events and a decreasing tendency in consumption of fast-acting nitrates were observed in spite of the low number of the patients studied. An adverse effect was observed in 1 patient and abnormal laboratory values were observed in 2 patients which were improved promptly after withdrawal of the drug. It was in 7 patients evaluated as `no problem`, while in 4 patients it was evaluated as `useful` or more. (author)

  11. Evaluation of instruments developed to measure the clinical learning environment: an integrative review. (United States)

    Hooven, Katie


    The nature of the clinical learning environment has a huge impact on student learning. This article reviews current methods available for evaluating the clinical learning environment. Five instruments were identified that measure the clinical learning environment. All of these instruments focus solely on the student perspective of the clinical learning environment. Although gaining student input is important, there are other perspectives that offer valuable insights on the nature of the clinical learning environment. The findings from this integrative review indicate the need for future development and testing of an instrument to evaluate the clinical learning environment from the staff nurse and nurse faculty perspective.

  12. The relation between personality and anxiety: findings from a 3-year prospective study. (United States)

    Gershuny, B S; Sher, K J


    The authors tested the extent to which the personality dimensions of neuroticism, extraversion, and psychoticism (H. J. Eysenck & S. B. G. Eysenck, 1975) prospectively predicted global anxiety (assessed by items from the Brief Symptom Inventory: L. R. Derogatis & M. S. Spencer, 1982). The authors also examined prospective relations among these personality dimensions and depression to evaluate the specificity of findings. Participants were 466 young adults, primarily undergraduate students, assessed twice over a 3-year interval. An interaction between neuroticism and extraversion predicted both global anxiety and depression 3 years later. Findings indicated that personality, in particular the combination of high neuroticism and low extraversion, may play an important predisposing, etiological role in anxiety. Interpretations and implications of the predictive importance of the Neuroticism x Extraversion interaction in anxiety are discussed, and further speculations about the relation between anxiety and depression are put forth.

  13. Evaluation of dermatologic emergeny patients: An unicentral prospective clinical study

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    Adem Köşlü


    Full Text Available Background and Design: The definition of emergent diseases includes potentially risky diseases that need urgent medical intervention. Diagnostic and therapeutic processes are managed mostly at ourpatient setting in dermatology. Therefore, it is unclear that which diseases are real emergencies and which patients apply urgently. There are a few studies assessing this topic. Our aim was to evaluate patients referred to our clinic urgently, and to review the concept of ‘‘real dermatologic emergency’’ by comparing dermatologic emergency patients and outpatients. Material and Method: A total of 800 patients (400 urgent patients, 400 outpatients were included. Demographic features, complaints, disease duration and severity, whether the disease occurs for the first time were questionned, application time and diagnosis were recorded. The opinions of patients and physicians were inquired about why they thought that the disease was emergent. Results: Most common skin diseases were acute urticaria-angioedema, contact dermatitis, and insect bite in emergency patients; acne vulgaris, verruca and tinea pedis in outpatients. Itching was more common in emergency patients. Emergency patients' complaints were more severe than those of outpatients. Patients who experience disease first time applied to emergency service more than others. Emergency patients had a shorter disease duration than outpatients. Patients and physicians revealed different reasons and criteria about the urgency of the diseases. 93.5% of patients and 49% of physicians thought that existing disease was emergent. Conclusion: Our data reveal that the concept of dermatologic emergency is unsettled. It changes according to socio-cultural, personal features and to the present health system. Determination of the main criteria of the definition of “dermatologic urgent”, and training of dermatologists, emergency centers’physicians and also of patients in this regard seem to be a necessity

  14. Clinical, molecular, and genetic evaluation of galactosemia in Turkish children (United States)

    Atik, Sezen Ugan; Gürsoy, Semra; Koçkar, Tuba; Önal, Hasan; Adal, Servet Erdal


    Aim Galactosemia is a carbohydrate metabolism disorder with autosomal recessive inheritance. The most frequent enzyme deficiency is galactose-1-phosphate-uridylytransferase, which causes classic galactosemia. When the enzyme is absent, an infant cannot metabolize galactose-1-phosphate and it cumulates in liver, kidney, brain, tongue, lens, and skin. This study aimed to evaluate the clinical and molecular characteristics of patients with galactosemia, which is observed more frequently in our country than anywhere else in the world. Material and Methods This is a retrospective study that includes the moleculer and genetic charcteristics of 14 patient who were diagnosed as having galactosemia between January 2009 and January 2011. Results Nine patients were male and 5 female. Consanguineous marriage was detected in the family history of 7 patients. One patient had a history of a deceased sibling with a confirmed diagnosis of galactosemia. The main reasons for admission to the hospital were jaundice in 9, hypoglycemia in 2, sepsis in 2, and elevated liver enzymes in 1 patient. The Beutler test was positive in all patients. The mean enzyme activity was 0.36±0.26 μmol/mL. Only 6 of our cases were diagnosed in the early period (first 15 days). Cataract was present in four patients. Q188R mutation was observed in 13 patients, and homozygote N314D and homozygote E340X mutations were observed in one patient. Three patients had impaired neurologic development according to the Denver Developmental Screening Test II. Conclusion The most common genetic abnormality was Q188R mutation. Only 43% of our patients’s disease could be diagnosed at an early stage. We suggest that galactosemia should be included in the national newborn screening program in order to make earlier diagnoses. PMID:28123333

  15. Endodontic diagnosis: evaluation between clinical and histological findings

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    Paloma Souza Gonçalves


    Full Text Available Objective: In this study, the aim was to analyze the histologic alterations in thirty dental pulps and correlate them with the clinical findings to verify agreement between the clinical and histopathologic diagnosis and contribute to knowledge about endodontic diagnosis. Methods: Using the methodology of Oliveira4, the pulpal conditions were clinically classified as normal, reversible pulpitis, pulpitis at the stage of transition, irreversible pulpitis and necrosis. Results: Lack of correlation was observed between the clinical and histopathologic diagnoses in the cases classified as reversible and at the stage of transition, which histologically consisted of irreversible lesions or degenerative alterations. All the cases clinically classified as irreversible corresponded to the histologic diagnoses. Conclusion: It was concluded that the correlation between clinical and histopathologic diagnosis of dental pulp was shown to be controversial, even though the semiotechnique used had been imperative for guidance about the irreversibility of pulpal lesion.

  16. SMOS Instrument Performance and Calibration after 3 Years in Orbit (United States)

    Martin-Neira, Manuel; Corbella, Ignasi; Torres, Francesc; Kainulainen, Juha; Oliva, Roger; Closa, Josep; Cabot, François; Castro, Rita; Barbosa, Jose; Gutierrez, Antonio; Anterrieu, Eric; Tenerelli, Joe; Martin-Porqueras, Fernando; Buenadicha, Guillermo; Delwart, Steven; Crapolicchio, Raffaele; Suess, Martin


    ESA's Soil Moisture and Ocean Salinity (SMOS) mission has been in orbit for already over 3 years which has allowed the calibration and data processing team consolidating both the calibration strategy and the Level-1 processor which transforms the raw visibility samples into polarimetric brightness temperature images. The payload on board SMOS, MIRAS, is quite unique in that it is the first microwave radiometer in space ever capable to generate wide field of view images at every snapshot measurement. This means that most of the calibration as well as image processing techniques are being developed for the first time with little heritage from any previous space mission. Issues intrinsically attached to its wide field of view such as spatial ripples across the snapshot images are particular to MIRAS and to no other earlier radiometer. Even the fundamental theory behind the instrument was put at test, first on ground inside an electromagnetic compatibility chamber, and now in orbit when imaging the Cosmic Microwave Background Radiation of the cold sky. A groundbreaking effort is being carried out by the SMOS project team to understand and master all calibration and image reconstruction issues of this novel microwave interferometer payload. MIRAS in-orbit performance is driven by the amplitude of spatial ripples across the image and orbital and seasonal radiometer stability. Spatial ripples are unique to interferometric radiometers and are produced by (a) a limited knowledge of the antenna patterns and, in general, of the model of the instrument, (b) some fundamental limitations related to the inverse problem of image reconstruction in undetermined conditions and (c) subtle data processing inconsistencies which are discovered and corrected. To reduce the spatial ripples sea surface salinity retrievals are performed by first removing the brightness temperature spatial errors using a uniform region of the Pacific Ocean. However soil moisture retrievals cannot benefit of

  17. The effectiveness of finasteride and dutasteride used for 3 years in women with androgenetic alopecia

    Directory of Open Access Journals (Sweden)

    Ids H Boersma


    Full Text Available Background: The effectiveness of finasteride and dutasteride in women with androgenetic alopecia has been the subject of debate. Aim: To evaluate the effectiveness of finasteride and dutasteride on hair loss in women with androgenetic alopecia over a period of 3 years. Methods: From a database containing systematically retrieved data on 3500 women treated for androgenetic alopecia between 2002 and 2012 with finasteride 1.25 mg or dutasteride 0.15 mg, a random sample stratified for age and type of medication was taken to yield 30 women in two age categories: below and above 50 years, and for both medications. Hair thickness of the three thinnest hairs was measured from standardized microscopic images at three sites of the scalp at the start of the treatment and after 3 years of continuous medication intake. The macroscopic images were evaluated independently by three European dermatologists/hair experts. The diagnostic task was to identify the image displaying superior density of the hair. Results: Both age categories showed a statistically significant increase in hair thickness from baseline over the 3-year period for finasteride and dutasteride (signed rank test, P = 0.02. Hair thickness increase was observed in 49 (81.7% women in the finasteride group and in 50 (83.3% women in the dutasteride group. On average, the number of post-treatment images rated as displaying superior density was 124 (68.9% in the finasteride group, and 118 (65.6% in the dutasteride group. Dutasteride performed statistically significantly better than finasteride in the age category below 50 years at the central and vertex sites of the scalp. Conclusions: Finasteride 1.25 mg and dutasteride 0.15 mg given daily for 3 years effectively increased hair thickness and arrested further deterioration in women with androgenetic alopecia.

  18. Exenatide once weekly: sustained improvement in glycemic control and cardiometabolic measures through 3 years

    Directory of Open Access Journals (Sweden)

    MacConell L


    .Conclusion: ExQW produced clinically meaningful improvements in glycemic control that were durable through 3 years of treatment. Significant improvements in cardiometabolic measurements were also observed. ExQW was well-tolerated during long-term treatment and no new adverse events were noted.Trial registration: NCT00308139.Keywords: diabetes, exenatide, GLP-1 receptor agonist, hyperglycemia, DURATION-1

  19. The development, facilitation and initial evaluation of a mindfulness group for a clinical psychology training course


    Fisher, Paul; Hemanth, P


    This article presents an evaluation of a Mindfulness group facilitate for trainee and qualified psychologists working in a university psychology clinic. the group was shown to have both personal and professional benefits for participants, but further evaluation is required.

  20. Study on Nursing Clinical Teachers' Comprehensive Quality Evaluation Model on the Basis of Fuzzy Mathematics

    Directory of Open Access Journals (Sweden)

    Zhijuan Liu


    Full Text Available In this study, we study on the nursing clinical teachers' comprehensive quality evaluation model on the basis of fuzzy mathematics. First, it obtains the nursing clinical teachers' comprehensive quality evaluation index framework by making use of Delphi method. Then, it constructs the comprehensive quality evaluation hierarchy model by applying the analytic hierarchy process, to obtain the weight for each index, based on which to establish fuzzy comprehensive evaluation model, thus acquiring new method for nursing clinical teachers' comprehensive quality evaluation. Examples have proven the feasibility and effectiveness of this method.

  1. Clinical evaluation of target controlled infusion system for sufentanil administration

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yan; ZHANG Li-ping; WU Xin-min; JIANG Jian-yu; DUAN Jing-li; HU Yong-fang; LI Min; LIU Wei; SHENG Xiao-yan; NI Cheng; XU Mao; GUO Xiang-yang


    Background Sufentanil target controlled infusion (TCI) provides stable analgesia, better hemodynamic control than a bolus injection of intravenous anesthetics, anticipated recovery and improved quality of anesthesia during perioperative period. This study evaluated the accuracy and feasibility of TCI system for sufentanil at high concentrations in Chinese surgical patients.Methods Twelve low risk adult patients undergoing elective surgery under general anesthesia were included in this study. Sufentanil was administered with a specific TCI system incorporating the population pharmacokinetic data of sufentanil previously reported, using a target effect-site concentration of sufentanil 4 or 6 ng/ml. Sufentanil TCI duration was 30 minutes. Frequent arterial blood samples were taken during and up to 24 hours after sufentanil TCI for determination of plasma sufentanil concentrations by liquid chromatography-mass spectrometry/mass spectrometry. The changes of circulatory system function during the precedure, recovery profile and adverse effects were recorded.Measured plasma sufentanil concentrations were compared with the values predicted by the TCI system. The bias (median performance error, MDPE), procision (median absolute performance error, MDAPE) and wobble (variability of performance error) of the sufentanil TCI system were determined.Results All patients had stable cardiovascular variables during induction and maintenance of anesthesia. Time to eye opening and extubation were (5.6±1.7) minutes when TCI set to 4 ng/ml and (7.2±9.3) minutes when set to 6 ng/ml.There was no episode of agitation, muscle rigidity or intraoperative awareness. The bias (MDPE), precision (MDAPE)and wobble of the sufentanil TCI system were -3.7%, 18.9% and 19.6% respectively during TCI, and the MDPE, MDAPE and wobble were -29.1%, 31.7% and 15.0% respectively after TCI (up to 8 hours).Conclusions The TCI system programmed for sufentanil at 4 or 6 ng/ml was considered acceptable for

  2. [Clinical and pharmacokinetic evaluation of ceftriaxone in children]. (United States)

    Fujita, K; Sakata, H; Murono, K; Yoshioka, H; Maruyama, S; Sanae, N


    Twenty-eight pediatric patients were treated with ceftriaxone (Ro 13-9904, CTRX) in the doses ranging from 8.75 to 25 mg/kg every 12 hours for 3.5 to 11.5 days, and the clinical efficacy and side effects were evaluated. Among the 21 children with bacterial infections including pneumonia, acute bronchitis, otitis media, tonsillitis and urinary tract infections, the results were excellent in 9, good in 11, and fair in 1 patient. Out of the 28 patients, 2 patients had diarrhea, 3 patients had slightly elevated serum concentrations of transaminases, and 2 patients showed eosinophilia. The serum concentrations of CTRX in 5 children ranged from 50.0 to 93.8 micrograms/ml (mean 75.0 micrograms/ml) at 15 minutes and from 10.2 to 15.6 micrograms/ml (mean 13.4 micrograms/ml at 6 hours after 10 mg/kg intravenous bolus injection of CTRX. The serum half-lives were from 2.61 to 8.30 hours (mean 6.16 hours), and urinary recovery rates were from 43.3 to 58.0% (mean 48.5%) during 0-6 hours and from 52.0 to 66.1% (mean 59.4%) during 0-12 hours. After 20 mg/kg intravenous bolus injection of CTRX in 4 children, the serum concentrations of CTRX were from 118.8 to 162.5 micrograms/ml (mean 139.1 micrograms/ml) at 15 minutes and from 18.0 to 21.1 micrograms/ml (mean 19.2 micrograms/ml) at 6 hours. The serum half-lives were 4.07 to 6.34 hours (mean 5.13 hours), and urinary recovery rates were 38.6 to 51.1% (mean 45.4%) during 0-6 hours and from 54.8 to 64.0% (mean 59.0%) during 0-12 hours. Patients with impairment of renal function were excluded from this pharmacokinetic study.

  3. Clinical and audiological evaluation of hearing impaired children

    Directory of Open Access Journals (Sweden)

    Zafarullah Beigh


    Full Text Available Daily activities, interpersonal relationship, employment, and general well being; among such skills, communication skills are essential to a successful life for all individuals. Such skills affect education, adequate hearing acuity is of paramount importance and acts as a prerequisite in the overall personality development of an individual. Hearing impairment at any age has serious effects on the day to day life of an individual and he/she feels handicapped socially, emotionally, and scholastically. A child stuck with this malady is a back bencher in the class, excommunicative, and absent-minded. This study was conducted in order to find out various causes of hearing impairment in children and to study role of various audiological and radiological tests in finding the cause of impaired hearing in children. Aims and Objectives: To assess the possible etiological causes of hearing impairment in children. Study role of various audiological tests in finding the cause of impaired hearing in children. Study Design: Prospective study. Materials and Methods: This study was conducted in the Department of ENT and HNS of government medical college Srinagar. A total of 150 children of age range 0-14 years visited our ENT Department with complaints of impaired hearing, but only 70 children who met the inclusion criteria of impaired hearing and defective/delayed speech were selected for this study. Results of initial evaluation by means of comprehensive clinical history and followed by proper thorough systemic physical examination from head to toe was performed. These hearing impaired children were subjected to various subjective and objective tests; pure tone audiometry and behavioral observation audiometry were performed for subjective tests and impedance audiometry, Oto-acoustic emissions (OAE, and brainstem evoked response audiometry (BERA were performed for objective tests. Results: Possible etiological cause on the basis of history were birth anoxia (2

  4. Development of temporomandibular disorder symptoms: a 3-year cohort study of university students. (United States)

    Akhter, R; Morita, M; Esaki, M; Nakamura, K; Kanehira, T


    The aims of this study were to examine the incidence of temporomandibular disorders (TMDs) over a 3-year period and to evaluate the risk of self-reported TMDs among university students in Japan. The study population comprised 2374 university students examined at the start of their undergraduate course and 492 students re-examined after 3 years using questionnaires on symptoms of TMD and experiences of jaw injury, stress, orthodontic treatment and parafunctional habits. Cumulative incidence (%) and relative risks were calculated overall. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to determine the degree of risks of these variables for symptoms of TMDs using logistic regression. Results of logistic regression analysis showed that male subjects with experience of jaw injury had a 3·54 (CI=1·45-8·68, Pstress and bruxism had 10·56 (CI=1·28-87·54, Pstress or bruxism. The results indicated that experiences of jaw injury, stress and bruxism were significantly associated with increased risks of development of TMJ disorders in a 3-year cohort.

  5. Evaluating clinical competence during nursing education: A comprehensive integrative literature review. (United States)

    Lejonqvist, Gun-Britt; Eriksson, Katie; Meretoja, Riitta


    This paper explored concepts, definitions and theoretical perspectives evaluating clinical competence during nursing education. The questions were: (i) How is clinical competence evaluated? and (ii) What is evaluated? An integrative review of 19 original research articles from 2009 to 2013 was performed. Results showed that evaluation tools were used in 14, observations in 2 and reflecting writing in 3 studies. The students participated in all but one evaluation alone or together with peers, faculty members or preceptors. Three themes were found: (i) professional practice with a caring perspective; (ii) clinical skills and reflective practice; and (iii) cognitive, affective and psychomotor skills both with a nursing perspective. This review shows an emphasis on structured methods with a risk reducing nursing to tasks and skills why combinations with qualitative evaluations are recommended. A holistic view of competence dominated and in designing evaluations, explicit perspectives and operationalized definitions of clinical competence became evident.

  6. Retention and marginal adaptation of a compomer placed in non-stress-bearing areas used with the total-etch technique: a 3-year retrospective study. (United States)

    Prati, C; Chersoni, S; Cretti, L; Montanari, G


    The aim of this clinical study was to evaluate class V and class III cavities restored with a polyacid-modified resin composite (compomer) restorative material in association with two different dentin-enamel bonding systems: Dyract-PSA (Primer Sealer Adhesive-DentSply, Germany) and Prime & Bond 2.0 (DentSply, Germany). The control group was a hybrid composite used with ProBond bonding system (DentSply, Germany). A total of 116 restorations (79 class V, 37 class III) were made and reevaluated after 1, 2 and 3 years in 55 patients in two private practices and in a university department. Class V nonretentive cavities were located at the CEJ level and class III at interproximal level close to CEJ. Each cavity was prepared using a water-cooled, high-speed handpiece with a fine diamond burr. A small bevel was prepared along enamel margin. Cavity dimensions were no more than 3.5 x 3.5 mm (using burr as reference point). Each restoration was finished immediately with fine diamond burrs and Sof-Lex disks (3 M, USA). The criteria that were evaluated by the USPHS method included: retention, color match, marginal integrity, marginal discoloration, and secondary caries. Results indicated that all compomer restorations were fully retained at 3 years, and that no secondary caries detected. Seven composite restorations were lost during the 3-year study. No statistical differences were observed between class III and class V or among other conditions (e.g., upper-lower arc, sex, age). This study demonstrates that compomers are suitable restorative materials for class III-V restorations. They may represent a clinical alternative to composites in class V and III restorations.

  7. Making the Case for Simulation-Based Assessments to Overcome the Challenges in Evaluating Clinical Competency. (United States)

    Leigh, Gwen; Stueben, Frances; Harrington, Deedra; Hetherman, Stephen


    The use of simulation in nursing has increased substantially in the last few decades. Most schools of nursing have incorporated simulation into their curriculum but few are using simulation to evaluate clinical competency at the end of a semester or prior to graduation. Using simulation for such high stakes evaluation is somewhat novel to nursing. Educators are now being challenged to move simulation to the next level and use it as a tool for evaluating clinical competency. Can the use of simulation for high-stakes evaluation add to or improve our current evaluation methods? Using patient simulation for evaluation in contrast to a teaching modality has important differences that must be considered. This article discusses the difficulties of evaluating clinical competency, and makes the case for using simulation based assessment as a method of high stakes evaluation. Using simulation for high-stakes evaluation has the potential for significantly impacting nursing education.

  8. Late Established Mutans Streptococci in Children over 3 Years Old

    Directory of Open Access Journals (Sweden)

    Mitsugi Okada


    Full Text Available Acquisition of mutans streptococci has been reported to most commonly occur at approximately 26 months of age. In the present study, we detected Streptococcus mutans and S. sobrinus using polymerase chain reaction (PCR assays in children, then re-examined the subjects to determine the time of acquisition of these bacteria over a 1-year period. The subjects were 57 children ranging in age from 3 to 5 years old, each with primary dentition. Plaque samples were collected from all erupted tooth sites using a sterile toothbrush. PCR assays were performed to detect the targeted mutans streptococci at the beginning of the study (baseline and after 1 year. At the baseline examination, the prevalence of S. mutans and S. sobrinus was 61.4% and 54.4%, respectively, in all subjects, of whom 14 (24.6% were positive for S. mutans alone, 10 (17.5% for S. sobrinus alone, and 21 (36.8% for both S. mutans and S. sobrinus, with 12 (21.1% negative for both. After 1 year, 4 of 22 (18.2% subjects newly had acquired S. mutans and 15 of 26 (57.7% had aquired S. sobrinus, while 5 (8.8% remained negative for both bacteria. The age of the first positive S. mutans finding ranged from 49 to 71 months, while that for S. sobrinus ranged from 49 to 81 months old. Our results suggest that S. sobrinus becomes established later than S. mutans in the oral cavities of children over the age of 3 years old.

  9. Porcelain laminate veneers: Clinical survey for evaluation of failure


    Diemah F Alhekeir; Al-Sarhan, Rana A.; Al Mashaan, Abdulmohsen F.


    Objective: To investigate the association of the failure of porcelain laminate veneers with factors related to the patient, material, and operator. Methods: This clinical survey involved 29 patients (19 women and 10 men) and their dentists, including undergraduate and postgraduate dental students and dental interns. Two questionnaires were distributed to collect information from participants. All patients were clinically examined. Criteria for failure of the porcelain laminate veneers incl...

  10. 78 FR 5816 - Guidance for Industry on Clinical Pharmacogenomics: Premarket Evaluation in Early-Phase Clinical... (United States)


    ... assist the pharmaceutical industry and other investigators engaged in new drug development in evaluating... interested persons engaged in new drug development in evaluating how variations in the human...

  11. 78 FR 70102 - Clinical Science Research and Development Service Cooperative Studies; Scientific Evaluation... (United States)


    ... AFFAIRS Clinical Science Research and Development Service Cooperative Studies; Scientific Evaluation... Committee Act, 5 U.S.C. App. 2, that the Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation Committee will hold a meeting on December 12, 2013, at the...

  12. 76 FR 65781 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation... (United States)


    ... AFFAIRS Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation... (Federal Advisory Committee Act) that a meeting of the Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation Committee will be held on November 9-10, 2011, at The Residence...

  13. 78 FR 53015 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation... (United States)


    ... AFFAIRS Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation... Committee Act, 5 U.S.C. App. 2, that the Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation Committee will hold a meeting on September 18, 2013, at 131 M Street...

  14. 78 FR 41198 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation... (United States)


    ... AFFAIRS Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation... Committee Act, 5 U.S.C. App. 2, that the Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation Committee will hold a meeting on July 10, 2013, at 131 M Street...

  15. 77 FR 31072 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation... (United States)


    ... AFFAIRS Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation... (Federal Advisory Committee Act) that a meeting of the Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation Committee will be held on July 12, 2012, at the Sheraton Suites...

  16. 76 FR 73781 - Clinical Science Research and Development Service; Cooperative Studies Scientific Evaluation... (United States)


    ... AFFAIRS Clinical Science Research and Development Service; Cooperative Studies Scientific Evaluation... (Federal Advisory Committee Act) that a meeting of the Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation Committee will be held on December 20, 2011, at the Hamilton...

  17. 76 FR 19189 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation... (United States)


    ... AFFAIRS Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation... (Federal Advisory Committee Act) that a meeting of the Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation Committee will be held on April 25, 2011, at The Ritz-Carlton...

  18. Predictive value of clinical evaluation in the follow-up of children with a brain tumor.

    NARCIS (Netherlands)

    Graaf, N. de; Hew, J.M.; Fock, J.M.; Kamps, W.A.; Graaf, S.S.N. de


    BACKGROUND: During follow-up of children with a brain tumor, traditionally surveillance-imaging studies are done in addition to clinical evaluations. The purpose of this study was to determine the role of clinical evaluations by a multidisciplinary team for the detection of recurrent tumor. PROCEDUR

  19. Predictive value of clinical evaluation in the follow-up of children with a brain tumor

    NARCIS (Netherlands)

    Hew, JM; Fock, JM; Kamps, WA


    Background. During follow-up of children with a brain tumor, traditionally surveillance-imaging studies are done in addition to clinical evaluations, The purpose of this study was to determine the role of clinical evaluations by a multidisciplinary team for the detection of recurrent tumor. Procedur

  20. Clinical Observed Performance Evaluation: A Prospective Study in Final Year Students of Surgery (United States)

    Markey, G. C.; Browne, K.; Hunter, K.; Hill, A. D.


    We report a prospective study of clinical observed performance evaluation (COPE) for 197 medical students in the pre-qualification year of clinical education. Psychometric quality was the main endpoint. Students were assessed in groups of 5 in 40-min patient encounters, with each student the focus of evaluation for 8 min. Each student had a series…

  1. [The importance of clinical data management in improvement of drug evaluation]. (United States)

    Huang, Qin; Wang, Jun


    Although the importance of clinical data is drawing more attention in drug development in China, the clinical data management is not good enough in the clinical trials right now. With the development of internet and progress of information technology, especially with the setup of the state innovation strategy for drug development, it is necessary and urgent to improve the clinical data quality. Good data quality is the primary basis of technical evaluation of drug at the marketing authorization. So Center for Drug Evaluation of CFDA has made some endeavors to enhance data management in the clinical trials in recent years. This article is focused on these aspects of data managment.

  2. Longitudinal behavioral analysis during dental care of children aged 0 to 3 years

    Directory of Open Access Journals (Sweden)

    Robson Frederico Cunha


    Full Text Available "When" and "how" the dentist intervenes have repercussions on children's physical and emotional patterns. The objective of the present study was to conduct a longitudinal behavioral analysis during dental care of babies aged 0 to 3 years. A total of 216 patients seen at the Baby Clinic of the School of Dentistry at Araçatuba, São Paulo State University (UNESP, were selected. The selection criterion was attendance at ten dental care sessions at bimonthly intervals for routine procedures such as clinical examination and oral hygiene. There was a predominance of cooperative behavior compared to uncooperative behavior when each visit was analyzed separately. The behavior of the patients must have been directly influenced by their psychomotor development. Constant attendance and exposure of the baby to non-stressful dental stimuli are factors that favor a cooperative behavior.

  3. Clinical Versus Computed Tomography Evaluation In The Diagnosis And Management Of Deep Neck Infection.


    Agricio Nubiato Crespo; Carlos Takahiro Chone; Adriano Santana Fonseca; Maria Carolina Montenegro; Rodrigo Pereira; João Altemani Milani


    CONTEXT: Deep neck infections have high potential for severe complications and even death, if not properly managed. The difference between clinical and computed tomography findings may demonstrate that clinical evaluation alone underestimates disease extent, which may lead to conservative treatment with worse prognosis. OBJECTIVE: To compare clinical and computed tomography findings from neck spaces affected by deep neck infections and to determine the main clinical and radiological features ...

  4. The Clinical Evaluation of Parkinson’s Tremor (United States)

    Zach, Heidemarie; Dirkx, Michiel; Bloem, Bastiaan R.; Helmich, Rick C.


    Abstract Parkinson’s disease harbours many different tremors that differ in distribution, frequency, and context in which they occur. A good clinical tremor assessment is important for weighing up possible differential diagnoses of Parkinson’s disease, but also to measure the severity of the tremor as a basis for further tailored treatment. This can be challenging, because Parkinson’s tremor amplitude is typically very variable and context-dependent. Here, we outline how we investigate Parkinson’s tremor in the clinic. We describe a simple set of clinical tasks that can be used to constrain tremor variability (cognitive and motor co-activation, several specific limb postures). This may help to adequately characterize the tremor(s) occurring in a patient with Parkinson’s disease. PMID:26406126

  5. 上海市闵行区出生的巨大儿0~3岁体格发育评价%Evaluation of the physical growth for birth weight≥4 000 g children aged from 0 to 3 years in Minhang district

    Institute of Scientific and Technical Information of China (English)

    黄俊; 肖丽萍; 李云; 张莺; 姚亦; 程紊


    [目的]了解闵行区出生的巨大儿0~3岁体格发育现状.[方法]接受闵行区儿童保健管理且出生的巨大儿,随访其0~3岁期间生长发育情况,共4178人次.[结果]各年龄别体重均值明显高于2005年上海市0~6岁儿童体格发育调查结果.超重的发生率平均值为20.90%,肥胖症发生率平均值为3.37%,6个月和3岁为超重发生高峰期.呈现出男童明显高于女童的分布特点.[结论]预防超重和肥胖应从胎儿期抓起,并在学龄前期控制体重质量的增长速度.%[Objective]To understand the status of the physical growth for birth weight ≥ 4 000 g children aged from 0 to 3 years in Minhang district.[Methods]The physical growth of the children at the age of 0~3 had been followed up,who was born on 4 kilos in weight and accept health care managing in Minhang distric.Follow-up children were 4178 person-time in total.[Results]The average weight of all ages was significantly higher than that in the investigation result 2005 about the physical growth of children aged from 0 to 6 years in Shanghai.The average incidence of overweight was 20.90%,which of obesity was 3.37%.The overweight peak occurred when children were 6 months and 3 years old.The distribution characteristic was demonstrated that the incidence of obesity in boys was obviously higher than that of girls.[Conclusion]It is necessary to prevent the occurrence of overweight and obesity from the prenatal period and to control the growth speed of body mass in preschool age.

  6. Analytical evaluation of the clinical chemistry analyzer Olympus AU2700 plus


    Juricek, Jasna; Derek, Lovorka; Unic, Adriana; Serdar, Tihana; Marijancevic, Domagoj; Zivkovic, Marcela; Romic, Zeljko


    Background: The objective of this study was to perform the analytical evaluation of the clinical chemistry analyzer Olympus AU2700 plus. The evaluation was performed according to the guidelines of the European Committee for Clinical Laboratory Standards (ECCLS). Materials and methods: The evaluation consisted of determination of within-run and between-run imprecision, inaccuracy and comparison with Olympus AU2700. The tested analytes were: glucose, creatinine, urate, total bilirubin, chole...

  7. Clinical evaluation of serum concentrations of intercellular adhesion molecule-1 in patients with colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    Xu Kang; Fang Wang; Jin-Dong Xie; Jun Cao; Pei-Zhong Xian


    AIM: To investigate the correlation between the serum soluble intercellular adhesion molecule-1 (sICAM-1) and the clinicopathologic features and to evaluate the possible prognostic significance of sICAM-1 concentration in colorectal cancer.METHODS: A total of 56 patients (mean age 57.3 years)having transitional cell carcinoma of the colorectal and 25 control patients (mean age 42.6 years) were enrolled in the study. The serum samples of the patients were obtained on the day before surgery. Sera were obtained by centrifugation, and stored at -80 ℃ until assay. Serumconcentrations of ICAM-1 were measured with enzymelinked immunoassay. Differences between the two groups were analyzed by Student's t-test.RESULTS: No significant increase of serum sICAM-1 could be demonstrated in the Dukes A1 patients (352.63±61.82μg/L) compared to the control group (345.72±49.81 μg/L,P>0.05), Dukes A1 patients (352.63±61.82 μg/L)compared to Dukes A2,3 patients (491.17±86.36 μg/L,P<0.05). Furthermore, the patients with Dukes B had significantly higher serum concentrations of sICAM-1than those of the control group (496.82±93.04 μg/L vs 345.72±49.81 μg/L, P<0.01). Compared with Dukes A2,3,B colorectal cancer patients, patients with more advanced clinical stage (Dukes C and D) had higher levels of sICAM-1 (743.68±113.74 μg/L vs491.17±86.36 μg/L and 496.82±93.04 μg/L, P<0.001). The difference was statistically significant in sICAM-1 levels between patients with positive lymph node status and those without lymph node involvement (756.25±125.57 μg/L vs445.62±69.18 μg/L, P<0.001).Patients with poorly differentiated colorectal cancer had a higher level of sICAM-1 than those with differentiated and highly differentiated cancer (736.49±121.97 μg/Lvs 410.23±67.47 μg/L, P<0.001).CONCLUSION: In this study, serum ICAM-1 levels were found to be related to tumor presence, clinical stages,and grade. Increased ICAM-1 in patients with colorectal cancer which should

  8. Clinical simulation as an evaluation method in health informatics

    DEFF Research Database (Denmark)

    Jensen, Sanne


    Safe work processes and information systems are vital in health care. Methods for design of health IT focusing on patient safety are one of many initiatives trying to prevent adverse events. Possible patient safety hazards need to be investigated before health IT is integrated with local clinical...

  9. Neural basis of nonanalytical reasoning expertise during clinical evaluation

    NARCIS (Netherlands)

    Durning, S.J.; Costanzo, M.E.; Artino, A.R.; Graner, J.; Vleuten, C.P.M. van der; Beckman, T.J.; Wittich, C.M.; Roy, M.J.H.M. van; Holmboe, E.S.; Schuwirth, L.


    INTRODUCTION: Understanding clinical reasoning is essential for patient care and medical education. Dual-processing theory suggests that nonanalytic reasoning is an essential aspect of expertise; however, assessing nonanalytic reasoning is challenging because it is believed to occur on the subconsci

  10. Ligand-targeted particulate nanomedicines undergoing clinical evaluations: current status

    NARCIS (Netherlands)

    Meel, van der Roy; Vehmeijer, Laurens J.C.; Kok, Robbert J.; Storm, Gert; Gaal, van Ethlinn V.B.


    Since the introduction of Doxil® on the market nearly 20 years ago, a number of nanomedicines have become part of treatment regimens in the clinic. With the exception of antibody–drug conjugates, these nanomedicines are all devoid of targeting ligands and rely solely on their physicochemical propert

  11. Evaluation of pharmacist clinical interventions in a Dutch hospital setting

    NARCIS (Netherlands)

    Bosma, Liesbeth; Jansman, Frank G. A.; Franken, Anton M.; Harting, Johannes W.; Van den Bemt, Patricia M. L. A.


    Objective Assessing the relevance of a clinically active pharmacist method compared to the traditional working method. Method The study was carried out in a general internal/gastro-enterology unit during two 8-weeks periods in 2004. It was an observational, non-randomized prospective study. Outcome

  12. Clinical evaluation of coded excitation in medical ultrasound

    DEFF Research Database (Denmark)

    Pedersen, Morten Høgholm; Misaridis, Thanssis; Jensen, Jørgen Arendt


    Despite the enormous development in medical ultrasound (US) imaging over the last decades, penetration depth with satisfying image quality is often a problem in clinical practice. Coded excitation, used for years in radar techniques to increase signal-to-noise ratio (SNR), has recently been...

  13. Clinical Evaluation and Early Finishing of Glass Ionomer Restorative Materials (United States)


    material reported in this study compare fa- present after 9 30 7 23 vorably with a study by Timmons, Laswell , and Robinson (1983) of eight composite...R W (1978) "ji TIMMONS, J H. LASWELL , H R & ROBINSON, F B (1983) A in vitro study of certain properties of a glass ionomer three-year clinical study

  14. Asthma and coagulation: A clinical and pathophysiological evaluation

    NARCIS (Netherlands)

    C.J. Majoor


    In clinical practice pulmonologists have suspected that pulmonary embolisms occur more often in patients with asthma. To confirm this suspicion, a study was initiated to investigate the incidence of venous thromboembolic events in patients with asthma compared to the general population. In addition,

  15. Evaluating the performance of clinical pharmacy faculty: putting the ACCP template to use. (United States)

    Schumock, G T; Crawford, S Y; Giusto, D A; Hutchinson, R A


    The responsibilities of clinical faculty members are often multifaceted and may include direct patient care, didactic and experiential teaching, research, and administrative duties. Specialization, poorly defined standards of care, and lack of direct supervision have traditionally made performance evaluation difficult. We implemented a method to evaluate clinical faculty as they carried out patient care activities using a revised template for the evaluation of a clinical pharmacist developed by the American College of Clinical Pharmacy Clinical Practice Affairs Committee. In addition, it allows individuals to report and evaluate their own performance in the areas of patient care, instructional activity, university and public service, research and scholarly activities, and administrative duties. Teaching evaluations from clerkship students and residents are also submitted and assessed during the annual interview. To determine the usefulness of the evaluation, including the template, we surveyed the opinions of clinical faculty (nontenured) at four primary practice sites (response rate 92%). Mean scores for responses suggested agreement with statements as to the merits of the evaluation system; however, there was some variation among practice sites. Incorporating the template into a broad evaluation system was effective in facilitating improved job performance and career development. Adaptation of the template may be practice site dependent and should be coordinated by a participative approach. Additional assessment may be facilitated by physician, nurse, or peer evaluation.

  16. Effect of curing on clinical retention. A 7-year evaluation

    DEFF Research Database (Denmark)

    van Dijken, Jan WV; Pallesen, Ulla

    Objective: To evaluate in a prospective evaluation the retention of Class V compomer and hybrid resin composite restorations placed with a 1-step self etch system and cured with continuous, soft-start and pulse-delay curing. Methods: 139 Class V restorations were placed and cured at random in 60...... subjects with a compomer (Dyract AP;68) or resin composite (Tetric Ceram:67) and cured for 40s with continuous, soft-start and pulse-delay modes. The restorations were evaluated with slightly modified USPHS criteria yearly during 7 years. Results: Of 135 restorations evaluated at 7 years, 29 were lost, 17...... compomer (25%) and 12 Tetric Ceram (18%). The cumulative loss rates for the compomer and resin composite restorations cured with the three curing modes were. continuous cure: 26.1%/18.2%, soft-start: 22.7%/19.0%, pulse delay: 26.1%/16.7%. No statistical difference were seen between the curing modes...

  17. An Evaluation of Interactive Bibliotherapy in a Clinical Setting. (United States)

    Rossiter, Charles; Brown, Rosalie


    Finds that senior staff at St. Elizabeth's Hospital, Washington, DC, were consistently positive in their evaluation of bibliotherapy as a modality. Discusses the kinds of patients that benefit the most and the least from bibliotherapy. (RS)

  18. Clinical evaluation of cytological diagnosis of nasopharyngeal malignancies. (United States)

    Molinari, R; Pilotti, S; Rilke, F


    Between 1970 and 1975 cytological examination was applied to the diagnosis of nasopharyngeal malignancies in a series of 216 consecutive patients who had either a tumour in the nasopharynx or clinical signs of nasopharyngeal carcinoma, or who were locally asymptomatic but had enlarged cervical lymph nodes. Smears were taken by introducing a small rough pad of compressed gauze through the mouth into the nasopharynx with an upward-angled forceps. In each case the cytological smear was taken immediately before biopsy; often, a lymph node was removed subsequently. When morphological diagnoses were doubtful and histological findings were at variance with positive cytological findings, the patients were reexamined clinically, and diagnosis was postponed. The case material was made up of 90 nasopharyngeal carcinomas, 24 lymphomas, one malignant melanoma, one adenoid cystic carcinoma and 100 patients without malignancies. Cytological findings from the first smear were positive in 77.8% of nasopharyngeal carcinomas, in 66.6% of lymphomas and in the cases of melanoma and adenoid cystic carcinoma. There were no false-positive results. When the nasopharyngeal carcinomas were subdivided into undifferentiated carcinomas of the nasopharyngeal type and squamous-cell carcinomas, cytological findings were positive in ,0% and 73%, respectively. Positivity of histological findings was distributed as follows: 91.7% for malignant lymphomas, 86.6% for undifferentiated carcinomas and 86.6% for squamous-cell carcinomas. With respect to clinical suspicion of malignancy, positive cytological findings were obtained in 50% of clinically occult cases and in 84.6% of patients with obvious malignancies; intermediate figures were found for clinically doubtful (64.3%) and for highly suspicious (77.8%) cases. Cyto-histological concordance was shown in 70% of cases; false-negative histological results were obtained in 7.8% and false-negative cytological results in 16.6% of cases. Combined cyto

  19. Posttraumatic stress disorder after motor vehicle accidents: 3-year follow-up of a prospective longitudinal study. (United States)

    Mayou, R A; Ehlers, A; Bryant, B


    The paper presents a 3-year follow-up of a prospective longitudinal study of posttraumatic stress disorder (PTSD) after motor vehicle accidents (J. Abnormal Psychol., 107 (1998) 508). Participants were 546 patients who had been assessed when attending an emergency clinic shortly after a motor vehicle accident, and at 3 months and 1 year afterwards. The prevalence of posttraumatic stress disorder PTSD at 3 years was 11%. Maintaining psychological factors, i.e. negative interpretation of intrusions, rumination, thought suppression and anger cognitions, were important in predicting the persistence of PTSD at 3 years, as were persistent health and financial problems after the accident. Other predictors were female sex, hospital admission for injuries, perceived threat and dissociation during the accident, and litigation.

  20. Evaluation of Candida strains isolated from clinical specimens

    Directory of Open Access Journals (Sweden)

    Hafize Sav


    [¤]METHODS[|]January 2011 to June 2012, Candida strains were isolated from 3905 clinical specimen. In identification of Candida species that were isolated, germ tube test, growth in Cornmeal-Tween 80 agar and formation of clamydospore, presence of pseudohyphae, carbonhytrate fermentation and assimilation tests, and the test of nitrate were studied.[¤]RESULTS[|]Finally 1122 Candida strains were isolated from 3905 various clinical specimens. The distribution of clinical specimens were as fallows: 556 from bronchoalveolar lavage (49.6%, 271 from sputum (24.2%, 114 from blood (10.2%, 51 vaginal swabs (4.6%, 50 from urine (4.4%, 30 from tissue (2.6%, 22 from endotracheal tracheal aspirate (ETA (1.9%, nine from pleural mai (0.80%, six from peritoneal fluid (0.53%, four from gastric fluid(0.35%,three from stool(0.28%,two from abscess (0.18%,three from nail (0.26%, one from cerebrospinal fluid (0.10%. From these clinical samples 848 C. albicans (75.6%, 143 C. glabrata (12.8%, 40 C. parapsilosis, (3.57%, 33 C. krusei (2.94%, 33 C. kefyr (2.94%, 19 C. tropicalis (1.7% were isolated. Other strains were identified as C. lusitania, C. lipolytica, C. norvegensis, C. pelliculosa ve C. zeylanoides.[¤]CONCLUSION[|] It was concluded that C.albicans has still been the most frequent species among Candida isolates of in our hospital; however, the incidence of non-albicans species have increased.[¤

  1. Evaluation of Neonatal Hemolytic Jaundice: Clinical and Laboratory Parameters


    Anet Papazovska Cherepnalkovski; Vjekoslav Krzelj; Beti Zafirovska-Ivanovska; Todor Gruev; Josko Markic; Natasa Aluloska; Nikolina Zdraveska; Katica Piperkovska


    BACKGROUND: Neonatal jaundice that occurs in ABO or Rhesus issoimunisation has been recognized as one of the major risk factors for development of severe hyperbilirubinemia and bilirubin neurotoxicity. AIM: Aim of our study was to investigate clinical and laboratory parameters associated with hemolytic jaundice due to Rh and ABO incompatibility and compare results with the group of unspecific jaundice. MATERIAL AND METHODS: One hundred sixty seven (167) neonatal hyperbilirubinemia cas...

  2. Clinical Practice Guideline Selection, Development, Implementation, and Evaluation (United States)


    sacroiliac joint : The joint between the sacrum and ilium and associated ligaments. Sacrum: The triangular-shaped bone lying between the 5th lumbar...forming the sacroiliac joints . Sciatica: A syndrome characterised by pain radiating from the back into the buttock and into the lower extremity along its...sprains or strains, ligament tears, muscle tears, lumbar spinal stenosis, joint problems, irritated discs, “slipped discs”, improper lifting Clinical

  3. [The development and clinical evaluation of the probiotic Bifidumbacterin forte]. (United States)

    Grigor'ev, A V; Bondarenko, V M; Abramov, N A; Murashova, A O; Feklisova, L V; Chuprinina, R P


    A new probiotic "Bifidumbacterin forte" containing bifidobacteria immobilized on carbon sorbent has been developed. The results of extensive clinical observation on the use of the preparation in patients (children and adults) with the infectious and surgical pathology of the gastrointestinal tract are presented. The clinico-bacteriological effect thus obtained makes it possible to recommend this new probiotic "Bifidumbacterin forte" for medical practice for the complex treatment of children and adults with acute and chronic diseases of the gastrointestinal tract.

  4. A review of how the quality of HIV clinical services has been evaluated or improved. (United States)

    Hung, Anna; Pradel, Françoise


    To examine approaches being used to evaluate and improve quality of HIV clinical services we searched the MEDLINE, Cochrane Library collection, EMBASE, Global Health, and Web of Science databases for articles and abstracts focused on evaluating or improving quality of HIV clinical services. We extracted country income level, targeted clinical services, and quality evaluation approaches, data sources, and criteria. Fifty journal articles and 46 meeting abstracts were included. Of the 96 studies reviewed, 65% were programme evaluations, 71% focused on low- and middle-income countries, and 65% focused on antiretroviral therapy services. With regard to quality, 45% used a quality improvement model or programme, 13% set a quality threshold, and 51% examined patient records to evaluate quality. No studies provided a definition for quality HIV care. Quality assurance and improvement of HIV clinical services is increasingly important. This review highlights gaps in knowledge for future research, and may also help countries and programmes develop their HIV care quality improvement frameworks.

  5. Evaluation of Clinical and Communication Skills of Pharmacy Students and Pharmacists with an Objective Structured Clinical Examination. (United States)

    Urteaga, Elizabeth M; Attridge, Rebecca L; Tovar, John M; Witte, Amy P


    Objective. To evaluate how effectively pharmacy students and practicing pharmacists communicate and apply knowledge to simulations of commonly encountered patient scenarios using an objective structured clinical examination (OSCE). Design. Second-, third-, and fourth-year pharmacy students completed an OSCE as part of their required courses in 2012 and 2013. All students in both years completed identical OSCE cases. Licensed pharmacists were recruited to complete the OSCE and serve as controls in 2012. A survey assessed student perception and acceptance of the OSCE as well as student confidence in performance. Assessment. Licensed pharmacists had significantly higher clinical and communication skills scores than did pharmacy students. Student progression in communication and clinical skills improved significantly over time. Survey results indicated that students felt the OSCE was well-structured and assessed clinical skills taught in pharmacy school; 86% of students felt confident they could provide these skills. Conclusion. Objective structured clinical examinations can evaluate clinical competence and communication skills among professional students. Implementation of OSCEs may be an effective tool for assessment of the Center for the Advancement of Pharmacy Education domains.

  6. A clinical evaluation of four alternative telemedicine systems. (United States)

    Conrath, D W; Dunn, E V; Bloor, W G; Tranquada, B


    A comparison was made of four alternative telecommunication systems used in delivering primary health care to remote populations. The media were color television, black and white television, still frame black and white television, and hands-free telephone. The patient population was that of a large organization in a Canadian province, a major component of a societal system. Over 1000 patients who came to a clinic seeking medical attention were examined remotely by one of the four systems. In addition, they were examined in the physical presence of a doctor at the clinic. The diagnoses, patient management programs, etc., of the clinic physician were used as the basis for comparison. We found no significant differences in diagnostic accuracy, proportion of supporting investigations requested, e.g., laboratory tests and X rays, time taken for the diagnostic consultations and the effectiveness of patient management across the four communication modes. On the contrary, in some instances it was found that behavior across the modes was significantly similar. Even patient attitudes showed only a slight preference for the more sensory rich modes of communication. It was concluded that there is little to distinguish the effectiveness of the four telecommunication modes when used for remote diagnostic consultations. Therefore, the cheapest mode is the most cost-effective. Phase four of the research program will compare the effects of the two least costly modes, still frame television and hands-free telephone, in an operational system in northern Ontario.

  7. Tarlov cysts: clinical evaluation of an italian cohort of patients. (United States)

    Marino, D; Carluccio, M A; Di Donato, I; Sicurelli, F; Chini, E; Di Toro Mammarella, L; Rossi, F; Rubegni, A; Federico, A


    Tarlov cyst syndrome is a rare, often asymptomatic disorder, characterised by isolated or multiple nerve-root cysts, usually occurring in the sacral spine, near the dorsal root ganglion, between the perineurium and endoneurium. The cysts may cause lower back pain, sacral radiculopathy, dyspareunia and urinary incontinence. There is little data in the literature on the relationship between Tarlov cysts and symptoms. Here, we report further details on the clinical impact of Tarlov cysts and investigate their pathogenesis and role as a cause of lumbosacral symptoms. We examined 157 patients with MRI evidence of symptomatic Tarlov cysts. Patients underwent complete neurological examination and were scored by the Hamilton Depression Rating Scale and the Visual Analogue Scale. Complete lower limb electromyography was performed in 32 patients. Clinical picture was correlated with size and number of cysts detected by MRI. Family history was recorded for signs of genetic inheritance. Almost all patients suffered perineal or lower back pain; 34 complained of sphincter and 46 of sexual disorders. Hamilton scores were abnormal, and family history was positive in a few cases. The scanty literature on Tarlov cysts mainly regards therapy by a neurosurgical approach. Our results provide new data on clinical impact and possible pathogenetic mechanisms.

  8. Recombinant human thrombopoietin: basic biology and evaluation of clinical studies. (United States)

    Kuter, David J; Begley, C Glenn


    Thrombocytopenia is a common medical problem for which the main treatment is platelet transfusion. Given the increasing use of platelets and the declining donor population, identification of a safe and effective platelet growth factor could improve the management of thrombocytopenia. Thrombopoietin (TPO), the c-Mpl ligand, is the primary physiologic regulator of megakaryocyte and platelet development. Since the purification of TPO in 1994, 2 recombinant forms of the c-Mpl ligand--recombinant human thrombopoietin (rhTPO) and pegylated recombinant human megakaryocyte growth and development factor (PEG-rHuMGDF)--have undergone extensive clinical investigation. Both have been shown to be potent stimulators of megakaryocyte growth and platelet production and are biologically active in reducing the thrombocytopenia of nonmyeloablative chemotherapy. However, neither TPO has demonstrated benefit in stem cell transplantation or leukemia chemotherapy. Other clinical studies have investigated the use of TPO in treating chronic nonchemotherapy-induced thrombocytopenia associated with myelodysplastic syndromes, idiopathic thrombocytopenic purpura, thrombocytopenia due to human immunodeficiency virus, and liver disease. Based solely on animal studies, TPO may be effective in reducing surgical thrombocytopenia and bleeding, ex vivo expansion of pluripotent stem cells, and as a radioprotectant. Ongoing and future studies will help define the clinical role of recombinant TPO and TPO mimetics in the treatment of chemotherapy- and nonchemotherapy-induced thrombocytopenia.

  9. Evaluating the students' perspectives of a clinic mentoring programme. (United States)

    Schwartz, B; Saad, M N; Goldberg, D


    The purpose of this article is to describe and examine the effectiveness of a mentoring program for third and fourth year clinical dental students. This is an educational intervention for the pre-doctoral students at the Schulich School of Dentistry. We have recently instituted this program and have developed a questionnaire to assess the student perspectives using a SWOT analysis of the strengths, weaknesses, opportunities and threats of this intervention by analyzing the quantitative and qualitative responses of the students towards their clinical education and patient management. Our findings, both quantitative and qualitative, indicated that the mentoring program was well received by most students who would like to see the program expanded. The majority of students felt that the mentoring program aligned well with comprehensive care of their patients while enhancing their clinical experience. One of the strongest areas of agreement involved the ability to discuss cases in a non-threatening environment. The SWOT analysis identified key areas for future improvements. We offer steps to successfully implement a similar program based on our findings. It is our hope that our results might be instrumental for other schools wishing to adopt a similar model which supports patient-based comprehensive care.

  10. Are the outcomes of clinical pathways evidence-based? A critical appraisal of clinical pathway evaluation research

    NARCIS (Netherlands)

    El Baz, N.; Middel, B.; Van Dijk, J.P.; Oosterhof, A.; Boonstra, P.W.; Reijneveld, S.A.


    Aim and objective To evaluate the validity of study outcomes of published papers that report the effects of clinical pathways (CP). Method Systematic review based on two search strategies, including searching Medline, CINAHL, Embase, Psychinfo and Picarta from 1995 till 2005 and ISI Web of Knowledge

  11. Radiology education. The evaluation and assessment of clinical competence

    Energy Technology Data Exchange (ETDEWEB)

    Hibbert, Kathryn M.; Van Deven, Teresa [The Univ. of Western Ontario, London, ON (Canada). Dept. of Medical Imaging; Chhem, Rethy K. [Medical Univ. of Vienna (Austria). Dept. of Radiology; Nagasaki Univ. (Japan). Atomic Bomb Disease Inst.; Wang, Shih-chang (eds.) [Univ. of Sydney Westmead Hospital (Australia). Dept. of Radiology; Royal Australian and New Zealand College of Radiologists, Sydney (Australia). Faculty of Radiodiagnosis


    Third volume of a trilogy devoted to radiology education and improvement of medical imaging students' learning, teaching, and scholarship. Reviews the philosophies, theories, and principles that underpin assessment and evaluation in radiology education. Includes a series of rich case studies. Written by an international group of experienced educators and medical professionals. This book reviews the philosophies, theories, and principles that underpin assessment and evaluation in radiology education, highlighting emerging practices and work done in the field. The sometimes conflicting assessment and evaluation needs of accreditation bodies, academic programs, trainees, and patients are carefully considered. The final section of the book examines assessment and evaluation in practice, through the development of rich case studies reflecting the implementation of a variety of approaches. This is the third book in a trilogy devoted to the scholarship of radiology education and is the culmination of an important initiative to improve medical imaging students' learning, teaching, and scholarship by bringing together experienced educators and medical professionals. The previous two books focused on the culture and the learning organizations in which our future radiologists are educated and on the application of educational principles in the education of radiologists. Here, the trilogy comes full circle: attending to the assessment and evaluation of the education of its members has much to offer back to the learning of the organization.

  12. Facial diplegia: etiology, clinical manifestations, and diagnostic evaluation

    Directory of Open Access Journals (Sweden)

    Sefer Varol


    Full Text Available ABSTRACT Objective Facial diplegia (FD is a rare neurological manifestation with diverse causes. This article aims to systematically evaluate the etiology, diagnostic evaluation and treatment of FD. Method The study was performed retrospectively and included 17 patients with a diagnosis of FD. Results Patients were diagnosed with Guillain-Barré syndrome (GBS (11, Bickerstaff’s brainstem encephalitis (1, neurosarcoidosis (1, non-Hodgkin’s Lymphoma (1, tuberculous meningitis (1 herpes simplex reactivation (1 and idiopathic (1. In addition, two patients had developed FD during pregnancy. Conclusion Facial diplegia is an ominous symptom with widely varying causes that requires careful investigation.

  13. [Clinical and pharmacokinetic evaluation of imipenem/cilastatin sodium in children]. (United States)

    Fujita, K; Kakehashi, H; Murono, K; Sakata, H; Ohmi, H; Yoshioka, H; Maruyama, S; Sanae, N; Inyaku, F


    Nineteen episodes of infection in 17 children (one had 3 episodes) were treated with imipenem/cilastatin sodium (MK-0787/MK-0791), and the clinical efficacy and side effects were evaluated. The ages of patients ranged from 1 month to 8 years 1 month and their body weights ranged from 3.9 to 25.2 kg. The MK-0787/MK-0791 was administered intravenously by a 30-60 minutes infusion, in doses ranging from 8-42 mg/8-42 mg/kg every 6 to 12 hours for 3 to 40.5 days. Among 18 episodes in 16 patients (one patient proved to have rubella meningoencephalitis and was excluded from evaluation of the clinical efficacy) with bacterial infections including sepsis, pneumonia, acute suppurative thyroiditis and urinary tract infections, the results were excellent in 10, good in 5, fair in 2, and poor in 1 episode. Some side effects were noted; among all 19 episodes in the 17 patients diarrhea was noted in 3, rash in 1, slightly elevated serum transaminases in 1 and thrombocytosis in 1 episode. Pharmacokinetic studies were done in 7 patients whose ages ranged from 3 years 2 months to 13 years 1 month. Plasma concentrations of MK-0787 in 2 children were 19.6 and 20.0 micrograms/ml at 15 minutes and 5.6 and 2.1 micrograms/ml at 2 hours after a 10 mg/10 mg/kg intravenous 30-minute drip infusion of MK-0787/MK-0791. Plasma half-lives of MK-0787 were 1.52 and 0.74 hour, and total urinary recoveries were 54.6 and 71.4% during 0-6 hours. After a 20 mg/20 mg/kg intravenous 30-minute drip infusion into 2 other children, plasma concentrations of MK-0787 were 46.8 and 44.0 micrograms/ml at 15 minutes and 7.8 and 7.4 micrograms/ml at 2 hours. Plasma half-lives were 0.82 and 0.83 hour, and total urinary recoveries were 110.2 and 80.5% during 0-6 hours. Plasma concentrations of MK-0787 were less than 0.2, 0.2 and 1.2 micrograms/ml just before the next doses in 3 patients given 11-20 mg/11-20 mg/kg of MK-0787/MK-0791 every 6-8 hours. The time course of the plasma levels and urinary excretion in these

  14. Changes in body composition in apparently healthy urban Indian women up to 3 years postpartum

    Directory of Open Access Journals (Sweden)

    Neha A Kajale


    Full Text Available Introduction: Dietary and life style practices differ in postpartum (PP and nonpregnant Indian women. Effect of these practices on postpartum weight retention (PPWR and development of cardio-metabolic risk (CMR has been scarcely studied in urban women. Aims of this study were to (i compare anthropometry, biochemical parameters and body composition up to 3 years PP (ii effect of PPWR, dietary fat intake and physical activity on CMR factors. Methods: Design: Cross-sectional, 300-fullterm, apparently healthy primi-parous women (28.6 ± 3.4 years randomly selected. 128 women within 7-day of delivery (Group-A, 88 with 1-2 years (Group-B and 84 with 3-4-year-old-children (Group-C were studied. Anthropometry, sociodemographic status, physical activity, diet, clinical examination, biochemical tests, body composition, at total body (TB, by dual energy X-ray absorptiometry (GE-Lunar DPX were collected. Results: Women at 3-year PP showed higher weight retention (6.5[10] kg than at 1-year (3.0[7] kg (median [IQR]. Android fat % (central obesity increased (P 0.1. Conclusion: Postdelivery, low physical activity and higher PPWR may increase CMR in Indian women.

  15. A clinical evaluation on adhesive posts in extensive composite restorations

    Directory of Open Access Journals (Sweden)

    Ghavamnasiri M. Associate Professor


    Full Text Available Problem: A few studies have been conducted about bioglass posts."nAim: The aim of this study was to compare bioglass posts with prefabricated metallic posts in clinical performance of extensive composite restorations for anterior endodontically treated teeth. Materials and Methods: Sixty endodontocally maxillary anterior teeth, with horizontally or vertically destruction, were selected. Teeth were divided into two groups based on the kind of post: Metallic prefabricated parapost and bioglass post. Each group was divided into three subgroups based on anterior bite: normal, deep bite and edge to edge. Gutta-percha was removed from 2/3 of canal length for parapost and 1/3 for bioglass post. After etching with phosphoric-acid (37% and applying dentine bonding syntac, Duo cement was used for the adhesion of bioglass post and a self cured composite (Degufil for parapost. Restoration was done with a hybrid composite (Heliomolar. Follow up studies, radio-graphically and clinically, were done every three months for a 1.5-year period. Exact Fisher and Pearson tests were used for data analysis."nResults: Apical lesion was not observed in any of the radiographs. Post seal was increased by resin cement and dentin bonding agent. Post type did not significantly affect on the clinical success rate of the restorations. The retention of restoration, for both posts, was the same. Crown destruction had no significant effect on success rate. The type of anterior bite had a significant effect on success rate, as the total 6.6% failure rate was related to the patients with anterior deep bite."nConclusion: It is suggested to use metallic paraposts and bioglass posts, in extensive composite restorations for patients with deep-bite, more conservatively.

  16. Clinical uses of melatonin: evaluation of human trials. (United States)

    Sánchez-Barceló, E J; Mediavilla, M D; Tan, D X; Reiter, R J


    During the last 20 years, numerous clinical trials have examined the therapeutic usefulness of melatonin in different fields of medicine. The objective of this article is to review, in depth, the science regarding clinical trials performed to date. The efficacy of melatonin has been assessed as a treatment of ocular diseases, blood diseases, gastrointestinal tract diseases, cardiovascular diseases, diabetes, rheumatoid arthritis, fibromyalgia, chronic fatigue syndrome, infectious diseases, neurological diseases, sleep disturbances, aging and depression. Melatonin has been also used as a complementary treatment in anaesthesia, hemodialysis, in vitro fertilization and neonatal care. The conclusion of the current review is that the use of melatonin as an adjuvant therapy seems to be well funded for macular degeneration, glaucoma, protection of the gastric mucosa, irritable bowel syndrome, arterial hypertension, diabetes, side effects of chemotherapy and radiation in cancer patients or hemodialysis in patients with renal insufficiency and, especially, for sleep disorders of circadian etiology (jet lag, delayed sleep phase syndrome, sleep deterioration associated with aging, etc.) as well as in those related with neurological degenerative diseases (Alzheimer, etc.,) or Smith-Magenis syndrome. The utility of melatonin in anesthetic procedures has been also confirmed. More clinical studies are required to clarify whether, as the preliminary data suggest, melatonin is useful for treatment of fibromyalgia, chronic fatigue syndrome, infectious diseases, neoplasias or neonatal care. Preliminary data regarding the utility of melatonin in the treatment of ulcerative colitis, Crohn's disease, rheumatoid arthritis are either ambiguous or negative. Although in a few cases melatonin seems to aggravate some conditions, the vast majority of studies document the very low toxicity of melatonin over a wide range of doses.

  17. The Retrospective Evaluation of Childhood Psoriasis Clinically and Demographic Features

    Directory of Open Access Journals (Sweden)

    Ayşe Serap Karadağ


    Full Text Available Objective: This study was aimed to define the clinical and demographic findings of psoriasis in childhood. Methods: In this retrospective study, the data from 64 children with psoriasis admitted at the our dermatology clinic between January 2007 and January 2011 were included whose data were fully. Results: Of the patients, 37 (57.8% were boys and 27 (42.2% were girls. Mean age of the children was 10.08 ±3.98 years (3-16. In 10 (15% cases, a positive family history was detected. The most frequent localizations at onset were trunk (46.9%, scalp (28.1%, knee-elbow (10.9% and extremities (7.9%, respectively. The most commonly seen clinical types were plaque (68.8%, guttate (20.3%, palmoplantar (9.4%, pustular (1.6%, respectively. Nine children had nail involvement. Out of all patients, 21.9% had upper respiratory tract infections and 9.4% had emotional stres. Four cases were diagnosed with depression. Of the cases, two cases were on non-steroid anti-inflammatory medication, and 4 of them were on antibiotics. Systemic treatments were given to 21.9% of the cases besides topical treatments. Conclusion: The epidemiological studies of psoriasis during childhood period for different countries have been reported. In this study, the ratio shows differences when compared to those previous studies. There are few epidemiologic studies for Turkey. We believe that further epidemiological studies including large number of patients' groups will contribute the diagnosis and treatment of the disease.

  18. 3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes

    DEFF Research Database (Denmark)

    le Roux, Carel W; Astrup, Arne; Fujioka, Ken


    BACKGROUND: Liraglutide 3·0 mg was shown to reduce bodyweight and improve glucose metabolism after the 56-week period of this trial, one of four trials in the SCALE programme. In the 3-year assessment of the SCALE Obesity and Prediabetes trial we aimed to evaluate the proportion of individuals wi...

  19. Hormonal treatment may harm the germ cells in 1 to 3-year-old boys with cryptorchidism

    DEFF Research Database (Denmark)

    Cortes, Dina; Thorup, Jørgen Mogens; Visfeldt, J


    Hormonal treatment with human chorionic gonadotropin (HCG) or gonadotropin releasing hormone may be given initially for cryptorchidism. We evaluated whether hormonal treatment is safe for the germ cells in boys with cryptorchidism 1 to 3 years old in whom follicle-stimulating hormone, luteinizing...... hormone and testosterone values are normally low....

  20. Symptom Dimensions of Depression and 3-Year Incidence of Dementia : Results From the Amsterdam Study of the Elderly

    NARCIS (Netherlands)

    Lugtenburg, Astrid; Zuidersma, Marij; Oude Voshaar, Richard C; Schoevers, Robert A


    OBJECTIVE: To evaluate the association between depressive symptom dimensions and incident dementia in a community sample of older persons. METHODS: Depressive symptoms at baseline and incident dementia at 3-year follow-up were assessed with the Geriatric Mental State (GMS)-Automated Geriatric Examin

  1. Evaluation of the Introduction of Ethics into Clinical Clerkship. (United States)

    Goetz, Carla M.; And Others


    This study evaluated a teaching method used to sensitize undergraduate pharmacy students to ethical concepts. The use of case scenarios resulted in improved ability to identify ethical issues but no increase in ability to generate alternatives and justify recommendations. An appendix presents guidelines for rating student responses to ethical…

  2. Sample sizes in dosage investigational clinical trials: a systematic evaluation


    Huang JH; Su QM; Yang J; Lv YH; He YC; Chen JC; Xu L; Wang K; Zheng QS


    Ji-Han Huang,1,* Qian-Min Su,2,* Juan Yang,1 Ying-Hua Lv,1 Ying-Chun He,1 Jun-Chao Chen,1 Ling Xu,1 Kun Wang,1 Qing-Shan Zheng11Center for Drug Clinical Research, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 2Department of Computer, College of Electronic and Electrical Engineering, Shanghai University of Engineering Science, Shanghai, People’s Republic of China *These authors contributed equally to this workAbstract: T...

  3. Selection and Evaluation Guidelines for Clinical Education Settings in Athletic Training. (United States)

    Weidner, Thomas G.; Laurent, Tim


    OBJECTIVE: To develop and test standards and associated criteria for the selection and evaluation of a clinical education setting in athletic training. DESIGN AND SETTING: A previously validated set of 20 standards for physical therapy clinical education settings, the associated criteria, and 2 related evaluation forms were systematically judged, revised, and adapted through a survey process. SUBJECTS: Program directors, clinical instructors, and students involved with athletic training clinical education from 28 athletic training education programs approved by the National Athletic Trainers' Association or accredited by the Commission on Accreditation of Allied Health Education Programs. MEASUREMENTS: We tabulated respondents' critiques and ratings by type of respondent. Items were judged as to whether they were relevant, practical, and suggestive of high-quality clinical education settings. RESULTS: We accepted a final set of 12 standards and 31 associated criteria to measure these standards. The student form lists 23 criteria relevant to these accepted standards. The accepted standards include the following: learning environment, program planning, ethical standards, administrative support, and Setting Coordinator of Clinical Education. CONCLUSIONS: The 12 standards, criteria, and related forms developed in this research project should be used as guidelines rather than as minimal requirements. They could be helpful in forming an impression not only about a particular clinical setting but also about the requirements of clinical education in general. Further research should include evaluating and comparing perceptions between sexes and among ethnic groups concerning their clinical education experiences. Also, standards and criteria for clinical instruction in athletic training should be systematically developed.

  4. Population-based clinical decision support: a clinical and economic evaluation. (United States)

    Eisenstein, Eric L; Anstrom, Kevin J; Edwards, Rex; Willis, Janese M; Simo, Jessica; Lobach, David F


    Governments are investing in health information technologies (HIT) to improve care quality and reduce medical costs. However, evidence of these benefits is limited. We conducted a randomized trial of three clinical decision support (CDS) interventions in 20,180 patients: email to care managers (n=3329), reports to primary care administrators (n=3368), letters to patients (n=3401), and controls (10,082). At 7-month follow-up, the letters to patients group had greater use of outpatient services and higher outpatient and total medical costs; whereas, the other groups had no change in clinical events or medical costs. As our CDS interventions were associated with no change or an increase in medical costs, it appears that investments in HIT without consideration for organizational context may not be sufficient to achieve improvements in clinical and economic outcomes.

  5. Non-clinical safety evaluation of intranasal iota-carrageenan.

    Directory of Open Access Journals (Sweden)

    Alexandra Hebar

    Full Text Available Carrageenan has been widely used as food additive for decades and therefore, an extended oral data set is available in the public domain. Less data are available for other routes of administration, especially intranasal administration. The current publication describes the non-clinical safety and toxicity of native (non-degraded iota-carrageenan when applied intranasally or via inhalation. Intranasally applied iota-carrageenan is a topically applied, locally acting compound with no need of systemic bioavailability for the drug's action. Animal experiments included repeated dose local tolerance and toxicity studies with intranasally applied 0.12% iota-carrageenan for 7 or 28 days in New Zealand White rabbits and nebulized 0.12% iota-carrageenan administered to F344 rats for 7 days. Permeation studies revealed no penetration of iota-carrageenan across nasal mucosa, demonstrating that iota-carrageenan does not reach the blood stream. Consistent with this, no relevant toxic or secondary pharmacological effects due to systemic exposure were observed in the rabbit or rat repeated dose toxicity studies. Data do not provide any evidence for local intolerance or toxicity, when carrageenan is applied intranasally or by inhalation. No signs for immunogenicity or immunotoxicity have been observed in the in vivo studies. This is substantiated by in vitro assays showing no stimulation of a panel of pro-inflammatory cytokines by iota-carrageenan. In conclusion, 0.12% iota-carrageenan is safe for clinical use via intranasal application.

  6. A "three-plus-one" evaluation model for clinical research management. (United States)

    Dilts, David M


    Clinical research management (CRM) is a critical resource for the management of clinical trials and it requires proper evaluation. This article advances a model of evaluation that has three local levels, plus one global level, for evaluating the value of CRM. The primary level for evaluation is that of the study or processes level. The managerial or aggregate level concerns management of the portfolio of trials under the control of the CRM office. The third, often overlooked level of evaluation, is the strategic level, whose goal is encapsulated in the phrase, "doing the right trials, while doing trials right." The global ("plus one") evaluation level concerns the need to evaluate the ever-increasing number of multi-institutional and multinational studies. As there are host of evaluation metrics, this article provides representative examples of metrics at each level and provides methods that can aid in the selecting appropriate metrics for an organization.

  7. Association between pneumonia in acute stroke stage and 3-year mortality in patients with acute first-ever ischemic stroke. (United States)

    Yu, Yi-Jing; Weng, Wei-Chieh; Su, Feng-Chieh; Peng, Tsung-I; Chien, Yu-Yi; Wu, Chia-Lun; Lee, Kuang-Yung; Wei, Yi-Chia; Lin, Shun-Wen; Zhu, Jun-Xiao; Huang, Wen-Yi


    The influence of pneumonia in acute stroke stage on the clinical presentation and long-term outcomes of patients with acute ischemic stroke is still controversial. We investigate the influence of pneumonia in acute stroke stage on the 3-year outcomes of patients with acute first-ever ischemic stroke. Nine-hundred and thirty-four patients with acute first-ever ischemic stroke were enrolled and had been followed for 3years. Patients were divided into two groups according to whether pneumonia occurred during acute stroke stage or not. Clinical presentations, risk factors for stroke, laboratory data, co-morbidities, and outcomes were recorded. The result showed that a total of 100 patients (10.7%) had pneumonia in acute stroke stage. The prevalence of older age, atrial fibrillation was significantly higher in patients with pneumonia in acute stroke stage. Total anterior circulation syndrome and posterior circulation syndrome occurred more frequently among patients with pneumonia in acute stroke stage (Ppneumonia in acute stroke stage is a significant predictor of 3-year mortality (hazard ratio=6.39, 95% confidence interval=4.03-10.11, Ppneumonia during the acute stroke stage is associated with increased risk of 3-year mortality. Interventions to prevent pneumonia in acute stroke stage might improve ischemic stroke outcome.

  8. Clinical and electrophysiological evaluation of dysphagia in myasthenia gravis



    OBJECTIVE—To evaluate dysphagia at the oropharyngeal stage of swallowing and to determine the pathophysiological mechanisms of dysphagia in patients with myasthenia gravis.
METHODS—Fifteen patients with myasthenia gravis with dysphagia and 10 patients without dysphagia were investigated by a combined electrophysiological and mechanical method described previously. Laryngeal movements were detected by a piezoelectric transducer and the related submental EMG (SM-EMG) and somet...

  9. Clinical evaluation of stereoscopic DSA for vascular lesions


    大川,元臣; 児島, 完治; 影山,淳一; 日野, 一郎; 高島, 均; 玉井,豊理; 田邉,正忠; 大本, 尭史; 植田, 清隆; 藤原, 敬


    Seventy-one series of stereoscopic DSA utilized on thirty-nine patients with intracranial vascular lesions were evaluated by comparison with subtracted magnified angiograms or independently. All stereoscopic series had good or fairly good stereoscopic quality. Stereoscopic DSA was useful in the preoperative stereoscopic vascular analysis of vascular lesions such as aneurysms, arteriovenous malformations, cartotid-cavernous fistulas, obstructive or stenotic vascular lesions and vascular elonga...

  10. Status of sperm morphology assessment: an evaluation of methodology and clinical value

    NARCIS (Netherlands)

    Hoven, L. van den; Hendriks, J.C.M.; Verbeet, J.G.M.; Westphal, J.R.; Wetzels, A.M.M.


    OBJECTIVE: To characterize methodological changes in sperm morphology assessment and to correlate sperm morphology with clinical outcome. DESIGN: In this observational study, sperm morphology profiles of patients were analyzed. The percentages of morphologically normal spermatozoa were evaluated wit

  11. Epidermoid Cyst in the Floor of the Mouth of a 3-Year-Old

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    Rossana Pascual Dabán


    Full Text Available Epidermoid cysts are a rare entity in the oral cavity and are even less frequent in the floor of the mouth, representing less than 0.01% of all the cases. We present the case of a 3-year-old girl with a growth in the floor of the mouth with 2 months of evolution and without changes since it was discovered by her parents. The lesion was asymptomatic; it did not cause dysphagia, dyspnea, or any other alteration. A CT scan with contrast was done which revealed the location and exact size of the lesion, allowing an intraoral approach for its excision. The histological examination confirmed the clinical speculation of an epidermoid cyst.

  12. Nephrotic Syndrome Following H1N1 Influenza in a 3-Year-Old Boy

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    Pio Liberatore


    Full Text Available Background: The pandemic influenza A/H1N1, spread through the world in 2009, producing a serious epidemic in Italy. Complications are generally limited to patients at the extremes of age (65years and those with comorbid medical illness. The most frequent complications of influenza involve the respiratory system.Case Presentation: A 3-year-old boy with a recent history of upper respiratory tract infection developed a nephrotic syndrome. Together with prednisone, furosemide and albumin bolus, a therapy with oseltamivir was started since the nasopharyngeal swab resulted positive for influenza A/H1N1. Clinical conditions andlaboratory findings progressively improved during hospitalization, becoming normal during a 2 month follow up.Conclusion: The possibility of a renal involvement after influenza A/H1N1 infection should be considered.

  13. Medical beam monitor—Pre-clinical evaluation and future applications

    CERN Document Server

    Frais-Kölbl, H; Schreiner, T; Georg, D; Pernegger, H


    Future medical ion beam applications for cancer therapy which are based on scanning technology will require advanced beam diagnostics equipment. For a precise analysis of beam parameters we want to resolve time structures in the range of microseconds to nanoseconds. A prototype of an advanced beam monitor was developed by the University of Applied Sciences Wiener Neustadt and its research subsidiary Fotec in co-operation with CERN RD42, Ohio State University and the Jožef Stefan Institute in Ljubljana. The detector is based on polycrystalline Chemical Vapor Deposition (pCVD) diamond substrates and is equipped with readout electronics up to 2 GHz analog bandwidth. In this paper we present the design of the pCVD-detector system and results of tests performed in various particle accelerator based facilities. Measurements performed in clinical high energy photon beams agreed within 1.2% with results obtained by standard ionization chambers.

  14. Clinical evaluation of amitraz for treatment of canine scabies. (United States)

    Folz, S D; Kakuk, T J; Henke, C L; Rector, D L; Tesar, F B


    A liquid concentrate formulation of amitraz (Mitaban: Upjohn) was used to topically treat 181 dogs with scabies, at an active drug level of 250 ppm, or 10.6 ml of concentrate in 2 gal water. After the dogs were clipped and bathed, the diluted medication was applied and allowed to dry on the animal. All treated dogs were clinically improved and 97.8% cured after a single treatment; 3 dogs required 2 treatments and 1 dog 3 treatments. Otodectes cynotis and Cheyletiella yasguri in several dogs were also cleared after 1 treatment. Mild, transient sedation occurred in 12.4% of treated dogs, with transient vomiting, increased appetite and diarrhea in less than 1%.

  15. Clinical evaluation of 30 patients with localized nasal rosacea. (United States)

    Lee, Woo Jin; Lee, Ye Jin; Won, Chong Hyun; Chang, Sung Eun; Choi, Jee Ho; Lee, Mi Woo


    The clinical features of localized nasal rosacea have not been described in detail. This study was designed to analyze the subtypes and severity of localized nasal rosacea. Our present study included 30 patients with localized nasal rosacea. The erythematotelangiectatic subtype (13/30, 43.3%) was the most common type, followed by the phymatous subtype (9/30, 30%). The duration of rosacea was shorter and the severity of localized nasal rosacea was lower in the erythematotelangiectatic subtype cases compared with the patients with mixed or phymatous subtypes. Almost all of the papulopustular eruptions or phymatous lesions were associated with erythematotelangiectatic lesions. These findings suggest that the erythematotelangiectatic subtype may be considered the initial phase of localized nasal rosacea.

  16. Clinical evaluation of isolated abutment teeth in removable partial dentures

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    Zarrati S


    Full Text Available "nBackground and Aims: Nowadays, removable partial dentures are applied to patients who are not able to use dental implants or fixed prosthesis. Although based on the studies the users of removable partial dentures are in the risk of plaque accumulation and unacceptable changes such as gingivitis, periodontitis and mobility in abutment tooth. It is not clear whether the negative effects of removable partial dentures are more on the isolated teeth which are a kind of abutment adjacent to endentulous area in both sides. The purpose of this study was to investigate the clinical condition of isolated abutment teeth without splinting in comparison to control abutment from the aspects of B.O.P (bleeding on probing, mobility, pocket depth and gingivitis."nMaterials and Methods: In this cross-sectional study, the prepared questionnaires were filled out by 50 patients who received removable partial dentures in department of removable prosthodontics of dental school of Tehran University of Medical Sciences. The patients had isolated abutment tooth and did not have any systemic disease. The obtained data were analyzed. Using Wilcoxon, exact Fisher and Kruskal-Wallis test."nResults: B.O.P (P=0.004, pocket depth (P=0.035, and mobility (P<0.001 in isolated abutments were more than those in control abutments, but there were not significant differences in the degree of caries (P=0.083 and gingivitis (P=0.07."nConclusion: This study showed that clinical condition of isolated abutments is worse than that of control abutments. More attention should be paid to healthiness of isolated teeth without splinting and periodic follow ups should be done in these cases.

  17. MR enterography to evaluate sub-clinical intestinal inflammation in children with spondyloarthritis


    Stoll Matthew L; Patel Ashish S; Punaro Marilynn; Dempsey-Robertson Molly


    Abstract Background Magnetic resonance enterography (MRE) is an established tool to evaluate for changes associated with inflammatory bowel disease (IBD), but has not been studied in sub-clinical IBD. We sought to evaluate the use of MRE in children with spondyloarthritis (SpA), who are at risk of having sub-clinical gut inflammation. Methods Children with juvenile idiopathic arthritis (JIA) with evidence of intestinal inflammation as evidence by an abnormal fecal calprotectin assay were offe...

  18. 77 FR 72438 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation... (United States)


    ... AFFAIRS Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation... Committee Act, 5 U.S.C. App. 2, that the Clinical Science Research and Development Service Cooperative... provided by section 10(d) of Public Law 92-463, as amended, closing portions of this meeting is...

  19. The feasibility, reliability, and validity of a post-encounter form for evaluating clinical reasoning.

    NARCIS (Netherlands)

    Durning, S.J.; Artino, A.; Boulet, J.; Rochelle, J. La; Vleuten, C.P.M. van der; Arze, B.; Schuwirth, L.


    BACKGROUND: Developing feasible, reliable and valid methods for the evaluation of clinical reasoning is challenging. AIM: To explore feasibility, reliability, and validity evidence for a post-encounter form assessing clinical reasoning. METHOD: A free-text, post-encounter form was used in an Objecti

  20. Evaluation of new drugs in daily clinical practice : anti-TNFα in rheumatoid arthritis patients

    NARCIS (Netherlands)

    Kievit, Wietske


    The objective of this thesis was to explore the value and the validity of data collected in daily clinical practice for drug evaluation and cost-effectiveness studies, using data collected on TNFa blocking agents in rheumatoid arthritis. First, the need for and value of information from daily clinic

  1. Deferasirox in Indian children with thalassemia major: 3 years experience

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    Mayank Dhamija


    Full Text Available Objective: To evaluate the efficacy and safety of the oral iron chelator deferasirox in treating transfusional hemosiderosis in a cohort of Indian children with thalassemia major with high iron load. Materials and Methods: The first 50 children (age 2-18 yrs with thalassemia major to commence deferasirox at our center were enrolled and followed up for a period of 36 months between April 2008 and March 2011. The dose of deferasirox was determined by their baseline serum ferritin and was adjusted to a maximum of 40 mg/kg/day depending on response. Ferritin levels, SGOT, SGPT, serum creatinine and urine albumin were regularly monitored. Results: Of the 50 patients, 76% documented a significant decline in serum ferritin ( P<0.05. Seven (14% patients had a stable ferritin whilst 5 patients (10% documented an increase over the study period. The mean serum ferritin at baseline, 12, 24 and 36 months was 4354, 3260, 3290 and 3042, respectively ( P<0.05. The median serum ferritin at the same time points was 3555, 2810, 2079 and 2271, respectively ( P<0.05. No severe toxicity was seen. Conclusions: Deferasirox, when given in doses ≥30 mg/kg, was found to be an effective and safe drug in reducing transfusional hemosiderosis. Thirty five (70% needed dose escalation upto 40 mg/kg/day. Fifteen (30%, however did not achieve a negative iron balance despite maximally permissible doses.

  2. Deferasirox in Indian children with thalassemia major: 3 years experience (United States)

    Dhamija, Mayank; Mahajan, Amita; Kalra, Manas; Virmani, Anju


    Objective: To evaluate the efficacy and safety of the oral iron chelator deferasirox in treating transfusional hemosiderosis in a cohort of Indian children with thalassemia major with high iron load. Materials and Methods: The first 50 children (age 2-18 yrs) with thalassemia major to commence deferasirox at our center were enrolled and followed up for a period of 36 months between April 2008 and March 2011. The dose of deferasirox was determined by their baseline serum ferritin and was adjusted to a maximum of 40 mg/kg/day depending on response. Ferritin levels, SGOT, SGPT, serum creatinine and urine albumin were regularly monitored. Results: Of the 50 patients, 76% documented a significant decline in serum ferritin (P<0.05). Seven (14%) patients had a stable ferritin whilst 5 patients (10%) documented an increase over the study period. The mean serum ferritin at baseline, 12, 24 and 36 months was 4354, 3260, 3290 and 3042, respectively (P<0.05). The median serum ferritin at the same time points was 3555, 2810, 2079 and 2271, respectively (P<0.05). No severe toxicity was seen. Conclusions: Deferasirox, when given in doses ≥30 mg/kg, was found to be an effective and safe drug in reducing transfusional hemosiderosis. Thirty five (70%) needed dose escalation upto 40 mg/kg/day. Fifteen (30%), however did not achieve a negative iron balance despite maximally permissible doses. PMID:23878481

  3. [Alfentanyl and midazolam in combined anesthesia. Clinical evaluation]. (United States)

    Arena, L; Di Sebastiano, N; Russo, L; Di Filippo, A


    We have evaluated the effectiveness of a technique of blended anaesthesia (epidural-general) in 31 patients undergoing major surgery. Thoracic epidural blockade with lidocaina CO2, adrenalin 1/200000, ensures analgesia while induction and hypnosis maintenance were obtained with midazolam, alfentanil, atracurium and N2O/O2. This technique seems able to protect the patients from endotracheal intubation and surgical stress and also to enable a rapid, quiet awakening. The dose of midazolam necessary to maintain hypnosis was inversely proportional to the patient's age. The reversal of hypnosis was necessary in 4 patients only.

  4. Clinical trial of pantomography for the evaluation of mandibular trauma. (United States)

    Johnston, C C; Doris, P E


    A trial study was conducted comparing the standard "four view" mandibular series and pantomography for th evaluation of mandibular trauma. During the six-month trial period a series of 17 patients with a total of 24 mandibular fractures was compiled. The pantomographs were more easily interpreted than the standard views because overlapping structures were blurred and spatial orientation was clear. In eight of the 17 patients the fractures were more clearly visualized by pantomography. Because the entire mandibule was seen so well on the pantomographs, no special views were required. Eleven patients had single fractures, which are in fact quite common.

  5. Initial clinical evaluation of stationary digital chest tomosynthesis (United States)

    Hartman, Allison E.; Shan, Jing; Wu, Gongting; Lee, Yueh Z.; Zhou, Otto; Lu, Jianping; Heath, Michael; Wang, Xiaohui; Foos, David


    Computed Tomography (CT) is the gold standard for image evaluation of lung disease, including lung cancer and cystic fibrosis. It provides detailed information of the lung anatomy and lesions, but at a relatively high cost and high dose of radiation. Chest radiography is a low dose imaging modality but it has low sensitivity. Digital chest tomosynthesis (DCT) is an imaging modality that produces 3D images by collecting x-ray projection images over a limited angle. DCT is less expensive than CT and requires about 1/10th the dose of radiation. Commercial DCT systems acquire the projection images by mechanically scanning an x-ray tube. The movement of the tube head limits acquisition speed. We recently demonstrated the feasibility of stationary digital chest tomosynthesis (s-DCT) using a carbon nanotube (CNT) x-ray source array in benchtop phantom studies. The stationary x-ray source allows for fast image acquisition. The objective of this study is to demonstrate the feasibility of s-DCT for patient imaging. We have successfully imaged 31 patients. Preliminary evaluation by board certified radiologists suggests good depiction of thoracic anatomy and pathology.

  6. Evaluation of measurement uncertainty of glucose in clinical chemistry. (United States)

    Berçik Inal, B; Koldas, M; Inal, H; Coskun, C; Gümüs, A; Döventas, Y


    The definition of the uncertainty of measurement used in the International Vocabulary of Basic and General Terms in Metrology (VIM) is a parameter associated with the result of a measurement, which characterizes the dispersion of the values that could reasonably be attributed to the measurand. Uncertainty of measurement comprises many components. In addition to every parameter, the measurement uncertainty is that a value should be given by all institutions that have been accredited. This value shows reliability of the measurement. GUM, published by NIST, contains uncertainty directions. Eurachem/CITAC Guide CG4 was also published by Eurachem/CITAC Working Group in the year 2000. Both of them offer a mathematical model, for uncertainty can be calculated. There are two types of uncertainty in measurement. Type A is the evaluation of uncertainty through the statistical analysis and type B is the evaluation of uncertainty through other means, for example, certificate reference material. Eurachem Guide uses four types of distribution functions: (1) rectangular distribution that gives limits without specifying a level of confidence (u(x)=a/ radical3) to a certificate; (2) triangular distribution that values near to the same point (u(x)=a/ radical6); (3) normal distribution in which an uncertainty is given in the form of a standard deviation s, a relative standard deviation s/ radicaln, or a coefficient of variance CV% without specifying the distribution (a = certificate value, u = standard uncertainty); and (4) confidence interval.

  7. The clinical and radiological evaluation of pyogenic arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Young Jun; Kim, Kyung Joo; Yoo, Jung Keun; Kim, Young Chul; Hur, Don [Chosun University College of Medicine, Gwangju (Korea, Republic of)


    Pyogenic arthritis remain a difficult problem, despite the availability of a wide range of powerful modern antibiotics. Early and correct diagnosis is imperative to assure the prompt initiation of an effective therapeutic regimen and the prevent of late sequela. Careful clinical, laboratory and roentgenological analysis are fundamental to early and precise diagnosis. Therefore, plain roentgenogram should not be overlooked. A radiological and clinical observation was made in 51 cases of pyogenic arthritis admitted to Chosun University Hospital during the period from January 1976 to December 1983 and following results were obtained. 1. Among the 51 cases, 36 cases (70.6%) were male and 15 cases (29.4%) were females. The most prevalent age was 5 to 9 (27.6%). 2. Symptom duration less than 5 days was in 21 cases (41.2%) and more than 31 days was in 6 cases (11.7%). 3. The most common symptom on admission was pain around the involved joint and others are limitation of motion, swelling, tenderness, fever, local heating and erythema. 4. The underlying causes were composed of unknown in 21 cases (41.2%), trauma in 18 cases (35.3%), infections focus in 8 cases (15.7%) and iatrogenic reason 4 cases (7.8%). 5. The most commonly affected joint was hip joint (45.1%). The other affected sites in order of frequency were knee, ankle, shoulder, S-I and elbow joint. In infants and children, hip and knee joint are commonly affected: in adults, knee joint is most is most commonly affected. 6. In laboratory findings, the number of W.B.C and E.S.R were increased in 56.9%. Symptom duration more than 31 days in 5 cases were increased E.S.R only. Causative microorganism was isolated in 31 cases: the most common microorganism was Staphylococcus aureus in 22 cases. Others are B-hemolytics Stretoocccus, Enterobacteriaceae species and Pseudomonas aeruginosa. 7. In 26 cases (50.9%) of the patients, roentgenographic findings was negative. The most common radiological findings was soft tissue

  8. Caustic Injury In Adults – A Study For 3 Year Period

    Directory of Open Access Journals (Sweden)

    Radenkova-Saeva J.


    Full Text Available The aim of the study is to present the results of a 3-year clinico-epidemiological investigation of caustic injury in adults. The study includes 43 patients with acute corrosive ingestion, hospitalized in the Toxicology Clinic, University Hospital “N. I. Pirogov”, Sofia, Bulgaria, for the period 01.01. 2010-31.12.2012. The methods used include: clinical observation and examination, clinical laboratory, imaging, and psychiatric methods and tests. 43 patients between the ages of 22 and 82 with acute corrosive ingestions have been observed. Eleven were male (25.6% and 32 female (74.4%. All ingestions were intentional. Alkaline agents were used by all of the patients. The severity of poisonings varied from moderate to extremely severe. Different complications were seen in 82% of the cases - severe bleeding, perforation, fistula or/and stricture formation. Two of the patients have undergone surgical intervention - coloesophagoplastic - and have recovered completely. The motivation in different age groups was also studied. Psychiatric comorbidity occurred in patients as depressive and schizoaffective disorder, as well as existential crises. Acute corrosive ingestions by alkaline agents cause severe pathology. The severity and complex character of the injuries require good coordination between different medical specialists.

  9. [Sodium cromoglycate in the treatment of food hypersensitivity in children under 3 years of age]. (United States)

    Zur, E; Kaczmarski, M


    Dietary elimination is a treatment of first choice in food hypersensitivity. Such therapy is not always enough to stop the disease and introduction of pharmacological treatment is necessary. In prevention and long term treatment antiallergic drugs are recommended. The aim of the study was to assess efficacy and safety of oral sodium cromoglycate in treatment of food hypersensitivity in the youngest children. In our study we examined: the group of 25 children aged 6 months-3 years treated with oral cromolyn sodium during the period 4-20 weeks and 29 children aged 6 months-3 years treated with ketotifen. Symptoms from skin, digestive and respiratory tract, behaviour status were evaluated for drugs efficacy. Cromolyn and ketotifen effected a significant decrease in total symptoms score. The treatment was well tolerated. No serious side effects were noted. The incidents of skin rash, disquiet during the night, diarrhoea and urticaria were only 8 percent. Sodium cromoglycate is safe and effective drug in treatment of food allergy in children; specially in symptoms from gastrointestinal tract and multi-organs allergy.

  10. Effects of PBBs on cattle. I. Clinical evaluations and clinical chemistry. (United States)

    Durst, H I; Willett, L B; Schanbacher, F L; Moorhead, P D


    Toxicosis was induced in pregnant heifers by feeding 25,000 mg/head/day of FireMaster BP-6, a commercial blend of polybrominated biphenyls (PBB). The PBB feeding decreased dry matter intake approximately 50% by 4 days exposure. Emaciated animals became anorexic a few days prior to death at 33 to 66 days. Weight losses of heifers average 80 kg. Other clinical signs observed were dehydration, diarrhea, excessive salivation and lacrimation, fetal death, abortion, and general depression as evidenced by depressed heart and respiratory rates. Clinical signs were apparent after 10 days exposure and progressively intensified along with loss of condition until death. Clinicopathologic changes included significantly increased serum glutamic-oxaloacetic transaminase and decreased serum calcium by 30 days exposure. Lactate dehydrogenase, urea nitrogen, and bilirubin were elevated, and serum albumin decreased by 36 to 40 days. Principal urine changes were decreased specific gravity and moderate proteinuria. Pregnant heifers fed 0.25 or 250 mg/head/day for 60 days and nonpregnant heifers fed 250 mg/head/day for 180 days displayed neither clinical signs nor clinicopathologic changes indicating adverse effects from PBB exposure. Post-exposure, all heifers exposed to PBB for 60 days calved normally with zero calf mortality and were successfully rebred. Milk production was not different from control animals. Birth weights of calves from dams exposed to 250 mg PBB/head/day were significantly greater than calves of dams exposed to 0 mg or 0.25 mg/head/day. PBB exposure of dams produced no detrimental effects on calves as indicated by clinical signs, clinicopathologic changes, or performance.

  11. Sheehan syndrome: clinical and laboratory evaluation of 20 cases. (United States)

    Ozkan, Yusuf; Colak, Ramis


    Sheehan syndrome (SS) or post-partum pituitary necrosis is a pituitary insufficiency secondary to excessive post-partum blood losses. SS is a very significant cause of maternal morbidity and mortality in developing countries although it is a rarity in developed countries in which obstetrical care has been improved. In this study, we reviewed 20 cases retrospectively who were diagnosed as SS in our clinic. The patients aged 40 to 65 years with a mean age of 51.12 +/- 9.44 years (mean +/- SD). Time to make a definitive diagnosis of the disease ranged between 5 and 25 years with a mean of 16.35 +/- 4.74 years. Three of our patient (15%) had a previous diagnosis of SS. Three patients (15%) were referred to emergency service for hypoglycemia, three patients (15%) for hypothyroidism and one patient (5%) for hyponatremia. Dynamic examination of the pituitary revealed GH, Prolactin, FSH, TSH and ACTH insufficiency in all of the patients. One of our patients had a sufficient LH response to LHRH challenge. All of the patients were imaged with pituitary MRI. Eleven patients had empty sella and 9 patients had partial empty sella. SS is still a common problem in our country, especially in rural areas. Considering the duration of disease, important delays occur in diagnosis and treatment of the disease.

  12. Clinical types of spinocerebellar degeneration and evaluation with MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kojima, Shigeyuki (Chiba Univ. (Japan). School of Medicine)


    Eighty one patients with the clinical diagnosis of non-hereditary spinocerebellar degeneration were examined by magnetic resonance imaging (MRI). The MRI findings were subdivided into non-cerebellar atrophy, cerebellar atrophy without and with apparent enlargement of the fourth ventricle as a result of atrophy of the middle or superior cerebellar peduncles. The first pattern of non-cerebellar atrophy included ataxias such as Friendreich's ataxia and Machado-Joseph disease (MJD; type II). In the patients with MJD, atrophy of the brainstem was frequently recognized. The second pattern largely included late cortical cerebellar atrophy and hereditary ataxia of Holmes type. The third pattern was subdivided further into atrophies of the middle and superior cerebellar peduncles. The pattern of the former included olivo-ponto-cerebellar atrophy (OPCA) and hereditary ataxia of Menzel type, and the pattern of the latter included MJD and dentato-rubro-pallido-luysian atrophy (DRPLA). In the patients with OPCA and hereditary ataxia of Menzel type, increased signal intensity on T2-weighted image was always observed in the transverese pontine fibers, middle cerebellar peduncles. In several patients with MJD and DRPLA, atrophy of both cerebellar peduncles was demonstrated, but abnormal signal intensity was not observed in the pontocerebellar areas. (author).

  13. Cytogenetic evaluation of patients with clinical spectrum of Turner syndrome

    Directory of Open Access Journals (Sweden)

    Rajasekhar Moka


    Full Text Available Aim: The objective of this study was to correlate the genotype, of female patients, withshort stature and primary amenorrhea. Materials and Methods: One hundred and forty-six subjects were recruited during 2005-2012. Microscopic and automated karyotyping analyses were done by using chromosomes isolated from the lymphocytes using Giemsa banding (GTG to identify chromosome abnormalities. Results: A total of 146 clinically suspected Turner syndrome (TS subjects were recruited for the study, of which, 61 patients were identified to have chromosome abnormalities. The chromosomal abnormalities detected were as follows: Monosomy X (n = 19, 13.01%, triple X syndrome (n = 4, 2.7%, mosaic TS (n = 12, 8.21%, XY gonadal dysgenesis (n = 13, 8.9%, and structural abnormalities including X chromosome (n = 15, 10.27% and one patient each with autosomal changes involving 9qh inversion and translocation of chromosomes 12 and 14. Conclusion: Karyotype abnormalities accounting for 46% in this study emphasize the need for karyotype testing in cases of short stature with primary amenorrhea.

  14. Breast imaging with SoftVue: initial clinical evaluation (United States)

    Duric, Neb; Littrup, Peter; Li, Cuiping; Roy, Olivier; Schmidt, Steven; Cheng, Xiaoyang; Seamans, John; Wallen, Andrea; Bey-Knight, Lisa


    We describe the clinical performance of SoftVue, a breast imaging device based on the principles of ultrasound tomography. Participants were enrolled in an IRB-approved study at Wayne State University, Detroit, MI. The main research findings indicate that SoftVue is able to image the whole uncompressed breast up to cup size H. Masses can be imaged in even the densest breasts with the ability to discern margins and mass shapes. Additionally, it is demonstrated that multi-focal disease can also be imaged. The system was also tested in its research mode for additional imaging capabilities. These tests demonstrated the potential for generating tissue stiffness information for the entire breast using through-transmission data. This research capability differentiates SoftVue from the other whole breast systems on the market. It is also shown that MRI-like images can be generated using alternative processing of the echo data. Ongoing research is focused on validating and quantifying these findings in a larger sample of study participants and quantifying SoftVue's ability to differentiate benign masses from cancer.

  15. Lead intoxication: clinic and diagnostic evaluation in children

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    Martínez-Riera Nora


    Full Text Available Poverty, poor nutrition, environmental and social injustice prevailing in Latin America are factorsthat determine the action of pollutants on children. Lead poisoning and pollution constitute apublic health problem throughout the world. Lead affects multiple organs: nervous system particularly,hematopoietic, renal, endocrine, bone and others. Objective: to assess clinical, biochemicaland vascular effects in children exposed to known source of lead. Materials and methods: Sevenchildren with defined source lead exposure were studied, general and specific lead laboratorywere made. Endothelial function and electrocardiographic parameters were assessed. Statistic:descriptive. Results: Age average was 6,2 years (DE± 1, 6, average haematocrit 31% (DE±0,02;hemoglobin average 10,2 g/dl (DE± 0,78. 100% presented hypochromia, microcitosis, anemiaand marked anisocytosis. Lead average: 37,9 ug/dl (DE±6,22, ALA-D average: 8,9 U/L (DE±4,5.No changes were found in lipid profile and kidney function. All presented microalbuminuriaand endothelial dysfunction. Conclusion: These results show the effects of environmental leadexposure that can result in children not occupationally exposed.

  16. Cytogenetic evaluation of patients with clinical spectrum of Turner syndrome (United States)

    Moka, Rajasekhar; Sreelakshmi, Kodandapani; Gopinath, Puthiya Mundyat; Satyamoorthy, Kapettu


    AIM: The objective of this study was to correlate the genotype, of female patients, withshort stature and primary amenorrhea. MATERIALS AND METHODS: One hundred and forty-six subjects were recruited during 2005-2012. Microscopic and automated karyotyping analyses were done by using chromosomes isolated from the lymphocytes using Giemsa banding (GTG) to identify chromosome abnormalities. RESULTS: A total of 146 clinically suspected Turner syndrome (TS) subjects were recruited for the study, of which, 61 patients were identified to have chromosome abnormalities. The chromosomal abnormalities detected were as follows: Monosomy X (n = 19, 13.01%), triple X syndrome (n = 4, 2.7%), mosaic TS (n = 12, 8.21%), XY gonadal dysgenesis (n = 13, 8.9%), and structural abnormalities including X chromosome (n = 15, 10.27%) and one patient each with autosomal changes involving 9qh inversion and translocation of chromosomes 12 and 14. CONCLUSION: Karyotype abnormalities accounting for 46% in this study emphasize the need for karyotype testing in cases of short stature with primary amenorrhea. PMID:24082654

  17. Evaluation of Asthmatic Patients Referred to Jahrom Hospital and Clinic

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    Soheila Alyasin


    Full Text Available Asthma is the most common chronic respiratory disease of children in the world. Serial studies in the world have showed an increased prevalence of bronchial asthma. In this study, the children younger than 12 years old referred to Jahrom hospital and clinic due to asthma were selected. We issued 100 questionnaires, according to International Study of Asthma and Allergies in Childhood (ISAAC criteria and were completed by the physicians. The ratio of male to female was 1 to 9. The patients who were under the age of 4, 3 and 1 year were 82%, 60% and 15% respectively. Passive smoking was present in 56% of the patients, and 22% had pets at home like cat, dog or bird. Home dampness was present in 33%. Ninety percent of patients had used breast feeding during the first year of life. Seventy percent of patients had family history of asthma. Food allergy was present and could trigger asthma in 15%. The result of ISSAC questionnaire showed that during the last year wheezing was present in 10%, 6% had 1-3 attacks and 4% had 4-12 attacks. Sleep disturbance by wheezing had occurred in 5% but cough in 16%. Thirteen percent of patients had wheezing after exercise. In Jahrom town the climate is warm and dry. In this town asthma in children is more common among the children who are younger than 4 years old. The risk factor like smoking at home, pets and home dampness should be eliminated from their environment.

  18. Comparison of three clinical techniques for evaluating joint sounds. (United States)

    Hardison, J D; Okeson, J P


    Two-hundred two consecutive adult patients presenting to the University of Kentucky for general dental care screening were examined for temporomandibular joint sounds by three techniques: (1) lateral pole surface palpation, (2) digital palpation in the external auditory canal, (3) auscultation by a stethoscope. Sixty-nine patients reported joint sounds, but only 32 had sounds diagnosed by auscultation resulting in a 54% false-negative reporting rate. Stethoscopic auscultation was used as the standard to which the other two techniques were compared. The false-negative rate for auditory canal digital palpation was 71% and 77% for lateral pole surface palpation. Surface palpation had only a 2% false-positive incidence while auditory canal digital palpation had a 51% false-positive rate. There was poor agreement between the patients' subjective reporting and clinical exam by any technique. Using stethoscopic auscultation as the standard, both auditory canal and surface palpation had a very high false-negative rate, but only the auditory canal palpation had a poor false-positive incidence. Auditory canal palpation often produces TMJ sounds that are not heard with a stethoscope during normal opening and closure.

  19. Iron overload accelerates bone loss in healthy postmenopausal women and middle-aged men: a 3-year retrospective longitudinal study. (United States)

    Kim, Beom-Jun; Ahn, Seong Hee; Bae, Sung Jin; Kim, Eun Hee; Lee, Seung-Hun; Kim, Hong-Kyu; Choe, Jae Won; Koh, Jung-Min; Kim, Ghi Su


    Despite extensive experimental and animal evidence about the detrimental effects of iron and its overload on bone metabolism, there have been no clinical studies relating iron stores to bone loss, especially in nonpathologic conditions. In the present study, we performed a large longitudinal study to evaluate serum ferritin concentrations in relation to annualized changes in bone mineral density (BMD) in healthy Koreans. A total of 1729 subjects (940 postmenopausal women and 789 middle-aged men) aged 40 years or older who had undergone comprehensive routine health examinations with an average 3 years of follow-up were enrolled. BMD in proximal femur sites (ie, the total femur, femur neck, and trochanter) was measured with dual-energy X-ray absorptiometry using the same equipment at baseline and follow-up. The mean age of women and men in this study was 55.8 ± 6.0 years and 55.5 ± 7.8 years, respectively, and serum ferritin levels were significantly higher in men than in women (p men. After adjustment for potential confounders, the rates of bone loss in all proximal femur sites in both genders were significantly accelerated in a dose-response fashion across increasing ferritin quartile categories (p for trend = 0.043 to <0.001). Consistently, compared with subjects in the lowest ferritin quartile category, those in the third and/or highest ferritin quartile category showed significantly faster bone loss in the total femur and femur neck in both genders (p = 0.023 to <0.001). In conclusion, these data provide the first clinical evidence that increased total body iron stores could be an independent risk factor for accelerated bone loss, even in healthy populations.

  20. Clinical evaluation of CT and radionuclide examination in renal diseases

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    Kutani, W.; Ishida, H.; Shirakawa, S.; Shintaku, T.; Funaki, R. (Osaka Medical Coll., Takatsuki (Japan))


    One hundred and twelve cases of renal diseases were studied by computed tomography (CT) using EMI 5005/12. Of them, 60 were examined by both CT and renal scintigraphy, and comparatively evaluated. The CT units were checked before and after the contrast enhancement. Renal scintigrams were obtained by gamma cameras (PHO/GAMMA HP 6406, PHO/GAMMA LFOV) using 99 M Tc-DMSA. CT was especially useful in diagnosing the renal cysts and the hydronephrosis. Cysts in other organs (liver, spleen and pancreas) were simultaneously ascertained in polycystic diseases. CT was not helpful in diagnosing nephritis and diabetic nephropathy. Floating kidney and horse-shoe kidney were difficult to diagnose with CT. The renal scintigram was the reflection of the renal function, and was relatively more useful than CT in diagnosing horse-shoe kidney, floating kidney and nephritis, while it was not useful for non-functioning kidneys.

  1. The post-arthro-CT of the wrist clinical evaluation

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    Scheurecker, G


    To compare the diagnostic effectiveness of post-arthro-CT (PACT) and 3-compartment wrist arthrography (AG) both separate and combined versus wrist arthroscopy for scapho-lunate ligament (SLL), luno-triquetral ligament (LTL) and triangular fibrocartilage (TFC) defects and chondromalacia of the carpal bones. Material and methods: in 58 patients (16-69 years) the affected wrist was examined initially by conventional 3-compartment wrist arthrography with digital subtraction technique during injection followed by digital stress images. Afterwards spiral arthro-CT was performed in the semi-coronal and axial plane with 1 mm slice thickness and secondary true-coronal and sagittal reconstructions. Within 1 month arthroscopy was performed in general anesthesia utilizing standard joint entry points combined with routine digital picture archiving. All examinations were evaluated for SLL, LTL and TFC defects, PACT and AS for ChM too. Results: AG versus AS: the following detection rates were observed (AG and AS positive/AG...

  2. Left Atrial Reverse Remodeling: Mechanisms, Evaluation, and Clinical Significance. (United States)

    Thomas, Liza; Abhayaratna, Walter P


    The left atrium is considered a biomarker for adverse cardiovascular outcomes, particularly in patients with left ventricular diastolic dysfunction and atrial fibrillation in whom left atrial (LA) enlargement is of prognostic importance. LA enlargement with a consequent decrease in LA function represents maladaptive structural and functional "remodeling" that in turn promotes electrical remodeling and a milieu conducive for incident atrial fibrillation. Medical and nonmedical interventions may arrest this pathophysiologic process to the extent that subsequent reverse remodeling results in a reduction in LA size and improvement in LA function. This review examines cellular and basic mechanisms involved in LA remodeling, evaluates the noninvasive techniques that can assess these changes, and examines potential mechanisms that may initiate reverse remodeling.

  3. Clinical evaluation of a water-in-oil emulsion with protective and regenerative properties for the anogenital area

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    Küppers V


    Full Text Available Volkmar Küppers,1 Michael Kemper,2 Christoph Abels2 1Gynecological Practice, Dysplasia-Clinic, Düsseldorf, Germany; 2Dr August Wolff GmbH & Co KG Arzneimittel, Bielefeld, Germany Abstract: Inadequate hygiene, aggressive cleansing, and chafing skin folds, as well as urine, feces, and sweat may trigger irritative contact dermatitis in the anogenital area. Serious recommendations for protection of the skin toward irritants include hygienic aspects and the use of appropriate skin care. Furthermore, preventing an accumulation of irritants on unprotected skin is mandatory. An intraindividual comparison study with 30 participants (17 female, 13 male; age: 44.2±8.3 years was performed to evaluate the properties of a newly developed water-in-oil (W/O balm on artificial sodium dodecyl sulfate-damaged epidermal barrier. The balm was applied 14 days twice daily, and transepidermal water loss and erythema were investigated. A significant improvement of both parameters after 12 days and even after 21 days could be confirmed. Two major clinical trials were performed to evaluate the safety and efficacy regarding protective and regenerative properties of the W/O balm on irritated skin in the anogenital area. Therefore, 29 children were enrolled (14 male, 15 female, age: 15.5±7.8 months in an open-labeled 4-week clinical study. The balm was used in the area under disposable diapers at least after diaper change or if required. Furthermore, in a second open, multicenter study, 43 women (mean age: 46.2±16.9 with predisposition to skin irritation in the outer anogenital region were included. The product was applied for 4 weeks 1–2 times daily. In both studies, skin tolerability, applicability, scent, spreadability, and removability of the balm were evaluated by participants and practitioners predominantly as good or even very good, also skin hydration, protection, and regeneration were judged positively. The studies confirmed that the newly developed W/O balm

  4. Evaluation of clinical symptoms of patients with scleroderma according to the onset time1

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    Khalvat A


    Full Text Available Systemic sclerosis is a generalized disorder of connective tissue, in which the pattern of disease extent, progression and outcome is heterogenous. To determine clinical features, disease extent and progression, we studied our patients in two phases of disease; early (the first 3 years and late phases (after 6 years of disease. 19 patients had diffuse cutaneous and 34 patients had limited cutaneous scleroderma. In patients with diffuse cutaneous scleroderma, disease progression has occurred mostly in the early phase of disease, but in patients with limited cutaneous scleroderma, disease progression was slow and incidious, so disease progression has occurred mostly in the late phase of the disease, thus raynaud's phenomenon, telangiectasia, hyperpigmentation and esophagitis were observed more in the late phase of the disease (statistically significant. In comparison of two groups, early and extensive organ involvement was observed in patients with diffuse cutaneous sclerodema.

  5. Evaluation of clinical symptoms of patients with scleroderma according to the onset time

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    Gharibduost F


    Full Text Available Systemic sclerosis is a generalized disorder of connective tissue, in which the pattern of disease extent, progression and outcome is heterogenous. To determine clinical features, disease extent and progression, we studied our patients in two phases of disease; early (the first 3 years and late phases (after 6 years of disease. 19 patients had diffuse cutaneous and 34 patients had limited cutaneous scleroderma. In patients with diffuse cutaneous scleroderma, disease progression has occurred mostly in the early phase of disease, but in patients with limited cutaneous scleroderma, disease progression was slow and incidious, so disease progression has occurred mostly in the late phase of the disease, thus raynaud's phenomenon, telangiectasia, hyperpigmentation and esophagitis were observed more in the late phase of the disease (statistically significant. In comparison of two groups, early and extensive organ involvement was observed in patients with diffuse cutaneous sclerodema.

  6. Reliability and Validity of the Objective Structured Clinical Examination in the Evaluation of Clinical Skills of Midwifery Students (Kashan, 2014

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    Saeideh Nasiri


    Full Text Available This study was conducted to determine the validity and reliability of OSCE in evaluating the clinical skills of midwifery students at Kashan University of Medical Sciences in 2014. This descriptive-correlational study was carried out on 23 senior midwifery students. The OSCE scores were calculated according to the structured objective checklists. Content and criterion validity and reliability were also assessed. The obtained data were analyzed by SPSS-16 using ANOVA and Spearman correlation coefficients. There was a significant relationship between the clinical scores and the OSCE score (P=0.03. The reliability results of the evaluation of stations by two observers showed that the lowest and highest correlation coefficients between observers were 0.58 and 1.00, respectively. Owing to good reliability and validity of this test in the first period of its implementation in Kashan, it can be recommended for subsequent periods as part of the final exam for midwifery students.

  7. Evaluation of clinical skills for first-year surgical residents using orientation programme and objective structured clinical evaluation as a tool of assessment

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    Pandya J


    Full Text Available Background: Postgraduate specialities require a combination of knowledge and clinical skills. The internship year is less structured. Clinical and practical skills that are picked up during training are not well regulated and the impact is not assessed. In this study, we assessed knowledge and skills using objective structured clinical examination (OSCE. Aim: To evaluate the clinical skills of new first-year surgical residents using orientation programme and OSCE as a tool for assessment. Settings and Design: Observational study. Materials and Methods: Twenty new first-year surgical residents (10 each in 2008 and 2009 participated in a detailed structured orientation programme conducted over a period of 7 days. Clinically important topics and skills expected at this level (e.g., suturing, wound care etc. were covered. The programme was preceded by an OSCE to test pre-programme knowledge (the "pre-test". The questions were validated by senior department staff. A post-programme OSCE (the "post-test" helped to evaluate the change in clinical skill level brought about by the orientation programme. Statistical Analysis: Wilcoxson matched-pairs signed-ranks test. Results: Passing performance was achieved by all participants in both pre- and post-tests. Following the orientation programme, significant improvement was seen in tasks testing the psychomotor and cognitive domains. (P = 0.0001 and P = 0.0401, respectively. Overall reliability of the OSCE was found to be 0.7026 (Cronbach′s coefficient alpha. Conclusions: This study highlighted the lacunae in current internship training, especially for skill-based tasks. There is a need for universal inclusion of structured orientation programmes in the training of first-year residents. OSCE is a reliable, valid and effective method for the assessment of clinical skills.

  8. Two-year clinical evaluation of resin composite in posterior teeth: A randomized controlled study (United States)

    Gianordoli-Neto, Ranulfo; Padovani, Gislaine Cristina; Mondelli, José; de Lima Navarro, Maria Fidela; Mendonça, Juliano Sartori; Santiago, Sérgio Lima


    Background: Clinical evaluations as fundamental method to prove the efficiency of restorative materials. Aim: This study evaluated the clinical performance of restorative systems during 2 years of clinical service. Materials and Methods: This study assessed the clinical performance of restorative systems (Filtek Z250 and P60), during 2 years of clinical service, using the US Public Health Service system. The randomized and double-blind study comprising thirty volunteers. The restorations were evaluated at baseline, 6, 12, and 24 months. It was used the following criteria: marginal discoloration (MD), marginal integrity (MI), superficial texture (ST), wear (W), postoperative sensitivity (PS) and recurrent caries (RC). Results: Statistic analysis was performed using Fisher's and McNemar's exact tests and Pearsons's Chi-square in a significance level of 5%. The results at baseline and 24 months for Group I were: MD – 100, 100%; MI – 100, 88.6%; ST – 100, 94.3%; W – 100, 94.3%; PS – 100, 100%; RC – 100, 100%, of alpha scores; Group II: MD – 100, 97.1%; MI – 100, 91.4%; ST – 100, 94.3%; W – 100, 91.4%; PS – 100, 100%; RC – 100, 100%, of alpha scores. It was observed no statistical difference in the evaluated criteria and period. Conclusions: After 24 months of evaluation, both restorative systems exhibited acceptable clinical performance. PMID:27563176

  9. An innovative medical and dental hygiene clinic for street youth: results of a process evaluation. (United States)

    Rowan, Margo S; Mason, Melanie; Robitaille, Annie; Labrecque, Lise; Tocchi, Cathy Lambert


    Canada has a noteworthy reputation for high quality health care. Nonetheless, street youth are one of our most vulnerable yet underserved populations. Consequently, a medical and dental clinic was created in downtown Ottawa, Ontario to respond to their needs. The purpose of this study is to describe a process evaluation of the clinic during its first year of operation with a focus on program fidelity, dose, reach, and satisfaction. A mixed methods approach was used involving interviews with providers, focus groups with street youth, analysis of Electronic Medical Record (EMR) data, and supplemental information such as document reviews. The evaluation identified areas that were working well along with challenges to program implementation. Areas of concerns and possible solutions were presented to the management team that then helped to plan and make improvements to the clinic. Our evaluation design and working relationship with clinic management promoted the integration of real-time evidence into program improvements.

  10. Evaluation of the Esthetic Properties of Developmental Defects of Enamel: A Spectrophotometric Clinical Study

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    Fabrizio Guerra


    Full Text Available Objectives. Detailed clinical quantification of optical properties of developmental defect of enamel is possible with spectrophotometric evaluation. Developmental defects of enamel (DDE are daily encountered in clinical practice. DDE are an alteration in quality and quantity of the enamel, caused by disruption and/or damage to the enamel organ during amelogenesis. Methods. Several clinical indices have been developed to categorize enamel defects based on their nature, appearance, microscopic features, or cause. A sample of 39 permanent teeth presenting DDE on labial surface was examined using the DDE Modified Index and SpectroShade evaluation. The spectrophotometric approach quantifies L* (luminosity, a* (quantity of green-red, and b* (quantity of blue-yellow of different DDE. Conclusions. SpectroShade evaluation of the optical properties of the enamel defect enhances clinical understanding of severity and extent of the defect and characterizes the enamel alteration in terms of color discrepancy and surface characterization.

  11. MARIA M4: clinical evaluation of a prototype ultrawideband radar scanner for breast cancer detection. (United States)

    Preece, Alan W; Craddock, Ian; Shere, Mike; Jones, Lyn; Winton, Helen L


    A microwave imaging system has been developed as a clinical diagnostic tool operating in the 3- to 8-GHz region using multistatic data collection. A total of 86 patients recruited from a symptomatic breast care clinic were scanned with a prototype design. The resultant three-dimensional images have been compared "blind" with available ultrasound and mammogram images to determine the detection rate. Images show the location of the strongest signal, and this corresponded in both older and younger women, with sensitivity of [Formula: see text], which was found to be maintained in dense breasts. The pathway from clinical prototype to clinical evaluation is outlined.

  12. The Development and Testing of a Community Health Nursing Clinical Evaluation Tool. (United States)

    Hawranik, Pamela


    Describes the development and testing of a clinical evaluation tool for a community health nursing course for registered nurses through review of the literature and focus groups with community health nurses and faculty. The article contains 22 references and an abbreviated form of the evaluation tool. (Author/JOW)

  13. Feasibility of Automatic Extraction of Electronic Health Data to Evaluate a Status Epilepticus Clinical Protocol. (United States)

    Hafeez, Baria; Paolicchi, Juliann; Pon, Steven; Howell, Joy D; Grinspan, Zachary M


    Status epilepticus is a common neurologic emergency in children. Pediatric medical centers often develop protocols to standardize care. Widespread adoption of electronic health records by hospitals affords the opportunity for clinicians to rapidly, and electronically evaluate protocol adherence. We reviewed the clinical data of a small sample of 7 children with status epilepticus, in order to (1) qualitatively determine the feasibility of automated data extraction and (2) demonstrate a timeline-style visualization of each patient's first 24 hours of care. Qualitatively, our observations indicate that most clinical data are well labeled in structured fields within the electronic health record, though some important information, particularly electroencephalography (EEG) data, may require manual abstraction. We conclude that a visualization that clarifies a patient's clinical course can be automatically created using the patient's electronic clinical data, supplemented with some manually abstracted data. Future work could use this timeline to evaluate adherence to status epilepticus clinical protocols.


    Institute of Scientific and Technical Information of China (English)


    Objective To evaluate the saliva ferning test (SFT) as diagnostic test for xerostomia in patients with Sjogren 's Syndrome (SS). Methods In this study, dried samples of freshly produced saliva from 78 patients with established SS according to European Community criteria and 80 healthy controls were examined by light microscopy. The crystallization was classified into 4 types according to the ferning phenomenon: uniformity, branching, spreading and integrity (type Ⅰ normal and type Ⅱ ,III ,Ⅳ abnormal ). Then , the 78 patients underwent labial salivary gland biopsy. According to Tarpley' s classifica tion, minor salivary gland biopsy (≥2+) was considered to be positive. Results 1. The sensitivity of SFT was high (70/ 78 = 89.74% ). And the specificity was also high (67/80 = 83.75% ). 2. Abnormal SFT was observed in 70/78(89.74%) samples from patients group and in 13/80 ( 16.25% ) samples from healthy controls. The differences of SFT in patients group versus controls were statistically significant (P0.05) as diagnostic tests in SS. Conclusion SFT was simple , sensitive and specific as diagnostic test in SS suspect patients just as mini labial gland biopsy.

  15. [Clinical evaluation of gingival tissue restored with stainless steel crown]. (United States)

    Chao, D D; Tsai, T P; Chen, T C


    The use of stainless steel crown for the restoration of primary molars is widely accepted in pediatric dentistry. There has been a concern regarding their effect on the health of the gingival tissue. It is a possibility that the preformed crown may be a contributing cause of gingivitis. This study evaluated one hundred and thirty-seven crowns in forty-five patients who had received pedodontic treatment at Chang Gung Memorial Hospital. The results indicated that the majority of stainless steel crowns had one or more defects, with crown crimping being the most common error. According to what the paired t-test showed, non-ideal crowns indicated that the gingival index was significantly higher than the entire mouth and control teeth. However the supragingival plaque accumulation of these teeth was significant lower than the entire mouth and control teeth. There was only a moderate positive correlation between supragingival plaque and gingivitis. The operator is necessary to adapt the stainless steel crown margin as closely as possible to the tooth and to avoid the mechanical defect of a crown. It minimizes the irritation of gingival tissue and diminishes the bacterial adherence of subgingival plaque, therefore preserving the health of gingival tissue.

  16. Tics and Tourette syndrome: clinical evaluation of 44 cases

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    Teive Hélio A.G.


    Full Text Available We evaluated 44 patients with tics and Tourette's syndrome (TS emphasising the age of onset of symptoms, sex, classification and localization of tics, associated symptoms and signs and comorbidities. Thirty-three patients (75.2% had TS defined criteria whereas 10 (22.7% had chronic motor and/or vocal tics. Simple motor tics were found in 43 cases (97.7%, mainly affecting the eyes (43.2%, mouth (43.2%, face (34.1%. Simple vocal tics occurred in 33 (75%. Coprolalia was found in just 6 cases (13.6% and copropraxia in just 2 (4.5%. Obsessive compulsive disorder and/or symptoms were found in 26 cases (59.1% and attention deficit in 17 (38.6%. Eighteen patients (40.9% had other disorders, such as alcoholism, tabagism, drug abuse, affective disorders, anxiety, sleep and learning disorders. The data obtained are similar to those found by other authors. We highlight the low frequency of coprolalia, as well as the associated neuropsychiatric disorders.

  17. Evaluation of clinical significance of dermoscopy in alopecia areata

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    Akhila Sai Guttikonda


    Full Text Available Background: Alopecia areata (AA is a common, chronic inflammatory disease characterized by nonscarring hair loss on the scalp or any hair-bearing area of the body. Recently, dermoscopy, a noninvasive diagnostic procedure, has been employed for the diagnosis of AA. Aim: To evaluate various dermoscopic patterns in AA and correlate these patterns with the disease activity and severity. Materials and Methods: Dermoscopy was performed on AA patients using DL1 dermoscope (magnification ×10 was used. The dermoscopic patterns recorded were analyzed to identify any correlation with the disease activity and severity. Results: A total of fifty patients of AA were recruited in the study. Female outnumbered males with the ratio being 1.173:1. Mean age of the patients was 25.06 years. Mean duration of disease was 14 months. The most common site involved was scalp (80% and type noted was patchy (84%. Various dermoscopic patterns noted were yellow dots (YD (88%, short vellus hair (66%, black dots (BD (58%, broken hairs (BHs (56%, tapering hair (TH (26%, Coudability hairs (14%, pigtail hair (14%, and Pohl-Pinkus constrictions (2%. Statistically significant correlation was observed between BD, BHs, THs, and disease activity. No significant correlation was found between severity and any of the dermoscopic features. Conclusion: The most common dermoscopic pattern in our study was YD. Presence of BDs, BHs, and THs indicate active disease. Dermoscopic patterns were not affected by severity of the disease.


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    Mohammed Naveed


    Full Text Available INTRODUCTION: Endoscopic Intra nasal approach to by-pass the obstruction of lacrimal apparatus is a simple and commonly practiced surgery among the ENT Surgeons. Various modifications in the form of usage of micro drill, application of Mitomycin C and preserving the nasal flap to line the opening in the sac to name a few are being used. Recurrence of epiphora and closure of the neo opening is described and observed are labeled as failed endonasal DCR. This study makes an attempt to review retrospectively and prospectively to evaluate the degree of recurrence and causes of failure. OBJECTIVE OF THE STUDY: This study also attempts to determine the causes of failure of endonasal DCR and its subsequent management. Thus this study precludes the role of revision DCR. Materials and Methods: 50 patients who underwent endonasal DCR surgery at GGH Kurnool and reported with symptoms of returning of epiphora, purulent discharge from the eye were included. A detailed history taking and endoscopic examination done to find the cause of failure. An attempt is made to classify the causes and find suitable remedy.RESULTS:36% of the patients showed tendency to form synaechiae, 18.6% of patients presented with thick lacrimal crest, 9% of them showed formation of a thin veil like membrane over the neo-ostium. All the patients were subjected to revision surgery and subjective improvement in 92% of the patients reported at the time of reporting of the study.

  19. Clinical evaluation of physical fitness in male obese Japanese

    Institute of Scientific and Technical Information of China (English)


    Abstract:Objective To establish an effective exercise prescription, the exercise capacity of obese subjects was investigated.Methods In 71 male obese (body mass index: BMI≥26.4) Japanese, aged 26-77 years, the body composition and physical fitness such as aerobic exercise level, muscle strength and flexibility were determined and compared with those of age- and sex-matched 71 borderline (24.2≤BMI<26.4) and 71 normal Japanese men (19.8≤BMI<24.2). The relationship between body composition and other parameters was evaluated in obese subjects.Results In obese subjects, body weight, BMI, body fat percentage, waist hip ratio, and skinfold thickness were higher than those of borderline and normal subjects. Lower aerobic exercise level and weight bearing index (WBI) were noted in obese subjects. There was a negative correlation between waist hip ratio and aerobic exercise level (oxygen uptake at ventilatory threshold) (r=-0.509, P<0.01) and also between waist hip ratio and WBI (r=-0.315, P<0.01). Conclusions Lower physical fitness is considered to be a general characteristic of male obese Japanese, and the accumulation of visceral adipose tissue might affect exercise capacity.

  20. The evaluation of radiological and clinical findings of bronchiectasis

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    Yoo, Jung Keun; Kang, Sung Ihn; Kim, Kil Jung; Ko, Seung Sook; Kim, Young Sook; Kim, Young Chul [Chosun University College of Medicine, Kwangju (Korea, Republic of)


    Bronchiectasis means a permanent abnormal dilatation off one or more large bronchi owing to destruction of the elastic and muscular components of the bronchial wall. Radiological study is the most important and mandatory procedure. Especially bronchography is essential for the definitive diagnosis of bronchiectasis and for the precise delineation of the type and extent of the disease. The radiological and clinical findings of 48 cases of bronchiectasis diagnosed by bronchography and treated at Chosun University Hospital during the 5 years from January 1980 to December 1984 were analyzed retrospectively. The results were as follows; 1. Among the 48 cases, 34 cases (70.8%) were male and 14 cases (29.2%) were female. Peak incidence was in second decade. 2. Chronic cough productive sputum and hemoptysis are main symptoms and others are chest pain, dyspnea and recurrent bouts of pneumonia. The most common physical sign is persistent moist rales over the involved area in 23 cases (47.9%). Others are no sign in 17 cases (35.4%), wheezing in 11 cases (22.9%) and digit clubbing in 3 cases (6.3%). 3. The presumed causes were composed of not known in 30 cases (62.5%)> and complications of measles in 7 cases (14.6%), pertussis in 5 cases (10.4%) and pneumonia in 4 cases (8.3%). Two cases were Kartagener's syndrome and unilateral hyperlucent lung. 4. Plain chest common radiological findings was accentuation of lung marking in 36 cases (85.7%), the others are include in order of frequency; pneumonic infiltration, linear radiolucencies, cystic radiolucencies, decreased affected lung volume, air-fluid, level and pleural thickening. 5. Bilateral bronchiectasis was demonstrated in 11 cases (22.9%) and the disease was much more often involved left lung than right. The most commonly involved lobe is left lower lobe, and the most common site of involvement was the posterior basal segment of the lower lobe. The type of bronchiectasis is cylindrical in 22 cases (45.8%), varicose in

  1. Evaluation of the usefulness of 2 prediction models of clinical prediction models in physical therapy: a qualitative process evaluation.

    NARCIS (Netherlands)

    Oort, L. van; Verhagen, A.F.; Koes, B.; Vet, R. de; Anema, H.; Heymans, M.


    OBJECTIVE: The purposes of this study were to (1) evaluate the usefulness of 2 prediction models by assessing the actual use and advantages/disadvantages of application in daily clinical practice and (2) propose recommendations to enhance their implementation. METHODS: Physical therapists working in

  2. Case studies on clinical evaluation of biosimilar monoclonal antibody: scientific considerations for regulatory approval. (United States)

    Kudrin, Alex; Knezevic, Ivana; Joung, Jeewon; Kang, Hye-Na


    The objective of this paper is to provide considerations based on comprehensive case studies important for regulatory evaluation of monoclonal antibodies as similar biotherapeutic products (SBPs) with a special emphasis on clinical aspects. Scientific principles from WHO Guidelines on SBPs were used as a basis for the exercise. Working groups consisted of regulators, manufacturers and academia. The following topics were discussed by the working groups: clinical criteria for biosimilarity, extrapolation approach and the overall regulatory decision making process. In order to determine typical pitfalls in the design of a SBP clinical programme and evaluate the gap of knowledge, amongst different industry and regulatory stakeholders on the appraisal of the data arising from SBP clinical studies, we have presented two fictional but realistic clinical case studies. The first case consists of the fictional development programme for an infliximab SBP candidate. The second case describes clinical studies proposed for a fictional rituximab SBP candidate. In the first scenario a highly similar quality profile has been taken forward into clinical studies whereas there was an important residual difference in functional attributes for the rituximab SBP candidate. These case studies were presented at the WHO implementation workshop for the WHO guidelines on evaluation of similar biotherapeutic products held in Seoul, Republic of Korea, in May 2014. The goal was to illustrate the interpretation of the clinical data arising from studies with SBP candidates and elicit knowledge gaps in clinical assessment. This paper reflects the outcome of the exercise and discussions held in Seoul and offers an analysis of the case studies as a learning opportunity on clinical development and evaluation of SBPs.

  3. Prostate needle biopsies: interobserver variation and clinical consequences of histopathological re-evaluation

    DEFF Research Database (Denmark)

    Berg, Kasper Drimer; Toft, Birgitte Grønkaer; Røder, Martin Andreas;


    pathology reports and with histopathology of the radical prostatectomy specimen. The consequences of re-evaluation for clinical workup and treatment of patients according to local algorithms were determined. For Gleason score (GS), complete agreement between primary report and re-evaluation was found in 76......-evaluations in 19.7% and 13.1% of patients, respectively. Gleason scoring based on the radical prostatectomy specimen was higher than in both primary reports and re-evaluation of biopsies. Although a relatively high degree of concordance was found between biopsy assessments, the significant trend towards higher...... Gleason scoring at re-evaluation, leading to frequent changes in clinical assessments and surgical strategy, justifies re-evaluation of PCa biopsies in patients with primary GS ≤ 6....

  4. Prostate needle biopsies: interobserver variation and clinical consequences of histopathological re-evaluation

    DEFF Research Database (Denmark)

    Berg, Kasper Drimer; Toft, Birgitte Grønkaer; Brasso, Klaus;


    pathology reports and with histopathology of the radical prostatectomy specimen. The consequences of re-evaluation for clinical workup and treatment of patients according to local algorithms were determined. For Gleason score (GS), complete agreement between primary report and re-evaluation was found in 76......-evaluations in 19.7% and 13.1% of patients, respectively. Gleason scoring based on the radical prostatectomy specimen was higher than in both primary reports and re-evaluation of biopsies. Although a relatively high degree of concordance was found between biopsy assessments, the significant trend towards higher...... Gleason scoring at re-evaluation, leading to frequent changes in clinical assessments and surgical strategy, justifies re-evaluation of PCa biopsies in patients with primary GS = 6....

  5. Clinical evaluations for transfer of juveniles to criminal court: current practices and future research. (United States)

    Kruh, I P; Brodsky, S L


    Completing clinical evaluations of juveniles considered for transfer to criminal court requires specialized expertise. However, there is little empirical foundation upon which they can be based. Within each of the three major evaluation domains (amenability to treatment, risk for future violence, and sophistication/maturity), we ask the following questions: a) Can forensic examiners properly assess this area, and if so using what tools?; b) How can social science research clarify the transfer evaluation, particularly as it is impacted by systems issues?; and c) How should the evaluation be structured? In doing so, we review clinical suggestions for completing these evaluations and identify pertinent research directions. A number of general issues specific to these evaluations are also discussed.

  6. Survival of patients identified as candidates for intestinal transplantation: a 3-year prospective follow-up

    DEFF Research Database (Denmark)

    Pironi, L.; Forbes, A.; Joly, F.


    BACKGROUND & AIMS: The US Medicare indications for intestinal transplantation are based on failure of home parenteral nutrition. The American Society of Transplantation also includes patients at high risk of death from their primary disease or with high morbidity intestinal failure. A 3-year...... prospective study evaluated the appropriateness of these indications. METHODS: Survival on home parenteral nutrition or after transplantation was analyzed in 153 (97 adult, 56 pediatric) candidates for transplantation and 320 (262 adult, 58 pediatric) noncandidates, enrolled through a European multicenter......%-100%), and 100% in parenteral nutrition failure, high-risk primary disease, and high-morbidity intestinal failure, respectively (P = .034). Fifteen candidates underwent transplantation. Six died, including all 3 of those who were in hospital, and 25% of those who were at home at time of transplantation (P = .086...

  7. Clinical and radiographic evaluation of a polyester prosthesis in dogs with cranial cruciate ligament rupture

    Directory of Open Access Journals (Sweden)

    Selmi André Luis


    Full Text Available Clinical and radiographic findings after intra-articular replacement of cranial cruciate ligament with a polyester prosthesis using a modified over-the-top technique were evaluated in six dogs. Seven surgeries were done due to bilateral involvement of the cranial cruciate ligament in one dog. Clinical evaluation was performed on postoperative days 3, 10 and 40, and radiographic evaluation was done at 5 and 24 months after surgery in five dogs, where signs of progressive degenerative joint disease were confirmed. Resolution of clinical signs was observed from 25 to 68 days after surgery as evaluated by dog owners. Overall function of joint movement after surgery was classified as good. Two dogs presented fraying of the implant after surgery. It was concluded that the polyester prosthesis, as implanted in these dogs, was not a satisfactory replacement for the injured ligament, as better results may be obtained with less invasive and simpler techniques.

  8. Effects of treatment with bimatoprost 0.03% for 3 years in patients with normal-tension glaucoma (United States)

    Inoue, Kenji; Shiokawa, Minako; Fujimoto, Takayuki; Tomita, Goji


    Purpose To evaluate the effects of bimatoprost 0.03% single treatment for 3 years on intraocular pressure (IOP) and visual field performance. Methods We monitored the IOP of 62 patients with normal-tension glaucoma every 1–3 months. The Humphrey visual field test was performed every 6 months after treatment and the results obtained were compared to those before treatment. In addition, visual field performance was evaluated using trend and event analysis. Results The mean ± standard deviation (SD) of IOP after treatment with bimatoprost for 3 years (13.6±3.1 mmHg) was significantly lower than that before treatment (16.8±2.4 mmHg, P<0.0001). No change was observed in the mean deviation and pattern SD values of the Humphrey visual field before and 3 years after treatment. Worsening of visual field performance was observed in one patient (3.0%) by using trend analysis and in four patients (12.1%) by using event analysis. Treatment was discontinued in 17 patients (27.4%) because of adverse reactions. Conclusion Bimatoprost 0.03% single treatment was effective in reducing the IOP at least during the 3 years of treatment, but visual field performance worsened by 3.0%–12.1% in patients with normal-tension glaucoma. PMID:24970996

  9. An Evaluation on Medical Students' Satisfaction with Clinical Education and its Effective Factors

    Directory of Open Access Journals (Sweden)

    Vahid Ziaee


    Full Text Available Purpose: To evaluate medical students' satisfaction with clinical education during medical internship and the effects of variables in the organizational domain on satisfaction. Method: A cross-sectional descriptive analytic study in 2000 identified students' satisfaction with clinical education in medical students of Tehran University of Medical Sciences. Students' satisfaction was assessed by a modified job satisfaction questionnaire. Clinical education was classified into; outpatient, bedside and theoretical teaching. Results: Overall satisfaction with clinical education was 38.8%; outpatient and bedside teaching 52% each and theoretical education 70.8%. Overall satisfaction had a significant association with approach to common and epidemic diseases, class size, and the course planning. Conclusion: Based on the present study, we conclude that clinical education should be reevaluated in our university with the specific attention to the class size, variety of diseases and course planning considered for each session in clinical education.

  10. A prospective 9-month human clinical evaluation of Laser-Assisted New Attachment Procedure (LANAP) therapy. (United States)

    Nevins, Marc; Kim, Soo-Woo; Camelo, Marcelo; Martin, Ignacio Sanz; Kim, David; Nevins, Myron


    This investigation was designed and implemented as a single-center, prospective study to evaluate the clinical response to the Laser-Assisted New Attachment Procedure (LANAP). Eight patients with advanced periodontitis were enrolled and treated with full-mouth LANAP therapy and monitored for 9 months. Fullmouth clinical measurements, including clinical attachment level (CAL), probing depth (PD), and recession, were provided at baseline and after 9 months of healing by a single calibrated examiner, including a total of 930 sites and 444 sites with initial PD equal to or greater than 5 mm. Clinical results for the 930 sites measured pre- and postoperatively revealed that mean PD was reduced from 4.62 ± 2.29 mm to 3.14 ± 1.48 mm after 9 months (P LANAP therapy should be further investigated with long-term clinical trials to compare the stability of clinical results with conventional therapy.

  11. Clinical governance: the need for new directions in Canada: [includes principles to guide changes and evaluation]. (United States)

    Carlow, Donald R


    As greater attention is paid to various facets of quality and safety within the Canadian healthcare system, it is important to understand the current state of clinical governance and clinical quality processes in Canada. Significant advances have been made internationally in understanding the important role of clinical governance in achieving quality and safety. It is clear, however, from various reports that major developments in clinical governance are needed if the quality and safety missions of governing boards of health authorities and other provincial and national bodies are to be achieved. In this paper, several key elements of an effective clinical governance system will be reviewed, some issues that characterize clinical governance in Canada will be raised and some principles that might help in evaluation and moving forward will be identified.

  12. Is it the time to rethink clinical decision-making strategies? From a single clinical outcome evaluation to a Clinical Multi-criteria Decision Assessment (CMDA). (United States)

    Migliore, Alberto; Integlia, Davide; Bizzi, Emanuele; Piaggio, Tomaso


    There are plenty of different clinical, organizational and economic parameters to consider in order having a complete assessment of the total impact of a pharmaceutical treatment. In the attempt to follow, a holistic approach aimed to provide an evaluation embracing all clinical parameters in order to choose the best treatments, it is necessary to compare and weight multiple criteria. Therefore, a change is required: we need to move from a decision-making context based on the assessment of one single criteria towards a transparent and systematic framework enabling decision makers to assess all relevant parameters simultaneously in order to choose the best treatment to use. In order to apply the MCDA methodology to clinical decision making the best pharmaceutical treatment (or medical devices) to use to treat a specific pathology, we suggest a specific application of the Multiple Criteria Decision Analysis for the purpose, like a Clinical Multi-criteria Decision Assessment CMDA. In CMDA, results from both meta-analysis and observational studies are used by a clinical consensus after attributing weights to specific domains and related parameters. The decision will result from a related comparison of all consequences (i.e., efficacy, safety, adherence, administration route) existing behind the choice to use a specific pharmacological treatment. The match will yield a score (in absolute value) that link each parameter with a specific intervention, and then a final score for each treatment. The higher is the final score; the most appropriate is the intervention to treat disease considering all criteria (domain an parameters). The results will allow the physician to evaluate the best clinical treatment for his patients considering at the same time all relevant criteria such as clinical effectiveness for all parameters and administration route. The use of CMDA model will yield a clear and complete indication of the best pharmaceutical treatment to use for patients

  13. Evaluation of clinical pharmacist recommendations in the geriatric ward of a Belgian university hospital

    Directory of Open Access Journals (Sweden)

    Somers A


    Full Text Available Annemie Somers,1 Hugo Robays,1 Peter De Paepe,2 Georges Van Maele,3 Katrina Perehudoff,4 Mirko Petrovic41Department of Pharmacy, Ghent University Hospital, Ghent, Belgium; 2Department of Emergency Medicine, Ghent University Hospital, Ghent, Belgium; 3Department of Medical Statistics, Ghent University Hospital, Ghent, Belgium; 4Department of Geriatrics, Ghent University Hospital, Ghent, BelgiumObjective: To evaluate the type, acceptance rate, and clinical relevance of clinical pharmacist recommendations at the geriatric ward of the Ghent university hospital.Methods: The clinical pharmacist evaluated drug use during a weekly 2-hour visit for a period of 4 months and, if needed, made recommendations to the prescribing physician. The recommendations were classified according to type, acceptance by the physician, prescribed medication, and underlying drug-related problem. Appropriateness of prescribing was assessed using the Medication Appropriateness Index (MAI before and after the recommendations were made. Two clinical pharmacologists and two clinical pharmacists independently and retrospectively evaluated the clinical relevance of the recommendations and rated their own acceptance of them.Results: The clinical pharmacist recommended 304 drug therapy changes for 100 patients taking a total of 1137 drugs. The most common underlying drug-related problems concerned incorrect dose, drug–drug interaction, and adverse drug reaction, which appeared most frequently for cardiovascular drugs, drugs for the central nervous system, and drugs for the gastrointestinal tract. The most common type of recommendation concerned adapting the dose, and stopping or changing a drug. In total, 59.7% of the recommendations were accepted by the treating physician. The acceptance rate by the evaluators ranged between 92.4% and 97.0%. The mean clinical relevance of the recommendations was assessed as possibly important (53.4%, possibly low relevance (38.1%, and possibly

  14. Evaluating Dopamine Reward Pathway in ADHD; clinical implications

    Energy Technology Data Exchange (ETDEWEB)

    Volkow, N.D.; Wang, G.; Volkow, N.D.; Wang, G.-J.; Kollins, S.H., Wigal, t.L.; Newcorn, J.H.; Telang, F.; Fowler, J.S.; Zhu, W.; Logan, J.; Ma, Y.; Pradhan, K.; Wong, C.T.; Swanson, J.M.


    Attention-deficit/hyperactivity disorder (ADHD) - characterized by symptoms of inattention and hyperactivity-impulsivity - is the most prevalent childhood psychiatric disorder that frequently persists into adulthood, and there is increasing evidence of reward-motivation deficits in this disorder. To evaluate biological bases that might underlie a reward/motivation deficit by imaging key components of the brain dopamine reward pathway (mesoaccumbens). We used positron emission tomography to measure dopamine synaptic markers (transporters and D{sub 2}/D{sub 3} receptors) in 53 nonmedicated adults with ADHD and 44 healthy controls between 2001-2009 at Brookhaven National Laboratory. We measured specific binding of positron emission tomographic radioligands for dopamine transporters (DAT) using [{sup 11}C]cocaine and for D{sub 2}/D{sub 3} receptors using [{sup 11}C]raclopride, quantified as binding potential (distribution volume ratio -1). For both ligands, statistical parametric mapping showed that specific binding was lower in ADHD than in controls (threshold for significance set at P < .005) in regions of the dopamine reward pathway in the left side of the brain. Region-of-interest analyses corroborated these findings. The mean (95% confidence interval [CI] of mean difference) for DAT in the nucleus accumbens for controls was 0.71 vs 0.63 for those with ADHD (95% CI, 0.03-0.13, P = .004) and in the midbrain for controls was 0.16 vs 0.09 for those with ADHD (95% CI, 0.03-0.12; P {le} .001); for D{sub 2}/D{sub 3} receptors, the mean accumbens for controls was 2.85 vs 2.68 for those with ADHD (95% CI, 0.06-0.30, P = .004); and in the midbrain, it was for controls 0.28 vs 0.18 for those with ADHD (95% CI, 0.02-0.17, P = .01). The analysis also corroborated differences in the left caudate: the mean DAT for controls was 0.66 vs 0.53 for those with ADHD (95% CI, 0.04-0.22; P = .003) and the mean D{sub 2}/D{sub 3} for controls was 2.80 vs 2.47 for those with ADHD (95% CI, 0

  15. Comparative heart failure profile over a 3-year period in a Romanian general hospital

    Directory of Open Access Journals (Sweden)

    Pop D


    Full Text Available Dana Pop,1 Oana Maria Penciu,1 Adela Viviana Sitar-Taut,2 Dumitru Tudor Zdrenghea11Department of Cardiology, Clinical Rehabilitation Hospital, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania; 2"Babes-Bolyai" University, Cluj-Napoca, RomaniaBackground: Heart failure (HF has become an increasingly significant public health problem, associated with repeated hospitalizations, high costs, low quality of life, and decreased survival rate. The progress of the disease may be slowed if treatment is administered in accordance with current guidelines.Objectives: To compare the clinical profile of HF patients in a Romanian general hospital over a 3-year period.Methods and results: We studied two cohorts of patients admitted in the cardiology department of a rehabilitation hospital with a diagnosis of chronic HF New York Heart Association class II–IV. The first, in 2006, included 415 patients, 67.08 ± 10.59 years; the second, in 2009, included 500 patients, 67.31 ± 11.27 years. Considering all patients, the left ventricle ejection fraction (LVEF was not statistically different in the two cohorts. Compared to the 2006 cohort, the 2009 female cohort had higher LVEF (60.49% ± 13.41% vs 64.42% ± 13.79%, P < 0.05, while males over 65 years of age had lower LVEF (52.75% ± 15.02% vs 54.37% ± 15.23%, P = NS. For females, the probability of having LVEF ,45% was higher in 2006 (odds ratio = 1.573. HF with preserved LVEF was more common in females, both in 2006 (78.2% vs 54.2% and 2009 (87.2% vs 57.3%. In the 2009 cohort, LVEF was higher both in young patients (59.08% ± 14.22% vs 55.35% ± 14.92% and patients ≥ than 75 years of age (62.28% ± 13.81% vs 56.79% ± 14.81% compared to the 2006 cohort. Ischemic heart disease was the main underlying cause for HF in both cohorts.Conclusion: HF appeared to have the same clinical profile over a 3-year period. Females diagnosed with HF showed higher rates of preserved LVEF.Keywords: heart

  16. Mini-clinical evaluation exercise til evaluering af kommunikation og samarbejde i ambulatoriet

    DEFF Research Database (Denmark)

    Eriksen, Jesper Grau; Simonsen, Dorit; Bastholt, Lars;


    INTRODUCTION: In the revised Danish medical specialist training increased focus has been placed on competences which are hard to evaluate such as communication skills. Mini-CEX seems promising as an evaluation tool. Our aim was to test: 1) whether mini-CEX was useable in the evaluation...... of communicative and cooperative skills and 2) whether mini-CEX would provide reproducible data. MATERIAL AND METHODS: Twenty-one residents were evaluated by mini-CEX by trained observers. Seventeen residents had at least two observations within a short period of time and these data were used to estimate the mini...... satisfied with the mini-CEX evaluations. CONCLUSION: The mini-CEX is a promising tool for the evaluation of communicative and cooperative skills. Udgivelsesdato: 2009-Mar-16...

  17. Rates of mutation and host transmission for an Escherichia coli clone over 3 years. (United States)

    Reeves, Peter R; Liu, Bin; Zhou, Zhemin; Li, Dan; Guo, Dan; Ren, Yan; Clabots, Connie; Lan, Ruiting; Johnson, James R; Wang, Lei


    Although over 50 complete Escherichia coli/Shigella genome sequences are available, it is only for closely related strains, for example the O55:H7 and O157:H7 clones of E. coli, that we can assign differences to individual evolutionary events along specific lineages. Here we sequence the genomes of 14 isolates of a uropathogenic E. coli clone that persisted for 3 years within a household, including a dog, causing a urinary tract infection (UTI) in the dog after 2 years. The 20 mutations observed fit a single tree that allows us to estimate the mutation rate to be about 1.1 per genome per year, with minimal evidence for adaptive change, including in relation to the UTI episode. The host data also imply at least 6 host transfer events over the 3 years, with 2 lineages present over much of that period. To our knowledge, these are the first direct measurements for a clone in a well-defined host community that includes rates of mutation and host transmission. There is a concentration of non-synonymous mutations associated with 2 transfers to the dog, suggesting some selection pressure from the change of host. However, there are no changes to which we can attribute the UTI event in the dog, which suggests that this occurrence after 2 years of the clone being in the household may have been due to chance, or some unknown change in the host or environment. The ability of a UTI strain to persist for 2 years and also to transfer readily within a household has implications for epidemiology, diagnosis, and clinical intervention.

  18. Impact of F-18 FDG-PET for the Clinical Multidisciplinary Evaluation of Dementia

    DEFF Research Database (Denmark)

    Prakash, Vineet; Vestergård, Karsten; Frost, Majbritt;

    .                       CONCLUSION            F-18 FDG-PET changed management in 44 % of patients seen in a specialist mutlidisciplinary dementia clinic.PET has promising clinical value for management decisions in patients where clinical evaluations combined with lab CSF results and dedicated MR imaging are equivocal for Alzheimers......PURPOSE            Dementia is a challenging clinical diagnosis. Compared with conventional clinical evaluations, F-18 Fluorodeoxyglucose (FDG) PET has been reported to improve not only the diagnostic accuracy of dementia but also help better define the underlying  type. This is because FDG PET...... demonstrates metabolic patterns reflecting neuronal function specific to different dementias.To assess the impact of PET on a multidisciplinary  dementia clinic for patients with suspected dementia by comparing it with the initial clinical evaluation and paraclinical tests.                       METHOD...

  19. [Impact on evaluation of clinical efficacy of traditional Chinese medicine for level in soft targets of processing technology]. (United States)

    Shao, Ming-Yi; Wei, Ming; Yan, Bo-Hua


    Traditional Chinese medicine (TCM) is a very practical subject, which has its unique theoretical system and clinical characteristics. In the course of clinical practice, the exact clinical efficacy is the key of existence and development. But the existing evaluation system is difficult to objectively evaluate the clinical efficacy of TCM. Therefore, how to objectively evaluate the clinical efficacy and get definitive evidence is the focus of the evaluation of clinical efficacy of TCM. Relative to modern medicine, TCM is more concerned about the changes of feelings and clinical symptoms of the patient in the course of the evolution of the disease. Soft targets mainly used for the evaluation of the clinical efficacy of symptoms and functional activity of the disease. The level in soft targets of processing technology is often used methods in clinical evaluation. But it has often produced the phenomenon which the results of the evaluation is mutual contradiction, which will ultimately affect the effect of evaluation of clinical efficacy of TCM. In order to better evaluate the clinical efficacy of TCM, in the process of adoption of soft targets, it clearly identify it's role, highlighting the characteristics of interventions on disease, and as much as possibly avoid the level in soft targets of processing technology to real assess clinical efficacy of TCM.

  20. Participation in clinical supervision (PACS): an evaluation of student nurse clinical supervision facilitated by mental health service users. (United States)

    Maplethorpe, Fran; Dixon, Julie; Rush, Brenda


    This paper discusses an innovative learning approach in which people having experience of mental health services facilitated humanistic clinical supervision with groups of student nurses in the classroom. A four-day course of preparation for the role of supervisor is described and the results of subsequent clinical supervision sessions are analysed. Seven service users who had previous experience of teaching students in the classroom and fifty students on a Diploma/BSc in mental health nursing course participated in the project, which was evaluated through focus groups. The results indicated that the service user supervisors appreciated the skills they had gained on the course and felt that they were more appropriate than lecturers to facilitate clinical supervision sessions. Some students expressed initial uncertainty about the appropriateness of service users as supervisors but as changes to the pedagogical process of supervision were made and the supervisors gained more experience and confidence, students expressed greater satisfaction. The authors conclude that clinical supervision facilitated by service users who have preparation and continual support can add considerable value to the learning experience of student nurses.

  1. Recognition and Evaluation of Clinical Section Headings in Clinical Documents Using Token-Based Formulation with Conditional Random Fields (United States)

    Dai, Hong-Jie; Syed-Abdul, Shabbir; Chen, Chih-Wei; Wu, Chieh-Chen


    Electronic health record (EHR) is a digital data format that collects electronic health information about an individual patient or population. To enhance the meaningful use of EHRs, information extraction techniques have been developed to recognize clinical concepts mentioned in EHRs. Nevertheless, the clinical judgment of an EHR cannot be known solely based on the recognized concepts without considering its contextual information. In order to improve the readability and accessibility of EHRs, this work developed a section heading recognition system for clinical documents. In contrast to formulating the section heading recognition task as a sentence classification problem, this work proposed a token-based formulation with the conditional random field (CRF) model. A standard section heading recognition corpus was compiled by annotators with clinical experience to evaluate the performance and compare it with sentence classification and dictionary-based approaches. The results of the experiments showed that the proposed method achieved a satisfactory F-score of 0.942, which outperformed the sentence-based approach and the best dictionary-based system by 0.087 and 0.096, respectively. One important advantage of our formulation over the sentence-based approach is that it presented an integrated solution without the need to develop additional heuristics rules for isolating the headings from the surrounding section contents. PMID:26380302

  2. Negative cognitive styles synergistically predict suicidal ideation in bipolar spectrum disorders: a 3-year prospective study. (United States)

    Stange, Jonathan P; Hamilton, Jessica L; Burke, Taylor A; Kleiman, Evan M; O'Garro-Moore, Jared K; Seligman, Nicole D; Abramson, Lyn Y; Alloy, Lauren B


    Rates of suicidal ideation and behavior are extremely high in bipolar spectrum disorders (BSDs). However, relatively little work has evaluated potentially synergistic relationships between cognitive and emotion-regulatory processes proposed by theoretical models of suicidality in BSDs. The present study evaluated whether negative cognitive style and subtypes of rumination would exacerbate the impact of self-criticism on suicidal ideation in a prospective study of individuals with BSDs. Seventy-two young adults with BSDs (bipolar II, bipolar NOS, or cyclothymia) completed diagnostic interviews and trait measures of self-criticism, negative cognitive style, and brooding and reflective rumination at a baseline assessment. The occurrence of suicidal ideation was assessed as part of diagnostic interviews completed every 4 months for an average of 3 years of follow-up. Negative cognitive style and reflective rumination strengthened the association between self-criticism and the prospective occurrence of suicidal ideation across follow-up. Individuals with high levels of self-criticism in conjunction with negative cognitive style or reflective rumination were most likely to experience the onset of suicidal ideation. Self-criticism may work synergistically with negative cognitive style and rumination to confer risk for suicidal ideation in bipolar spectrum disorders. These results support theoretical models of suicidality in BSDs and indicate that evaluating and understanding negative cognitive styles may help to identify individuals who are at risk of suicide.

  3. Evaluation of the fulfillment grade and clinical management of the treatment with immunotherapy in allergic patients.

    Directory of Open Access Journals (Sweden)

    Marisela L. Pérez Pacaréu


    Full Text Available Background: Immunotherapy efficacy in the control of patients affected by allergic diseases has been quite proved since 1911, it is of great importance for their betterment. Objectives: To determine the adherence to the treatment and patient´s satisfaction with control immunotherapy. Methods: A study made in the ¨Dr. Gustavo Aldereguia Lima¨ Hospital, where 100 patients from the external allergy consulter were evaluated for a year. Authorized personnel checked out the level of fulfilment of the security rules, clinical betterment was evaluated with a daily control of symptoms correlated with clinical history of allergy, and satisfaction was evaluated through a questionaire.Results: The 82% fits correctly with the treatment program, the 94% presented clinical betterment, and the 90% has an excellent satisfaction level.

  4. Self-discrepancy: structural differences between clinical and non-clinical populations evaluated with MCMI-II

    Directory of Open Access Journals (Sweden)

    Ângela Brandão


    Full Text Available This research addresses the personality as a complex and dynamic structure and it relates the self-discrepancy theory with Millon's theory of personality. Self-discrepancy theory predicts that Ideal and Ought discrepancies originate different negative emotions. Millon's bipsychosocial theoty emphasizes the interaction between organism, environment and social learning, making salient the circularity of the interaction. The present study refers to the Real-Self (RS, Ideal-Self (IS and Ought-Self (OS discrepancies, evaluated using the MCMI-II in two different samples (clinical and non-clinical. The RSs results are different in the two samples and they were analized scale by scale. The RS-IS and RS-OS discrepancies results for each trait scale analyzes were mixed. It was given greater emphasis to RS-RI discrepancies and implications for personality theories and case conceptualization are taken into consideration.

  5. Psoriatic Arthritis in Psoriasis Patients: Evaluation of Clinical and Radiological Features

    Directory of Open Access Journals (Sweden)

    Hatice Reşorlu


    Full Text Available Objective: The purpose of this study was to perform radiological and clinical determination of the presence of psoriatic arthritis (PsA in patients with psoriasis and to evaluate associations with clinical findings. Materials and Methods: The medical files of 72 patients with psoriasis presenting to our clinic between years 2009-2014 with a pre-diagnosis of PsA were reviewed retrospectively. Hand, foot and sacroiliac joint radiograms were evaluated by a radiologist who was blinded to the patient’s clinical status and who is experienced on musculoskeletal radiology. Patients with psoriasis were divided into two groups according to the presence of arthritis which was determined based on radiographic findings or on Classification Criteria for Psoriatic Arthritis (CASPAR criteria. All patients’ demographic characteristics, length of disease, nail involvement, smoking-alcohol consumption were recorded. Results: The mean age of all patients was 47.24±14.61 years, and the mean duration of disease was 14.13±11.92 years. Smoking and alcohol consumptions were determined in 54.2% (n=39 and 23.6% (n=17 of the cases, respectively. Nail involvement was determined in 56.9% (n=41 of the cases. PsA was determined based on radiological findings in 58.3% (n=42 of the patients. The mean age and age at onset of disease were higher in PsA (+ patients than in radiologically non-PsA subjects. Based on clinical findings, PsA based on CASPAR criteria was determined in only 18.1% (n=13 of all patients. Conclusion: A higher level of PsA was determined using radiological evaluation in this study. The main cause of this condition is the existence of asymptomatic-subclinical patients. A detailed medical history should therefore be taken from patients, and good clinical evaluation is very important. Radiological and clinical evaluation should be performed together in the diagnosis.

  6. [Development and Quality Evaluation of Evidence-based Clinical Practice Guidelines of Chinese Medicine]. (United States)

    Jiang, Yue-rong; Chen, Ke-ji


    More attentions have been paid to the development of evidence-based clinical practice guidelines (ECPGs) of Chinese medicine (CM). International guideline evaluation instruments such as Appraisal of Guidelines for Research and Evaluation (AGREE I) has been gradually applied in ECPGs quality evaluation of CM. Nowadays, there are some certain methodological defects in partial ECPGs of Chinese medicine, with relatively low applicability and slowly update. It is suggested to establish technical specifications of CM-ECPGs in accordance with the characteristics of CM and international general specification, strengthen the quality evaluation of CM-ECPGs, attach great importance to the regularly update as well as popularization and application of CM-ECPGs.

  7. [Evaluation of secondary care in oral health: a study of specialty clinics in Brazil]. (United States)

    Goes, Paulo Sávio Angeiras de; Figueiredo, Nilcema; Neves, Jerlucia Cavalcanti das; Silveira, Fabiana Moura da Motta; Costa, José Felipe Riani; Pucca Júnior, Gilberto Alfredo; Rosales, Maritza Sosa


    This article discusses the evaluation of secondary care in the area of health surveillance. This was a descriptive and normative/evaluative study. Performance analysis drew on secondary data, based on a historical series of dental procedures conducted at the specialized dental clinics implemented in Brazil and recorded by the Outpatient Information System of the Unified National Health System (SIA/SUS) in 2007, as well as primary data from site visits to the clinics, based on questionnaires completed by clinic staff. Performance of the clinics was poor in most regions of the country, and the North of Brazil had the lowest percentage of specialty services implemented. The indicator "Performance of Secondary Care in Oral Health" was 64.4%. The type 3 specialty clinics showed better results in terms of performance and achievement of targets. The study showed the need to review the legal framework for implementing specialized dental clinics by adjusting the criteria and norms, as well as definition of new standards for achievement of goals in the evaluation and monitoring of these services.

  8. Evaluating research for clinical significance: using critically appraised topics to enhance evidence-based neuropsychology. (United States)

    Bowden, Stephen C; Harrison, Elise J; Loring, David W


    Meehl's (1973, Psychodiagnosis: Selected papers. Minneapolis: University of Minnesota Press) distinction between statistical and clinical significance holds special relevance for evidence-based neuropsychological practice. Meehl argued that despite attaining statistical significance, many published findings have limited practical value since they do not inform clinical care. In the context of an ever expanding clinical research literature, accessible methods to evaluate clinical impact are needed. The method of Critically Appraised Topics (Straus, Richardson, Glasziou, & Haynes, 2011, Evidence-based medicine: How to practice and teach EBM (4th ed.). Edinburgh: Elsevier Churchill-Livingstone) was developed to provide clinicians with a "toolkit" to facilitate implementation of evidence-based practice. We illustrate the Critically Appraised Topics method using a dementia screening example. We argue that the skills practiced through critical appraisal provide clinicians with methods to: (1) evaluate the clinical relevance of new or unfamiliar research findings with a focus on patient benefit, (2) help focus of research quality, and (3) incorporate evaluation of clinical impact into educational and professional development activities.

  9. Clinicopathological pattern of brain tumors: A 3-year study in a tertiary care hospital in India

    Directory of Open Access Journals (Sweden)

    Sajeeb Mondal


    Full Text Available Background: Brain tumors are heterogeneous group of neoplasms, affecting different age groups. Although some studies have been published regarding pathological pattern of brain tumors from different countries of the world and also from India, comprehensive clinicopathological studies from Eastern India is lacking. Aims: The aim of this study was to observe recent incidence of different brain tumors and to study clinical and histopathological spectrum of brain tumors in Eastern India. Materials and Methods: The present study was a cross-sectional observational study involving 130 cases of brain tumors which were diagnosed during the 3-year study period (January 2010–December 2012. Data regarding clinical presentation and radiological features of all cases were collected from all patients. Histopathological diagnosis was correlated with clinical and radiological diagnosis. Results: We found 130 cases of brain tumor with a male preponderance. The cases were distributed in a wide age range from 4 years to 78 years with the mean age of 42.38 years. Most common tumor type in our study was neuroepithelial tumor (92 cases, 70.76%. Among the neuroepithelial tumors, most frequent subtype was astrocytic tumor (54 cases, 41.5%. The second most frequent brain tumor was meningioma (20 cases, 15.3%. We found higher incidence of oligodendroglial tumor (8.46% and medulloblastoma (7.69% in our series. Conclusion: Males are more predispose to brain tumors in comparison to females. Astrocytic tumors are most common subtype in Eastern India. However, the WHO Grade I neoplasms are more frequent brain tumors.

  10. STP Best Practices for Evaluating Clinical Pathology in Pharmaceutical Recovery Studies. (United States)

    Tomlinson, Lindsay; Ramaiah, Lila; Tripathi, Niraj K; Barlow, Valerie G; Vitsky, Allison; Poitout-Belissent, Florence M; Bounous, Denise I; Ennulat, Daniela


    The Society of Toxicologic Pathology formed a working group in collaboration with the American Society for Veterinary Clinical Pathology to provide recommendations for the appropriate inclusion of clinical pathology evaluation in recovery arms of nonclinical toxicity studies but not on when to perform recovery studies. Evaluation of the recovery of clinical pathology findings is not required routinely but provides useful information on risk assessment in nonclinical toxicity studies and is recommended when the ability of the organ to recover is uncertain. The study design generally requires inclusion of concurrent controls to separate procedure-related changes from test article-related changes, but return of clinical pathology values toward baseline may be sufficient in some cases. Evaluation of either a select or full panel of standard hematology, coagulation, and serum and urine chemistry biomarkers can be scientifically justified. It is also acceptable to redesignate dosing phase animals to the recovery phase or vice versa to optimize data interpretation. Assessment of delayed toxicity during the recovery phase is not required but may be appropriate in development programs with unique concerns. Evaluation of the recovery of clinical pathology data for vaccine development is required and, for efficacy markers, is recommended if it furthers pharmacologic understanding.


    Institute of Scientific and Technical Information of China (English)

    梁繁荣; 李瑛


    Objective: To try to give an objective evaluation on the clinical research situation about acupuncturetreatment of facial paralysis in the past 50 years and try to provide a possible evidence for clinical practice. Methods:All papers are searched and assessed according to the international standards and clinical epidemiology. Results:There is no systematic review (SR) on acupuncture treatment of facial palsy in a total of 1021 articles enlisted in thepresent paper. Comparing with the quantity of the descriptive studies and expert opinions (constituting 84.84% ), thatof the randomized controlled trials (RCTs) and clinical controlled trials (CCTs) is smaller (constituting 15. 16%), be-sides, the quality of RCTs and CCTs is unsatisfactory. Conclusion: At present, the quantity and quality of studies withRCTs about acupuncture treatment of facial paralysis can't meet the need of clinical practice, and in order to improvethe therapeutic effect, a higher quality of RCTs and SR is required.

  12. A Pilot Evaluation of Portfolios for Quality Attestation of Clinical Ethics Consultants. (United States)

    Fins, Joseph J; Kodish, Eric; Cohn, Felicia; Danis, Marion; Derse, Arthur R; Dubler, Nancy Neveloff; Goulden, Barbara; Kuczewski, Mark; Mercer, Mary Beth; Pearlman, Robert A; Smith, Martin L; Tarzian, Anita; Youngner, Stuart J


    Although clinical ethics consultation is a high-stakes endeavor with an increasing prominence in health care systems, progress in developing standards for quality is challenging. In this article, we describe the results of a pilot project utilizing portfolios as an evaluation tool. We found that this approach is feasible and resulted in a reasonably wide distribution of scores among the 23 submitted portfolios that we evaluated. We discuss limitations and implications of these results, and suggest that this is a significant step on the pathway to an eventual certification process for clinical ethics consultants.

  13. [Thought on several problems of post-marketing herbs clinical evaluation in special populations]. (United States)

    Zhou, Ai; Lian, Fengmei


    The re-evaluation of clinical post-marketing herbs in special populations, such as children, the aged, pregnant women, lactating women, has attracted attention in our country. The media is drug adverse reaction reports and package insert. The safety of combined administration in aged and children's growth should have been taken long-term follow-up study. Perfecting traditional chinese medicine FDA system will be beneficial to the re-evaluation of clinical postmarketing herbs in pregnant women. Dose-effect study in children also should cause the concern of researchers.

  14. Clinical evaluation of a novel herbal dental cream in plaque formation: a double-blind, randomized, controlled clinical trial


    Patki, Pralhad; Amruthesh ,Sunita; Tandur,Prakash; Tandur,AP; Malini


    Sunita Amrutesh1, J Malini2, Prakash S Tandur3, Pralhad S Patki41Department of Oral Medicine and Radiology, 2Department of Microbiology, 3Department of Oral and Maxillofacial Surgery, K.L.E. College of Dental Sciences and Hospital, Bangalore, India; 4Medical Services and Clinical Trials, R&D Center, The Himalaya Drug Company, Bangalore, IndiaBackground: The aim of this study was to evaluate the efficacy and safety of herbal dental cream in comparison to fluoride dental cream.Objective...

  15. A Quantitative and Qualitative Evaluation of Sentence Boundary Detection for the Clinical Domain. (United States)

    Griffis, Denis; Shivade, Chaitanya; Fosler-Lussier, Eric; Lai, Albert M


    Sentence boundary detection (SBD) is a critical preprocessing task for many natural language processing (NLP) applications. However, there has been little work on evaluating how well existing methods for SBD perform in the clinical domain. We evaluate five popular off-the-shelf NLP toolkits on the task of SBD in various kinds of text using a diverse set of corpora, including the GENIA corpus of biomedical abstracts, a corpus of clinical notes used in the 2010 i2b2 shared task, and two general-domain corpora (the British National Corpus and Switchboard). We find that, with the exception of the cTAKES system, the toolkits we evaluate perform noticeably worse on clinical text than on general-domain text. We identify and discuss major classes of errors, and suggest directions for future work to improve SBD methods in the clinical domain. We also make the code used for SBD evaluation in this paper available for download at

  16. Technology-Assisted Patient Access to Clinical Information: An Evaluation Framework for Blue Button (United States)

    Nazi, Kim M; Luger, Tana M; Amante, Daniel J; Smith, Bridget M; Barker, Anna; Shimada, Stephanie L; Volkman, Julie E; Garvin, Lynn; Simon, Steven R; Houston, Thomas K


    Background Patient access to clinical information represents a means to improve the transparency and delivery of health care as well as interactions between patients and health care providers. We examine the movement toward augmenting patient access to clinical information using technology. Our analysis focuses on “Blue Button,” a tool that many health care organizations are implementing as part of their Web-based patient portals. Objective We present a framework for evaluating the effects that technology-assisted access to clinical information may have on stakeholder experiences, processes of care, and health outcomes. Methods A case study of the United States Department of Veterans Affairs' (VA) efforts to make increasing amounts of clinical information available to patients through Blue Button. Drawing on established collaborative relationships with researchers, clinicians, and operational partners who are engaged in the VA’s ongoing implementation and evaluation efforts related to Blue Button, we assessed existing evidence and organizational practices through key informant interviews, review of documents and other available materials, and an environmental scan of published literature and the websites of other health care organizations. Results Technology-assisted access to clinical information represents a significant advance for VA patients and marks a significant change for the VA as an organization. Evaluations of Blue Button should (1) consider both processes of care and outcomes, (2) clearly define constructs of focus, (3) examine influencing factors related to the patient population and clinical context, and (4) identify potential unintended consequences. Conclusions The proposed framework can serve as a roadmap to guide subsequent research and evaluation of technology-assisted patient access to clinical information. To that end, we offer a series of related recommendations. PMID:24675395

  17. Portfolio assessment and evaluation: Implications and guidelines for clinical nursing education


    M M Chabeli


    With the advent of Outcomes-Based Education in South Africa, the quality of nursing education is debatable, especially with regard to the assessment and evaluation of clinical nursing education, which is complex and renders the validity and reliability of the methods used questionable. This paper seeks to explore and describe the use of portfolio assessment and evaluation, its implications and guidelines for its effective use in nursing education. Firstly, the concepts of assessment, evaluati...

  18. Disabled children (0-3 years) and integrated services--the impact of Early Support. (United States)

    Young, Alys; Temple, Bogusia; Davies, Linda; Parkinson, Gillian; Bolton, Joanna


    Early Support (ES) is the flagship government programme aimed at improving multi-agency working with, and supporting enhanced outcomes for, children with a disability 0-3 years and their families. This paper draws on results from the recently completed Department for Education and Skills commissioned national evaluation of ES involving 46 pathfinder projects throughout England. Data were collected by survey at two points in time (9 months apart), by focus groups with service providers and parents, and through secondary data analyses, including exploratory economic evaluation. This paper outlines some of the key findings pertaining to the relationship between integrated children's services and the impact of ES. As such, we address three concerns: what the evidence from ES can tell us about the relationships between universal and targeted provision within integrated children's service structures, the relationship between specific short-term initiatives and their longer-term sustainability within integrated children's services structures and the potential costs and benefits of ES looking forward to its implementation on a national basis within an integrated children's services environment. Although focused primarily on children with a disability in the early years, implications will be drawn for the implementation of Lead Professional Guidance and the Common Assessment Framework more generically.

  19. Interictal SPECT of rCBF is of clinical utility in the preoperative evaluation of patients with partial epilepsy

    DEFF Research Database (Denmark)

    Andersen, A.R.; Hansen, B.A.; Hogenhaven, H;


    Fifty-eight patients with drug-resistant partial epilepsy were studied preoperatively by interictal rCBF measurements using 99mTc-HMPAO and a dedicated brain SPECT camera (Tomomatic 64). Follow-up of seizure outcome, using the 'Engel score', was at least 3 years. The data were analyzed in a blind...... patients ictal SPECT of rCBF was additionally performed. In 2 cases it added further information to the patient evaluation...

  20. Interictal SPECT of rCBF is of clinical utility in the preoperative evaluation of patients with partial epilepsy

    DEFF Research Database (Denmark)

    Andersen, A R; Hansen, B A; Høgenhaven, H;


    Fifty-eight patients with drug-resistant partial epilepsy were studied preoperatively by interictal rCBF measurements using 99mTc-HMPAO and a dedicated brain SPECT camera (Tomomatic 64). Follow-up of seizure outcome, using the "Engel score", was at least 3 years. The data were analyzed in a blind...... patients ictal SPECT of rCBF was additionally performed. In 2 cases it added further information to the patient evaluation....

  1. Portfolio assessment and evaluation: Implications and guidelines for clinical nursing education

    Directory of Open Access Journals (Sweden)

    M.M. Chabeli


    Full Text Available With the advent of Outcomes-Based Education in South Africa, the quality of nursing education is debatable, especially with regard to the assessment and evaluation of clinical nursing education, which is complex and renders the validity and reliability of the methods used questionable. This paper seeks to explore and describe the use of portfolio assessment and evaluation, its implications and guidelines for its effective use in nursing education. Firstly, the concepts of assessment, evaluation, portfolio and alternative methods of evaluation are defined. Secondly, a comparison of the characteristics of the old (traditional methods and the new alternative methods of evaluation is made. Thirdly, through deductive analysis, synthesis and inference, implications and guidelines for the effective use of portfolio assessment and evaluation are described.

  2. Evaluation of children's dental anxiety levels at a kindergarten and at a dental clinic. (United States)

    Kilinç, Gulser; Akay, Aynur; Eden, Ece; Sevinç, Nilgün; Ellidokuz, Hülya


    This study evaluated the dental anxiety levels of preschool children at a kindergarten and at a dental clinic. The anxiety levels of ninety 4-6-year-old (4.99 ± 0.81) preschool children were evaluated according to pulse rates, the facial image scale (FIS), the Venham picture test (VPT), and the Frankl behavior rating scale. The children's mothers were asked to complete the state-trait anxiety inventory (STAI) forms 1 and 2 (STAI 2 and STAI 2). The sample t-test, Mann-Whitney U test, and Pearson's correlation test were used. A statistically significant difference was observed between the children's pulse rates when measured at the dental clinic and those when measured at the kindergarten (p kindergarten when assessed using FIS and VPT (p = 0.090 and p = 0.108, respectively). There was a statistically significant correlation between the transient anxiety levels (STAI 1) of mothers and the VPT scores of their children evaluated at the dental clinic (r = 0.506, p kindergarten, their anxiety levels seemingly increased as they arrived at the dental clinic. The significant increase observed in the children's pulse rates was a physical indicator that their anxiety levels had increased. It can be concluded that the children felt more anxious at the dental clinic that at the kindergarten.

  3. Integrating economic evaluation methods into clinical and translational science award consortium comparative effectiveness educational goals. (United States)

    Iribarne, Alexander; Easterwood, Rachel; Russo, Mark J; Wang, Y Claire


    With the ongoing debate over health care reform in the United States, public health and policy makers have paid growing attention to the need for comparative effectiveness research (CER). Recent allocation of federal funds for CER represents a significant move toward increased evidence-based practice and better-informed allocation of constrained health care resources; however, there is also heated debate on how, or whether, CER may contribute to controlling national health care expenditures. Economic evaluation, in the form of cost-effectiveness or cost-benefit analysis, is often an aspect of CER studies, yet there are no recommendations or guidelines for providing clinical investigators with the necessary skills to collect, analyze, and interpret economic data from clinical trials or observational studies. With an emphasis on multidisciplinary research, the Clinical and Translational Science Award (CTSA) consortium and institutional CTSA sites serve as an important resource for training researchers to engage in CER. In this article, the authors discuss the potential role of CTSA sites in integrating economic evaluation methods into their comparative effectiveness education goals, using the Columbia University Medical Center CTSA as an example. By allowing current and future generations of clinical investigators to become fully engaged not only in CER but also in the economic evaluations that result from such analyses, CTSA sites can help develop the necessary foundation for advancing research to guide clinical decision making and efficient use of limited resources.

  4. Large ameloblastic fibro-odontoma in a 3 year- old child: case report

    Directory of Open Access Journals (Sweden)

    Laurindo Moacir Sassi


    Full Text Available Introduction: The ameloblastic fibro-odontoma is a rare mixed neoplasm composed of proliferating odontogenic epithelium, ectomesenchymal tissue, and varying degrees of dental hard tissue formation. The mean age of the incidence is from 8-12 years and there is no gender or anatomic site predilection, but it is most commonly found in children’s or teenager’s jaws. Case report: A 3-year-old female patient showed a swelling in anterior maxilla, with facial asymmetry. Radiographically, it presented as a mixed lesion with undefined limits. Clinical hypothesis was odontoma. Enucleating surgery was conducted with tooth germs preservation. The final diagnosis was ameloblastic fibro-odontoma. No recurrence was observed at 1-year follow-up period, and the permanent tooth germs were correctly positioned for eruption. Conclusion: Although ameloblastic fibro-odontoma is a benign lesion, it developed in a very early age, with rapid growth and destruction of cortical bone. Proper surgical enucleation allowed the teeth maintenance.

  5. Conservative management of external root resorption after tooth reimplantation: a 3-year follow-up. (United States)

    Ionta, Franciny Querobim; de Oliveira, Gabriela Cristina; de Alencar, Catarina Ribeiro Barros; Gonçalves, Priscilla Santana Pinto; Alcalde, Murilo Priori; Minotti, Paloma Gagliardi; Machado, Maria Aparecida de Andrade Moreira; Rios, Daniela


    The aim of this case report is to describe the treatment of a 9-year-old patient who suffered external root resorption of the permanent maxillary left lateral incisor following reimplantation of the avulsed left central and lateral incisors. Sixteen days after reimplantation and splinting of the incisors in a hospital emergency department, the patient was brought to the pediatric department of a dental school for further treatment. Root canal access was created in the maxillary left lateral and central incisors, and calcium hydroxide paste was used as intracanal dressing. At the 5-month follow-up, a radiograph revealed extensive external root resorption, a communicating root canal, and a periodontal lesion affecting the left lateral incisor. Management of the root resorption included obturation of the apical third of the canal with gutta percha and the middle third with mineral trioxide aggregate (MTA). At the 3-year recall examination, the patient was asymptomatic, and no mobility or soft tissue alterations were observed clinically. There was no radiographic sign that resorption had progressed. Despite the success of treatment, observation is still required. The use of MTA may be considered an alternative treatment for external root resorption after tooth reimplantation. The technique may allow tooth preservation in children until skeletal growth and development are completed and implant treatment may be considered.

  6. Benign occipital epilepsy of childhood: Panayiotopoulos syndrome in a 3 year old child

    Directory of Open Access Journals (Sweden)

    Menon Narayanankutty Sunilkumar , Vadakut Krishnan Parvathy


    Full Text Available Panayiotopoulos syndrome (PS is a relatively frequent and benign epileptic syndrome seen in children in the age group of 3-6 years and is characterised by predominantly autonomic symptoms and/or simple motor focal seizures followed or not by impairment of consciousness. Although multifocal spikes with high amplitude sharp-slow wave complexes at various locations can be present in the EEG, interictal electroencephalogram (EEG in children with this particular type of epilepsy characteristically shows occipital spikes. This syndrome has known to be a masquerader and can imitate gastroenteritis, encephalitis, syncope, migraine, sleep disorders or metabolic diseases. In the absence of thorough knowledge of types of benign epilepsy syndromes and their various clinical presentations, epilepsy such as PS can be easily missed. The peculiar aspects of this type of epilepsy in children should be known not only by paediatricians but also by general doctors because a correct diagnosis would avoid aggressive interventions and concerns on account of its benign outcome. In this case study, we report a case of PS in a 3 year old child.

  7. Treatment of male varicoceles by transcatheter polidocanol foam sclerotherapy: evaluation of clinical success, complications, and patients' satisfaction with regard to alternative techniques

    Energy Technology Data Exchange (ETDEWEB)

    Ali, Alma; Wirth, Stefan; Treitl, Karla Maria; Treitl, Marcus [Hospital of the Ludwig-Maximilians University of Munich, Institute for Clinical Radiology, Munich (Germany)


    We report our experience with polidocanol foam sclerotherapy with no additional coils, evaluating clinical success, patients' satisfaction, and complications. We conducted a retrospective study of 141 patients with 146 varicoceles (mean age: 29.3 years; range: 13 - 60 years) who underwent foam sclerotherapy with polidocanol 2 % (range: 2 - 12 ml) in an outpatient setting between January 2007 and December 2013. For the follow-up, telephone interviews with the patients were conducted (mean follow-up time: 46.4 months, standard deviation: 20.17 months). The technical success rate was 91.8 %. There was a 55.8 % response rate to the telephone interviews. Follow-up revealed a clinical success rate of 83.9 % and a persistence or relapse rate of 16.1 %. Of the patients, 81.9 % were absolutely satisfied with the outcome. In 94.9 % of cases, pain or discomfort resolution was reported, and in 97 % of cases, aesthetic issues were no longer a problem. Of partners, 63.2 % achieved pregnancy, and in 50 % of patients with preprocedural testicular atrophy, catch-up growth was observed. One patient with pampiniform plexus phlebitis received inpatient treatment with no long-term damage recorded. Polidocanol foam varicocele sclerotherapy is a safe and effective procedure, with a high rate of patients' satisfaction, clinical and technical success, and considerable catch-up growth and pregnancy achievement. (orig.)

  8. 21 CFR 312.87 - Active monitoring of conduct and evaluation of clinical trials. (United States)


    ... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Active monitoring of conduct and evaluation of clinical trials. 312.87 Section 312.87 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE INVESTIGATIONAL NEW DRUG APPLICATION Drugs Intended to Treat Life-threatening...

  9. Clinical and radiographic evaluation of early loaded narrow-diameter implants

    DEFF Research Database (Denmark)

    Maiorana, Carlo; King, Paul; Quaas, Sebastian;


    OBJECTIVE: To evaluate the clinical reliability of narrow implants placed in a one-stage procedure and early loaded in the upper and lower incisor region. MATERIAL AND METHODS: This is a prospective, single-arm, multicenter study in which patients with missing natural dentition in upper lateral a...

  10. The clinical evaluation of the upper limb joints' function: back to Hippocrates. (United States)

    Kapandji, Adalbert I


    This article provides evidence that evaluation of upper limb joint function may be performed without the use of instruments and using only clinical means to diagnose in most cases. Hippocrates would have proceeded the same way in the early ages of medicine.

  11. Evaluating an Objective Structured Clinical Examination (OSCE) Adapted for Social Work (United States)

    Bogo, Marion; Regehr, Cheryl; Katz, Ellen; Logie, Carmen; Tufford, Lea; Litvack, Andrea


    Objectives: To evaluate an objective structured clinical examination (OSCE) adapted for social work in a lab course and examine the degree to which it predicts competence in the practicum. Method: 125 Masters students participated in a one-scenario OSCE and wrote responses to standardized reflection questions. OSCE performance and reflections were…

  12. Evaluation of the Cochrane tool for assessing risk of bias in randomized clinical trials

    DEFF Research Database (Denmark)

    Jørgensen, Lars; Paludan-Müller, Asger Sand; Laursen, David R. T.;


    BACKGROUND: The Cochrane risk of bias tool for randomized clinical trials was introduced in 2008 and has frequently been commented on and used in systematic reviews. We wanted to evaluate the tool by reviewing published comments on its strengths and challenges and by describing and analysing how ...

  13. Pain response of healthy workers following a Functional Capacity Evaluation and implications for clinical interpretation

    NARCIS (Netherlands)

    Soer, Remko; Groothoff, Johan W.; Geertzen, Jan H. B.; van der Schans, Cees P.; Reesink, David D.; Reneman, Michiel F.


    Background and aim Functional Capacity Evaluations (FCEs) are used to quantify physical aspects of work capacity. Safety is a critical issue for clinical use of an FCE. Patients with Chronic Low Back Pain (CLBP) are known to report a temporary increase in pain following an FCE, but it is not known w

  14. A CIS (Clinical Information System) Quality Evaluation Tool for Nursing Care Services (United States)

    Lee, Seon Ah


    The purpose of this study was to develop a tool to evaluate the quality of a clinical information system (CIS) conceived by nurses and conduct a pilot test with the developed tool as an initial assessment. CIS quality is required for successful implementation in information technology (IT) environments. The study started with the realization that…

  15. An Antipodean Evaluation of Problem-Based Learning by Clinical Educators. (United States)

    Williams, Allison F.


    The use of problem-based learning in an Australian nursing education program was evaluated through interviews with 14 clinical teachers. They saw improvement in students' self-direction and holistic views of patients, but felt students lacked psychomotor skills and fundamental knowledge of anatomy and physiology. (SK)

  16. 5-Year randomized clinical evaluation of posterior bulk-fill restorations

    DEFF Research Database (Denmark)

    Pallesen, Ulla; van Dijken, Jan WV

    Purpose/aim: To evaluate in a randomized controlled study the 5-year clinical durability of a flowable resin composite bulk-fill technique in Class I and Class II restorations. Materials and methods: 38 pairs Class I and 62 pairs Class II restorations were placed in 44 male and 42 female (mean age...

  17. 75 FR 81611 - Submission for OMB Review; Comment Request; National Evaluation of the Clinical and Translational... (United States)


    ... collected will be used to provide analytical and policy support to NCRR, assisting NIH in making decisions... HUMAN SERVICES Submission for OMB Review; Comment Request; National Evaluation of the Clinical and... Health has submitted to the Office of Management and Budget (OMB) a request to review and approve...

  18. Clinical differentiation and outcome evaluation in vegetative and minimally conscious state patients: the neurophysiological approach (United States)

    De Salvo, Simona; Bramanti, Placido; Marino, Silvia


    Summary The neurophysiological approach to patients with disorders of consciousness allows recording of both central and peripheral nervous system electrical activities and provides a functional assessment. Data obtained using this approach can supplement information from clinical neurological examination, but also from the use of morphological neuroimaging techniques: computed tomography and magnetic resonance imaging. Neurophysiological techniques, such as electroencephalography (EEG), evoked potentials, transcranial magnetic stimulation, and EEG in association with functional magnetic resonance imaging, allow monitoring of clinical conditions and can help in the formulation of a prognosis. The aim of this review is to describe the main neurophysiological techniques used in disorders of consciousness to evaluate residual cerebral function, to provide information on the neuronal dysfunction for outcome evaluation, and to differentiate clinically between the vegetative and minimally conscious states. PMID:23402676

  19. Development and impact analysis of 3-year-old child FE human model

    NARCIS (Netherlands)

    Koizumi, T.; Tsujiuchi, N.; Taki, N.; Forbes, P.A.; Lange, R. de


    In a previous study, a 3-year old child FE human model was developed by scaling down an adult male FE human model. Scaling down was performed for body dimensions, joint characteristics, and material properties. The focus of this current study is biofidelity validation and enhancement of the 3-year-o

  20. Perception and Production of Lexical Tones by 3-Year-Old, Mandarin-Speaking Children (United States)

    Wong, Puisan; Schwartz, Richard G.; Jenkins, James J.


    The present study investigated 3-year-old children's perception and production of Mandarin lexical tones in monosyllabic words. Thirteen 3-year-old, Mandarin-speaking children participated in the study. Tone perception was examined by a picture-pointing task, and tone production was investigated by picture naming. To compare children's productions…

  1. Allocation of Resources to Collaborators and Free-Riders in 3-Year-Olds (United States)

    Melis, Alicia P.; Altrichter, Kristin; Tomasello, Michael


    Recent studies have shown that in situations where resources have been acquired collaboratively, children at around 3 years of age share mostly equally. We investigated 3-year-olds' sharing behavior with a collaborating partner and a free-riding partner who explicitly expressed her preference not to collaborate. Children shared more equally with…

  2. Effects of total laryngectomy on olfactory function, health-related quality of life, and communication: a 3-year follow-up study

    Directory of Open Access Journals (Sweden)

    Möller Riitta


    Full Text Available Abstract Background As total laryngectomy results in loss of airflow through the nose, one of the adverse effects for a majority of patients is the reduced or complete loss of olfactory function. However, with the introduction of a new method, the Nasal Airflow-Inducing Maneuver (NAIM, an important technique is available for laryngectomized patients to regain the ability to smell. The purpose of the present study was to assess changes in olfaction, health-related quality of life (HRQL and communication 3 years after NAIM rehabilitation. Methods 18 patients (15 men and 3 women; mean age, 71 years who had undergone laryngectomy and NAIM rehabilitation were followed longitudinally for 3 years. For comparison an age and gender matched control group with laryngeal cancer treated with radical radiotherapy was included. Olfactory function was assessed using the Questionnaire on Odor, Taste and Appetite and the Scandinavian Odor Identification Test. HRQL was assessed by: 1 the European Organization for Research and Treatment for cancer quality of life questionnaires; and 2 the Hospital Anxiety and Depression Scale. Communication was assessed by the Swedish Self-Evaluation of Communication Experiences after Laryngeal Cancer. Descriptive statistics with 95% confidence interval were calculated according to standard procedure. Changes over time as well as tests between pairs of study patients and control patients were analyzed with the Fisher nonparametric permutation test for matched pairs. Results Thirty-six months after rehabilitation 14 of 18 laryngectomized patients (78% were smellers. There were, with one exception (sleep disturbances, no clinically or statistically significant differences between the study and the control group considering HRQL and mental distress. However, statistical differences (p Conclusion Olfactory training with NAIM should be integrated into the multidisciplinary rehabilitation program after total laryngectomy. Our study shows

  3. Clinical evaluation of Synthetic Aperture Sequential Beamforming and Tissue Harmonic Imaging

    DEFF Research Database (Denmark)

    Brandt, Andreas Hjelm; Hemmsen, Martin Christian; Hansen, Peter Møller


    This study determines if the data reduction achieved by the combination Synthetic Aperture Sequential Beamforming (SASB) and Tissue Harmonic Imaging (THI) affects image quality. SASB-THI was evaluated against the combination of Dynamic Received Focusing and Tissue Harmonic Imaging (DRF-THI). A BK...... liver pathology were scanned to set a clinical condition, where ultrasonography is often performed. A total of 114 sequences were recorded and evaluated by five radiologists. The evaluators were blinded to the imaging technique, and each sequence was shown twice with different left-right positioning...

  4. Evaluation of clinical pathology data: correlating changes with other study data. (United States)

    Everds, Nancy E


    During the conduct of in vivo toxicology studies, in-life, clinical pathology, and anatomic pathology parameters are collected and interpreted. These sets of parameters are evaluated in an integrative manner to determine the overall toxicity of a test article. For clinical pathology parameters, the inherent variability and physiologic factors affecting each analyte must be understood prior to interpretation. Changes in clinical pathology parameters that are considered to be test article-related are then assessed with respect to changes in the concurrent data sets such as clinical signs and anatomic pathology to determine the underlying pathophysiology. In this article, examples of hemolysis and hepatotoxicity are used to demonstrate the relationships among the various parameters and data sets. Whereas there was tight correlation of all data sets in the example of hemolysis in rats, the examples of altered enzymes and other biomarkers indicating liver injury and dysfunction were more often discordant with other data sets.

  5. Assessing students' English language proficiency during clinical placement: A qualitative evaluation of a language framework. (United States)

    San Miguel, Caroline; Rogan, Fran


    The increase in nursing students for whom English is an additional language requires clinical facilitators to assess students' performance regarding clinical skills, nursing communication and English language. However, assessing language proficiency is a complex process that is often conflated with cultural norms and clinical skills, and facilitators may lack confidence in assessing English language. This paper discusses an evaluation of a set of guidelines developed in a large metropolitan Australian university to help clinical facilitators make decisions about students' English language proficiency. The study found that the guidelines were useful in helping facilitators assess English language. However, strategies to address identified language problems needed to be incorporated to enable the guidelines to also be used as a teaching tool. The study concludes that to be effective, such guidelines need embedding within a systematic approach that identifies and responds to students who may be underperforming due to a low level of English language proficiency.

  6. Development of criteria for evaluating clinical response in thyroid eye disease using a modified Delphi technique

    DEFF Research Database (Denmark)

    Douglas, Raymond S; Tsirbas, Angelo; Gordon, Mark;


    OBJECTIVE: To identify components of a provisional clinical response index for thyroid eye disease using a modified Delphi technique. METHODS: The International Thyroid Eye Disease Society conducted a structured, 3-round Delphi exercise establishing consensus for a core set of measures for clinical...... exercise, we developed provisional core measures for assessing disease activity and severity in clinical trials of therapies for thyroid eye disease. These measures will be iteratively refined for use in multicenter clinical trials.......% of participants) rated 153 criteria in Delphi 3 (67 criteria were excluded because of redundancy). Criteria with a mean greater than 6 (1 = least appropriate to 9 = most appropriate) were further evaluated by the nominal group technique and provisional core measures were chosen. CONCLUSIONS: Using a Delphi...

  7. Diagnosis of cystocele--the correlation between clinical and radiological evaluation. (United States)

    Altman, Daniel; Mellgren, Anders; Kierkegaard, Jonas; Zetterström, Jan; Falconer, Christian; López, Annika


    In patients with genital prolapse involving several compartments simultaneously, radiologic investigation can be used to complement the clinical assessment. Contrast medium in the urinary bladder enables visualization of the bladder base at cystodefecoperitoneography (CDP). The aim of the present study was to evaluate the correlation between clinical examination using the Pelvic Organ Prolapse Quantification system (POP-Q) and CDP. Thirty-three women underwent clinical assessment and CDP. Statistical analysis using Pearson's correlation coefficient ( r) demonstrated a wide variability between the current definition of cystocele at CDP and POP-Q ( r=0.67). An attempt to provide an alternative definition of cystocele at CDP had a similar outcome ( r=0.63). The present study demonstrates a moderate correlation between clinical and radiologic findings in patients with anterior vaginal wall prolapse. It does not support the use of bladder contrast at radiologic investigation in the routine preoperative assessment of patients with genital prolapse.

  8. Evaluation of undergraduate nursing students' clinical confidence following a mental health recovery camp. (United States)

    Cowley, Thomas; Sumskis, Sue; Moxham, Lorna; Taylor, Ellie; Brighton, Renee; Patterson, Chris; Halcomb, Elizabeth


    In the present study, we evaluate the impact of participation in a mental health recovery camp on the clinical confidence of undergraduate nursing students in dealing with individuals with mental illness. Twenty undergraduate nursing students who participated in the recovery camp completed the Mental Health Nursing Clinical Confidence Scale both before and directly after attending the camp. Data were analysed using descriptive and inferential statistics. Participation in the recovery camp was associated with a statistically-significant increase in students' level of overall confidence between the pretest and post-test data (P students over the age of 25 years and who do not have a family history of mental illness are more likely to self-report a higher level of confidence in both the pre- and post-results. The clinical confidence of undergraduate nursing students improved through participation in an immersive clinical experience within the recovery camp.

  9. Clinical and Ultrasonographic Evaluation of Lower-extremity Vein Thrombosis in Behcet Syndrome (United States)

    Seyahi, Emire; Cakmak, Osman Serdal; Tutar, Burcin; Arslan, Caner; Dikici, Atilla Suleyman; Sut, Necdet; Kantarci, Fatih; Tuzun, Hasan; Melikoglu, Melike; Yazici, Hasan


    Abstract Vascular involvement can be seen in up to 40% of patients with Behcet syndrome (BS), the lower-extremity vein thrombosis (LEVT) being the most common type. The aim of the current study was to compare venous Doppler findings and clinical features between BS patients with LEVT and control patients diagnosed as having LEVT due to other causes. All consecutive 78 patients (71 men, 7 women; mean age 38.6 ± 10.3 years) with LEVT due to BS and 50 control patients (29 men, 21 women; mean age 42.0 ± 12.5 years) who had LEVT due to other causes, or idiopathic, were studied with the help of a Doppler ultrasonography after a detailed clinical examination. Patterns of venous disease were identified by cluster analyses. Clinical features of chronic venous disease were assessed using 2 classification systems. Venous claudication was also assessed. Patients with BS were more likely to be men, had significantly earlier age of onset of thrombosis, and were treated mainly with immunosuppressives and less frequently with anticoagulants. Furthermore, they had significantly more bilateral involvement, less complete recanalization, and more frequent collateral formation. While control patients had a disorganized pattern of venous involvement, BS patients had a contiguous and symmetric pattern, involving all deep and superficial veins of the lower extremities, with less affinity for crural veins. Clinical assessment, as measured by the 2 classification systems, also indicated a more severe disease among the BS patients. In line, 51% of the BS patients suffered from severe post-thrombotic syndrome (PTS) and 32% from venous claudication, whereas these were present in 8% and 12%, respectively, among the controls. Among BS patients, a longer duration of thrombosis, bilateral femoral vein involvement, and using no anticoagulation along with immunosuppressive treatment when first diagnosed were found to be associated independently with severe PTS. Lower-extremity vein

  10. Evaluation of Clinical and MRI Staging for Prostate Cancer before Radical Prostatectomy

    Institute of Scientific and Technical Information of China (English)

    ZHONGChenyang; ZOUEnze; CHENMin; WANGWenchao; ZHAOWeifeng; WANBen; DENGShuming; YANGJianye


    To evaluate the clinical significance of clinical staging and magnetic resonance imaging (MRI) staging for prostate cancer before radical prostatectomy. Methods: Thirty-two patients with organ confined prostate cancer were reviewed to assess the accuracy of clinical staging and MRI staging to correlate with pathological staging results after radical prostatectomy. Results: 33.3% (10/30) prostate cancer patients with staging C and 3.3% (1/30) prostate cancer patients with staging D were diagnosed by pathology after radical prostatectomy in 30 patients with prostate cancer with clinical staging B, and 36.7% (11/30) under staging; Only one patient was over staging in clinical staging C. 19.1% (4/21) prostate cancer patients with staging C were diagnosed in 21 patients with prostate cancer and under staging with MRI staging B; 11.1% (1/9) was over staging with MRI staging C. The clinical staging and MRI staging had more correlation with pathological staging results (P=0.002), and PPV of the organ confined prostate cancer by clinical staging and MRI staging were 63.3% and 80.9% respectively, and NPV of nonorgan confined prostate cancer by clinical staging and MRI staging were 50% and 88.9% respectively. MRI staging was more specificity and accuracy than that of clinical staging to predict pathological staging results before radical prostatectomy (P=0.023). Conclusion: The MRI staging was more accuracy than that of clinical staging to predict pathological staging results in organ confined and nonorgan confined prostate cancer before radical prostatectomy.

  11. Formative clinical evaluation of first-year students in fundamental nursing science

    Directory of Open Access Journals (Sweden)

    I. Wannenburg


    Full Text Available The outcome of any system of evaluation has a considerable impact on the daily lives of students in a variety of educational settings. Hence, it was attempted to illustrate the complexity of the problem when evaluating the performance skills of first year students in the clinical environment of the general hospital. The choice of the research field originated from the increasing concern of the researcher about the reliability of the current evaluation practices in the formative assessment of first year student nurses. The impression gained is that nurse educators are more concerned with the end results of evaluation than with the teaching-learning process needed to reach this goal. Due to the many variables that can influence its results, the implementation of the evaluation process in clinical nursing is extremely complicated. In the course of studying the literature relevant to the research field, the researcher identified aspects that can be considered as of critical importance in the assessment of student performance in clinical nursing.

  12. Portfolio assessment and evaluation: implications and guidelines for clinical nursing education. (United States)

    Chabeli, M M


    With the advent of Outcomes-Based Education in South Africa, the quality of nursing education is debatable, especially with regard to the assessment and evaluation of clinical nursing education, which is complex and renders the validity and reliability of the methods used questionable. This paper seeks to explore and describe the use of portfolio assessment and evaluation, its implications and guidelines for its effective use in nursing education. Firstly, the concepts of assessment, evaluation, portfolio and alternative methods of evaluation are defined. Secondly, a comparison of the characteristics of the old (traditional) methods and the new alternative methods of evaluation is made. Thirdly, through deductive analysis, synthesis and inference, implications and guidelines for the effective use of portfolio assessment and evaluation are described. In view of the qualitative, descriptive and exploratory nature of the study, a focus group interview with twenty students following a post-basic degree at a university in Gauteng regarding their perceptions on the use of portfolio assessment and evaluation method in clinical nursing education was used. A descriptive method of qualitative data analysis of open coding in accordance with Tesch's protocol (in Creswell 1994:155) was used. Resultant implications and guidelines were conceptualised and described within the existing theoretical framework. Principles of trustworthiness were maintained as described by (Lincoln & Guba 1985:290-327). Ethical considerations were in accordance with DENOSA's standards of research (1998:7).

  13. Developing a Framework for Evaluating Ethical Outcomes of Good Participatory Practices in TB Clinical Drug Trials. (United States)

    MacQueen, Kathleen M; Eley, Natalie T; Frick, Mike; Mingote, Laia Ruiz; Chou, Alicia; Seidel, Stephanie S; Hannah, Stacey; Hamilton, Carol


    Good Participatory Practice Guidelines for TB Drug Trials (GPP-TB) were issued in 2012, based on similar guidelines for HIV prevention and reflecting growing acceptance of the importance of community engagement and participatory strategies in clinical research. Though the need for such strategies is clear, evaluation of the benefits and burdens are needed. Working with a diverse group of global TB stakeholders including advocates, scientists, and ethicists, we used a Theory of Change approach to develop an evaluation framework for GPP-TB that includes a clearly defined ethical goal, a set of powerful strategies derived from GPP-TB practices for achieving the goal, and outcomes connecting strategies to goal. The framework is a first step in systematically evaluating participatory research in clinical trials.

  14. Maternal evaluations of young children’s developmental status: A comparison of clinic- and non-clinic-groups

    Directory of Open Access Journals (Sweden)

    Pia Deimann


    Full Text Available The question whether parents’ reports on their children’s development provide reliable information is a subject of controversial debate. While parental rating scales and parental interviews are widely used in clinical practice, empirical findings have shown that parents cannot assess their children well. Previous research has illustrated that most parents tend to overestimate the developmental status and cognitive performance of their children. If the child displays behavior problems, the accuracy of mothers’ appraisals decreases substantially. The aim of this study was (1 to examine whether mothers who are concerned about their children’s development still overestimate the developmental status and (2 whether maternal beliefs about developmental norms influence the accuracy of evaluation. The sample consisted of 14 mother-child-dyads who were clients of two outpatient clinics in Vienna and had concerns about the child’s development, 16 mother-child-dyads without concerns who sought advice because of their children’s potential high abilities, and 30 mother-child-dyads without concerns and no clinic referral. While the children were tested using the Wiener Entwicklungstest (Viennese Developmental Test, WET, Kastner-Koller & Deimann, 2002, a developmental test for children 3 to 6 years old, mothers were asked to estimate which items of the WET (1 their own child and (2 a normal peer would be able to solve. Mothers with concerns had limited knowledge of what a child of a certain age can achieve and they expected too much. Though they realized that their own developmentally delayed child did not fulfill these high expectations, they were not able to appraise his/her performance accurately. Mothers whose children were normally developed or even above average were able to evaluate their own children much more precisely. Moreover, these mothers estimated developmental norms more accurately. Both mothers of gifted children and of

  15. Progression of white matter hyperintensities and incidence of new lacunes over a 3-year period: the Leukoaraiosis and Disability study

    DEFF Research Database (Denmark)

    Gouw, A.A.; Flier, W.M. van der; Fazekas, F.;


    of new lacunes, which were found in 19% of the subjects (maximum=9), also appeared in the subcortical white matter, mainly of the frontal lobes, whereas most baseline lacunes were located in the basal ganglia. Baseline WMH and lacunes predicted both WMH progression and new lacunes. Furthermore, previous......, predominantly in the subcortical white matter. Progression was observed especially in subjects with considerable WMH and lacunes at baseline. Moreover, the presence of vascular risk factors at baseline predicted WMH progression and new lacunes over a 3-year period Udgivelsesdato: 2008/5......BACKGROUND AND PURPOSE: We studied the natural course of white matter hyperintensities (WMH) and lacunes, the main MRI representatives of small vessel disease, over time and evaluated possible predictors for their development. METHODS: Baseline and repeat MRI (3-year follow-up) were collected...

  16. Hormonal treatment may harm the germ cells in 1 to 3-year-old boys with cryptorchidism

    DEFF Research Database (Denmark)

    Cortes, D; Thorup, J; Visfeldt, J


    PURPOSE: Hormonal treatment with human chorionic gonadotropin (HCG) or gonadotropin releasing hormone may be given initially for cryptorchidism. We evaluated whether hormonal treatment is safe for the germ cells in boys with cryptorchidism 1 to 3 years old in whom follicle-stimulating hormone......, luteinizing hormone and testosterone values are normally low. MATERIALS AND METHODS: We measured the number of spermatogonia per tubule at orchiopexy in 72 consecutive boys with cryptorchidism who underwent simultaneous testicular biopsy. In 19 patients gonadotropin releasing hormone was unsuccessful, while 8...... after surgery alone (p = 0.06). Gonadotropin releasing hormone and HCG influenced germ cells equally. CONCLUSIONS: In 1 to 3-year-old boys with cryptorchidism gonadotropin releasing hormone or HCG given for testicular descent may suppress the number of germ cells....

  17. Summary of Medipix Technology's 3-Years in Space and Plans for Future Developments (United States)

    Pinsky, Lawrence


    NASA has evaluated 7 Timepix-based radiation imaging detectors from the CERN-based Medipix2 collaboration on the International Space Station (ISS), collecting more than 3-years of data, as well on the December, 2014 EFT-1 mission testing the new Orion Multi-Purpose Crew Vehicle. These data along with data collected at ground-based accelerator facilities including the NASA Space Radiation Lab (NSRL) at Brookhaven in the US, as well as at the HIMAC facility at the National Institute for Radiological Sciences in Japan, have allowed the development of software analysis techniques sufficient to provide a stand-alone accurate assessment of the space radiation environment for dosimetric purposes. Recent comparisons of the performance of the Timepix with both n-on-p and p-on-n Si sensors will be presented. The further evolution of the Timepix technology by the Medipix3 collaboration in the form of the Timepix3 chip, which employs a continuous data-driven readout scheme, is being evaluated for possible use in future space research applications. Initial performance evaluations at accelerators will be reported. The Medipix2 Collaboration is also in the process of designing an updated version of the Timepix chip, called the Timepix2, which will continue the frame-based readout scheme of the current Timepix chip, but add simultaneous charge encoding using the Time-Over-Threshold (TOT) and first-hit Time-of-Arrival (TOA) encoding. Current plans are to replace the Timepix by the Timepix2 with minimal reconfiguration of the supporting electronics. Longer-term plans include participation in the currently forming Medipix4 collaboration. A summary of these prospects will also be included.


    Directory of Open Access Journals (Sweden)

    Rizwana Habib


    Full Text Available BACKGROUND: Postmenopausal bleeding is a dreaded symptom both for the women and gynaecologist. Though it can be of benign origin, malignancy has to be ruled out and as such needs prompt evaluation. OBJECTIVE: (1 To study the etiological factors of postmenopausal bleeding and establish various endometrial causes of postmenopausal bleeding through histopathological evaluation. (2 To investigate the clinical significance of postmenopausal bleeding in terms of risk factors, incidence of malignancy and histopathological evaluation. METHODOLOGY: This observational study was conducted at Lalla Ded Hospital Srinagar over a period of 18 months in which 116 cases of postmenopausal bleeding were enrolled in the study. All patients were subjected to detailed history, examination and investigations follo wed by diagnostic curettage. Endometrial curretings were sent for histopathological examination. STATISTICAL ANALYSIS: Statistical Package for Social Sciences (SPSS V.16.0 and Microsoft Excel were used to carry statistical analysis of data. Data was analy zed with the help of descriptive statistics viz. %age, mean S.D. Graphically data was presented by bar and pie diagrams. RESULTS: Majority of the patients with postmenopausal bleeding were in the age of 45 - 55 years (63.8%, majority of cases 64(55.2% were para 1 - 3, uterus was of normal size in 53 cases (45.7% . Mean age of onset of menopause was 48.7 years. Obesity was found in 40 cases (34.5%, hypertension in 35 cases (30.2% , and diabetes in 12 cases (10.3% . Out of the 116 cases studied; the most commo n cause of bleeding in the postmenopausal age group was endometrial hyperplasia in 41 out of 116(35.3% followed by atrophic endometrium in 39 of 116(33.6% . Endometrial polyps were found in 9 (7.8% cases, proliferat ive endometrium was found in 10 (8.6% , endometritis was seen in 3(2.6% cases, secretory endometrium in 1(0.9% cases and adenofibroma in 1(0.9% cases. The incidence of endometrial carcinoma

  19. Effects of treatment with bimatoprost 0.03% for 3 years in patients with normal-tension glaucoma

    Directory of Open Access Journals (Sweden)

    Inoue K


    Full Text Available Kenji Inoue,1 Minako Shiokawa,1 Takayuki Fujimoto,1 Goji Tomita21Inouye Eye Hospital, Tokyo, Japan; 22nd Department of Ophthalmology, Toho University School of Medicine, Tokyo, JapanPurpose: To evaluate the effects of bimatoprost 0.03% single treatment for 3 years on intraocular pressure (IOP and visual field performance.Methods: We monitored the IOP of 62 patients with normal-tension glaucoma every 1–3 months. The Humphrey visual field test was performed every 6 months after treatment and the results obtained were compared to those before treatment. In addition, visual field performance was evaluated using trend and event analysis.Results: The mean ± standard deviation (SD of IOP after treatment with bimatoprost for 3 years (13.6±3.1 mmHg was significantly lower than that before treatment (16.8±2.4 mmHg, P<0.0001. No change was observed in the mean deviation and pattern SD values of the Humphrey visual field before and 3 years after treatment. Worsening of visual field performance was observed in one patient (3.0% by using trend analysis and in four patients (12.1% by using event analysis. Treatment was discontinued in 17 patients (27.4% because of adverse reactions.Conclusion: Bimatoprost 0.03% single treatment was effective in reducing the IOP at least during the 3 years of treatment, but visual field performance worsened by 3.0%–12.1% in patients with normal-tension glaucoma.Keywords: IOP, visual field, trend analysis, event analysis

  20. Valproate-associated reversible encephalopathy in a 3-year-old girl with Pallister-Killian syndrome. (United States)

    Gerstner, Thorsten; Bell, Nellie; Koenig, Stephan A


    Valproic acid (VPA) is considered to be a drug of first choice for the therapy of generalized and focal epilepsies, including special epileptic syndromes. The drug is usually well tolerated, rare serious complications may occur in some patients, including hemorrhagic pancreatitis, coagulapathies, bone marrow suppression, VPA-induced hepatotoxicity and encephalopathy. We report a case of VPA-associated encephalopathy without hyperammonemia in a 3-year-old girl with Pallister-Killian-Syndrom, combined with a mild hepatopathy and thrombopathy. After withdrawal of VPA, the clinical symptoms and the electroencephalography-alterations vanished rapidly.

  1. Patients with the tako-tsubo cardiomyopathy-clinical evaluation and outcome

    Institute of Scientific and Technical Information of China (English)

    Agata Salska; Izabela Plesiewicz; Marzenna Zielinska; Krzysztof Chiżynski


    Objective:Tako-tsubo cardiomyopathy(TTC) or is a rare, acute, reversible cardiac dysfunction mimicking an acute coronary syndrome(ACS) and usually connected with a preceding intense physical or emotional stress trigger.This case series-observational study is to evaluate the clinical findings(including the depression and anxiety disorders) and outcome in patients with the tako-tsubo cardiomyopathy treated in ourCentre, during18 month period.Methods:From the group of730 patients, who were admitted with the suspected acute myocardial infarct, ten patients, who fulfilled diagnostic criteria forTTC, were evaluated.For each patient we assessed: clinical characteristic, previous medical history including coronary disease risk factors and preceding stress trigger,12-leads electrocardiography and laboratory tests.All patients underwent coronary-artery angiography, trans-thoracic echocardiography and completed the questionnaire evaluating the depression and anxiety disorders.Results:The estimated prevalence and clinical features of patients with the tako-tsubo cardiomyopathy in ourCentre were similar to those in the literature, with the wide range of stress triggers.There was a statistically significant improvement in the ejection fraction during the hospitalization.Psychological tests revealed the0.7 occurrence of depression or anxiety disorders among our patients.Conclusions:The exact pathogenesis of the tako-tsubo cardiomyopathy remains uncertain, but it is important to take it into account as a differential diagnosis in patients with the clinical features of myocardial infarct in the absenceof coronary artery stenosis.

  2. Mini clinical evaluation exercise in undergraduate dermatovenereology education: an experience of University of Pamukkale, Medical Faculty

    Directory of Open Access Journals (Sweden)

    Şeniz Ergin


    Full Text Available Background and Design: Mini Clinical Evaluation Exercise (Mini-CEX is being widely used in medical education and is a reliable and valid method for the assessment of residents’ competency in medical interviewing, physical examination, humanistic qualities/professionalism, clinical judgment, counseling skills, organization, and efficiency. In order to enhance formative evaluation methods in our faculty, we planned to apply the method to students on dermatovenereology training. Materials and Methods: The Mini-CEX was performed by residents to 42 medical students. At first, 5 residents were evaluated by a faculty member with Mini-CEX and were informed about their application-oriented evaluator roles. The students were informed prior to conducting the assessment. Standard Mini-CEX form was used for the assessment. The participants were rated in 7 competencies and each was rated using a 9-point Likert scale. At the end of each encounter, students and evaluators rated their satisfaction with Mini-CEX using a 9-point Likert scale. Student’s t-test and one-way ANOVA were used for statistical analysis. Student feedback was evaluated with “grounded theory”. Results: A total of 50 assessments, 44 in outpatient and 6 in inpatient clinic, were performed. Satisfaction with the Mini-CEX was rated by the evaluators and the students as 7,16 and 7,98, respectively. There was no significant difference between the evaluators in terms of student satisfaction. Average time spent on observing the encounter and in giving feedback was 16.5 and 6.5 minutes, respectively. There was no significant difference between assessors in terms of time spent observing and giving feedback. Average scores of assessed clinical competencies were between 4,28 and 8,14. The highest scores were reported on humanistic qualities/ professionalism whereas the lowest were reported on clinical judgment skills. Discussion: According to our data, we believe that Mini-CEX may be used as an

  3. Traditional Chinese Medicine Diagnosis and Evaluation of the Clinical Effect in Post-hepatitic Cirrhosis based on Fuzzy Analysis

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hao-wei; ZHU Xun-sheng


    In view of the problem of traditional Chinese medicine (TCM) diagnosis, fuzzy comprehensive evaluation is introduced to the diagnosis and evaluation of the clinical effect of hepatitis. A new diagnosis and evaluation model of the TCM clinical effect standard was presented. The old disputed evaluation model by subjective analysis can be displaced by this objective method in its evaluation system. The foundation of this method is the fuzzy diagnosis model. This method has been realized to diagnose hepatitis and its values in practice has been validated through examples of clinical syndromes of post-hepatitic cirrhosis.

  4. Dissemination and implementation science in program evaluation: A telemental health clinical consultation case example. (United States)

    Arora, Prerna G; Connors, Elizabeth H; Blizzard, Angela; Coble, Kelly; Gloff, Nicole; Pruitt, David


    Increased attention has been placed on evaluating the extent to which clinical programs that support the behavioral health needs of youth have effective processes and result in improved patient outcomes. Several theoretical frameworks from dissemination and implementation (D&I) science have been put forth to guide the evaluation of behavioral health program implemented in the context of real-world settings. Although a strong rationale for the integration of D&I science in program evaluation exists, few examples exist available to guide the evaluator in integrating D&I science in the planning and execution of evaluation activities. This paper seeks to inform program evaluation efforts by outlining two D&I frameworks and describing their integration in program evaluation design. Specifically, this paper seeks to support evaluation efforts by illustrating the use of these frameworks via a case example of a telemental health consultation program in pediatric primary care designed to improve access to behavioral health care for children and adolescents in rural settings. Lessons learned from this effort, as well as recommendations regarding the future evaluation of programs using D&I science to support behavioral health care in community-based settings are discussed.

  5. Clinical and Radiographic Evaluation of Immediate Loaded Dental Implants With Local Application of Melatonin: A Preliminary Randomized Controlled Clinical Trial. (United States)

    El-Gammal, Mona Y; Salem, Ahmed S; Anees, Mohamed M; Tawfik, Mohamed A


    Immediate loading of dental implants in situations where low bone density exist, such as the posterior maxillary region, became possible recently after the introduction of biomimetic agents. This 1-year preliminary clinical trial was carried out to clinically and radiographically evaluate immediate-loaded 1-piece implants with local application of melatonin in the osteotomy site as a biomimetic material. 14 patients with missing maxillary premolars were randomized to receive 14 implants of 1-piece type that were subjected to immediate loading after 2 weeks of initial placement. Group I included 7 implants with acid-etched surface while group II included 7 implants with acid-etched surface combined with local application of melatonin gel at the osteotomy site. Patients were recalled for follow up at 1, 3, 6, and 12 months after loading. All implants were considered successful after 12 months of follow-up. Significant difference (P implant loading when considering the implant stability. At 1 and 3 months there were significant differences in the marginal bone level between the 2 groups. These results suggest that the local application of melatonin at the osteotomy site is associated with good stability and minimal bone resorption. However, more studies for longer follow-up periods are required to confirm the effect of melatonin hormone on osseointegration of dental implants.

  6. Role of the clinical pathology laboratory in the evaluation of endometrial carcinomas for Lynch syndrome. (United States)

    Djordjevic, Bojana; Broaddus, Russell R


    Molecular diagnostic testing of endometrial carcinomas in the pathology laboratory has recently emerged as a key component of the clinical evaluation of Lynch syndrome in many centers. Testing modalities involve immunohistochemical and PCR-based analyses. This article outlines the routine application of these analyses, provides a practical guide for troubleshooting some of the common technical issues related to their performance, and reviews common pitfalls in their interpretation. Discrepancies between tissue testing and genetic testing results are discussed in the context of the current understanding of endometrial cancer biology. The merits of universal versus targeted tissue testing based on clinical patient history and histological tumor appearance are also addressed.

  7. Evaluation of the Dade Behring Dimension RxL clinical chemistry analyzer. (United States)

    Cuka, S; Dvornik, S; Drazenović, K; Mihić, J


    The performance of the Dade Behring Dimension RxL clinical chemistry analyzer was evaluated according to the guidelines of the European Committee for Clinical Laboratory Standards. The following analytes were tested: glucose, urea, creatinine, albumin, phosphorus, cholesterol, triglyceride, uric acid, magnesium, sodium, potassium, chloride, calcium, iron and total bilirubin. The Dade Behring Dimension RxL was compared with the Hitachi 704, Bayer RA-1000, Ektachem 250 and Chiron 865 depending on available tests on these analyzers. Coefficients of correlation showed high correlation between compared analyzers. Other performances (intra- and inter-assay variation, carry-over and interferences) of the analyzer were satisfactory.

  8. Laboratory evaluation of the Beckman Synchron CX3 clinical chemistry analyzer. (United States)

    Peake, M J; Pejakovic, M; White, G H


    In this evaluation of the Beckman Synchron CX3, the multi-analyte clinical chemistry analyzer exhibited high precision, good linearity, and no carryover for each of the eight analytes measured. Results obtained correlated well with those produced by our routine instrumentation (Beckman Astra, Varian atomic absorption spectrophotometer). The instrument can process up to 75 samples per hour (600 tests per hour if all tests available are requested) and, after calibration, can provide urgent results for the complete panel of tests within 2 1/2 min. The performance characteristics of this instrument make it ideal as a routine or a "stat" analyzer for commonly requested tests in the clinical chemistry laboratory.

  9. Assessment and classification of psychopathology in epidemiological research of children 0-3 years of age: a review of the literature

    DEFF Research Database (Denmark)

    Skovgaard, A M; Houmann, T; Landorph, S L;


    The research of psychopathology in children 0-3 years of age is dominated by clinical case studies and theoretical reflections, and epidemiological studies are few. This paper reviews methods to assess and classify psychopathology in children 0-3 years old in an epidemiological context. Diagnostic...... psychopathology in children 0-3 years of age: screening instruments with established psychometric properties, such as the Child Behaviour Checklist (CBCL) and the Checklist for Autism in Toddlers (CHAT), and methods of in-depth assessment known from both clinical practice and research: developmental tests......, such as the Bayley Scales, and relationship assessments, such as the Early Relational Assessment (ERA). The classification of psychopathology in young children can be approved by the Diagnostic Classification 0-3. The reliability and validity of DC 0-3 have not yet been established, but preliminary results seem...

  10. Clinical and Radiographic Evaluation of Pulpotomized Primary Molars Restored with Stainless Steel Crown and Amalgam

    Directory of Open Access Journals (Sweden)

    Haghgoo R.


    Full Text Available Statement of Problem: Pulpotomy is the most common pulp treatment in primary teeth. Final restoration of the pulpotomized primary molar can affect the success rate of treatment. Purpose: The aim of this study was to evaluate the success rate of formocresol pulpotomy in primary molars restored with stainless steel crowns as compared to those restored with amalgam.Materials and Method: In this randomized clinical trial study, 110 primary molars to be treated with pulpotomy were treated by a conventional pulpotomy technique. Then these teeth were randomly divided into 2 groups: amalgam and crown. 55 teeth were restored by stainless steel crown and 55 by amalgam. The clinical and radiographic evaluation was done at 6-12-24 months. The data were analyzed by Exact Fisher test.Results: During the 6 months of evaluation, no clinical and radiographic failure was seen. In the 12 months of follow up in the amalgam group, 1 case showed swelling and furcal radiolucency. During the 24 months of evaluation, mobility was seen in 2 teeth in the crown group, and in the amalgam group radiolucency was seen in 1 case, mobility in 1 case, and internal resorption in 1 tooth. Exact Fisher test showed that there was no significant difference in the success rate of pulpotomized molars restored by stainless steel crown and amalgam.Conclusion: If the tooth is selected correctly for pulpotomy, SSC and amalgam restoration can be used as the final restoration.

  11. Process Evaluation of a Community Garden at an Urban Outpatient Clinic. (United States)

    Milliron, Brandy-Joe; Vitolins, Mara Z; Gamble, Elizabeth; Jones, Robert; Chenault, Margaret C; Tooze, Janet A


    In addition to expediting patient recovery, community gardens that are associated with medical facilities can provide fresh produce to patients and their families, serve as a platform for clinic-based nutrition education, and help patients develop new skills and insights that can lead to positive health behavior change. While community gardening is undergoing resurgence, there is a strong need for evaluation studies that employ valid and reliable measures. The objective of this study was to conduct a process evaluation of a community garden program at an urban medical clinic to estimate the prevalence of patient awareness and participation, food security, barriers to participation, and personal characteristics; garden volunteer satisfaction; and clinic staff perspectives in using the garden for patient education/treatment. Clinic patients (n = 411) completed a community garden participation screener and a random sample completed a longer evaluation survey (n = 152); garden volunteers and medical staff completed additional surveys. Among patients, 39% had heard of and 18% had received vegetables from the garden; the greatest barrier for participation was lack of awareness. Volunteers reported learning about gardening, feeling more involved in the neighborhood, and environmental concern; and medical staff endorsed the garden for patient education/treatment. Comprehensive process evaluations can be utilized to quantify benefits of community gardens in medical centers as well as to point out areas for further development, such as increasing patient awareness. As garden programming at medical centers is formalized, future research should include systematic evaluations to determine whether this unique component of the healthcare environment helps improve patient outcomes.

  12. A retrospective evaluation of haematological values in clinical cases of water buffaloes

    Directory of Open Access Journals (Sweden)

    Nittin D. Singh


    Full Text Available Aim: To evaluate the important haematological values of the retrospective clinical cases of buffaloes presented to the Teaching Veterinary Hospital of the College of Veterinary Science, Guru Angad Dev Veterinary and Animal Science University, Ludhiana over a period of 4 years from January 2007 to December 2010. Materials and methods: The blood was collected from jugular vein in EDTA containing vials. Statistical analysis of haematological values with different case history/clinical signs was performed using SPSS 16.0 version by applying one way ANOVA at P<0.05. Clinical pathology of these cases was monitored by comparing hemogram values with the reference range. Results: The most common disorders found in water buffaloes were digestive disorders followed by fever and respiratory disorders. Haematological values viz. TLC, DLC (neutrophil, lymphocyte and eosinophil counts showed significant differences depending upon the case history/clinical signs while haemoglobin count was found to be statistically nonsignificant. Conclusion: TLC and DLC are found to be the important indicators of health status of water buffaloes in general which are more related to clinical history/clinical signs of this species than other the haematological parameters viz. haemoglobin count. [Vet World 2013; 6(2.000: 103-105

  13. Evaluation of an in-clinic assay for the diagnosis of canine parvovirus. (United States)

    Decaro, N; Desario, C; Billi, M; Lorusso, E; Colaianni, M L; Colao, V; Elia, G; Ventrella, G; Kusi, I; Bo, S; Buonavoglia, C


    The results of a study designed to evaluate the performance of an in-clinic test for the detection of canine parvovirus (CPV) are reported. A total of 150 faecal samples collected from dogs with acute diarrhoea were tested using the in-clinic test, a haemagglutination assay (HA) and a real-time PCR assay for CPV detection, quantification and characterisation. CPV was detected in 66, 73, and 101 faecal samples by in-clinic, HA and PCR testing, respectively. The relative sensitivity and specificity of the in-clinic test were 86.3% and 96.1%, respectively, when the test was compared to HA, and 65.3% and 100%, respectively, when compared to real-time PCR. The sample distribution according to the virus type was CPV-2a, n=44; CPV-2b, n=11; CPV-2c, n=44, CPV-2, n=2, as determined by minor groove binder probe assays and/or sequence analysis. The percentage of positive in-clinic tests was 70.5% for CPV-2a, 72.7% for CPV-2b and 75.0% for CPV-2c (P>0.05). Using real-time PCR as the reference standard for CPV detection, the in-clinic test was more specific than HA and had comparable sensitivity to HA, demonstrating detection rates similar to those previously observed for other rapid in-clinic tests. The in-clinic test was also able to detect all CPV types at equivalent rates.


    Directory of Open Access Journals (Sweden)

    Sesha Prasad


    Full Text Available INTRODUCTION : 124 patients with common dermatological conditions with an auto - immune etiology are evaluated for hearing , irrespective of complaints of hearing loss . Auto - immunity is described as an etiology of Sudden or Progressive Sensory neural Hearing Loss ; similarly auto - immunity is described as an etiology for many skin diseases like Psoriasis , De rmatomyositis etc ., and the present study evaluates hearing thresholds in patients with auto - immune skin disorders . Auto - immunity is the etiology for both these conditions , causes many changes in the micro vasculature of the various organs and produces imm une complexes in the body . Hence evaluation of other organs in the presence of clinically evident autoimmune disease in one organ will guide the clinician for early diagnosis of auto immunity . So the patients with alopecia areata , Dermatomyositis , Psoriasis , Systemic sclerosis , Systemic Lupus Erythematoses , Vitiligo , Epidermolysis Bullosa and scleroderma are included in the present study for hearing evaluation . MATERIALS AND METHODS : 124 Patients attending the department of Dermatology and diagnosed with the following diseases are included in the present study ; 1 . Alopecia areata 2 . Dermatomyositis 3 . Psoriasis 4 . Systemic sclerosis 5 . Systemic Lupus Erythematoses 6 . Vitiligo 7 . Epidermolysis Bullosa . This is a prospective study conducted at GGH , Kur nool , and Andhra Pradesh . The diagnosis of the clinical entities included in this study is done according to clinical and Histopathological findings . The patients are referred from the Department of Dermatology for evaluation . After thorough history taking , the Patients are subjected for ENT examination . Pure Tone Audiometry at 250 , 500 , 1 , 000 , 2 , 000 , 4 , 000 , 6 , 000 and 8 , 000 Hz is done followed by Impedance audiometry ; including tympanometry and acoustic reflexes are done . CONCLUSION : Audiological evaluation in autoimmune skin diseases

  15. Evaluation and the NIH clinical and translational science awards: a "top ten" list. (United States)

    Pincus, Harold Alan; Abedin, Zainab; Blank, Arthur E; Mazmanian, Paul E


    Since 2006, a total of 61 Clinical and Translational Science Institutes (CTSAs) have been funded by the National Institutes of Health (NIH), with the aim of reducing translation time from a bench discovery to when it impacts patients. This special issue of Evaluation & the Health Professions focuses on evaluation within and across the large, complex system of the CTSA Program of NIH. Through insights gained by reading the articles in this special edition and the experience of the authors, a "top ten" list of lessons learned and insights gained is presented. The list outlines issues that face those who evaluate the influence of the CTSA Program, as they work to anticipate what will be needed for continuing success. Themes include (1) considering the needs of stakeholders, (2) the perspective of the evaluators, (3) the importance of service improvement, (4) the importance of teams and people, (5) costs and return on investments, (6) methodology considerations to evaluate the CTSA enterprise, (7) innovation in evaluation, (8) defining the transformation of research, (9) evaluating the long-term impact of the CTSAs on public health, and (10) contributing to science policy formulation and implementation. The establishment of the CTSA Program, with its mandated evaluation component, has not only influenced the infrastructure and nature of translational research but will continue to impact policy and management in science.

  16. Latin America Zika Outbreak Should 'Burn Out' Within 3 Years, Scientists Say (United States)

    ... Zika Outbreak Should 'Burn Out' Within 3 Years, Scientists Say As more people become immune after infection, ... Rico and other parts of the Americas, said scientists from Johns Hopkins University Bloomberg School of Public ...

  17. Health Impact Assessment and Evaluation of a Clinical Waste Management Policy for Cameroon. (United States)

    Gulis, Gabriel; Mochungong, Peter Ikome Kuwoh


    Health impact assessment (HIA) was carried out to evaluate development of a clinical waste management policy for Cameroon. Fifteen stakeholders of different portfolios within the health sector were selected during a HIA initiating study trip to the Northwest region of Cameroon. Questionnaires were then developed and emailed to the stakeholders. The stakeholders identified cross-contamination, environmental pollution, physical injuries and poor waste management sites as potential risk factors that can be associated with poor clinical waste management. They recommended strong economic and political capital as a prerequisite for the development and implementation of a successful clinical waste policy. Local impacts on health, according to the stakeholders, should be prioritized in deciding any treatment and disposal option. The whole HIA process run through 2008-2010.

  18. Health impact assessment and evaluation of a clinical waste management policy for Cameroon

    Directory of Open Access Journals (Sweden)

    Gabriel Gulis


    Full Text Available Health impact assessment (HIA was carried out to evaluate development of a clinical waste management policy for Cameroon. Fifteen stakeholders of different portfolios within the health sector were selected during a HIA initiating study trip to the Northwest region of Cameroon. Questionnaires were then developed and emailed to the stakeholders. The stakeholders identified cross-contamination, environmental pollution, physical injuries and poor waste management sites as potential risk factors that can be associated with poor clinical waste management. They recommended strong economic and political capital as a prerequisite for the development and implementation of a successful clinical waste policy. Local impacts on health, according to the stakeholders, should be prioritized in deciding any treatment and disposal option. The whole HIA process run through 2008-2010.

  19. Evaluation of the William S. Hall Psychiatric Institute Clinical Psychology Internship: a replication and extension. (United States)

    Stader, Sandra R; Myers, DeRosset; Forand, Angela Q; Holmes, George R; McNulty, George F; Frey, Linda; Bolton, Staci S


    This study extends three earlier investigations involving participants who completed their predoctoral clinical psychology internship at the William S. Hall Psychiatric Institute. Intern graduates (N = 37) evaluated how effectively their internship training prepared them for seven aspects of their current work as practicing psychologists. Participants also rated the relevancy of 24 different internship training experiences to their current work and how much these experiences contributed to their development as clinical psychologists. The present study, in conjunction with the three previous studies, covers most of the 40-year period since the inception of the internship program. Analysis of the current data indicates the internship has improved over time and was deemed an exceptional training experience by its graduates. Findings may be of particular interest to internship directors and faculty interested in improving their training program and those who plan to conduct a self-study to maintain their accreditation for clinical psychology internship.

  20. Implementation and evaluation of a clinical data management programme in a primary care centre.

    LENUS (Irish Health Repository)

    Sweeney, J


    Electronic health records (EHR) support clinical management, administration, quality assurance, research, and service planning. The aim of this study was to evaluate a clinical data management programme to improve consistency, completeness and accuracy of EHR information in a large primary care centre with 10 General Practitioners (GPs). A Clinical Data Manager was appointed to implement a Data Management Strategy which involved coding consultations using ICPC-2 coding, tailored support and ongoing individualised feedback to clinicians. Over an eighteen month period there were improvements in engagement with and level of coding. Prior to implementation (August 2011) 4 of the 10 GPs engaged in regular coding and 69% of their consultation notes were coded. After 12 months, all 10 GPs and 6 nurses were ICPC-2 coding their consultations and monthly coding levels had increased to 98%. This structured Data Management Strategy provides a feasible sustainable way to improve information management in primary care.

  1. Agreement between Therapists, Parents, Patients, and Independent Evaluators on Clinical Improvement in Pediatric Obsessive-Compulsive Disorder (United States)

    Lewin, Adam B.; Peris, Tara S.; De Nadai, Alessandro S.; McCracken, James T.; Piacentini, John


    Objective: Independent evaluators (IE) are used widely in clinical trials to make unbiased determinations of treatment response. By virtue of being kept blind to treatment condition, however, IEs are also kept unaware of many pertinent clinical details that are relevant for decisions about clinical improvement. In this study, agreement among…

  2. Breastfeeding and dietary variety among preterm children aged 1-3 years. (United States)

    Husk, Jesse S; Keim, Sarah A


    Among infants born at term, breastfeeding is associated with increased dietary variety in childhood. Preterm birth can limit early feeding options while simultaneously increasing risk for negative health outcomes that could benefit from dietary-based preventative measures. We assessed whether breastfeeding is associated with increased dietary variety at 1-3 years amongst children born preterm. We analyzed baseline data from two clinical trials investigating cognitive development after fatty-acid supplementation for 10-39 month-old children born before 35 weeks gestation (n = 189). At baseline, mothers reported breastfeeding history and completed a 161-item food-frequency questionnaire for their child. Dietary variety was assessed via 3 measures: (1) proportion items consumed at least once per month, (2) servings of a given item consumed relative to total monthly food servings, (3) daily probability of consuming a given item. Overall, 88% of children were ever breastfed (median duration = 89 days, range = 0-539), and 48% of children were ever exclusively breastfed (median duration = 59 days, range = 3-240). Exclusive breastfeeding duration was associated with dietary variety increases of 0.9% (95% CI = 0.1-1.7) for vegetables, 1.6% (95% CI = 0.2-3.0) for meat/fish, and 1.3% (95% CI = 0.2-2.4) for grain/starch, for each additional month of exclusive breastfeeding after adjustment for key confounders. Correspondingly, the variety of sweets consumed decreased by 1.2% (CI: -2.1, -0.3) per month of any breastfeeding after adjustment. These results are consistent with those in children born at term, and if causal, could provide additional support for exclusive breastfeeding to improve diet and health in children born preterm.

  3. Molecular diagnosis of toxoplasmosis in immunocompromised patients: a 3-year multicenter retrospective study. (United States)

    Robert-Gangneux, Florence; Sterkers, Yvon; Yera, Hélène; Accoceberry, Isabelle; Menotti, Jean; Cassaing, Sophie; Brenier-Pinchart, Marie-Pierre; Hennequin, Christophe; Delhaes, Laurence; Bonhomme, Julie; Villena, Isabelle; Scherer, Emeline; Dalle, Frédéric; Touafek, Feriel; Filisetti, Denis; Varlet-Marie, Emmanuelle; Pelloux, Hervé; Bastien, Patrick


    Toxoplasmosis is a life-threatening infection in immunocompromised patients (ICPs). The definitive diagnosis relies on parasite DNA detection, but little is known about the incidence and burden of disease in HIV-negative patients. A 3-year retrospective study was conducted in 15 reference laboratories from the network of the French National Reference Center for Toxoplasmosis, in order to record the frequency of Toxoplasma gondii DNA detection in ICPs and to review the molecular methods used for diagnosis and the prevention measures implemented in transplant patients. During the study period, of 31,640 PCRs performed on samples from ICPs, 610 were positive (323 patients). Blood (n = 337 samples), cerebrospinal fluid (n = 101 samples), and aqueous humor (n = 100 samples) were more frequently positive. Chemoprophylaxis schemes in transplant patients differed between centers. PCR follow-up of allogeneic hematopoietic stem cell transplant (allo-HSCT) patients was implemented in 8/15 centers. Data from 180 patients (13 centers) were further analyzed regarding clinical setting and outcome. Only 68/180 (38%) patients were HIV(+); the remaining 62% consisted of 72 HSCT, 14 solid organ transplant, and 26 miscellaneous immunodeficiency patients. Cerebral toxoplasmosis and disseminated toxoplasmosis were most frequently observed in HIV and transplant patients, respectively. Of 72 allo-HSCT patients with a positive PCR result, 23 were asymptomatic; all were diagnosed in centers performing systematic blood PCR follow-up, and they received specific treatment. Overall survival of allo-HSCT patients at 2 months was better in centers with PCR follow-up than in other centers (P toxoplasmosis in HIV-negative ICPs and suggests that regular PCR follow-up of allo-HSCT patients could guide preemptive treatment and improve outcome.

  4. Dissemination of behavioural activation for depression to mental health nurses: training evaluation and benchmarked clinical outcomes. (United States)

    Ekers, D M; Dawson, M S; Bailey, E


    Depression causes significant distress, disability and cost within the UK. Behavioural activation (BA) is an effective single-strand psychological approach which may lend itself to brief training programmes for a wide range of clinical staff. No previous research has directly examined outcomes of such dissemination. A 5-day training course for 10 primary care mental health workers aiming to increase knowledge and clinical skills in BA was evaluated using the Training Acceptability Rating Scale. Depression symptom level data collected in a randomized controlled trial using trainees were then compared to results from meta-analysis of studies using experienced therapists. BA training was highly acceptable to trainees (94.4%, SD 6%). The combined effect size of BA was unchanged by the addition of the results of this evaluation to those of studies using specialist therapists. BA offers a promising psychological intervention for depression that appears suitable for delivery by mental health nurses following brief training.

  5. Clinical evaluation of a two-incision fistula technique for the treatment of oral ranulas. (United States)

    Wang, Shaoyi; Zhang, Zhiyuan; Yang, Chi


    Oral ranulas are caused by extravasation of mucus from the sublingual glands, and the preferred treatment varies. We have developed a two-incision fistula operation for their treatment, and in this clinical study we have evaluated the efficacy and safety of this approach. Twelve patients with oral ranulas confirmed by fine needle aspiration cytology were enrolled and gave their consent to be treated by our new technique. The clinical outcomes and complications were evaluated during a period that ranged from 8-24 months. Nine ranulas became smaller and gradually disappeared, and there were no complications or injury to Wharton's duct. Three ranulas recurred, but disappeared after a second operation. The two-incision fistula operation can be effective and safe as an initial treatment for oral ranulas, and the method may become the preferred management for retention cysts.

  6. A clinical evaluation of comprehensive dental treatment for children under general anesthesia. (United States)

    Su, H L; Chen, P S


    The purpose of this study is to evaluate the comprehensive dental treatment for children under general anesthesia. From 1989 to 1991, 57 children with mean age of 3 years 2 months were treated, followed up with a minimal of 1 year. This procedure allows the dentition to be restored in one visit. Further care including preventive options and behavior shaping was provided on a 3-6 months recall schedule. The reasons for general anesthesia are that these children were either unable to accept treatment because of handicaps, extreme fear or young age. Their mean number of decayed tooth was 15 (Standard Deviation, SD = 5) and nearly three quarters of the children were under 6 years old. The most frequent treatment procedures were the extraction of teeth, composite resin restoration and Ni-Cr crown restoration. The Ni-Cr crown (1.7% failure rate) was more successful than the amalgam and composite resin restoration (9.7% failure rate). Pedo-strip crown had the highest failure rate (22%) for anterior teeth restoration. Nineteen children needed retreatment with conventional behavior guide. Six children had new caries and required further treatment. Thirty eight children returned for regular recall during the minimal 1 year follow-up period.

  7. Development and validation of evaluation tools of nursing students’ clinical pharmacology unit (United States)

    Navabi, Nasrin; Ghaffari, Fatemeh; Shamsalinia, Abbas; Faghani, Safieh


    Introduction The need for valid, reliable, and objective tools has always been emphasized in studies related to the clinical assessment of nursing students. The aims of this study were to develop and assess the validity and reliability of the tools used to evaluate the clinical pharmacology unit. Methods This study was a methodological one, conducted in 2016. An item pool was developed based on the literature review and personal interviews with faculty members. The tool’s validity was determined through assessment of face validity, content validity, and construct validity, using exploratory factor analysis on the data provided by 264 second- and third-semester nursing students of the Islamic Azad University of Babol University of Medical Sciences. Reliability was determined through internal and external consistency, using a Cronbach’s coefficient of the correlation between classes. Results Based on the exploratory factor analysis, all items with a special value of >1 were grouped into six factors: 1) professional behavior; 2) effective communication; 3) recognition of medical terminology; 4) nursing actions before administering medicine; 5) nursing actions while administering medicine; and 6) nursing actions after administering medicine. These factors explained 77% of the total variance of the concept of assessment of the clinical pharmacology unit. In this study, reliability was demonstrated by a Cronbach’s alpha coefficient of 0.96; the correlation coefficient between floors for the total tool was 0.91, ranging from 0.64 to 0.89 in its dimensions. Conclusion The evaluation tool of the clinical pharmacology unit has an acceptable construct validity and satisfactory reliability and validity. Therefore, it can be used to evaluate the clinical pharmacology unit in the nursing education system in Iran. PMID:28008285

  8. Assessment and classification of psychopathology in epidemiological research of children 0-3 years of age: a review of the literature

    DEFF Research Database (Denmark)

    Skovgaard, A M; Houmann, T; Landorph, S L;


    psychopathology in children 0-3 years of age: screening instruments with established psychometric properties, such as the Child Behaviour Checklist (CBCL) and the Checklist for Autism in Toddlers (CHAT), and methods of in-depth assessment known from both clinical practice and research: developmental tests...

  9. 77 FR 35689 - Guidance for Industry on Irritable Bowel Syndrome-Clinical Evaluation of Drugs for Treatment... (United States)


    ... HUMAN SERVICES Food and Drug Administration Guidance for Industry on Irritable Bowel Syndrome--Clinical Evaluation of Drugs for Treatment; Availability; Correction AGENCY: Food and Drug Administration, HHS. ACTION... guidance for industry entitled ``Irritable Bowel Syndrome--Clinical Evaluation of Drugs for...

  10. Evaluating Creative Thinking of Rn-Bsn Students in the Course of Clinical Case Study and Practicum (United States)

    Ku, Ya-Lie


    This case study evaluated creative thinking of RN-BSN students in the course of clinical case study and practicum. Study design used quantitative and qualitative evaluations of creative thinking of RN-BSN students by triangulation method in the course of clinical case study and practicum. Sixty RN-BSN students self-perceived the changing levels of…

  11. Penicillin allergy evaluation: experience from a drug allergy clinic in an Arabian Gulf Country, Kuwait


    Al-Ahmad, Mona; Rodriguez Bouza, Tito; Arifhodzic, Nermina


    Background Hypersensitivity to penicillin has been studied worldwide, but data regarding patterns of sensitization in Arabian Gulf countries are scarce. Objective To describe the patterns of penicillin hypersensitivity during a 6-year study in Kuwait in terms of demographics, type of the culprit drug, in vivo and in vitro allergy testing. Methods One hundred and twenty-four patients referred to the drug allergy clinic for penicillin allergy were fully evaluated by skin prick and intradermal t...

  12. Using an Innovative Curriculum Evaluation Tool to Inform Program Improvement: The Clinical Skills Fair (United States)

    Narayan, Aditee P.; Whicker, Shari A.; Staples, Betty B.; Bookman, Jack; Bartlett, Kathleen W.; McGann, Kathleen A.


    Background Program evaluation is important for assessing the effectiveness of the residency curriculum. Limited resources are available, however, and curriculum evaluation processes must be sustainable and well integrated into program improvement efforts. Intervention We describe the pediatric Clinical Skills Fair, an innovative method for evaluating the effectiveness of residency curriculum through assessment of trainees in 2 domains: medical knowledge/patient care and procedure. Each year from 2008 to 2011, interns completed the Clinical Skills Fair as rising interns in postgraduate year (PGY)-1 (R1s) and again at the end of the year, as rising residents in PGY-2 (R2s). Trainees completed the Clinical Skills Fair at the beginning and end of the intern year for each cohort to assess how well the curriculum prepared them to meet the intern goals and objectives. Results Participants were 48 R1s and 47 R2s. In the medical knowledge/patient care domain, intern scores improved from 48% to 65% correct (P < .001). Significant improvement was demonstrated in the following subdomains: jaundice (41% to 65% correct; P < .001), fever (67% to 94% correct; P < .001), and asthma (43% to 62% correct; P  =  .002). No significant change was noted within the arrhythmia subdomain. There was significant improvement in the procedure domain for all interns (χ2  =  32.82, P < .001). Conclusions The Clinical Skills Fair is a readily implemented and sustainable method for our residency program curriculum assessment. Its feasibility may allow other programs to assess their curriculum and track the impact of programmatic changes; it may be particularly useful for program evaluation committees. PMID:24701324



    Mohan,, V.; Ram Murugan


    BJECTIVES 1. To evaluate the Vitek 2 system for clinical identification of Candida species and their antifungal susceptibility test; 2. To study the incidence of various types of Candida species in this part of Tamilnadu. METHODS Samples collected from different wards were subjected for culture, isolation and identification of Candida Species and Antifungal Susceptibility testing by Vitek System. Vitek 2 test was carried out in Apollo Specialty Hospital Lab Services, Madurai....

  14. Clinical pathological evaluation and risk factors of oral cancer cases of east coast of peninsular Malaysia


    Farini, M. S.; Azlina, A; Rushdan, I.; Manoharan, M; Zain, R. B.; Samsudin, A. R.


    Introduction: Oral cancer is one of the common cancers m Malaysia. Tile population of east coast of Peninsular Malaysia has a different hfestyle and Malay is the predominant race. Oral cancer research in this area started since the Malaysian National Oral Cancer group was established. The am: of this study is to evaluate the clinical pathological findings and to investigate the role of tobacco smoking, alcohol consurnption and betel quid chewing as tile risk factors among oral cancer cases m ...

  15. [Self evaluation questionnaires for clinical psychodiagnosis in school-age children]. (United States)

    Littmann, E


    A survey of the literature is given on methodological problems associated with, and results of, the clinical diagnosis of personality in school age with questionnaires for self-evaluation. Further is given an outline of a number of major personality inventories used in (german) practice. Finally are presented the results of validation and standardisation gained with two children's inventories (PF/SF) for the multidimensional registration of psychic and social features of behaviorally disturbed children.

  16. Endocrinological and clinical evaluation of two doses of formestane in advanced breast cancer.


    Bajetta, E; Zilembo, N.; Buzzoni, R.; Noberasco, C.; Di Leo, A; Bartoli, C.; Merson, M; Sacchini, V.; Moglia, D; Celio, L.


    Formestane is a selective inhibitor of oestrogen synthesis by aromatase enzymes and induces disease regression in breast cancer patients. This phase II randomised study was carried out to determine whether there were any differences in the effects of two different doses of formestane on oestradiol (E2) serum levels and to evaluate the corresponding clinical activity in post-menopausal patients with positive or unknown oestrogen receptor status pretreated or not for advanced disease. Furthermo...

  17. Primary Corneal Squamous Cell Carcinoma in a Dog: Clinical and Histopathological Evaluation


    Giovanni Barsotti; Lorenzo Ressel; Riccardo Finotello; Veronica Marchetti; Francesca Millanta


    An 8-year-old male pug with a 12-month history of a progressive nonpainful mass on the left cornea was evaluated. Ocular examination showed a severe bilateral keratoconjunctivitis sicca, pigmentary keratitis, and an exophytic irregular pink mass occupying approximately 75% of the total corneal surface of the left eye. A squamous cell carcinoma (SCC) was suspected on cytology, and clinical investigations showed no evidence of metastases. A transpalpebral enucleation was therefore performed, an...

  18. Evaluation of clinical signs, parasitemia, hematologic and biochemical changes in cattle experimentally infected with Trypanosoma vivax


    Otavio Luiz Fidelis Junior; Paulo Henrique Sampaio; Rosangela Zacarias Machado; Marcos Rogério André; Luiz Carlos Marques; Fabiano Antonio Cadioli


    Abstract Infections by Trypanosoma vivax cause great losses to livestock in Africa and Central and South Americas. Outbreaks due this parasite have been occurred with increasing frequency in Brazil. Knowledge of changes caused byT. vivax during the course of this disease can be of great diagnostic value. Thus, clinical signs, parasitemia, hematologic and biochemical changes of cattle experimentally infected by this hemoparasite were evaluated. Two distinct phases were verified during the infe...

  19. Evaluation of the i-STAT portable clinical analyzer in chickens (Gallus gallus)


    Steinmetz, H W; Vogt, R.; Kästner, S; Riond, B.; Hatt, J M


    The i-STAT portable clinical analyzer (PCA) was evaluated for performance in avian species. With the EG7+ cartridge, which provided results for hydrogen ion concentration, oxygen tension, carbon dioxide tension, sodium, potassium, ionized calcium, hematocrit, and various calculated parameters, analytical accuracy and precision were tested by comparing obtained values to those of established traditional blood gas and chemistry analyzers. Deming's regression and bias plots were used to compare ...

  20. Evaluation of clinical and radiographic success of primary molars pulpotomy with Root MTA and formocresol

    Directory of Open Access Journals (Sweden)

    Haghgoo R.


    Full Text Available "nBackground and Aim: Several agents were used for pulpotomy in primary molars. Formocresol is the most common drug in this procedure. In some studies it has been shown that, this material has potential some side effects, so it is essential to find other alternatives. The aim of this study was to evaluate clinical and radiographic success rates of mineral trioxide aggregate and formocresol. "nMaterials and Methods: In this randomized clinical trial study, 70 carious primary teeth of 4 to 7-year-old children were pulpotomized, and remaining pulp was dressed with Root MTA and formocresol. The clinical and radiographic follow up evaluations were performed at 6, 12 months by a blind dentist. The data were analyzed by Fisher's exact test. "nResults: At the end of 1-year follow-up period, in formocresol group sinus tract and tenderness to percussion were seen in 2 teeth, internal resorption was seen in 1 tooth, and furcation radiolucency was seen in 2 teeth. Clinical and radiographic signs of failure were not seen in any case of (Iranian Root MTA group. "nConclusion: Based on the results of this study, Iranian MTA can be used for pulpotomy in primary molars.

  1. NREM-related parasomnias in Machado-Joseph disease: clinical and polysomnographic evaluation. (United States)

    Silva, Giselle Melo Fontes; Pedroso, José Luiz; Dos Santos, Diogo Fernandes; Braga-Neto, Pedro; Do Prado, Lucila Bizari Fernandes; De Carvalho, Luciane Bizari Coin; Barsottini, Orlando G P; Do Prado, Gilmar Fernandes


    Spinocerebellar ataxias (SCA) are autosomal dominant neurodegenerative disorders that affect the cerebellum and its connections, and have a marked clinical and genetic variability. Machado-Joseph disease (MJD) or spinocerebellar ataxia type 3 (SCA3)--MJD/SCA3--is the most common SCA worldwide. MJD/SCA3 is characterized classically by progressive ataxia and variable other motor and non-motor symptoms. Sleep disorders are common, and include rapid eye movement (REM) sleep behaviour disorder (RBD), restless legs syndrome (RLS), insomnia, excessive daytime sleepiness, excessive fragmentary myoclonus and sleep apnea. This study aims to focus upon determining the presence or not of non-REM (NREM)-related parasomnias in MJD/SCA 3, using data from polysomnography (PSG) and clinical evaluation. Forty-seven patients with clinical and genetic diagnosis of MJD/SCA3 and 47 control subjects were evaluated clinically and by polysomnography. MJD/SCA3 patients had a higher frequency of arousals from slow wave sleep (P parasomnia complaints (confusional arousal/sleep terrors, P = 0.001; RBD, P parasomnias must be included in the spectrum of sleep disorders in MJD/SCA3 patients.

  2. Evaluation of nisin-β-lactam antibiotics against clinical strains of Salmonella enterica serovar Typhi. (United States)

    Rishi, Praveen; Preet Singh, Aman; Garg, Neha; Rishi, Madhuri


    There is an imperative need to discover novel antimicrobials and anti-infective agents and build up innovative strategies to combat multidrug-resistant Salmonella. In this context, we had earlier confirmed that nisin has the potential to act in conjunction with β-lactams against murine salmonellosis using standard strain. However, evaluation of efficacy of these combinations against clinical isolates of Salmonella could be the next key step to confirm the value added potential of this peptide. The present study was therefore planned to validate the synergistic effects of nisin-β-lactams combinations against clinical isolates of Salmonella enterica serovar Typhi. MICs of the selected β-lactams, EDTA and nisin were determined by micro and macro broth dilution assays. In-vitro synergism between the agents was evaluated by fractional inhibitory concentration (FIC) index (checkerboard test) and time-kill assay. All the tested combinations showed synergy against the tested clinical strains except three, as evident by FIC index (checkerboard test) and time-kill assay. Especially, nisin-ceftriaxone and nisin-cefotaxime combinations demonstrated excellent synergistic activity. In view of the encouraging results obtained from the previous and present study, further studies need to be carried out using large number of strains from different regions to take into account the clinical variability of the strains. Though it is a simple study but highlights an important point about the possibility of using the said combination while making strategies to develop newer formulations.

  3. An interdisciplinary methodology for the comparative evaluation of splinting materials (orthotics, thermoplastics, clinical research). (United States)

    Shimeld, A; Campbell, G; Ernest, M


    The methodology developed includes both the use of laboratory evaluation and clinical assessment in an area where there are no standard requirements, no specifications, nor any continuity of data available on the various thermoplastic splinting materials now on the market. A series of laboratory tests and clinical trials were devised such that these could be interpreted with regard to clinical considerations, cost analyses and serviceability factors relating to the materials. Laboratory testing covered possible effects on the chemical and mechanical properties of material likely to be caused by various environmental, sterilization and working factors. The complementary clinical evaluation to highlight the behaviour of materials during the fabrication and wearing of splints consisted of specific information generated with the assistance of experienced occupational therapists, occupational therapy students and patients. Biocompatibility studies were also carried out. The data to be published will provide needed information to physicians, occupational therapists, physical therapists, orthotists, prosthetists, and administrators with regard to their making informed decisions on the selection, purchase and use of thermoplastic materials.

  4. Clinical and radiographic evaluation of maxillary central incisors exposure in patients undergoing maxillary advancement

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    Guilherme dos Santos Trento


    Full Text Available Abstract Introduction: Patients with dentofacial deformities may undergo orthodontic or orthodontic-surgical treatment. Both modalities can affect esthetics. Objective: This study aims to evaluate clinical and radiographic changes in exposure of maxillary central incisors occurring after orthognathic surgery for maxillary advancement. Methods: A total of 17 patients who underwent orthognathic surgery for maxillary advancement between September, 2010 and July, 2011 were selected. Exposure of maxillary central incisors was evaluated clinically and by lateral cephalograms. Measurements were taken one week before and three months after surgery. Data were paired in terms of sex, age, nasolabial angle, height and thickness of the upper lip, the amount of maxillary advancement, clinical exposure and inclination of maxillary central incisor by statistical tests (CI 95%. Results: After maxillary advancement, incisor clinical exposure had increased even with relaxed lips and under forced smile. Moreover, there was a mean increase of 23.33% revealed by lateral cephalograms. There was an inverse correlation between upper lip thickness and incisors postsurgical exposure revealed by radiographic images (p = 0.002. Conclusions: Significant changes in the exposure of maxillary central incisors occur after maxillary advancement, under the influence of some factors, especially lip thickness.

  5. The role of 3DCT for the evaluation of chop injuries in clinical forensic medicine. (United States)

    Wittschieber, Daniel; Beck, Laura; Vieth, Volker; Hahnemann, Maria L


    As hatchet blows to the human head frequently cause fatal injuries, the forensic examination of survivors with cranial chop injuries is a rare phenomenon in forensic casework. Besides evaluation of clinical records, photographs, and medico-legal physical examination, the analysis and 3-dimensional reconstruction of pre-treatment computed tomography data (3DCT) must be considered an important and indispensable tool for the assessment of those cases because the characteristics of chopping trauma often appear masked or changed by clinical treatment. In the present article, the role of 3DCT for the evaluation of chop wounds in clinical forensic medicine is demonstrated by an illustrative case report of a young man who was attacked with a hatchet. 3DCT provides additional possibilities for supplementing missing information, such as number and direction of blows as well as weapon identification. Furthermore, 3DCT facilitates demonstration in court and understanding of medical lay people. We conclude that 3DCT is of particular value for the evaluation of survivors of life-threatening head and face injury. An increasing significance of this technique may be expected.

  6. Highly reliable heterologous system for evaluating resistance of clinical herpes simplex virus isolates to nucleoside analogues. (United States)

    Bestman-Smith, J; Schmit, I; Papadopoulou, B; Boivin, G


    Clinical resistance of herpes simplex virus (HSV) types 1 and 2 to acyclovir (ACV) is usually caused by the presence of point mutations within the coding region of the viral thymidine kinase (TK) gene. The distinction between viral TK mutations involved in ACV resistance or part of viral polymorphism can be difficult to evaluate with current methodologies based on transfection and homologous recombination. We have developed and validated a new heterologous system based on the expression of the viral TK gene by the protozoan parasite Leishmania, normally devoid of TK activity. The viral TK genes from 5 ACV-susceptible and 13 ACV-resistant clinical HSV isolates and from the reference strains MS2 (type 2) and KOS (type 1) were transfected as part of an episomal expression vector in Leishmania. The susceptibility of TK-recombinant parasites to ganciclovir (GCV), a closely related nucleoside analogue, was evaluated by a simple measurement of the absorbance of Leishmania cultures grown in the presence of the drug. Expression of the TK gene from ACV-susceptible clinical isolates resulted in Leishmania susceptibility to GCV, whereas expression of a TK gene with frameshift mutations or nucleotide substitutions from ACV-resistant isolates gave rise to parasites with high levels of GCV resistance. The expression of the HSV TK gene in Leishmania provides an easy, reliable, and sensitive assay for evaluating HSV susceptibility to nucleoside analogues and for assessing the role of specific viral TK mutations.

  7. Clinical and electrophysiological evaluation of neutral wrist nocturnal splinting in patients with carpal tunnel syndrome. (United States)

    Weng, Chao; Dong, Hongjuan; Chu, Hong; Lu, Zuneng


    [Purpose] To prospectively assess the effectiveness of neutral wrist nocturnal splinting in patients with carpal tunnel syndrome (CTS) by using clinical scores and nerve conduction studies (NCS). [Subjects and Methods] Forty-one patients enrolled in the study were clinically evaluated by a symptom severity scale (SSS) and functional status scale (FSS), and were electrophysiologically evaluated by conventional NCS; distal motor latency (DML), sensory conduction velocity (SCV), and difference in sensory latency between the median and ulnar nerves (ΔDSL) were measured. Subjects were treated with wrist splinting. Patients who showed no improvement in symptoms were treated with other conservative treatments, the remaining patients continued to wear splints. SSS, FSS, and NCS were evaluated after splinting as well. [Results] The follow-up was completed in 20 patients (31 wrists) with splinting. SSS and FSS decreased, the DML shortened and ΔDSL decreased significantly after splinting for 3.03 ± 1.16 months. There were significant correlations between SSS and DML, SCV of wrist digit 2, and SCV of wrist digit 4. No correlations were found between SSS and ΔDSL, and FSS and the parameters of NCS. [Conclusion] Neutral wrist nocturnal splinting is effective in at least short term for CTS patients. There is a weak correlation between clinical scores and NCS, which suggests that both approaches should be used to effectively assess the therapeutic effect of CTS treatment.

  8. Criteria for evaluating response and outcome in clinical trials for children with juvenile myelomonocytic leukemia.

    LENUS (Irish Health Repository)

    Niemeyer, Charlotte M


    Juvenile myelomonocytic leukemia is a rare myeloproliferative disease in young children. While hematopoietic stem cell transplantation remains the only curative therapeutic option for most patients, children with juvenile myelomonocytic leukemia increasingly receive novel agents in phase I-II clinical trials as pre-transplant therapy or therapy for relapse after transplantation. However, response criteria or definitions of outcome for standardized evaluation of treatment effect in patients with juvenile myelomonocytic leukemia are currently lacking. Here we propose criteria to evaluate the response to the non-transplant therapy and definitions of remission status after hematopoietic stem cell transplantation. For the evaluation of non-transplant therapy, we defined 6 clinical variables (white blood cell count, platelet count, hematopoietic precursors and blasts in peripheral blood, bone marrow blast percentage, spleen size and extramedullary disease) and 3 genetic variables (cytogenetic, molecular and chimerism response) which serve to describe the heterogeneous picture of response to therapy in each individual case. It is hoped that these criteria will facilitate the comparison of results between clinical trials in juvenile myelomonocytic leukemia.

  9. Evaluation of Clinical and Ultrasonographic Parameters in Psoriatic Arthritis Patients Treated with Adalimumab: A Retrospective Study

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    M. Teoli


    Full Text Available Objectives. The aim of this study was to evaluate clinical and US-PD parameters in PsA during adalimumab treatment. Methods. A retrospective study has been conducted in forty patients affected by moderate-to-severe peripheral PsA. Clinical, laboratory, and US-PD evaluations were performed at baseline, after 4, 12, and 24 weeks of treatment. They included erythrocyte sedimentation rate (ESR, C-reactive protein (CRP, visual analogue scale (VAS, Health Assessment Questionnaire (HAQ modified for Spondyloarthritis, Psoriasis Area Severity Index (PASI score, the 28-joint Disease Activity Score (DAS 28, and US-PD assessment. US-PD findings were scored according to a semiquantitative scale (ranging 0–3 for synovial proliferation (SP, joint effusion (SE, bone erosions (BE, and PD. Results. Data obtained for clinical, laboratory findings and US-PD evaluation showed statistical significant improvement in all the measures performed except for BE. A significant parallel decrease in SE, SP, and PD values were demonstrated. Conclusion. This study demonstrated that US-PD is a valid technique in monitoring the response to adalimumab in moderate-to-severe PsA.

  10. Clinical and electrophysiological evaluation of neutral wrist nocturnal splinting in patients with carpal tunnel syndrome (United States)

    Weng, Chao; Dong, Hongjuan; Chu, Hong; Lu, Zuneng


    [Purpose] To prospectively assess the effectiveness of neutral wrist nocturnal splinting in patients with carpal tunnel syndrome (CTS) by using clinical scores and nerve conduction studies (NCS). [Subjects and Methods] Forty-one patients enrolled in the study were clinically evaluated by a symptom severity scale (SSS) and functional status scale (FSS), and were electrophysiologically evaluated by conventional NCS; distal motor latency (DML), sensory conduction velocity (SCV), and difference in sensory latency between the median and ulnar nerves (ΔDSL) were measured. Subjects were treated with wrist splinting. Patients who showed no improvement in symptoms were treated with other conservative treatments, the remaining patients continued to wear splints. SSS, FSS, and NCS were evaluated after splinting as well. [Results] The follow-up was completed in 20 patients (31 wrists) with splinting. SSS and FSS decreased, the DML shortened and ΔDSL decreased significantly after splinting for 3.03 ± 1.16 months. There were significant correlations between SSS and DML, SCV of wrist digit 2, and SCV of wrist digit 4. No correlations were found between SSS and ΔDSL, and FSS and the parameters of NCS. [Conclusion] Neutral wrist nocturnal splinting is effective in at least short term for CTS patients. There is a weak correlation between clinical scores and NCS, which suggests that both approaches should be used to effectively assess the therapeutic effect of CTS treatment. PMID:27630413

  11. [Thinking about vertigo effectiveness evaluation methods in clinical research of Chinese medicine]. (United States)

    Liu, Hong-mei; Li, Tao


    Vertigo is a kind of patients' subjective feelings. The severity of vertigo is closely related to many factors. But we are short of a well accepted quantitative evaluation method capable of accurately and comprehensively evaluating vertigo in clinics. Reducing the onset of vertigo, enhancing the re- covery of equilibrium function, and improving the quality of life of vertigo patients should be taken as the focus of evaluating therapeutic effects. As for establishing a Chinese medical effectiveness evaluation system for vertigo, we believe we should distinguish different "diseases". We could roughly identify it as systemic vertigo and non-systemic vertigo. For systemic vertigo, the efficacy of vertigo could be comprehensively evaluated by UCLA vertigo questionnaire or dizziness handicap inventory combined with equilibrium function testing indices. But for non-systemic vertigo, the efficacy of vertigo could be comprehensively evaluated by taking UCLA vertigo questionnaire or dizziness handicap inventory as main efficacy indices. Secondly, we should analyze different reasons for vertigo, choose symptoms and signs in line with vertigo features as well as with Chinese medical theories, and formulate corresponding syndrome effectiveness standards according to different diseases. We should not simply take syndrome diagnosis standards as efficacy evaluation standards.

  12. A peripheral ameloblastic fibro-odontoma in a 3-year-old girl: case report, immunohistochemical analysis, and literature review. (United States)

    Lin, Yi-Chun; Hsu, Hsiu-Ming; Liu, Chiang-Shin; Yuan, Kuo


    Ameloblastic fibro-odontoma (AFO) predominantly occurs in the jaw bones of children and young adults. Extraosseous AFO is extremely rare. We describe a peripheral ameloblastic fibro-odontoma in the maxillary gingiva of a 3-year-old girl. The clinical appearance resembled fiery red reactive gingival lesions. The histopathological examination of the excised lesion showed small islands and cords of odontogenic epithelium with cellular myxoid stroma in the subepithelial tissue. The mass contained calcified material and an enamel-like deposit. Many small blood vessels appeared in the connective tissue surrounding the odontogenic epithelium. The immunohistochemical assays showed strong reactivity for amelogenin, β-catenin, CD44, and CD31 in the tissue sections. There was no recurrence after the 1-year follow-up. Because this lesion clinically resembles other nonneoplastic lesions and is very rare in gingiva, establishing a correct diagnosis is achieved only based on specific histological characteristics. Conservative excision of the tumor is the treatment of choice.

  13. Evaluation of clinical, laboratory, and electrophoretic profiles for diagnosis of malnutrition in hospitalized dogs

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    Andrei Kelliton Fabretti


    Full Text Available Malnutrition is a major factor associated with increased rates of mortality and readmission, longer hospital stays, and greater health care spending. Recognizing malnourished or at-risk animals allows for nutritional intervention and improved prognosis. This study evaluated the association between clinical, laboratory, and electrophoretic variables and the nutritional status (NS of hospitalized dogs in order to generate a profile of the sick dog and to facilitate the diagnosis of malnutrition. We divided 215 dogs into groups according to the severity of the underlying disease and we determined the clinical NS based on the assessment of the body condition score and the muscle mass score. The NS was classified as clinically well nourished, clinical moderate malnutrition, or clinical severe malnutrition. Statistical analyses were conducted by using the chi-square test or Fisher’s exact test; the Kruskal-Wallis test was used for continuous variables. A strong association was found between malnutrition and the severity of the underlying disease. In hospitalized dogs, low body mass index values, anemia, low hemoglobin concentrations, high fibrinogen concentrations, decreased albumin fraction, and increased gamma-globulin fraction (in electrophoresis were associated with malnutrition, reinforcing the classification of poor NS. However, the skin and coat characteristics, the total number of lymphocytes, blood glucose, cholesterol, and total protein concentration were not found to be good predictors of NS.

  14. Performance evaluation of the ADVIA 2120 hematology analyzer: an international multicenter clinical trial. (United States)

    Harris, Neil; Jou, Josep Maria; Devoto, Gianluigi; Lotz, J; Pappas, James; Wranovics, David; Wilkinson, Mary; Fletcher, Suzanne R; Kratz, Alexander


    Automated cell counters are widely used in modern clinical laboratories to provide reliable, fast, and cost-effective complete blood counts (CBCs), white blood cell differentials, and reticulocyte measurements. In addition, some advanced instruments provide novel parameters, such as the hemoglobin content of reticulocytes or the percentage of hypochromic cells, and are capable of analysis of a variety of body fluids. Bayer recently introduced the ADVIA 2120 system as an automation-ready cell counter for mid- to high-volume testing in the clinical laboratory. This instrument, which builds on the established technology of the ADVIA 120 system, operates with a cyanide-free method for hemoglobin measurement, has a new user interface, and can routinely analyze biological fluid samples in addition to blood. We used 749 samples from 6 worldwide trial sites to evaluate the clinical performance of this new device. Accuracy of the ADVIA 2120 system versus its predecessor model, the ADVIA 120 system, was excellent for all CBC and white cell differential parameters and reticulocyte counts (all correlation coefficients except for basophils >0.9). Correlation of the white cell differential with the standard manual method and within-run precision of the ADVIA 2120 system also was very good. Use of the novel cyanide-free method for hemoglobin measurement had no clinically significant impact on hemoglobin results, even in patients with hemoglobinopathies. We concluded that the ADVIA 2120 system has clinically equivalent performance to the ADVIA 120 system.

  15. Multiple trait genetic evaluation of clinical mastitis in three dairy cattle breeds. (United States)

    Govignon-Gion, A; Dassonneville, R; Baloche, G; Ducrocq, V


    In 2010, a routine genetic evaluation on occurrence of clinical mastitis in three main dairy cattle breeds-- Montbéliarde (MO), Normande (NO) and Holstein (HO)--was implemented in France. Records were clinical mastitis events reported by farmers to milk recording technicians and the analyzed trait was the binary variable describing the occurrence of a mastitis case within the first 150 days of the first three lactations. Genetic parameters of clinical mastitis were estimated for the three breeds. Low heritability estimates were found: between 2% and 4% depending on the breed. Despite its low heritability, the trait exhibits genetic variation so efficient genetic improvement is possible. Genetic correlations with other traits were estimated, showing large correlations (often>0.50, in absolute value) between clinical mastitis and somatic cell score (SCS), longevity and some udder traits. Correlation with milk yield was moderate and unfavorable (ρ=0.26 to 0.30). High milking speed was genetically associated with less mastitis in MO (ρ=-0.14) but with more mastitis in HO (ρ=0.18). A two-step approach was implemented for routine evaluation: first, a univariate evaluation based on a linear animal model with permanent environment effect led to pre-adjusted records (defined as records corrected for all non-genetic effects) and associated weights. These data were then combined with similar pre-adjusted records for others traits in a multiple trait BLUP animal model. The combined breeding values for clinical mastitis obtained are the official (published) ones. Mastitis estimated breeding values (EBV) were then combined with SCSs EBV into an udder health index, which receives a weight of 14.5% to 18.5% in the French total merit index (ISU) of the three breeds. Interbull genetic correlations for mastitis occurrence were very high (ρ=0.94) with Nordic countries, where much stricter recording systems exist reflecting a satisfactory quality of phenotypes as reported by the

  16. Evaluating the informatics for integrating biology and the bedside system for clinical research

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    Meystre Stéphane M


    Full Text Available Abstract Background Selecting patient cohorts is a critical, iterative, and often time-consuming aspect of studies involving human subjects; informatics tools for helping streamline the process have been identified as important infrastructure components for enabling clinical and translational research. We describe the evaluation of a free and open source cohort selection tool from the Informatics for Integrating Biology and the Bedside (i2b2 group: the i2b2 hive. Methods Our evaluation included the usability and functionality of the i2b2 hive using several real world examples of research data requests received electronically at the University of Utah Health Sciences Center between 2006 - 2008. The hive server component and the visual query tool application were evaluated for their suitability as a cohort selection tool on the basis of the types of data elements requested, as well as the effort required to fulfill each research data request using the i2b2 hive alone. Results We found the i2b2 hive to be suitable for obtaining estimates of cohort sizes and generating research cohorts based on simple inclusion/exclusion criteria, which consisted of about 44% of the clinical research data requests sampled at our institution. Data requests that relied on post-coordinated clinical concepts, aggregate values of clinical findings, or temporal conditions in their inclusion/exclusion criteria could not be fulfilled using the i2b2 hive alone, and required one or more intermediate data steps in the form of pre- or post-processing, modifications to the hive metadata, etc. Conclusion The i2b2 hive was found to be a useful cohort-selection tool for fulfilling common types of requests for research data, and especially in the estimation of initial cohort sizes. For another institution that might want to use the i2b2 hive for clinical research, we recommend that the institution would need to have structured, coded clinical data and metadata available that can be

  17. Evaluating current automatic de-identification methods with Veteran’s health administration clinical documents

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    Ferrández Oscar


    Full Text Available Abstract Background The increased use and adoption of Electronic Health Records (EHR causes a tremendous growth in digital information useful for clinicians, researchers and many other operational purposes. However, this information is rich in Protected Health Information (PHI, which severely restricts its access and possible uses. A number of investigators have developed methods for automatically de-identifying EHR documents by removing PHI, as specified in the Health Insurance Portability and Accountability Act “Safe Harbor” method. This study focuses on the evaluation of existing automated text de-identification methods and tools, as applied to Veterans Health Administration (VHA clinical documents, to assess which methods perform better with each category of PHI found in our clinical notes; and when new methods are needed to improve performance. Methods We installed and evaluated five text de-identification systems “out-of-the-box” using a corpus of VHA clinical documents. The systems based on machine learning methods were trained with the 2006 i2b2 de-identification corpora and evaluated with our VHA corpus, and also evaluated with a ten-fold cross-validation experiment using our VHA corpus. We counted exact, partial, and fully contained matches with reference annotations, considering each PHI type separately, or only one unique ‘PHI’ category. Performance of the systems was assessed using recall (equivalent to sensitivity and precision (equivalent to positive predictive value metrics, as well as the F2-measure. Results Overall, systems based on rules and pattern matching achieved better recall, and precision was always better with systems based on machine learning approaches. The highest “out-of-the-box” F2-measure was 67% for partial matches; the best precision and recall were 95% and 78%, respectively. Finally, the ten-fold cross validation experiment allowed for an increase of the F2-measure to 79% with partial matches


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    Uzay KOÇ VURAL


    Full Text Available Purpose: The aims of this study were to investigate the etiologic factors and to evaluate performance of composite resin on fractured crown in permanent anterior teeth at 6 and 12 months. Subjects and Methods: Records from 51 patients were retrieved from a Dental School Clinic, comprising 73 fractured anterior teeth directly restored with a submicron hybrid composite (Spectrum TPH resin and respective adhesive system (Prime&Bond NT were evaluated. The United States Public Health Service criteria were used to assess the clinical evaluation. Data were analyzed using the Wilcoxon Signed Rank, Kruskal–Wallis, Mann–Whitney U, and Siegel and Castellan tests. Results: Seventy-two maxillary incisors and one canine of 51 patients were evaluated. The patient’s age at the time of therapy ranged from 14 to 64 years old (mean 25.47. Mostly observed crown fracture was seen in upper incisors (84.9% and due to falls (58.8%. At the 6-month follow-up, one patient lost one restoration and at the 12-month, one patient lost one and one lost two restorations. A statistically significant difference was found in terms of marginal adaptation between 6 and 12 months. Conclusion: In this short-term observation period, remaining tooth structure was conserved and good patient compliance was achieved. Factors such as esthetic and/or cost should be considered to indicate the direct composite restorations.

  19. Portfolio as a tool to evaluate clinical competences of traumatology in medical students

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    Santonja-Medina F


    Full Text Available Fernando Santonja-Medina,1,2 M Paz García-Sanz,3 Francisco Martínez-Martínez,1,2 David Bó,1,2,4 Joaquín García-Estañ,5 1Faculty of Medicine, Department of Traumatology, 2Faculty of Medicine, University Hospital Virgen de la Arrixaca, 3Faculty of Medicine, Department of Education, 4Faculty of Medicine, University Hospital Morales Meseguer, 5Faculty of Medicine, Department of Physiology, University of Murcia, Murcia, Spain Abstract: This article investigates whether a reflexive portfolio is instrumental in determining the level of acquisition of clinical competences in traumatology, a subject in the 5th year of the degree of medicine. A total of 131 students used the portfolio during their clinical rotation of traumatology. The students’ portfolios were blind evaluated by four professors who annotated the existence (yes/no of 23 learning outcomes. The reliability of the portfolio was moderate, according to the kappa index (0.48, but the evaluation scores between evaluators were very similar. Considering the mean percentage, 59.8% of the students obtained all the competences established and only 13 of the 23 learning outcomes (56.5% were fulfilled by >50% of the students. Our study suggests that the portfolio may be an important tool to quantitatively analyze the acquisition of traumatology competences of medical students, thus allowing the implementation of methods to improve its teaching. Keywords: competence-based education, evaluation, assessment, teaching methodologies

  20. Clinical characteristics, diagnostic evaluation, and antibiotic prescribing patterns for skin infections in nursing homes

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    Norihiro Yogo


    Full Text Available Background: The epidemiology and management of skin infections in nursing homes has not been adequately described. We reviewed the characteristics, diagnosis and treatment of skin infections among residents of nursing homes to identify opportunities to improve antibiotic use. Methods: A retrospective study involving 12 nursing homes in the Denver metropolitan area. For residents at participating nursing homes diagnosed with a skin infection between July 1, 2013 and June 30, 2014, clinical and demographic information was collected through manual chart review.Results: Of 100 cases included in the study, the most common infections were non-purulent cellulitis (n=55, wound infection (n=27, infected ulcer (n=8, and cutaneous abscess (n=7. In 26 cases, previously published minimum clinical criteria for initiating antibiotics (Loeb criteria were not met. Most antibiotics (n=52 were initiated as a telephone order following a call from a nurse, and 41 patients were not evaluated by a provider within 48 hours after initiation of antibiotics. Nearly all patients (n=95 were treated with oral antibiotics alone. The median treatment duration was 7 days (interquartile range [IQR] 7-10; 43 patients received treatment courses of ≥ 10 days.Conclusions: Most newly diagnosed skin infections in nursing homes were non-purulent infections treated with oral antibiotics. Antibiotics were initiated by telephone in over half of cases, and lack of a clinical evaluation within 48 hours after starting antibiotics was common. Improved diagnosis through more timely clinical evaluations and decreasing length of therapy are important opportunities for antibiotic stewardship in nursing homes.

  1. Validity and Reliability of the Clinical Competency Evaluation Instrument for Use among Physiotherapy Students; Pilot study

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    Zailani Muhamad


    Full Text Available Objectives: The aim of this study was to determine the content validity, internal consistency, testretest reliability and inter-rater reliability of the Clinical Competency Evaluation Instrument (CCEVI in assessing the clinical performance of physiotherapy students. Methods: This study was carried out between June and September 2013 at University Kebangsaan Malaysia (UKM, Kuala Lumpur, Malaysia. A panel of 10 experts were identified to establish content validity by evaluating and rating each of the items used in the CCEVI with regards to their relevance in measuring students’ clinical competency. A total of 50 UKM undergraduate physiotherapy students were assessed throughout their clinical placement to determine the construct validity of these items. The instrument’s reliability was determined through a cross-sectional study involving a clinical performance assessment of 14 final-year undergraduate physiotherapy students. Results: The content validity index of the entire CCEVI was 0.91, while the proportion of agreement on the content validity indices ranged from 0.83–1.00. The CCEVI construct validity was established with factor loading of ≥0.6, while internal consistency (Cronbach’s alpha overall was 0.97. Test-retest reliability of the CCEVI was confirmed with a Pearson’s correlation range of 0.91–0.97 and an intraclass coefficient correlation range of 0.95–0.98. Inter-rater reliability of the CCEVI domains ranged from 0.59 to 0.97 on initial and subsequent assessments. Conclusion: This pilot study confirmed the content validity of the CCEVI. It showed high internal consistency, thereby providing evidence that the CCEVI has moderate to excellent inter-rater reliability. However, additional refinement in the wording of the CCEVI items, particularly in the domains of safety and documentation, is recommended to further improve the validity and reliability of the instrument.

  2. Etiology and audiological outcomes at 3 years for 364 children in Australia.

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    Hans-Henrik M Dahl

    Full Text Available Hearing loss is an etiologically heterogeneous trait with differences in the age of onset, severity and site of lesion. It is caused by a combination of genetic and/or environmental factors. A longitudinal study to examine the efficacy of early intervention for improving child outcomes is ongoing in Australia. To determine the cause of hearing loss in these children we undertook molecular testing of perinatal "Guthrie" blood spots of children whose hearing loss was either detected via newborn hearing screening or detected later in infancy. We analyzed the GJB2 and SLC26A4 genes for the presence of mutations, screened for the mitochondrial DNA (mtDNA A1555G mutation, and screened for congenital CMV infection in DNA isolated from dried newborn blood spots. Results were obtained from 364 children. We established etiology for 60% of children. One or two known GJB2 mutations were present in 82 children. Twenty-four children had one or two known SLC26A4 mutations. GJB2 or SLC26A4 changes with unknown consequences on hearing were found in 32 children. The A1555G mutation was found in one child, and CMV infection was detected in 28 children. Auditory neuropathy spectrum disorder was confirmed in 26 children whose DNA evaluations were negative. A secondary objective was to investigate the relationship between etiology and audiological outcomes over the first 3 years of life. Regression analysis was used to investigate the relationship between hearing levels and etiology. Data analysis does not support the existence of differential effects of etiology on degree of hearing loss or on progressiveness of hearing loss.

  3. Report on the use of non-clinical studies in the regulatory evaluation of oncology drugs. (United States)

    Hayakawa, Yoshihiro; Kawada, Manabu; Nishikawa, Hiroyoshi; Ochiya, Takahiro; Saya, Hideyuki; Seimiya, Hiroyuki; Yao, Ryoji; Hayashi, Masahiro; Kai, Chieko; Matsuda, Akira; Naoe, Tomoki; Ohtsu, Atsushi; Okazaki, Taku; Saji, Hideo; Sata, Masataka; Sugimura, Haruhiko; Sugiyama, Yuichi; Toi, Masakazu; Irimura, Tatsuro


    Non-clinical studies are necessary at each stage of the development of oncology drugs. Many experimental cancer models have been developed to investigate carcinogenesis, cancer progression, metastasis, and other aspects in cancer biology and these models turned out to be useful in the efficacy evaluation and the safety prediction of oncology drugs. While the diversity and the degree of engagement in genetic changes in the initiation of cancer cell growth and progression are widely accepted, it has become increasingly clear that the roles of host cells, tissue microenvironment, and the immune system also play important roles in cancer. Therefore, the methods used to develop oncology drugs should continuously be revised based on the advances in our understanding of cancer. In this review, we extensively summarize the effective use of those models, their advantages and disadvantages, ranges to be evaluated and limitations of the models currently used for the development and for the evaluation of oncology drugs.

  4. Oral S-adenosylmethionine in primary fibromyalgia. Double-blind clinical evaluation

    DEFF Research Database (Denmark)

    Jacobsen, Søren; Danneskiold-Samsøe, B; Andersen, R B


    score, isokinetic muscle strength, disease activity, subjective symptoms (visual analog scale), mood parameters and side effects were evaluated. Improvements were seen for clinical disease activity (P = 0.04), pain experienced during the last week (P = 0.002), fatigue (P = 0.02), morning stiffness (P......S-adenosylmethionine is a relatively new anti-inflammatory drug with analgesic and anti-depressant effects. Efficacy of 800 mg orally administered s-adenosylmethionine daily versus placebo for six weeks was investigated in 44 patients with primary fibromyalgia in double-blind settings. Tender point...... = 0.03) and mood evaluated by Face Scale (P = 0.006) in the actively treated group compared to placebo. The tender point score, isokinetic muscle strength, mood evaluated by Beck Depression Inventory and side effects did not differ in the two treatment groups. S-adenosylmethionine has some beneficial...

  5. Evaluation of Leber's hereditary optic neuropathy patients prior to a gene therapy clinical trial (United States)

    Yang, Shuo; Yang, Hong; Ma, Si-qi; Wang, Shuai-shuai; He, Heng; Zhao, Min-jian; Li, Bin


    Abstract Gene therapy may be a promising approach for the treatment of Leber hereditary optic neuropathy. The aim of this study was to evaluate patients with this condition who were recruited into an upcoming gene therapy clinical trial and to assess any changes in the detection parameters to provide support for the clinical trial. Sixteen patients with Leber hereditary optic neuropathy were evaluated using visual function tests 12 months before the initiation of gene therapy. Then, the results of visual acuity (VA), visual field (VF), RNFL (retinal nerve fiber layer) thickness, and Pattern-reversal Visual evoked potential (PR-VEP) were compared and analyzed. A total of 32 eyes of 16 patients were evaluated. Based on the best-corrected visual acuity (BCVA), 24 eyes were relatively stable compared with the baseline evaluation, and 8 eyes had significant changes, including 5 eyes that showed improvement and 3 eyes that showed impairment. In all eyes, the changes in the best-corrected visual acuity were significantly correlated with the changes in the visual field index (VFI), mean defect (MD), and P100 of the visual evoked potential. In the eyes with relatively stable BCVA and those with an obvious improvement in the BCVA, only the visual mean defect showed a significant change; the other indicators were not significantly different. Aside from the patients showing a tendency of spontaneous improvement, the others were in accordance with the requirement. The effects of Leber hereditary optical neuropathy (LHON) gene therapy should be evaluated primarily based on visual acuity. Additionally, visual field, neural fiber thickness, and electrophysiology should be considered in the evaluation. PMID:27749593

  6. A clinical evaluation of the Cobas Fara clinical chemistry analyzer for some routine serum enzymes and glucose. (United States)

    Moses, G C; Lightle, G O; Tuckerman, J F; Henderson, A R


    The authors evaluated the Cobas FARA centrifugal analyzer with respect to pipetting precision and accuracy, instrument temperature, spectrophotometric response, and analytic performance for the assay of five serum enzymes and glucose. Spectrophotometric response, temperature response, pipetting precision, and accuracy were satisfactory. However, sufficient time must be allowed for cuvet contents to reach a stable temperature before measurements are made. Total day-to-day imprecision (within plus between run) was less than 5% (coefficient of variation) for aspartate and alanine aminotransferases (AST; Enzyme Commission classification number [EC] EC; and ALT; EC; alkaline phosphatase (AP; EC; gamma-glutamyltransferase (GGT; EC; lactate dehydrogenase (LD; EC; creatine kinase (CK; EC; and glucose assays. Results compare well with those obtained with other current clinical chemistry analyzers; correlation coefficients were greater than 0.993. Sample-to-sample carryover was negligible, and method linearity was satisfactory for all tests.

  7. One-year clinical evaluation of compomer restorations in cervical lesions of different aetiology

    Directory of Open Access Journals (Sweden)

    Premović Milica


    Full Text Available Introduction. The aim of this one-year prospective clinical study was to evaluate the treatment results of compomer restorations (Dyract® eXtra/ Dentsply/De Trey, Konstanz, Germany with a single step self-etching dental adhesive (Xeno® III Dentsply/De Trey, Konstanz, Germany used for restoring class V lesions (non-carious and primary carious cervical lesions. Material and Methods. A total number of 62 class V restorations (n = 62 were placed by one dentist in 30 patients on incisors, canines and premolars. The fillings were placed due to different indications: non-carious cervical defects (n = 32 and primary carious lesions (n = 30. The restorations were evaluated by a single-blind design, according to the Modified United States Public Health Service system 6 and 12 months following the placement. The following were evaluated: retention, marginal integrity, marginal discoloration, wear, postoperative sensitivity and secondary caries. The statistical analysis compared the ratings of each criteria between materials using the Pearson chi-square or Fisher’s exact test at a level of significance of 5% (p<0.05. Results. Two restorations of the non-carious lesion group were lost after 6 months, and after 12 months one restoration was lost in the group of primary carious lesions. There were no statistically significant differences between restorations for all evaluated criteria in both groups. Conclusion. The compomer restorations in combination with a single step self-etching dental adhesive showed acceptable clinical performance in Class V lesions after one year of clinical service.


    da Rocha, Válney Luiz; Thomé, André Luiz Coelho; da Silva Castro, Daniel Labres; de Oliveira, Leandro Zica; de Moraes, Frederico Barra


    Objective: To evaluate the clinical and radiological medium-term results from surgical treatment of developmental hip dysplasia through Salter innominate bone osteotomy and Ombrédanne femoral shortening. Methods: Fourteen patients were evaluated, with surgical treatment on 18 hips (seven right-side hips and eleven left-side hips) using the proposal technique, performed between 1998 and 2008. The Dutoit and Severin criteria were used respectively for clinical and radiographic evaluations. Results: The average preoperative index for the seven right-side hips was 43.3° (40° to 50°), and this was corrected through surgery to an average of 31.57° (24° to 42°). The average preoperative index for the eleven left-side hips was 42.1° (36° to 56°), and this was corrected through surgery to an average of 30.36° (20° to 44°). There was a statistically significant difference between the preoperative and postoperative acetabular indexes, with P > 0.05. The clinical evaluation showed that there were seven excellent hips (38.9%), eight good ones (44.4%), three fair hips (16.7%) and no poor ones (0%). By grouping the hips rated good and excellent as satisfactory and those rated poor and fair as unsatisfactory, 83.3% of the results were seen to be favorable. There were no statistically significant correlations between occurrences of complications and patient age at the time of surgery or between complications and the preoperative acetabular index (p > 0.05). The complications observed consisted of one case each of subluxation, osteonecrosis and osteonecrosis together with subluxation. Conclusion: The combined procedure of Salter and Ombrédanne is a viable option for treating developmental hip dysplasia after patients have started to walk. PMID:27027068

  9. A new cognitive evaluation battery for Down syndrome and its relevance for clinical trials. (United States)

    de Sola, Susana; de la Torre, Rafael; Sánchez-Benavides, Gonzalo; Benejam, Bessy; Cuenca-Royo, Aida; Del Hoyo, Laura; Rodríguez, Joan; Catuara-Solarz, Silvina; Sanchez-Gutierrez, Judit; Dueñas-Espin, Ivan; Hernandez, Gimena; Peña-Casanova, Jordi; Langohr, Klaus; Videla, Sebastia; Blehaut, Henry; Farre, Magi; Dierssen, Mara


    The recent prospect of pharmaceutical interventions for cognitive impairment of Down syndrome (DS) has boosted a number of clinical trials in this population. However, running the trials has raised some methodological challenges and questioned the prevailing methodology used to evaluate cognitive functioning of DS individuals. This is usually achieved by comparing DS individuals to matched healthy controls of the same mental age. We propose a new tool, the TESDAD Battery that uses comparison with age-matched typically developed adults. This is an advantageous method for probing the clinical efficacy of DS therapies, allowing the interpretation and prediction of functional outcomes in clinical trials. In our DS population the TESDAD battery permitted a quantitative assessment of cognitive defects, which indicated language dysfunction and deficits in executive function, as the most important contributors to other cognitive and adaptive behavior outcomes as predictors of functional change in DS. Concretely, auditory comprehension and functional academics showed the highest potential as end-point measures of therapeutic intervention for clinical trials: the former as a cognitive key target for therapeutic intervention, and the latter as a primary functional outcome measure of clinical efficacy. Our results also emphasize the need to explore the modulating effects of IQ, gender and age on cognitive enhancing treatments. Noticeably, women performed significantly better than men of the same age and IQ in most cognitive tests, with the most consistent differences occurring in memory and executive functioning and negative trends rarely emerged on quality of life linked to the effect of age after adjusting for IQ and gender. In sum, the TESDAD battery is a useful neurocognitive tool for probing the clinical efficacy of experimental therapies in interventional studies in the DS population suggesting that age-matched controls are advantageous for determining normalization of

  10. A new cognitive evaluation battery for Down syndrome and its relevance for clinical trials

    Directory of Open Access Journals (Sweden)

    Susana ede Sola


    Full Text Available The recent prospect of pharmaceutical interventions for cognitive impairment of Down syndrome(DS has boosted a number of clinical trials in this population. However, running the trials has raised some methodological challenges and questioned the prevailing methodology used to evaluate cognitive functioning of DS individuals. This is usually achieved by comparing DS individuals to matched healthy controls of the same mental age. We propose a new tool, the TESDAD Battery that uses comparison with age-matched typically developed adults. This is an advantageous method for probing the clinical efficacy of DS therapies, allowing the interpretation and prediction of functional outcomes in clinical trials. In our DS population the TESDAD battery permitted a quantitative assessment of cognitive defects, which indicated language dysfunction and deficits in executive function, as the most important contributors to other cognitive and adaptive behavior outcomes as predictors of functional change in DS. Concretely, auditory comprehension and functional academics showed the highest potential as end-point measures of therapeutic intervention for clinical trials: the former as a cognitive key target for therapeutic intervention, and the latter as a primary functional outcome measure of clinical efficacy. Our results also emphasize the need to explore the modulating effects of IQ, gender and age on cognitive enhancing treatments. Noticeably, women performed significantly better than men of the same age and IQ in most cognitive tests, with the most consistent differences occurring in memory and executive functioning and negative trends rarely emerged on quality of life linked to the effect of age after adjusting for IQ and gender. In sum, the TESDAD battery is a useful neurocognitive tool for probing the clinical efficacy of experimental therapies in interventional studies in the DS population suggesting that age-matched controls are advantageous for determining

  11. Evaluation of an eportfolio for the assessment of clinical competence in a baccalaureate nursing program. (United States)

    Garrett, Bernard M; MacPhee, Maura; Jackson, Cathryn


    This paper reports a study undertaken to evaluate the implementation of an electronic portfolio (eportfolio) tool for the assessment of clinical competence in a Bachelor of Science in Nursing program. Baccalaureate nursing programs increasingly use information and communications technologies to support student learning, assess and record progress. Portfolio based practice assessment and electronic portfolios represent growing trends to enhance learning via student reflection and self-identification of further learning needs. Using an action-research process, a mixed-methods evaluation strategy explored the efficacy of the eportfolio in its second year of use. Website tracking analytics and descriptive statistics were used to explore trends in eportfolio usage. Instructor and student surveys and focus groups were carried out at the end of the second year. Instructors valued the eportfolios convenience, improved transparency, an improved ability to track student progress, enhanced theory-practice links, and the competency based assessment framework. Students valued accessibility and convenience, but expressed concerns over assessment data openness and processes for standardization. Both groups felt that the eportfolio navigation required simplification. Electronic portfolios represent a technological evolution from paper-based clinical assessment systems. Although there appear to be many student and instructor advantages in using eportfolios, to maximize successful implementation, clinical teachers require additional training in this new pedagogic approach. Strategies to assist an institutional culture shift towards more transparent assessment processes may also need consideration.

  12. Evaluation of Clinical Interest of Anti-Aquaporin-4 Autoantibody Followup in Neuromyelitis Optica

    Directory of Open Access Journals (Sweden)

    Jean-Baptiste Chanson


    Full Text Available Neuromyelitis optica (NMO is an autoimmune disease in which a specific biomarker named NMO-IgG and directed against aquaporin-4 (AQP4 has been found. A correlation between disease activity and anti-AQP4 antibody (Ab serum concentration or complement-mediated cytotoxicity has been reported, but the usefulness of longitudinal evaluation of these parameters remains to be evaluated in actual clinical practice. Thirty serum samples from 10 NMO patients positive for NMO-IgG were collected from 2006 to 2011. Anti-AQP4 Ab serum concentration and complement-mediated cytotoxicity were measured by flow cytometry using two quantitative cell-based assays (CBA and compared with clinical parameters. We found a strong correlation between serum anti-AQP4 Ab concentration and complement-mediated cytotoxicity (P<0.0001. Nevertheless, neither relapse nor worsening of impairment level was closely associated with a significant increase in serum Ab concentration or cytotoxicity. These results suggest that complement-mediated serum cytotoxicity assessment does not provide extra insight compared to anti-AQP4 Ab serum concentration. Furthermore, none of these parameters appears closely related to disease activity and/or severity. Therefore, in clinical practice, serum anti-AQP4 reactivity seems not helpful as a predictive biomarker in the followup of NMO patients as a means of predicting the onset of a relapse and adapting the treatment accordingly.

  13. Er:YAG laser ablation: evaluation after a two-year clinical treatment (United States)

    Dostalova, Tatjana; Jelinkova, Helena; Kucerova, Hana; Krejsa, Otakar; Hamal, Karel; Kubelka, Jiri; Prochazka, Stanislav


    The aim of the clinical study is to evaluate Er:YAG laser ablation after two year-long clinical treatment. One hundred fifty cavities were volunteered for checking. Three restorative materials were used following manufacturer's directions. For the experiment, an Er:YAG laser drilling machine was applied. The laser delivered energy from 100 to 450 mJ, repetition rate from 1 to 4 Hz. The length of the generated pulses was 200 microseconds. During our experiments cooling of the teeth was achieved by fine water mist. The number of pulses was from 16 to 489. Caries of enamel and dentin were treated. Old insufficient fillings were also removed (not amalgam or metal alloys). The experiments followed the guidelines of the Declaration of Helsinki (1964), Tokyo (1975), Venice (1983) and Hong-Kong (1989). Clinical evaluation of fillings after 6, 12, 18 and 24 months based on ADA recommendation was used. Eight criteria were applied for the restoration control. Composite resins and glassionomers could be used as filling materials.

  14. Evaluation of pharmacy students’ clinical interventions on a general medicine practice experience

    Directory of Open Access Journals (Sweden)

    Jones JD


    Full Text Available As colleges of pharmacy prepare a new generation of practitioners, it is important that during practice experiences students learn the impact of clinical interventions. For over ten years, pharmacy students have been a vital part of the multidisciplinary team at the military treatment facility. The overall impact of the student interventions on patient care has not been evaluated. To evaluate the impact, the students began documenting their clinical interventions in Medkeeper RxInterventions™, an online database. The program is used to document faculty and fourth year pharmacy students’ pharmaceutical interventions.Objective: The objective of this study was to analyze the interventions completed by fourth year pharmacy students during a general medicine advanced pharmacy practice experience at a military treatment facility.Methods: The students completing their general medicine advanced pharmacy practice experience at the military treatment facility are responsible for self reporting all interventions made during clinical rounds into the Medkeeper RxIntervention™ database. The researchers retrospectively collected and analyzed interventions made from June 2008 to June 2009.Results: The total number of interventions recorded by 8 fourth year pharmacy students was 114. Students averaged a number of 14.3 interventions during an eight week practice experience. Students spent an average of 5 minutes per intervention. Ninety- five percent of the interventions were accepted.Conclusion: Fourth year pharmacy students’ recommendations were accepted at a high rate by resident physicians. The high acceptance rate may have the ability to positively impact patient care.

  15. Evaluation of Asperger Syndrome in Youth Presenting to a Gender Dysphoria Clinic (United States)

    Reisner, Sari L.; Edwards-Leeper, Laura; Tishelman, Amy


    Abstract Purpose: There is evolving evidence that children and adolescents with gender dysphoria have higher-than-expected rates of autism spectrum disorder (ASD), yet clinical data on ASD among youth with gender dysphoria remain limited, particularly in North America. This report aims to fill this gap. Methods: We conducted a retrospective review of patient chart data from 39 consecutive youth ages 8 to 20 years (mean age 15.8 years, natal male: n = 22, natal female: n = 17) presenting for evaluation at a multidisciplinary gender clinic in a large U.S. pediatric hospital from 2007 to 2011 to evaluate the prevalence of ASD in this patient population. Results: Overall, 23.1% of patients (9/39) presenting with gender dysphoria had possible, likely, or very likely Asperger syndrome as measured by the Asperger Syndrome Diagnostic Scale (ASDS). Conclusion: These findings are consistent with growing evidence supporting increased prevalence of ASD in gender dysphoric children. To guide provision of optimal clinical care and therapeutic intervention, routine assessment of ASD is recommended in youth presenting for gender dysphoria. PMID:26651183

  16. Development and Evaluation of a Hematology-Oriented Clinical Research Training Program in Latin America. (United States)

    Sung, Lillian; Rego, Eduardo; Riva, Eloisa; Elwood, Jessica; Basso, Joe; Clayton, Charles P; Mikhael, Joseph


    The objectives of the study were to describe the development of a patient-oriented clinical research training program in a low- or middle-income country (LMIC) setting, to describe perceived benefits of the program and barriers to application, and to make recommendations for future training programs. The program was developed by the American Society of Hematology in collaboration with Latin American stakeholders and clinical researchers. Session types were didactic, small group, and one-on-one faculty/participant dyad formats. Outcomes were assessed by quantitative surveys of trainees and qualitative feedback from both trainees and faculty members. The program is an annual 2-day course specifically for Latin American hematologists. Through course evaluations, all trainees described that the didactic sessions were relevant. All session types were useful for gaining knowledge and skills, particularly one-on-one meetings. The potential for networking was highly valued. Barriers to trainee applications were the concerns that skill level, proposed research program, and knowledge of English were not sufficiently strong to warrant acceptance into the course, and financial costs of attendance. We have described the development and initial evaluation of a clinical research training program in a LMIC setting. We learned several valuable lessons that are applicable to other research training programs.

  17. Prospective clinical evaluation of 273 modified acid-etched dental implants: 1- to 5- year results

    Directory of Open Access Journals (Sweden)

    Michele De Franco


    Full Text Available Aim: The aim of this study was to evaluate the implant survival and the implant-crown success of implants with surface treated with organic acids. Materials and methods: A total of 273 implants (Implus®, Leader-Novaxa, Milan, Italy were inserted in 63 patients, from June 2006 to June 2010, in a single clinical centre. In each annual follow up session, clinical, radiographic and prosthetic parameters were evaluated. The implant-crown success criteria included the absence of pain, suppuration and clinical mobility, a distance between the implant shoulder and the first visible bone contact (DIB <2.0 mm from the surgery and the absence of prosthetic complications at the implantabutment interface. Prosthetic restorations were 32 fixed partial prostheses, 48 single crowns and 16 fixed full arches. Results: The cumulative survival rate was 95.70% (93.81 maxilla, 98.24% mandible. Among the surviving implants, the implant-crown success was 96.07%. At the 5-year control, the mean DIB was 1.2 mm (± 0.5. Conclusion: Implants with surface treated with organic acids seem to represent a good solution for the prosthetic rehabilitation of partially and completely edentulous patients.

  18. Clinical and parasitological evaluation of pour-on fluazuron and ivermectin for treating canine demodicosis

    Directory of Open Access Journals (Sweden)

    Clarissa P. Souza


    Full Text Available The objective of the study was to evaluate the efficacy of pour-on formulations of fluazuron and ivermectin in different therapeutic protocols for treatment of demodicosis by means of quantifying mites with skin scraping, histological and clinical evaluation in dogs. Eighteen dogs with skin scrapings positive for Demodex canis were evaluated, divided into three groups. All the animals were treated every 14 days, completing 6 treatments for each animal (days 0, 14, 28, 42, 56 and 70. In group 1, pour-on 2.5% fluazuron was used at the dose of 20mg/kg; in the group 2 pour-on 2.5% fluazuron at a dose of 20 mg/kg in association with pour-on 0.5% ivermectin at the dose of 0.6mg/kg; and in group 3, pour-on 0.5% ivermectin alone was used, at the dose of 0.6mg/kg. The treatment was evaluated and monitored through skin scrapings and clinical follow-up of the lesions every 14 days for 84 days, and through histopathological examination at the end of each treatment protocol. The success rate was defined as the percentage of dogs in each group that had negative skin scrapings after the treatment: this was 16.67% for group 1, and 50% for groups 2 and 3. The reduction in mite counts reached effectiveness of 67.66%, 88.99% and 84.29% for groups 1, 2 and 3 respectively. The Wilcoxon test showed that there was a significant difference between the number of mites before and after treatment in groups 2 and 3. The histopathological examination revealed that only group 1 showed no significant difference in the intensity of infestation between days 0 and 84. Clinically, there was no significant difference between the evaluation before and after treatment in the three groups. pour-on 2.5% fluazuron and pour-on 0.5% ivermectin were not effective for treating canine demodicosis, either in association or as single therapy, when applied every 14 days for a period of 70 days. Quantification of mites using skin scrapings and histological evaluation proved to be ineffective

  19. To Use or Not? Evaluating ASPECTS of Smartphone Apps and Mobile Technology for Clinical Care in Psychiatry. (United States)

    Torous, John B; Chan, Steven R; Yellowlees, Peter M; Boland, Robert


    In this commentary, we discuss smartphone apps for psychiatry and the lack of resources to assist clinicians in evaluating the utility, safety, and efficacy of apps. Evaluating an app requires new considerations that are beyond those employed in evaluating a medication or typical clinical intervention. Based on our software engineering, informatics, and clinical knowledge and experiences, we propose an evaluation framework, "ASPECTS," to spark discussion about apps and aid clinicians in determining whether an app is Actionable, Secure, Professional, Evidence-based, Customizable, and TranSparent. Clinicians who use the ASPECTS guide will be more informed and able to make more thorough evaluations of apps.

  20. Preclinical Evaluation of Raman Nanoparticle Biodistribution for their Potential Use in Clinical Endoscopy Imaging

    DEFF Research Database (Denmark)

    Zavaleta, Cristina L; Hartman, Keith B; Miao, Zheng


    Raman imaging offers unsurpassed sensitivity and multiplexing capabilities. However, its limited depth of light penetration makes direct clinical translation challenging. Therefore, a more suitable way to harness its attributes in a clinical setting would be to couple Raman spectroscopy with endo......Raman imaging offers unsurpassed sensitivity and multiplexing capabilities. However, its limited depth of light penetration makes direct clinical translation challenging. Therefore, a more suitable way to harness its attributes in a clinical setting would be to couple Raman spectroscopy...... with endoscopy. The use of an accessory Raman endoscope in conjunction with topically administered tumor-targeting Raman nanoparticles during a routine colonoscopy could offer a new way to sensitively detect dysplastic lesions while circumventing Raman's limited depth of penetration and avoiding systemic...... toxicity. In this study, the natural biodistribution of gold surface-enhanced Raman scattering (SERS) nanoparticles is evaluated by radiolabeling them with (64) Cu and imaging their localization over time using micropositron emission tomography (PET). Mice are injected either intravenously (IV...