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Sample records for 3-year clinical evaluation

  1. 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

    2015-01-01

    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.

  2. 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

    2015-01-01

    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......). 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...... in increments up to 4 mm as needed to fill the cavity 2 mm short of the occlusal cavosurface. The occlusal part was completed with an ormocer-based nanohybrid resin composite (Ceram X mono+). In the other cavity, only the resin composite CeramX mono+ was placed in 2 mm increments. The restorations were...

  3. Oral mucoceles in infants younger than 3 years old. A 15 years clinical retrospective study.

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    Polytimi PASCHALIDI

    2015-08-01

    Full Text Available SUMMARY: Mucocele is a common cystic lesion of the minor salivary glands with or without epithelium lining. It derives following trauma of the gland itself or its excretory duct resulting to saliva accumulation within the soft tissues. The most common site of occurrence is the lower lip. Aim: In this retrospective study, mucoceles in infants (0-3 years old were evaluated. Material and methods: Data were retrieved from the medical records of patients up to 3 years old, treated under general anesthesia the period 2000-2014 at the pediatric Hospital «P. and A. Kyriakou». Parameters evaluated included gender, age, site of occurrence, clinical appearance of the lesion, etiology for the development, type of treatment, histological findings and recurrences. Results: 17 patients were included in the study, 8 boys (47% and 9 girls (53%. Age ranged from 5 months to 3 years (mean: 20 months. All lesions were in the lower lip and most common aetiology was trauma. They presented as small sized asymptomatic swellings, soft in palpation, elastic or flaccid, covered with normal or irritated oral mucosa. Treatment was surgical in all cases under general anesthesia, with removal of both the cystic lesion and the minor salivary gland. No recurrence occurred. Conclusion: Mucoceles can be found in very young ages even before the eruption of deciduous teeth. These lesions are treated surgically and because of the very young age general anesthesia is preferable.

  4. Caries preventive effects of toothpastes containing monofluorophosphate and trimetaphosphate: a 3-year clinical trial.

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    Andlaw, R J; Palmer, J D; King, J; Kneebone, S B

    1983-06-01

    The caries-preventive effects of two toothpastes were tested in a 3-year clinical trial involving 1319 children aged 11-13 years. The test toothpastes were: 1) a low abrasion paste containing 0.8% sodium monofluorophosphate (MFP), and 2) a paste containing 3% sodium trimetaphosphate (TMP). The control toothpaste was a conventional, moderately abrasive paste containing 0.8% sodium monofluorophosphate. The children were examined clinically and radiologically each year. Toothpaste was supplied to the children's homes, and its use was unsupervised. Caries increments after 3 years, in terms of DMF teeth and DMF surfaces, showed no significant differences between the MFP test group (444 children) and the MFP control group (450 children). However, the TMP test group (425 children) had significantly higher caries increments than the MFP control group. All three groups of children showed some improvement in oral hygiene and in gingival health, but there were no significant differences between the groups. PMID:6342928

  5. Care of burns in Scotland: 3-year data from the managed clinical network national registry

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    Gilhooly, Charlotte; Kinsella, John

    2014-01-01

    Introduction The Managed Clinical Network for Care of Burns in Scotland (COBIS) was launched in April 2007. Primary aims included establishing and maintaining a registry of complex burn injury in Scotland and setting mechanisms to regularly audit outcome of burn treatment against nationally agreed standards of care. On behalf of COBIS, we present 3-year incidence and mortality data of Scottish patients admitted with a complex burn injury in this abstract. Methods From January 2010 o...

  6. The effect of sodium trimetaphosphate on caries: a 3-year clinical toothpaste trial.

    Science.gov (United States)

    Städtler, P; Müller-Bruckschwaiger, K; Schäfer, F; Huntington, E

    1996-01-01

    The objective of this study was to assess the anticaries efficacy of a toothpaste containing 3% sodium trimetaphosphate (TMP; test) relative to a toothpaste containing no caries-preventive agent (control). The study was designed as a 3-year double-blind caries incidence study involving about 2,500 subjects aged 11 years at baseline. After a clinical examination, subjects were stratified by sex, presence of supragingival calculus and caries status and randomly assigned to either the control or the test group. Clinical examinations then took place at annual intervals. At baseline and at the final examination bite-wing radiographs were taken of subjects not radiographed within the previous 6 months. The change in caries between baseline and the 3-year examination was calculated as DMFS increments. The results showed a statistically significant difference of 8% between the test and control groups (p < 0.05). In subjects brushing twice daily the difference between the test and control group was 11% (p < 0.01). It is concluded that, when used regularly, a toothpaste containing 3% TMP will be effective against caries. PMID:8946103

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

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    Aslı Aytekin

    2015-12-01

    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.

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

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

    2016-01-01

    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

  9. 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

    1999-01-01

    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.

  10. Cyto-histology and clinical correlation of thyroid gland lesions: A 3 year study in a tertiary hospital

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    Sunita Bamanikar

    2014-01-01

    Full Text Available Background: Fine needle aspiration cytology (FNAC is a cost-effective and time saving diagnostic test used to specifically distinguish between benign and malignant lesions by histocytology. The aim of this study was to study the spectrum of thyroid lesions and to correlate the FNAC findings with histopathology of excised specimens. Materials and Methods: A total of 300 patients with thyroid swelling were included in this study who had FNAC during 3 years study period, from July 2011 to July 2013, at a tertiary care hospital. All patients with thyroid swelling were assessed by medical history, clinical examination, biochemical tests and radiological investigations. The FNAC diagnoses were correlated with clinical features, radiological investigations, hormonal findings and subsequent histological examination of the thyroid specimens. Results: Out of 300 patients, females outnumbered males in thyroid diseases and revealed preponderance toward younger population (21-40 years. Nodular colloid goiter was the most common cause of thyroid swelling presented during 1 month to 1-year period. There were 104 patients (34.7% who had surgical intervention and 86 (28.7% patients reported for follow-up and had thyroid function tests done. The diagnostic accuracy, sensitivity and specificity for malignancy were 94.2%, 50% and 100% respectively in our study. Conclusion: FNAC is a reliable, safe and accurate method as an initial simple diagnostic test for thyroid nodules in decision making about surgical intervention. Our study suggested that FNAC has higher specificity than sensitivity in detecting thyroid malignancy; hence its use as a reliable diagnostic tool for evaluation of thyroid swelling cannot be overemphasized.

  11. Reforming the Israeli health system: findings of a 3-year evaluation.

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    Gross, R; Rosen, B; Shirom, A

    2001-04-01

    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

  12. Abdominal Sacrohysteropexy in Women with Uterovajinal Prolapse: Our 3 Years Clinical Experience

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    Atilla Karateke

    2015-11-01

    Full Text Available Aim: Weakening of uterine supporting ligaments, especially cardinal and uterosacral ligaments, causes uterovaginal prolapse. Although uterovaginal prolapse is not related to uterus, hysterectomy has been the most preferred surgery in these situations. However, in recent years, uterine preservation surgery has become popular because patients begin to prefer uterus preservation for psychological reasons and site specific surgery has been developed. One of the most important uterine preservation surgery is abdominal sacrohysteropexy(ASH. In this study, we aim to present our clinical result of ASH surgey in women with uterovaginal prolapsus. Material and Method: Of 27 patients who had ASH operation due to uterovaginal prolapsus between January 2010- March 2013 in our clinic were included in the study. All the patients had preoperative urogenital examination and transvaginal ultrasonography were performed before operation. Pelvic organ prolapsus degree were recorded according to the pelvic organ prolapsus quantification system(POP-Q. ASH operation was performed by laparatomy to all patients. Of 5 patients who had stress type incontinance had %u2018Burch%u2019 operation concomitantly. Results: The mean hospitalization day of patients who had ASH operation was 2.6 days(range 2-5days and the mean age of patients were 52.8 ±7.5. None of the patients had bladder, ureter or intestine injury due to operation. While anatomical success rate were 92.6%, recurrence rate was 7.4 % at the end of first year. Ileus was not observed and only one patient who had burch operation had recurrent urinary incontinance symptoms at the end of the first year. Discussion: Our study results showed that ASH operation is a successfull operation in pelvic organ prolapse. This method also was found to be superior to others in terms of minimal complications.

  13. IQ trajectory, cognitive reserve, and clinical outcome following a first episode of psychosis: a 3-year longitudinal study.

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    Leeson, Verity C; Sharma, Pranev; Harrison, Masuma; Ron, Maria A; Barnes, Thomas R E; Joyce, Eileen M

    2011-07-01

    Comparison of current and estimated premorbid IQ in schizophrenia suggests that there are subgroups with low IQ, deteriorated IQ (DIQ), or preserved IQ and that this is established by psychosis onset. There are no controlled studies examining the trajectory of these IQ subgroups longitudinally or their relationship with clinical and social outcomes. Of 129 individuals with first-episode schizophrenia or schizoaffective disorder, 25% showed stable low IQ, 31% showed stable IQ in the average/high range, and 44% demonstrated intellectual deterioration by 10 points or more. Patients in the low and deteriorated groups were equally impaired on tests of memory and executive function compared with the preserved average/high-IQ group and controls and showed more negative and disorganization symptoms than the preserved average/high-IQ group. Sixty patients and 27 controls were assessed again 1 and 3 years later. There was no evidence that those with IQ deterioration at baseline continued on a declining cognitive trajectory or that those with preserved average/high IQ experienced subsequent IQ decline. The low IQ group showed no change in IQ, whereas both the DIQ and the preserved IQ groups improved. However, the rate of improvement of these 2 subgroups was no greater than that of the healthy controls, suggesting that this reflected practice effects. Both the low and the deteriorated groups had longer index admissions, more core negative symptoms, and worse occupational outcomes at 3 years. These data suggest that following psychosis onset, IQ is stable and that it is IQ at psychosis onset rather than premorbid IQ predicts a more severe illness. PMID:19934212

  14. A randomised clinical trial on the influence of splinted and unsplinted oral implants in mandibular overdenture therapy. A 3-year report.

    Science.gov (United States)

    Naert, I E; Gizani, S; Vuylsteke, M; van Steenberghe, D

    1997-06-01

    A randomised clinical trial was performed to investigate whether there is a need or advantage to splint two implants in the mandible retaining a hinging overdenture. Furthermore, patient satisfaction was evaluated for different attachment systems retaining the overdenture. Thirty-six edentulous patients were randomised into three groups of equal size and treated with either magnets, ball attachments or straight bars (reference group). After 3 years of observation no implants were lost in any of the groups. Besides, no statistically significant differences were noted for the peri-implant outcome. Although the bar group presented the highest retention force, the general satisfaction of the patients in the three groups did not differ. The patients with bar retentions showed less prosthetic complications of the retention elements but more at the level of the denture-supporting mucosa. Finally, the clinical outcome of all groups confirms that overdenture treatment demands regular controls with limited time intervals. PMID:9552823

  15. 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;

    2010-01-01

    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....

  16. 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

    2013-01-01

    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

  17. 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)

    2012-04-15

    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.

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

    International Nuclear Information System (INIS)

    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.

  19. Evaluation of the proximal aortic neck enlargement following endovascular repair of abdominal aortic aneurysm: 3-years experience

    Energy Technology Data Exchange (ETDEWEB)

    Napoli, Vinicio; Bargellini, Irene; Petruzzi, Pasquale; Cioni, Roberto; Vignali, Claudio; Bartolozzi, Carlo [Division of Diagnostic and Interventional Radiology, Department of Oncology, Transplants and Advanced Technologies in Medicine, University of Pisa, Via Roma 67, 56126, Pisa (Italy); Sardella, Savino G.; Ferrari, Mauro [Division of Vascular Surgery, Cisanello Hospital, Pisa (Italy)

    2003-08-01

    The aim of this study was to evaluate incidence, potential risk factors and effects on stent-graft migration of proximal neck dilatation after endoluminal repair of abdominal aortic aneurysm (EVAR), and the role of ultrasound (US) in detecting neck enlargement. From November 1998 to October 2001, 90 patients underwent EVAR. On follow-up, US and CT angiography (CTA) were performed, and diameters of the suprarenal and infrarenal aortic necks were monitored. Incidence of significant neck enlargement ({>=}2.5 mm) and distal stent-graft migration (>10 mm) was calculated. Several factors were evaluated as predictive of neck enlargement. Ultrasound and CTA measurements were compared. The US and CTA examinations were available in 68, 39, and 11 patients at 1, 2, and 3 years follow-up (mean follow-up 15 months). Incidence of significant neck dilatation was 21.8% at the infrarenal level (13, 33, and 36% at 1, 2, and 3 years follow-up) and 13.8% at the suprarenal level (9, 18, and 27% at 1, 2, and 3 years follow-up). Significant stent-graft migration occurred in 14 of 87 patients (16%) and was associated with neck dilatation in 8 (2 suprarenal and 6 infrarenal). No risk factors were identified. Ultrasound was less accurate than CT in measuring neck diameter, in particular at the suprarenal level. Proximal aortic neck enlargement occurs in up to 30% of patients after EVAR and represents the main risk factor for stent-graft migration. The risk of infrarenal neck dilatation is higher at 2 years follow-up, whereas the suprarenal neck enlarges later. Ultrasound is not useful in monitoring neck diameter. (orig.)

  20. Cyto-histology and clinical correlation of thyroid gland lesions: A 3 year study in a tertiary hospital

    OpenAIRE

    Sunita Bamanikar; Pinky Soraisham; Sudhir Jadhav; Harsh Kumar; Pradeep Jadhav; Arvind Bamanikar

    2014-01-01

    Background: Fine needle aspiration cytology (FNAC) is a cost-effective and time saving diagnostic test used to specifically distinguish between benign and malignant lesions by histocytology. The aim of this study was to study the spectrum of thyroid lesions and to correlate the FNAC findings with histopathology of excised specimens. Materials and Methods: A total of 300 patients with thyroid swelling were included in this study who had FNAC during 3 years study period, from July 2011 to July ...

  1. CLINICAL EVALUATION OF THYROID SWELLINGS

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    Vikrant

    2016-05-01

    Full Text Available BACKGROUND Thyroid nodule is the most common entity and presentation of underlying thyroid pathology. Term goitre is generalized enlargement of thyroid gland. The management of thyroid swelling depends on clinical examination, battery of tests to reach correct diagnosis. METHODS This is prospective study of clinical evaluation of thyroid swellings done on 100 patients presented with palpable thyroid swellings in Department of Otorhinolaryngology and Head and Neck Surgery, Government Medical College and Hospital, Haldwani, Nainital, Uttarakhand. The time period of study was from November 2013 to November 2015. RESULTS Thyroid swellings is more common in females (M:F ratio 1:5.66. Majority of the patients are in the age group of 31-40 years. Swelling in the anterior neck was the commonest mode of presentation. In majority of the patients, duration of swelling prior to presentation was between 6 months and 3 years

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

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    Chinyere Nnenne Pedro-Egbe

    2014-01-01

    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.

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

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    Márcia Cristina Furlaneto

    2011-10-01

    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.

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

    OpenAIRE

    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

    2011-01-01

    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...

  5. Success of 6-mm Implants with Single-Tooth Restorations: A 3-year Randomized Controlled Clinical Trial.

    Science.gov (United States)

    Sahrmann, P; Naenni, N; Jung, R E; Held, U; Truninger, T; Hämmerle, C H F; Attin, T; Schmidlin, P R

    2016-06-01

    The aim of the study was to test whether implants of 6 mm in length perform equally well as 10-mm implants in terms of survival and marginal bone-level changes when supporting single crowns. Patients with a posterior single-tooth gap were randomly allocated to either the placement of a 6-mm (test) or 10-mm implant (control). The treatment protocol allowed for internal sinus lift but not for lateral bone augmentation. After a healing period of 10 wk, implants were loaded with screw-retained single crowns. Survival rates, number of pockets ≥5 mm, and bleeding-on-probing were assessed clinically. The change of marginal bone level and crown-to-implant ratios were analyzed by 2 examiners. Longitudinal intragroup analyses for marginal bone levels were performed applying the Wilcoxon signed rank test. Intergroup differences at baseline and at 3 y were compared using the Mann-Whitney U test. The effect of implant length and crown-to-implant ratio on changes of marginal bone level also was determined. Of 94 implants placed (47 test and 47 control), 78 implants (40 test and 38 control) were available for follow-up examination at 3 y of loading. One test implant was lost during the second year. Hence, implant survival was not significantly different between the 2 groups after 3 y (98% test; 100% control). We found no significant change in the crestal bone level from baseline to 3 y for test and control implants with -0.19 ± 0.62 mm and -0.33 ± 0.71 mm, respectively. The intergroup difference was not significant. Crown-to-implant ratios were not associated with a statistically significant difference in marginal bone loss. However, the number of sites with pockets ≥5 mm was significantly higher in the test group. Based on the 3-y assessment, the use of 6-mm implants can be considered a viable option when reconstructing posterior single tooth gaps (German Clinical Trials Registry: DRKS00006290). PMID:26917439

  6. STRUCTURED CLINICAL EVALUATION

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    Arabela Maria Barbosa Sampaio

    2014-05-01

    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.

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

    OpenAIRE

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

    2009-01-01

    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 a...

  8. Evaluation of awake burr hole drainage for chronic subdural hematoma in geriatric patients: a retrospective analysis of 3 years

    OpenAIRE

    Serdal Albayrak; ibrahim Burak Atci; Necati Ucler; Hakan Yilmaz; Metin Kaplan

    2016-01-01

    Purpose: The goal of this research was to evaluate the effectiveness of burr hole drainage under local anesthesia in geriatric patients with chronic subdural hematoma. Material and Methods: This retrospective study involved 21 geriatric patients with chronic subdural hematoma who applied to the department of neurosurgery in an education and research hospital between 2011 and 2014. Sedoanalgesia was performed on 21 patients, then awake burr hole drainage was performed after scalp and perios...

  9. The Evaluation Of Clinical Competence

    OpenAIRE

    Boucher, François-Gilles; Palmer, Wilfred H.; Page, Gordon; Barriault, Ronald; Seely, Janet

    1980-01-01

    During a workshop on the evaluation of clinical competence, the participants identified the process skills that comprise clinical competence and examined the techniques available for evaluating these skills. No single technique allows satisfactory evaluation of all the process skills; the most commonly used methods (chart review and case presentation) evaluate few process skills. An adequate performance profile in all the process skills requires a combination of evaluation techniques. Medical...

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

    Directory of Open Access Journals (Sweden)

    Jaleh Samadi

    2006-06-01

    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.

  11. Clinical analysis of allergic rhinitis in children between 1 and 3 years of age%幼儿变应性鼻炎临床特征分析

    Institute of Scientific and Technical Information of China (English)

    戴伟利; 张杰; 潘岳松; 陈敏; 张亚梅

    2011-01-01

    之一,血清总IgE水平升高与吸人性变应原筛查阳性率升高有关;吸入组变应原阳性、有蚊虫叮咬性皮炎和父亲患AR与出现湿疹或哮喘病史有关.%Objective To study the atopy spectrum and its related factors in 1 to 3 years old children with allergic rhinitis.Methods Ninety-six children with allergic rhinitis,aged between 1 and 3years old,referred to ENT department of Beijing Children's Hospital between August 2009 and November 2010 were retrospectively reviewed.Data were recorded for patients' age,age stratification,sex,the age of first symptom,the duration of history,and the allergic history of children,the allergic history of parents.The screening tests on inhalant and food allergens were conducted by immunoblot assay using the Allergy Screen system.The total serum IgE level was also measured.The distribution of the inhalant and food allergens was summarized.The influence of the clinical characteristics was analyzed according to the age subgroup determined by month,allergen category and positiveness of eczema or asthma Logistic regression was used to analyze the relationship of clinical characteristics and allergen spectrum.Results The total positive rates of allergic screening test rate were 81.3%.The inhalant and food allergens were 62.5% and 53.1% respectively.The commonest allergy was mixed fungal(50.0% ),followed by milk(34.4% ),lamb (31.3%),beef(26.0% ),dust mite ( 21.0% ),wheat ( 18.8% ),mugwort ( 12.5% ),egg white or egg yolk( 11.5% ).62.5% of patients could be diagnosed as AR,the remaining could be diagnosed temporarily as non-allergic rhinitis temporarily.Single factor analysis of clinical characteristics in different subgroup determined by month showed that:inhalant allergen(positive/negative) ( x2 =13.699,P =0.001 ),father suffered from AR( x2 =14.060,P =0.001 ),and father or mother suffered from AR ( x2 =7.396,P =0.025) were statistically significant at three monthly age groups

  12. Evaluation of a Program to Teach Phonemic Awareness to Young Children: A 2- and 3-Year Follow-Up and a New Preschool Trial.

    Science.gov (United States)

    Byrne, Brian; Fielding-Barnsley, Ruth

    1995-01-01

    A follow-up study of 62 children in grades 1 and 2 instructed in phonemic awareness in preschool showed that, compared with 53 controls, trained children were superior in nonword reading 2 and 3 years later and in reading comprehension at 3 years. A supplemental study supported these results. (SLD)

  13. Annual Change in Pulmonary Function and Clinical Characteristics of Combined Pulmonary Fibrosis and Emphysema and Idiopathic Pulmonary Fibrosis: Over a 3-Year Follow-up

    OpenAIRE

    Kim, Yu Jin; Shin, Seong Hyun; Park, Jeong-Woong; Kyung, Sun Young; Kang, Shin Myung; Lee, Sang-Pyo; Sung, Yon Mi; Kim, Yoon Kyung; Jeong, Sung Hwan

    2014-01-01

    Background Combined pulmonary fibrosis and emphysema (CPFE) have different pulmonary function tests (PFTs) and outcomes than idiopathic pulmonary fibrosis (IPF). The intention of this study was to identify unknown differences between CPFE and IPF by a retrospective comparison of clinical data including baseline and annual changes in pulmonary function, comorbidities, laboratory findings, clinical characteristics and cause of hospitalization. Methods This study retrospectively enrolled patient...

  14. 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

    1990-01-01

    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...

  15. Parkinson's disease is overdiagnosed clinically at baseline in diagnostically uncertain cases: a 3-year European multicenter study with repeat [123I]FP-CIT SPECT

    NARCIS (Netherlands)

    V.L. Marshall; C.B. Reininger; M. Marquardt; J. Patterson; D.M. Hadley; W.H. Oertel; H.T.S. Benamer; P. Kemp; D. Burn; E. Tolosa; J. Kulisevsky; L. Cunha; D. Costa; J. Booij; K. Tatsch; K.R. Chaudhuri; G. Ulm; O. Pogarell; H. Höffken; A. Gerstner; D.G. Grosset

    2009-01-01

    Overdiagnosis of Parkinson's disease (PD) is suggested by specialist review of community diagnosis, and in postmortem studies. In specialist centers 4 to 15% of patients entered into clinical trials as early PD do not have functional imaging support for a PD diagnosis. In a European multicenter, pro

  16. Clinical evaluation of functional dysphonia.

    Science.gov (United States)

    Monday, L A

    1983-10-01

    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.

  17. Surgical combined approach for alveolar ridge augmentation with titanium mesh and rhPDGF-BB: a 3-year clinical case series.

    Science.gov (United States)

    De Angelis, Nicola; De Lorenzi, Marco; Benedicenti, Stefano

    2015-01-01

    The purpose of this case series was to report the clinical outcomes and histologic findings of vertical ridge augmentation using a combination of titanium mesh and recombinant human platelet-derived growth factor BB (rhPDGF-BB). Two patients were included, and anorganic bovine bone particles were used. The bone graft was mixed with rhPDGF-BB and loaded onto the bony defect up to the level of the adjacent alveolar crest. A preadapted titanium mesh was placed over the grafted region; no areas of the grafted region were exposed. Postoperative healing was without complications. During reentry surgery for removal of the titanium mesh, all implants could be placed according to the prosthetic design. This report demonstrates the remarkable efficacy of guided bone regeneration using a combination of titanium mesh and rhPDGF for vertical ridge augmentation, thus expanding the indications for implant therapy and allowing recovery of the three-dimensional esthetic architecture in a severely resorbed alveolar ridge. PMID:25738343

  18. Clinical evaluation of contemporary oxygenators.

    Science.gov (United States)

    Stanzel, Roger D P; Henderson, Mark

    2016-01-01

    Advances in cardiopulmonary bypass equipment have played a critical role in improving outcomes for cardiac surgery patients. Recent advancements include reduced priming volumes, biocompatible coatings and gaseous microemboli handling, as well as the incorporation of an arterial filter into the oxygenator.The purpose of this study was to conduct a comprehensive clinical evaluation of adult oxygenators on the market. Oxygenators assessed included the Sorin Synthesis(®) (n = 30), the Sorin Inspire 6F(®) (n = 10) and Inspire 8F(®) (n = 30), the Terumo FX15(®) (n = 13) and FX25(®) (n = 30), the Maquet Quadrox-i(®) (n = 30) and the Medtronic Fusion(®) (n = 30). Parameters assessed included functional prime volumes, gas exchange, pressure gradients and the effects on patient hematology.The Synthesis had the largest functional prime volume (1426 ml), the FX15 the lowest (956 ml). The Inspire 6F, 8F and Fusion had the greatest O2 transfer. The Sorin oxygenators required the lowest sweep gas flows to obtain a PaCO2 of 40 mmHg. The Sorin oxygenators had the largest pressure gradients. While no differences were observed for hemoglobin and platelet levels post cross-clamp removal, the Sorin Synthesis and Inspire 8F had the largest increases in white blood cell (WBC) counts (122% and 141% of baseline, respectively) and neutrophils (162% and 185% of baseline, respectively).The data demonstrate that no single product is superior in all aspects. The choice of ideal oxygenator depends on the aspect(s) of oxygenator performance the perfusion team believes most clinically acceptable based on available data. PMID:26407816

  19. 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.

    Science.gov (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

    2013-08-01

    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.

  20. Nuclear medicine and image research: instrumentation and quantitative methods of evaluation. Comprehensive 3-year progress report, January 15, 1983-January 14, 1986

    International Nuclear Information System (INIS)

    This program of research addresses problems involving the basic science and technology of radioactive tracer methods as they relate to nuclear medicine and imaging. The broad goal is to develop new instruments and methods for image formation, processing, quantitation, and display, so as to maximize the diagnostic information per unit of absorbed radiation dose to the patient. Project I addresses problems with the quantitative imaging a single-photon emitters; Project II addresses similar problems associated with the quantitative imaging of positron emitters; Project III addresses methodological problems associated with the quantitative evaluation of the efficacy of diagnostic imaging procedures

  1. Identifying questions in the American Association of Swine Veterinarian's PRRS risk assessment survey that are important for retrospectively classifying swine herds according to whether they reported clinical PRRS outbreaks in the previous 3 years.

    Science.gov (United States)

    Holtkamp, Derald J; Lin, Hui; Wang, Chong; O'Connor, Annette M

    2012-09-01

    The American Association of Swine Veterinarian's (AASV) Production Animal Disease Risk Assessment Program (PADRAP) is a web-based program that offers a set of risk assessment surveys being used by veterinarians who are members of the AASV. Members use PADRAP to help producers systematically assess risk factors that may be associated with clinical outcomes. As assessments are performed the completed surveys are added to the dataset maintained at the Iowa State University College of Veterinary Medicine. One of the surveys included in PADRAP is the porcine reproductive and respiratory syndrome (PRRS) Risk Assessment for the Breeding Herd. The aim of the study was to categorize questions in version 2 of the PRRS Risk Assessment for the Breeding Herd survey as important or unimportant for classifying herds according to whether they reported clinical PRRS outbreaks in the previous 3 years. The results elucidate the relative importance of risk factors and areas of risk factors for clinical outcomes and removing unimportant questions may reduce the time required to complete the survey without affecting the quality of information obtained. Surveys from 896 sow herd sites in the United States and Canada completed between March 2005 and March 2009 were included in the analysis. The survey contained a large number of questions with a complex correlation structure among the questions. Responses for several questions were dependent upon responses to others. To address these issues, an approach was developed using a series of statistical methods including random forest, principle component analysis, logistic regression and receiver operating characteristic (ROC) analysis to classify the herds using the questions in the survey as explanatory variables. Questions were ranked by importance and systematically excluded from least important to most important. The questions excluded, without significantly affecting the performance of the model for classifying herds were identified as

  2. Clinical evaluation of Graves ophthalmopathy

    Directory of Open Access Journals (Sweden)

    Janićijević-Petrović Mirjana A.

    2012-01-01

    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.

  3. Evaluation of a Rheumatology Transition Clinic

    OpenAIRE

    Stringer, Elizabeth; Scott, Rachel; Mosher, Dianne; MacNeill, Inez; Huber, Adam M.; Ramsey, Suzanne; Lang, Bianca

    2015-01-01

    Background An adolescent with a chronic condition must prepare for transition from the pediatric to the adult health care system. Ideally, transition is a purposeful and coordinated process between the two systems. We sought to evaluate a pediatric rheumatology transition clinic from the perspective of the young adults who attended the clinic. Methods Young adults who attended the IWK Health Centre Pediatric Rheumatology Transition Clinic in Halifax, Nova Scotia, Canada were asked to complete...

  4. Developments in statistical evaluation of clinical trials

    CERN Document Server

    Oud, Johan; Ghidey, Wendimagegn

    2014-01-01

    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.

  5. Ceftriaxone: in vitro studies and clinical evaluation.

    OpenAIRE

    Gnann, J. W.; Goetter, W E; Elliott, A M; Cobbs, C G

    1982-01-01

    The in vitro activity of ceftriaxone against 437 clinical isolates of gram-negative bacilli was determined. Ceftriaxone was found to have high in vitro activity against Enterobacteriaceae, with the exception of Enterobacter cloacae. Ceftriaxone was only minimally active against Pseudomonas aeruginosa and Acinetobacter calcoaceticus. We evaluated the clinical efficacy and toxicity of ceftriaxone in 55 adult patients. Bacterial infection was confirmed by the isolation of etiological bacteria in...

  6. Clinical evaluation of leg ulcers in elderly patients

    Directory of Open Access Journals (Sweden)

    Jordana Prado Benevides

    2012-06-01

    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.

  7. How Grammatical Are 3-Year-Olds?

    Science.gov (United States)

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

    2012-01-01

    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…

  8. Evaluating clinical dermatology practice in medical undergraduates.

    Science.gov (United States)

    Casanova, J M; Sanmartín, V; Martí, R M; Morales, J L; Soler, J; Purroy, F; Pujol, R

    2014-06-01

    The acquisition of competences (the set of knowledge, skills and attitudes required to perform a job to a professional level) is considered a fundamental part of medical training. Dermatology competences should include, in addition to effective clinical interviewing and detailed descriptions of skin lesions, appropriate management (diagnosis, differentiation, and treatment) of common skin disorders and tumors. Such competences can only be acquired during hospital clerkships. As a way of certifying these competences, we propose evaluating the different components as follows: knowledge, via clinical examinations or critical incident discussions; communication and certain instrumental skills, via structured workplace observation and scoring using a set of indicators; and attitudes, via joint evaluation by staff familiar with the student. PMID:23664251

  9. [Elaboration and critical evaluation of clinical guidelines].

    Science.gov (United States)

    García Villar, C

    2015-11-01

    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.

  10. Experimental evaluation of clinical colon anastomotic leakage

    DEFF Research Database (Denmark)

    Pommergaard, Hans-Christian

    2014-01-01

    , ischemia and insufficient surgical technique have been suggested to play a central role. Animal models are valuable means to evaluate pathophysiological mechanisms and may be used to test preventive measures aiming at reducing the risk of anastomotic leakage, such as external anastomotic coating. The aim...... of this thesis was to: Clarify the best suited animal to model clinical anastomotic leakage in humans; Create animal models mimicking anastomotic leakage in humans induced by insufficient surgical technique and tissue ischemia; Determine the best suited coating materials to prevent anastomotic leakage. STUDY 1...... of experimental animals were identified. The results indicated that the mouse and the pig are the best suited animals to evaluate clinical anastomotic leakage. However, the pig model is less validated and more costly to use compared with the mouse. Most frequently, rats are used as models. However, extreme...

  11. Evaluation of HRSA's Clinical Pharmacy Demonstration Projects

    OpenAIRE

    Suzanne Felt-Lisk; Lindsay Harris; Meredith Lee; Rebecca Nyman

    2004-01-01

    This study evaluated demonstration projects that aimed to expand access to needed pharmaceuticals through comprehensive pharmacy services and improve the health of the mostly low-income population served by HRSA-supported health centers. Researchers examined 18 networks that collaborated with a school of pharmacy to expand services at their health center sites, with a focus on disease management programs run by a clinical pharmacist for patients with diabetes. The demonstration showed substan...

  12. A 3-year randomized therapeutic trial of nitisinone in alkaptonuria.

    Science.gov (United States)

    Introne, Wendy J; Perry, Monique B; Troendle, James; Tsilou, Ekaterini; Kayser, Michael A; Suwannarat, Pim; O'Brien, Kevin E; Bryant, Joy; Sachdev, Vandana; Reynolds, James C; Moylan, Elizabeth; Bernardini, Isa; Gahl, William A

    2011-08-01

    Alkaptonuria is a rare, autosomal recessive disorder of tyrosine degradation due to deficiency of the third enzyme in the catabolic pathway. As a result, homogentisic acid (HGA) accumulates and is excreted in gram quantities in the urine, which turns dark upon alkalization. The first symptoms, occurring in early adulthood, involve a painful, progressively debilitating arthritis of the spine and large joints. Cardiac valvular disease and renal and prostate stones occur later. Previously suggested therapies have failed to show benefit, and management remains symptomatic. Nitisinone, a potent inhibitor of the second enzyme in the tyrosine catabolic pathway, is considered a potential therapy; proof-of-principle studies showed 95% reduction in urinary HGA. Based on those findings, a prospective, randomized clinical trial was initiated in 2005 to evaluate 40 patients over a 36-month period. The primary outcome parameter was hip total range of motion with measures of musculoskeletal function serving as secondary parameters. Biochemically, this study consistently demonstrated 95% reduction of HGA in urine and plasma over the course of 3 years. Clinically, primary and secondary parameters did not prove benefit from the medication. Side effects were infrequent. This trial illustrates the remarkable tolerability of nitisinone, its biochemical efficacy, and the need to investigate its use in younger individuals prior to development of debilitating arthritis. PMID:21620748

  13. Scurvy in a 3-year-old boy: MRI features

    OpenAIRE

    Cock, J.,; Renard, M; de Smet, M.; Breysem, L

    2012-01-01

    A 3-year-old boy presented with painful knees (especially the right knee) and difficulty in walking for a few weeks. He complained of lower limb weakness. He was irritable and thinly built. At clinical examination movement of the knees and hips was painful. He had previously been diagnosed with autism. The mother reported that he didn’t eat well.

  14. Body Composition at 3-years of Age

    DEFF Research Database (Denmark)

    Ejlerskov, Katrine Tschentscher

    Background: Birth weight and high weight gain the first years of life is associated with later body composition and increased risk of obesity. A detailed description of body composition at 3 years of age and factors related to the distribution of fat and fat-free mass is interesting, since body......D study was to look at which factors were related to body composition at 3 years of age with a special focus on factors related to later obesity risk. A methodological objective was to be able to predict body composition by using bioelectrical impedance and anthropometry. Secondly, an objective...... was to identify growth periods with relation to body composition at 3 years and whether the impact of growth was modified by nutrition. A third objective was to examine the relation between IGF-I levels at 9 and 36 months and body composition at 3 years. Since the IGF-I level was expected to be affected...

  15. 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

    2015-01-01

    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

  16. A 3-year follow-up study of mandibular two-implant overdentures retained with ball attachments:clinical outcomes and pros-thetic complications%球帽固位下颌双种植体覆盖义齿修复效果的前瞻性研究

    Institute of Scientific and Technical Information of China (English)

    张仁国; 张太梅; 解永富; 顾静怡; 施晓玲

    2015-01-01

    目的:评价球帽固位的下颌双种植体覆盖义齿的临床修复效果及其修复并发症。方法对下颌牙槽骨重度萎缩的10例无牙颌患者,在前牙区与中线等距平行植入2枚种植体,3个月后采用球帽附着体固位方式制作下颌种植覆盖义齿。在覆盖义齿戴入后1周、1年、2年、3年进行随访,评价种植体边缘骨吸收情况、种植体周围软组织健康状况、患者满意度及义齿并发症情况。结果10例两球帽固位的下颌种植覆盖义齿经过3年观察,种植体存留率100%,边缘骨吸收<1 mm,种植体周围软组织健康,患者满意度显著提高且维持稳定,义齿无重衬或折断现象,义齿并发症主要是球帽附着体O 型圈的置换或固位金属簧的固位力再激活,修理频次0.67次/(年·人)。结论在种植体植入位置、方向合适的情况下,球帽附着体固位的下颌双植体覆盖义齿,可获得长期稳定的临床修复效果。%Objective To evaluate the clinical outcomes and prosthetic complications of mandibular two-implant overdentures re-tained with ball attachments over 3 years. Methods 10 patients with severely reabsorbed mandibular edentulous jaws were treated with delay-loaded mandibular two-implant overdentures retained with ball attachments 3 months after the implants were placed in the man-dibular anterior region with good consistency in the horizontal level,angulation,and distance from the midline. The implant survival rate,peri-implant tissue status,prosthetic complications and patients′ satisfaction were evaluated 1 week,1 year,2 years and 3 years af-ter overdenture rehabilitation. Results Over 3 years′ rehabilitation of mandibular two-implant overdentures retained with ball attach-ments,no implants failed,the overall marginal bone loss was lower than 1mm,the mucosal conditions were healthy,and the patients′ sat-isfaction was significantly improved and remained high over

  17. Gastroschisis: factors influencing 3-year survival and digestive outcome

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    Lília Valente

    2015-12-01

    Full Text Available Background: Gastroschisis patients’ morbidity is still high, underlining the importance of identifying factors associated with adverse outcomes.Objective: To determine factors influencing gastroschisis patients’ morbimortality during the first 3 years of life in “Centro Hospitalar São João” (CHSJ.Methodology: Records of infants born with gastroschisis between January 2002 and December 2011 admitted to CHSJ were reviewed. The relation between demographic and clinical data and morbimortality during the first 3 years of life, specifically anthropometric evolution and digestive outcome, was evaluated. The factors that were compared were simple versus complex gastroschisis and primary versus secondary closure.Results: Forty records were analysed. The survival rate was 92.3%. Patients with complex gastroschisis had worse outcomes: hospital stay (median 59 versus 23.5 days, total parenteral nutrition (50 versus 19 days, total oral intake reached (47 versus 22.5 days, morphine analgesia (9 versus 3 days, intestinal occlusion (60% versus 11.8%, perforation (60% versus 0% and ischaemia (40% versus 0%, sepsis (100% versus 32.4%, short bowel syndrome (40% versus 3.1%, laxative need during 1-year follow-up (40% versus 0%, weight percentile < 5 at 6 months (75% versus 13.6% and gastrointestinal symptoms after the first year of life (OR: 42; 95% CI: 2.01-877.5. Secondary closure patients had worse outcomes: start of oral intake (25 versus 11.5 days, total oral intake reached (48 versus 23 days, necrotizing enterocolitis (40% versus 2.9% and mortality (40% versus 2.9%.Conclusion: Complex gastroschisis and secondary closure were both associated with higher morbidity. Secondary closure was also associated with higher mortality. Complex gastroschisis revealed to be a predictive factor for higher incidence of gastrointestinal symptoms after the first year of life. Therefore, follow-up at least until 3 years of life of patients with complex gastroschisis

  18. Evaluation of clinical and laboratory correlates of sickle leg ulcers.

    Science.gov (United States)

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

    2013-01-01

    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.

  19. Clinical evaluation in periodontitis patient after curettage

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    Widowati Witjaksono

    2006-09-01

    Full Text Available Curettage is used in periodontics to scrap off the gingival wall of a periodontal pocket, and is needed to reduce loss of attachment (LOA by developing new connective tissue attachment in patients with periodontitis. The purpose of this study was to evaluate the success of curettage by the formation of tissue attachment. This clinical experiment was done by comparing LOA before curettage, 2 weeks and 3 weeks after curettage on 30 teeth with the indication of curettage. Study population were periodontitis patient who attending dental clinic at Hospital University Science Malaysia (HUSM with inclusion criteria good general health condition, 18 to 55 years old male or female and presented with pocket depth > 3mm. The teeth were thoroughly scaling before intervention and evaluated by measuring the periodontal attachment before curettage, two weeks and three weeks after curettage. Repeated measure ANOVA and Paired T Test were used to analyze the data. The result of the study showed that there was reduction in the periodontal attachment loss in periodontitis patient after curettage either in the anterior or posterior teeth which were supported by statistical analysis. This study concluded that curettage could make reattachment of the tissue

  20. 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

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    Guido Biele

    2014-12-01

    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.

  1. 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

    2006-12-01

    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.

  2. Clinical evaluation of ischemic heart diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Kamei, Fumio (Sendai Railway Hospital (Japan))

    1983-09-01

    Attempt were made to detect the existence of myocardial ischemia by means of both radiographic and scintigraphic techniques. Firstly, a new polygraph was especially designed for selecting the arbitrary phases in a cardiac cycle at which the corresponding radiogram should be synchronously obtained. A comparative investigation on the difference between end-systolic and-diastolic cardiac transverse diameters revealed a remarkable difference of 3.6% in normal subjects and 0.6% in patients with ischemic heart disease. These data indicating the difference of overall heart size was reflected in local dyskinesis documentation of recently developed techniques. For daily clinical purposes, radiography of the chest based on synchronously selected phases would contribute to accurate diagnosis and treatment of heart disease. Secondly, scintigraphic display using intravenously injected thallium-201 was clinically applied. For detection of ischemia, comparative study was performed of initial image relative to selective coronary cineangiography and stress scintigraphy. The former indicated a good correlation of 90%, whereas the latter served to enhance sensitivity. Sequential images (initial and delayed) facilitated the distinction of normal, necrotic, and ischemic areas. Scintigram was used for objective evaluation of coronary dilator (dilazep), either at immediate or follow-up stage. In the same way, it was also possible to indicate the effectiveness of sublingually given nitroglycerin by myocardial scintigram, where by significant increase of uptake was observed 20 minutes after administration. Rehabilitation after acute heart disease was discussed, especially on the peripheral effect. Ratio of the thigh muscle to myocardium shown in this study was useful for objective evaluation. Another preliminary study is to separate normal coronary arteries from myocardial necrosis.

  3. 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: ron.waksman@medstar.net

    2014-04-15

    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.

  4. Implementing Peer Evaluation of Clinical Teaching

    Science.gov (United States)

    Laske, Rita Ann

    2013-01-01

    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…

  5. Clinical evaluation of seven anticalculus dentifrice formulations.

    Science.gov (United States)

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

    1991-01-01

    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.

  6. 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

    2010-01-01

    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.

  7. AID awards 3-year Guatemala contract.

    Science.gov (United States)

    1984-01-01

    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.

  8. Disease-free survival at 2 and 3 years is a significant early surrogate marker predicting the 5-year overall survival in patients treated with radical cystectomy for urothelial carcinoma of the bladder: external evaluation and validation in a cohort of Korean patients

    Directory of Open Access Journals (Sweden)

    Hyung Suk eKim

    2015-10-01

    Full Text Available Purpose: We aimed to externally validate the association of 2- and 3-year disease-free survival with 5-year overall survival in patients treated with radical cystectomy for urothelial carcinoma of the bladder. Materials and Methods: We reviewed the clinical data of 422 patients who underwent radical cystectomy for urothelial carcinoma of the bladder in our institution between 1991 and 2012. Survival curves were plotted with the Kaplan–Meier method. The Kappa statistic and Kendall tau-b test were used to assess the agreements between 2- and 3-year disease free survival and 5-year overall survival. Results: In the entire study population, 2- and 3-year disease free and 5-year overall survival rates were 76.4%, 71.5%, and 67.4%, respectively. All Kappa and Kendall’s tau-b test values for agreements between 2- and 3-year disease free and 5-year overall survival were more than 0.40, indicating moderate agreement for all patients and in each patient subgroup selected according to specific variables (all p values <0.05. Kaplan–Meier analysis for disease free survival and Cox-proportional hazard models for landmark analysis at each time point indicated that most recurrences occurred within 3 years after surgery. The 5-year overall survival rates of patients who were recurrence free at each time point gradually increased to more than 95% in an extended recurrence-free interval of 12–36 months.Conclusions: Our external validation results support the existing finding that 2- and 3-year disease free survival can be a valid early surrogate end point to predict 5-year overall survival after radical cystectomy in patients with urothelial carcinoma of the bladder.

  9. [Spondyloarthropathies--clinical evaluation and physical therapy].

    Science.gov (United States)

    Vlak, Tonko

    2004-01-01

    Spondyloarthropathy is a group of chronic autoimmune disorders including ankylosing spondylitis, reactive arthritis, psoriatic arthritis, arthritis associated with inflammatory bowel disease, acute anterior uveitis and undifferentiated spondyloarthropathies. The spondyloarthropathies share common clinical, radiological, and genetic features that are clearly distinct from other inflammatory rheumatic diseases. The major goal in the management of patients with rheumatic disorders is to control or cure the disease and to preserve and control function and health status. To measure treatments' efficacy standardized assessment of organ morphology, function, and of health status are required. The instruments for measuring health status or quality of life cover a variety of dimensions of health, including physical, social, and emotional functioning. Measurements used to evaluate the efficacy of treatments in ankylosing spondylitis include spinal and chest movement, duration and severity of morning stiffness, and quality of sleep. Health status indices such as the HAQ or AIMS are not readily applicable to spondyloarthropaties. It is reason to use some others: 1. Functional status measure S-HAQ for patients with spondylitis by adding five items to the HAQ, to cover the activities identified as most problematic; 2. Functional index for the assessment of ankylosing spondylitis (Dougados Functional Index - DFI) - it is valid and reliable and shows sufficient responsiveness; S-HAQ appears at least as sensitive to change as the Dougados Index; 3. The Leeds Disability Questionnaire assesses disability in ankylosing spondylitis, inquiring about four areas of function: mobility, bending down, reaching up and neck movements, and postures; 4. The Bath Ankylosing Spondylitis Functional Index (BASFI) 10 item self-administered questionnaire to assess function and activities of daily living in patients with ankylosing spondylitis. Physical therapy is one of the most important way to

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

    Science.gov (United States)

    2013-01-28

    ... assist the pharmaceutical industry and other investigators engaged in new drug development in evaluating... HUMAN SERVICES Food and Drug Administration Guidance for Industry on Clinical Pharmacogenomics... announcing the availability of a guidance for industry entitled ``Clinical Pharmacogenomics:...

  11. Effectiveness of Dietary Allergen Exclusion Therapy on Eosinophilic Colitis in Chinese Infants and Young Children ≤ 3 Years of Age

    Directory of Open Access Journals (Sweden)

    Min Yang

    2015-03-01

    Full Text Available Eosinophilic colitis is a well recognized clinical entity mainly associated with food allergies. Empiric treatment options include dietary allergen exclusion (extensively hydrolyzed protein formula and elimination diet, anti-allergy medications (antihistamines and leukotriene receptor antagonists and corticosteroids. We evaluated the effectiveness of dietary antigen exclusion on clinical remission of eosinophilic colitis in infants and young children. We retrospectively reviewed charts of all infants and children ≤3 years of age who were diagnosed with eosinophilic colitis (defined as mucosal eosinophilia ≥20 hpf−1 from 1 January 2011 to 31 December 2013 at a tertiary children’s hospital in China. Forty-nine children were identified with eosinophilic colitis. Elemental formula, simple elimination diet or combination therapy resulted in clinical improvement in 75%, 88.2% and 80% of patients, respectively. In conclusion, eosinophilic colitis in infants and children ≤3 years of age responded well to dietary allergen exclusion.

  12. Clinical image quality evaluation for panoramic radiography in Korean dental clinics

    OpenAIRE

    Choi, Bo-ram; Choi, Da-Hye; Huh, Kyung-Hoe; Yi, Won-Jin; Heo, Min-Suk; Choi, Soon-Chul; Bae, Kwang-Hak; Lee, Sam-Sun

    2012-01-01

    Purpose The purpose of this study was to investigate the level of clinical image quality of panoramic radiographs and to analyze the parameters that influence the overall image quality. Materials and Methods Korean dental clinics were asked to provide three randomly selected panoramic radiographs. An oral and maxillofacial radiology specialist evaluated those images using our self-developed Clinical Image Quality Evaluation Chart. Three evaluators classified the overall image quality of the p...

  13. Clinical evaluation of three caries removal approaches in primary teeth

    DEFF Research Database (Denmark)

    Phonghanyudh, A; Phantumvanit, P; Songpaisan, Y;

    2012-01-01

    To evaluate the clinical performance and radiographic outcome of glass ionomer cement (GIC) restoration in primary molars using three caries removal techniques.......To evaluate the clinical performance and radiographic outcome of glass ionomer cement (GIC) restoration in primary molars using three caries removal techniques....

  14. 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

    2015-01-01

    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

  15. Clinical evaluation of 413 Thalassemic patients

    Directory of Open Access Journals (Sweden)

    Korosdari Gh.H

    2000-08-01

    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.

  16. 3D Printing/Additive Manufacturing Single Titanium Dental Implants: A Prospective Multicenter Study with 3 Years of Follow-Up

    Science.gov (United States)

    2016-01-01

    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

  17. 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

    2016-01-01

    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.

  18. 3D Printing/Additive Manufacturing Single Titanium Dental Implants: A Prospective Multicenter Study with 3 Years of Follow-Up.

    Science.gov (United States)

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

    2016-01-01

    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

  19. 3D Printing/Additive Manufacturing Single Titanium Dental Implants: A Prospective Multicenter Study with 3 Years of Follow-Up.

    Science.gov (United States)

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

    2016-01-01

    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.

  20. The Clinical Evaluation of Parkinson's Tremor

    NARCIS (Netherlands)

    Zach, H.; Dirkx, M.; Bloem, B.R.; Helmich, R.C.

    2015-01-01

    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 basi

  1. Changes in Strength Abilities of Adolescent Girls: The Effect of a 3-Year Physical Education Curriculum

    Science.gov (United States)

    Czarniecka, Renata; Milde, Katarzyna; Tomaszewski, Pawel

    2012-01-01

    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…

  2. Clinical evaluation of synthetic aperture sequential beamforming

    DEFF Research Database (Denmark)

    Hansen, Peter Møller; Hemmsen, Martin Christian; Lange, Theis;

    2012-01-01

    the ultrasound beam. Five ultrasound experts (radiologists) evaluated the sequence pairs in a side-by-side comparison, and the results show that image quality using SASB was better than conventional B-mode imaging. 73 % of the evaluations favored SASB, and a probability of 70 % was calculated for a...... new radiologist to prefer SASB over conventional imaging, if a new sequence was recorded. There was no significant difference in penetration depth....

  3. Clinical Evaluation of Baccalaureate Nursing Students Using SBAR Format: Faculty versus Self Evaluation

    Science.gov (United States)

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

    2016-01-01

    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…

  4. A Model for Evaluating Student Clinical Psychomotor Skills.

    Science.gov (United States)

    And Others; Fiel, Nicholas J.

    1979-01-01

    A long-range plan to evaluate medical students' physical examination skills was undertaken at the Ingham Family Medical Clinic at Michigan State University. The development of the psychomotor skills evaluation model to evaluate the skill of blood pressure measurement, tests of the model's reliability, and the use of the model are described. (JMD)

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

    Directory of Open Access Journals (Sweden)

    MM Chabeli

    2001-09-01

    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.

  6. Clinical evaluation of desoximetasone in treatment of dermatoses and psoriasis.

    Science.gov (United States)

    Nair, B K; Nair, C H

    1975-05-01

    A comparative clinical evaluation of desoximetasone, a corticosterone derivative by a double blind study showed that desoximetasone has potent topical activity as effective as betamethasone valerate and probably more effective than triamcinolone acetonide. PMID:1093984

  7. Evaluation of clinical teaching models for nursing practice.

    Science.gov (United States)

    Croxon, Lyn; Maginnis, Cathy

    2009-07-01

    Clinical placements provide opportunities for student nurses to learn experientially. To create a constructive learning environment staff need to be friendly, approachable, available and willing to teach. There must be adequate opportunities for students to develop confidence and competence in clinical skills with a focus on student learning needs rather than service needs of facilities. A popular model for clinical teaching of nursing students is the preceptor model. This model involves a student working under the supervision of individual registered nurses who are part of the clinical staff. This model was failing to meet students' needs in acute nursing practice areas, largely due to Registered Nurse staff shortages and demanding workloads. The students' evaluations led to the trial of a 'cluster' or group model of eight students, with a clinical facilitator who is paid by the university, in each acute nursing ward. Evaluation of twenty nursing students' perceptions of their acute nursing practice clinical placements was conducted using a mixed method approach to evaluate the two models of student supervision. Results indicate that the students prefer small groups with the clinical facilitator in one area. Thus evaluation and feedback from students and the perceptions of their clinical placement is essential. PMID:18722161

  8. Interprofessional student clinics: an economic evaluation of collaborative clinical placement education.

    Science.gov (United States)

    Haines, Terry P; Kent, Fiona; Keating, Jennifer L

    2014-07-01

    Interprofessional student clinics can be used to create clinical education placements for health professional students in addition to traditional hospital-based placements and present an opportunity to provide interprofessional learning experiences in a clinical context. To date, little consideration has been given in research literature as to whether such clinics are economically viable for a university to run. We conducted an economic evaluation based upon data generated during a pilot of an interprofessional student clinic based in Australia. Cost-minimization analyses of the student clinic as opposed to traditional profession-specific clinical education in hospitals were conducted from university, Commonwealth Government, state government and societal perspectives. Cost data gathered during the pilot study and market prices were used where available, while $AUD currency at 2011 values were used. Per student day of clinical education, the student clinic cost an additional $289, whereas the state government saved $49 and the Commonwealth Government saved $66. Overall, society paid an additional $175 per student day of clinical education using the student clinic as opposed to conventional hospital-based placements, indicating that traditional hospital-based placements are a cost-minimizing approach overall for providing clinical education. Although interprofessional student clinics have reported positive patient and student learning outcomes, further research is required to determine if these benefits can justify the additional cost of this model of education. Considerations for clinic sustainability are proposed. PMID:24417539

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

    Directory of Open Access Journals (Sweden)

    Cunha, Renata Andrade da

    2014-01-01

    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.

  10. Clinical simulation as an evaluation method in health informatics

    DEFF Research Database (Denmark)

    Jensen, Sanne

    2016-01-01

    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...... work practice including other technology and organizational structure. Clinical simulation is ideal for proactive evaluation of new technology for clinical work practice. Clinical simulations involve real end-users as they simulate the use of technology in realistic environments performing realistic...

  11. Clinical Evaluation of Inpatients with Acute Urticaria

    Directory of Open Access Journals (Sweden)

    Ayşe Serap

    2011-12-01

    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

  12. Integrated care for diabetes: clinical, psychosocial, and economic evaluation. Diabetes Integrated Care Evaluation Team.

    OpenAIRE

    1994-01-01

    OBJECTIVES--To evaluate integrated care for diabetes in clinical, psychosocial, and economic terms. DESIGN--Pragmatic randomised trial. SETTING--Hospital diabetic clinic and three general practice groups in Grampian. PATIENTS--274 adult diabetic patients attending a hospital clinic and registered with one of three general practices. INTERVENTION--Random allocation to conventional hospital clinic care or integrated care. Integrated care patients seen in general practice every three or four mon...

  13. CLINICAL EVALUATION OF SELECTED COLOURING HERBALS IN SAVARNIKARAN

    Directory of Open Access Journals (Sweden)

    Wadikar Sujata Surendra

    2013-03-01

    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.

  14. 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.

    2012-01-01

    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

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

    OpenAIRE

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

    1987-01-01

    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...

  16. Evaluation of the Olympus AU 400 clinical chemistry analyzer.

    Science.gov (United States)

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

    2000-01-01

    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.

  17. Protected clinical teaching time and a bedside clinical evaluation instrument in an emergency medicine training program.

    Science.gov (United States)

    Shayne, Philip; Heilpern, Katherine; Ander, Douglas; Palmer-Smith, Victoria

    2002-11-01

    In a process that has evolved over the last four years, the Emory University Emergency Medicine Education Committee has developed an "academic attending" teaching shift incorporating a formatted lecture series with a clinical evaluation exercise (CEE). The program structures the approach to clinical teaching at the bedside, provides an objective clinical evaluation tool specific to emergency medicine residents, and provides targeted learning for medical students and residents rotating in the emergency department (ED). The CEE instrument was designed to be quick and efficient, satisfy requirements of assessment of the Accreditation Council for Graduate Medical Education (ACGME) general competencies, and incorporate the language of the "Model of the Clinical Practice of Emergency Medicine." The original program called for unstructured bedside teaching three days a week, by faculty freed from clinical duties, combined with a limited series of introductory emergency medicine lectures. The program proved more successful when concentrated in a once weekly structured educational program. The prepared, repeating lecture series has been expanded to include many of the most common ED presenting chief complaints and has significantly advanced a curriculum for medical students and visiting interns. A CEE was developed to evaluate and provide immediate feedback to residents on many of the core ACGME competencies. The CEE has been successfully used to structure the bedside educational encounter. This dedicated non-clinical "teaching" shift appears effective in meeting the educational goals of the authors' academic ED. This is a description of the program and its evolution; the program has not been formally evaluated. PMID:12414493

  18. Caries risk assessment in young adults: a 3 year validation of the Cariogram model

    OpenAIRE

    Petersson, Gunnel Hänsel; Twetman, Svante

    2015-01-01

    Background To validate baseline caries risk classifications according to the Cariogram model with the actual caries development over a 3-year period in a group of young adults living in Sweden. Methods The study group consisted of 1,295 19-year-old patients that completed a comprehensive clinical baseline examination, including radiographs and salivary tests. An individual caries risk profile was computed and the patient was placed in one of five risk categories. After 3 years, 982 patients (...

  19. Clinical breast evaluation skills of house officers and students.

    Science.gov (United States)

    Chalabian, J; Garman, K; Wallace, P; Dunnington, G

    1996-10-01

    Current health care reform is placing primary care physicians in an increasingly significant role as the front-line providers of women's health care. It is critical that primary care physicians as well as surgeons develop the knowledge base, physical examination skills, and interpersonal skills necessary to care for patients with breast cancer. This study uses a standardized patient breast case in an Objective Structured Clinical Examination (OSCE) format to objectively assess clinical breast evaluation skill performance by house officers and medical students. Performance of USC medical students, exposed to a uniform clinical breast evaluation curriculum, were compared with MSIVs from four other medical schools, and postgraduate year I and II categorical surgical residents. USC medical students were found to maintain performance between an initial surgical OSCE breast station and a delayed clinical practice exam (CPX) reexam as MSIVs (breast exam, P = 0.21; patient-physician interaction, P = 0.67). USC MSIVs had statistically significantly higher performance on the CPX breast station when compared with other MSIVs (T = 11.701, two-tailed test, P = 0.0001). House officers demonstrated significantly poorer skills than medical students (P = 0.03). An incoming housestaff group showed improvement with clinical breast evaluation checklists and orientation as part of their intern orientation program and ongoing curriculum. PMID:8813167

  20. How nurses seek and evaluate clinical guidelines on the Internet

    NARCIS (Netherlands)

    Verhoeven, Fenne; Steehouder, Michael F.; Hendrix, Ron M.G.; Gemert-Pijnen, van Julia E.W.C.

    2010-01-01

    Aim: This paper is a report of a study conducted to assess nurses’ information-seeking strategies and problems encountered when seeking clinical guidelines on the Internet, and to investigate the criteria they apply when evaluating the guidelines and the websites communicating the guidelines. - Back

  1. Evaluation Guidelines for the Clinical and Translational Science Awards (CTSAs)

    Science.gov (United States)

    Trochim, William M.; Rubio, Doris M.; Thomas, Veronica G.

    2014-01-01

    The National Center for Advancing Translational Sciences (NCATS), a part of the National Institutes of Health, currently funds the Clinical and Translational Science Awards (CTSAs), a national consortium of 61 medical research institutions in 30 states and the District of Columbia. The program seeks to transform the way biomedical research is conducted, speed the translation of laboratory discoveries into treatments for patients, engage communities in clinical research efforts, and train a new generation of clinical and translational researchers.. An endeavor as ambitious and complex as the CTSA program requires high-quality evaluations in order to show that the program is well implemented, efficiently managed, and demonstrably effective. In this article, the Evaluation Key Function Committee of the CTSA Consortium presents an overall framework for evaluating the CTSA program and offers policies to guide the evaluation work. The guidelines set forth are designed to serve as a tool for education within the CTSA community by illuminating key issues and practices that should be considered during evaluation planning, implementation, and utilization. Additionally, these guidelines can provide a basis for ongoing discussions about how the principles articulated in this article can most effectively be translated into operational reality. PMID:23919366

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

    Directory of Open Access Journals (Sweden)

    Carmelo Ibáñez Aguirre

    2013-08-01

    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.

  3. Developing an evaluation framework for clinical redesign programs: lessons learnt.

    Science.gov (United States)

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

    2016-09-19

    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.

  4. Developing an evaluation framework for clinical redesign programs: lessons learnt.

    Science.gov (United States)

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

    2016-09-19

    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. PMID:27681027

  5. Clinical Application and Evaluation of Pharmacogenomics in Tumor Chemotherapy

    Institute of Scientific and Technical Information of China (English)

    Feng Jifeng

    2014-01-01

    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.

  6. CLINICAL EVALUATION OF SELECTED COLOURING HERBALS IN SAVARNIKARAN

    OpenAIRE

    Wadikar Sujata Surendra; Reddy Govind R.

    2013-01-01

    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...

  7. Percutaneous sclerotherapy of foot venous malformations: Evaluation of clinical response

    International Nuclear Information System (INIS)

    Aim: To evaluate a single institutional experience with percutaneous sclerotherapy of venous malformations (VM) of the foot. Materials and methods: Sixteen patients (mean age 14.6 years; range 6–27.3 years), who underwent 34 sclerotherapy procedures were retrospectively analysed. Technical success, Puig classification, VM size reduction, and the complication rate were evaluated. In procedures in which C-arm computed tomography (CT) was performed, the VM-to-skin surface distance was measured. Additionally, an e-mail-based questionnaire to evaluate the response to sclerotherapy was answered by the patients. Results: Technical success was 97%. The mean number of procedures per patient was 2.1 (range 1–5). In all procedures, sodium tetradecyl sulphate foam was used. Appropriate follow-up was available for 29/33 procedures (88%). Post-procedural complications occurred after 6/29 procedures (21%), all of which were self-limited skin complications. C-arm CT was performed in 19/33 procedures (58%). The lesion-to-skin surface distance was significantly shorter in patients with skin post-procedural complications (p < 0.001). The e-mail-based questionnaire was completed by 13/16 patients (81%). Decrease in swelling, improvement of foot function and a significant decrease in pain (p = 0.003) was reported. No patient reported dis-improvement after sclerotherapy. Conclusion: Percutaneous sclerotherapy is an effective option for treating foot VMs. Skin complication rates are higher with shorter VM-to-skin surface distance. - Highlights: • Treatment of foot venous malformations is a challenge due to their diffuse nature. • Percutaneous sclerotherapy is an effective treatment option. • Patients reported decrease in swelling and pain, and improvement of foot function. • Self limited post-procedural skin complications occur after 21% of the procedures. • A shorter lesion to skin surface distance was related to higher complications

  8. Evaluation of different imaging chains in clinical chest radiography

    Energy Technology Data Exchange (ETDEWEB)

    Manninen, H.; Terho, E.O.; Wiljasalo, M.; Wiljasalo, S.; Soimakallio, S. (Kuopio Central Hospital (Finland))

    1984-11-01

    Six imaging techniques in clinical chest radiography have been evaluated: four film-screen combinations in the conventional grid technique and two combinations in the air gap technique. Five parameters characterising the quality of a chest radiograph were evaluated by three radiologists and one chest physician by using a nominal grading scale from -2 to +2 compared with the standard technique. The quality parameters judged were: the visibility of peripheral lung vessels, lung parenchyme, the pulmonary hilum, and lung structure behind the heart shadow, as well as the visibility of miscellaneous findings of clinical interest. The air gap technique was shown to be superior to the ordinary grid technique. The diagnostic quality of chest radiography does not necessarily deteriorate with the screen speed. However, statistically significant differences were noticed, even between techniques which had equal speed and physical resolution.

  9. Epidemiological, clinical and sleep laboratory evaluations of insomnia

    Science.gov (United States)

    Bixler, E. O.; Kales, A.; Kales, J. D.

    1975-01-01

    Epidemiological studies have contributed to the understanding of the total scope of the insomnia problem, both in terms of the incidence of sleep difficulties, and the extent and frequency of hypnotic drug use. Clinical studies - at the Sleep Research and Treatment Center - have been used to evaluate the medical, psychological, pharmacological and situational factors contributing to insomnia, and to evaluate the psychotherapy and chemotherapy best suited to treatment of insomnia. The sleep laboratory studies were of two types: (1) the study of sleep induction, sleep maintenance, and sleep stages, and (2) the use of hypnotic drugs, emphasizing their effectiveness in inducing and maintaining sleep, and the duration of this effectiveness.

  10. Clinical evaluation of sodium flouride chewable tablets in dental caries.

    Science.gov (United States)

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

    1999-01-01

    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.

  11. A Clinical Evaluation Denture Adhesives Used by Patients With Xerostomia

    OpenAIRE

    Bogucki, Zdzislaw A.; Napadlek, Piotr; Dabrowa, Tomasz

    2015-01-01

    Abstract The purpose of study was to analyze the participants’ opinions concerning the effectiveness of 6 denture adhesives (DA). The study group included 60 participants. Criteria for selecting the patients were as follows: reduced retention and stabilization of maxillary complete dentures and xerostomia. These features were evaluated on basis of clinical examination and standard sialometry tests (u-SFR). Retention of maxillary dentures was scored by modified Kapur index before application o...

  12. Neurofibromatosis: Evaluation of Clinical Features of 11 Cases

    Directory of Open Access Journals (Sweden)

    Gülşen Akoğlu

    2013-12-01

    Full Text Available Objective: Neurofibromatosis (NF is one of the most commonly seen autosomal dominantly inherited neurocutaneous syndromes. The most common subtypes are NF1 and NF2. The clinical course of NF may be heterogeneous.In this study, clinical features of patients with NF and its rare manifestations were described. Methods: Records of 11 patients with NF diagnosed between May 2008 and August 2011 were retrospectively reviewed. Demographic and clinical features of patients were detailed. Results: Six female and 5 male patients were enrolled. Patients' ages ranged between 1.5 and 58 years. Seven of them had positive family history for NF. A 1.5-year-old baby presented early appearance of Lisch nodules. One female patient had unilateral segmentally distributed pigmentary macules with bilateral Lisch nodules. Severe scoliosis and multiple painful neurofibromas were observed in a male patient. An asymptomatic arachnoid cyst was detected incidentally in a female patient. A male patient with NF1 had diffuse large B cell lymphoma and glioblastoma multiforme. Conclusion: Patients with NF may present with diverse clinical manifestations. Since patients may first apply to a dermatology outpatient clinic with only cutaneous complaints, early diagnosis of NF both in the patients and in their first degree relatives by careful dermatological and ophthalmological examinations and radiological evaluations can be possible.

  13. 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

    2011-01-01

    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

  14. Evaluating suspected work-related neurologic disorders (clinical diagnosis).

    Science.gov (United States)

    Lotti, Marcello; Aminoff, Michael J

    2015-01-01

    The clinical diagnosis of work-related neurologic disorders is essentially one of exclusion because symptoms and signs are often nonspecific. The clinical reasoning requires a three-step approach: (1) establish the characteristics of the presenting disease; (2) ascertain that observed clinical features are consistent with those caused by the suspected agent(s); and (3) assess occupational exposures. A detailed history is of paramount importance in evaluating patients with suspected work-related neurologic disorders as it is in other clinical contexts, especially because in some circumstances it may represent the only criterion to establish causality. Thus, besides characterization of neurologic symptoms, including their location, quality, timecourse, and possible other associated symptoms, the work environment of the patient should be understood in full detail. In this respect, when a neurotoxin is suspected, then the history collection can be guided by the knowledge of the likely syndromes it produces. Similarly, physical examination should be directed to the target of toxicity/entrapment based on information from the work history. Although specific sites and elements of the nervous system may be affected depending on the offending agent, most neurotoxic disorders are characterized by generalized rather than focal neurologic abnormalities. Laboratory toxicologic tests have limited application for the etiologic diagnosis of neurotoxic disorders, except in cases of acute poisoning and in patients exposed to neurotoxic chemicals with prolonged half-life. In most cases examination takes place after the end of exposure, when the offending chemical is no longer detectable in body fluids. Electrophysiologic studies, in particular evoked potentials, electromyography, and conduction velocities, are important to confirm the organic basis of symptoms, particularly to detect subclinical or early neurologic involvement and to reduce the number of disorders to be considered in

  15. Evaluation of psychology practitioner competence in clinical supervision.

    Science.gov (United States)

    Gonsalvez, Craig J; Crowe, Trevor P

    2014-01-01

    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.

  16. Changes in skin test reactivity among adults with atopic disease: a 3-year prospective study

    DEFF Research Database (Denmark)

    Aslund, N.; Thomsen, S.F.; Molgaard, E.;

    2008-01-01

    , 186 candidates, ranging in age from 14 to 44 years, who in a screening questionnaire reported symptoms suggestive of respiratory allergic disease, 344 individuals with a positive skin prick test (SPT) result concomitantly with asthma and/or rhinitis were clinically studied on 2 occasions, 3 years...

  17. Cross-system evaluation of clinical trial search engines.

    Science.gov (United States)

    Jiang, Silis Y; Weng, Chunhua

    2014-01-01

    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.

  18. Clinical Evaluation of Superficial Fungal Infections in Children

    Directory of Open Access Journals (Sweden)

    Ragıp Ertaş

    2015-12-01

    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.

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

    Directory of Open Access Journals (Sweden)

    S.A. Arias

    2013-12-01

    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.

  20. Medical Care and Your 2- to 3-Year-Old

    Science.gov (United States)

    ... Tropical Delight: Melon Smoothie Pregnant? Your Baby's Growth Medical Care and Your 2- to 3-Year-Old ... that often seen with an ear infection Common Medical Problems On average, young children have 6 to ...

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

    DEFF Research Database (Denmark)

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

    2006-01-01

    as either "confirmed" or "probable" events was highest for cervical cancer (100%), non-Hodgkin's lymphoma (88%), cryptococcosis (82%), and cryptosporidiosis (80%) and was lowest for HIV encephalopathy (25%), HIV wasting syndrome (33%), and multidermatomal herpes zoster (35%). 25% of cases required...... adjudication between reviewers before diagnostic certainty was assigned. CONCLUSION: Important requirements for HIV trials using clinical endpoints include objective definitions of "confirmed" and "probable," a formal reporting process with adequate information and supporting source documentation, evaluation...

  2. [Clinical diagnosis and standardized evaluation of borderline personality: preliminary report].

    Science.gov (United States)

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

    1995-01-01

    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.

  3. 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

    2015-01-01

    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.

  4. Clinical Evaluation of Heart Failure: Agreement among Tests.

    Science.gov (United States)

    Pandey, Amit K; Penny, William F; Bhargava, Valmik; Lai, N Chin; Xu, Ronghui; Hammond, H Kirk

    2016-01-01

    Methods commonly used clinically to assess cardiac function in patients with heart failure include ejection fraction (EF), exercise treadmill testing (ETT), and symptom evaluation. Although these approaches are useful in evaluating patients with heart failure, there are at times substantial mismatches between individual assessments. For example, ETT results are often discordant with EF, and patients with minimal symptoms sometimes have surprisingly low EFs. To better define the relationship of these methods of assessment, we studied 56 patients with heart failure with reduced EF (HFrEF) who underwent measurement of ETT duration, EF by echocardiography, quantitative symptom evaluation, and LV peak dP/dt (rate of left ventricular pressure development and decline, measured invasively). Correlations were determined among these four tests in order to assess the relationship of EF, ETT, and symptoms against LV peak dP/dt. In addition, we sought to determine whether EF, ETT, and symptoms correlated with each other. Overall, correlations were poor. Only 15 of 63 total correlations (24%) were significant (p < 0.05). EF correlated most closely with LV peak -dP/dt. Linear regression analysis indicated that EF, ETT, and symptoms taken together predicted LV peak dP/dt better than any one measure alone. We conclude that clinical tests used to assess LV function in patients with HFrEF may not be as accurate or correlate as well as expected. All three clinical measures considered together may be the best representation of cardiac function in HFrEF patients currently available. PMID:27537778

  5. The effects of aging on clinical vestibular evaluations

    Directory of Open Access Journals (Sweden)

    Maxime eMaheu

    2015-09-01

    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.

  6. 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)

    2014-06-01

    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.

  7. 76 FR 9583 - Draft Guidance for Industry on Clinical Pharmacogenomics: Premarketing Evaluation in Early Phase...

    Science.gov (United States)

    2011-02-18

    ... 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...

  8. IT-benchmarking of clinical workflows: concept, implementation, and evaluation.

    Science.gov (United States)

    Thye, Johannes; Straede, Matthias-Christopher; Liebe, Jan-David; Hübner, Ursula

    2014-01-01

    Due to the emerging evidence of health IT as opportunity and risk for clinical workflows, health IT must undergo a continuous measurement of its efficacy and efficiency. IT-benchmarks are a proven means for providing this information. The aim of this study was to enhance the methodology of an existing benchmarking procedure by including, in particular, new indicators of clinical workflows and by proposing new types of visualisation. Drawing on the concept of information logistics, we propose four workflow descriptors that were applied to four clinical processes. General and specific indicators were derived from these descriptors and processes. 199 chief information officers (CIOs) took part in the benchmarking. These hospitals were assigned to reference groups of a similar size and ownership from a total of 259 hospitals. Stepwise and comprehensive feedback was given to the CIOs. Most participants who evaluated the benchmark rated the procedure as very good, good, or rather good (98.4%). Benchmark information was used by CIOs for getting a general overview, advancing IT, preparing negotiations with board members, and arguing for a new IT project. PMID:24825693

  9. A Safety Analysis Approach to Clinical Workflows: Application and Evaluation

    Directory of Open Access Journals (Sweden)

    Lamis Al-Qora’n

    2014-11-01

    Full Text Available Clinical workflows are safety critical workflows as they have the potential to cause harm or death to patients. Their safety needs to be considered as early as possible in the development process. Effective safety analysis methods are required to ensure the safety of these high-risk workflows, because errors that may happen through routine workflow could propagate within the workflow to result in harmful failures of the system’s output. This paper shows how to apply an approach for safety analysis of clinical workflows to analyse the safety of the workflow within a radiology department and evaluates the approach in terms of usability and benefits. The outcomes of using this approach include identification of the root causes of hazardous workflow failures that may put patients’ lives at risk. We show that the approach is applicable to this area of healthcare and is able to present added value through the detailed information on possible failures, of both their causes and effects; therefore, it has the potential to improve the safety of radiology and other clinical workflows.

  10. 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

    2015-01-01

    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...

  11. Clinical evaluation strategies for a live attenuated tetravalent dengue vaccine.

    Science.gov (United States)

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

    2015-12-10

    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.

  12. 75 FR 79446 - Clinical Science Research and Development Service; Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2010-12-20

    ... 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...

  13. Ultrasound and clinical evaluation of soft-tissue versus hardware biceps tenodesis: is hardware tenodesis worth the cost?

    Science.gov (United States)

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

    2014-02-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Ahmet İrdem

    2004-01-01

    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.

  15. 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

    2015-01-01

    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.

  16. 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

    2002-01-01

    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.

  17. Final Results of a 3-Year Literacy-Informed Intervention to Promote Annual Fecal Occult Blood Test Screening.

    Science.gov (United States)

    Arnold, Connie L; Rademaker, Alfred; Wolf, Michael S; Liu, Dachao; Lucas, Geoffrey; Hancock, Jill; Davis, Terry C

    2016-08-01

    This three arm study was designed to make CRC screening with FOBTs more accessible, understandable and actionable for patients cared for in predominantly rural Federally Qualified Health Centers. Patients in an enhanced version of usual care received an annual CRC recommendation and FOBT kit; those in the education arm additionally received brief literacy and culturally appropriate education and those in the nurse arm received the education by a nurse manager who followed up by telephone. Baseline FOBT rates in this population were 3 %. We evaluated if FOBT rates could be sustained over 3 years. A three-arm, quasi-experimental evaluation was conducted among eight clinics in Louisiana. Screening efforts included: (1) enhanced usual care, (2) literacy-informed education of patients, and (3) education plus nurse support. Overall, 961 average-risk patients, ages 50-85, eligible for routine CRC screenings were recruited. The primary outcome was completing three annual FOBT tests. Of 961 patients enrolled, 381 (39.6 %) participants did not complete a single FOBT, 60.4 % completed at least one FOBT of which 318 (33.1 %) completed only one, 162 (16.9 %) completed two and 100 (10.4 %) completed three FOBTs over the 3-year period (the primary study outcome). The primary outcome, return of three FOBT kits over the 3-year period, was achieved by 4.7 % in enhanced care, 11.4 % in education and 13.6 % in the nurse arm (p = 0.005). Overall 3-year FOBT screening rates were not sustained with any of the three interventions, despite reports of promising interim results at years 1 and 2. New strategies for sustaining FOBT screening over several years must be developed. PMID:26769026

  18. 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.

    2011-01-01

    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

  19. 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;

    2010-01-01

    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...

  20. Clinical evaluation of Er:YAG laser caries treatment

    Science.gov (United States)

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

    1997-05-01

    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.

  1. Clinical Evaluation on Several anti- HIV Diagnostic Reagents

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    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.

  2. Similarity Predicts Liking in 3-Year-Old Children

    Science.gov (United States)

    Fawcett, Christine A.; Markson, Lori

    2010-01-01

    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…

  3. A Study of Differentiated Instructional Change over 3 Years

    Science.gov (United States)

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

    2008-01-01

    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…

  4. Echocardiographic evaluation of clinically healthy Florida manatees (Trichechus manatus latirostris).

    Science.gov (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

    2013-06-01

    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. PMID:23805547

  5. Echocardiographic evaluation of clinically healthy Florida manatees (Trichechus manatus latirostris).

    Science.gov (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

    2013-06-01

    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.

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

    Science.gov (United States)

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

    1987-01-01

    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.

  7. Evaluation of the Konelab 20XT clinical chemistry analyzer.

    Science.gov (United States)

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

    2005-01-01

    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.

  8. [Clinical evaluation of a novel HBsAg quantitative assay].

    Science.gov (United States)

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

    2007-07-01

    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.

  9. A Formative Program Evaluation of Electronic Clinical Tracking System Documentation to Meet National Core Competencies.

    Science.gov (United States)

    Smith, Lynette S; Branstetter, M Laurie

    2016-09-01

    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.

  10. Evaluation of clinical reflection and reasoning skills in undergraduate occupational therapy students

    OpenAIRE

    Dasari, B.D.

    2006-01-01

    Given the current focus on the importance of clinical reasoning in occupational therapy education, various ways to examine and evaluate clinical reflection and reasoning skills should be available. The main focus of this paper therefore is to examine and evaluate students’ clinical reflection and the process thereof as a fundamental dimension of clinical reasoning using the Self-Assessment of Clinical Reflection and Reasoning (SACRR) instrument (Royeen et al., 1994). This study adopted a long...

  11. The Varicocele: Clinical Presentation, Evaluation, and Surgical Management.

    Science.gov (United States)

    Lomboy, Jason R; Coward, Robert M

    2016-09-01

    A varicocele is an abnormal dilatation and tortuosity of the veins of the spermatic cord. Although varicoceles are common in the general population and are frequently found on routine physical examinations, they represent the most common correctable cause of male factor infertility. Varicoceles are also often incidental findings on imaging studies, particularly scrotal ultrasound. Importantly, not all varicoceles should be treated equally (or at all), and basic guidelines on the evaluation and indications for treatment of adult varicoceles should be reviewed before counseling and treatment. A semen analysis should be obtained for any male patient of reproductive age considering intervention. The adolescent varicocele is managed much differently than the adult varicocele and remains a source of controversy. This review describes the clinical presentation and the evaluation of adult and pediatric varicoceles, and provides guidance on their diagnosis and workup. It also describes options for surgical repair and the success and complication rates associated with each surgical approach, ultimately supporting microsurgical subinguinal varicocele repair as the current surgical standard. PMID:27582602

  12. Arthrographic study of the Wiberg's CE angle in cadavers of children under 3 years old

    International Nuclear Information System (INIS)

    Forty hip arthrographies in cadavers of children under 3 years of age are presented. The articular relationships of the hip through the definition of the morphology of the proximal femoral epyphysis are evaluated. The location of point 'C' and the evaluation of 'CE' angle in this age group are related. The results of the arthrographic 'CE' osseous angle are compared with Salvati's method and with Massie and Howorth's method. (M.A.C.)

  13. Evaluating dose response from flexible dose clinical trials

    Directory of Open Access Journals (Sweden)

    Baron David

    2008-01-01

    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.

  14. Health Blogging and Social Support: A 3-Year Panel Study.

    Science.gov (United States)

    Keating, David M; Rains, Stephen A

    2015-01-01

    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.

  15. Aluminum Industry Try to stop 3 Years Loss Status

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Huang Libin,Deputy Director of the Operation Monitoring&Coordination; Bureau of the Ministry of Industry and Information Technology,said on July 22 that,currently the polarization in the industry is very serious,the aluminum industry in the past 3 years remained in loss condition across the industry,in recent years it insisted ion promoting industry structural adjustment,and this year the situation

  16. Reflections on 3 years of mlearning implementation (2007-2009)

    OpenAIRE

    Cochrane, Thom; Bateman, Roger

    2010-01-01

    This paper discusses the implications of 3 years of action research mlearning projects investigating the potential of mobile web 2.0 tools to facilitate social constructivist learning environments across multiple learning contexts. Highlighted are the design framework, identified critical success factors, and implementation strategy developed from the thirteen mlearning projects undertaken between 2007 and 2009. The projects encompassed five different courses, forming five case studies spanni...

  17. A standardized clinical evaluation of phenotypic diversity in diabetic polyneuropathy.

    Science.gov (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

    2016-10-01

    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. PMID:27322439

  18. Laser resistant stainless steel endotracheal tube: experimental and clinical evaluation.

    Science.gov (United States)

    Fried, M P; Mallampati, S R; Liu, F C; Kaplan, S; Caminear, D S; Samonte, B R

    1991-01-01

    A fire due to endotracheal tube (ET) ignition is a catastrophic event that may occur during laser surgery of the upper airway, regardless of the wavelength utilized. Although methods exist that permit laser surgery without an ET, this is frequently not feasible. The current investigation was undertaken to evaluate the efficacy of a double-cuffed stainless steel ET, first in the laboratory and subsequently in a clinical setting. Bench testing was performed using CO2 (both standard and milliwatt) and KTP/532 lasers. Only the distal polyvinyl chloride cuffed end of the tube was potentially ignitable, however, the appropriate use of saline to fill the cuffs allowed only for cuff perforation without ignition. Canine testing was performed in 10 animals: 4 dogs were intubated from 3 to 4.5 hours with the laser resistant stainless steel endotracheal tube (LRSS-ET) (Laser-Flex Tracheal Tube; Mallinckrodt Anesthesia Products, St. Louis, MO) and 2 with an aluminum tape wrapped red rubber ET. Visual and histological examination were performed in both groups at 3 and 7 days. Four dogs underwent CO2 laser laryngeal surgery with visual and histological examination performed at 7 days postoperatively. No untoward effects could be demonstrated due to the LRSS-ET. A clinical study was then performed in 24 patients who underwent laser surgery of the upper aerodigestive tract with either a CO2 or KTP/532 laser. In all cases ventilation was adequate, the shaft of the LRSS-ET proved impervious to the laser, and the distal end of the tube protected the tracheobronchial tree safely.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1861569

  19. [Clinical effectiveness and economical evaluation of preventive vaccination].

    Science.gov (United States)

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

    2011-01-01

    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.

  20. Evaluation of a novel electronic genetic screening and clinical decision support tool in prenatal clinical settings.

    Science.gov (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

    2014-07-01

    "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.

  1. 21 CFR 312.87 - Active monitoring of conduct and evaluation of clinical trials.

    Science.gov (United States)

    2010-04-01

    ... clinical trials. 312.87 Section 312.87 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH... and evaluation of clinical trials. For drugs covered under this section, the Commissioner and other agency officials will monitor the progress of the conduct and evaluation of clinical trials and...

  2. Combined Individual Cognitive Behavior Therapy and Parent Training for Childhood Depression: 2-3-Year Follow-Up

    OpenAIRE

    Eckshtain, Dikla; Gaynor, Scott T

    2013-01-01

    Fourteen children with significant depressive symptoms from an open clinical trial of Primary and Secondary Control Enhancement Training augmented with Caregiver–Child Relationship Enhancement Training, participated in a 2-3-year follow-up assessment. The results suggested that the significant decreases in depressive symptoms observed at post-treatment were maintained at 2-3-year follow-up. Mothers’ reports of significant improvement of child psychosocial functioning were also maintained, pro...

  3. Clinical evaluation of desensitizing treatments for cervical dentin hypersensitivity

    Directory of Open Access Journals (Sweden)

    Ana Cecilia Corrêa Aranha

    2009-09-01

    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.

  4. CONTROL CLINICAL EVALUATION OF KULATTHADI YOGA AS ASHMARIBHEDAN IN MUTRASHMARI

    Directory of Open Access Journals (Sweden)

    Jangle Vidya Muralidhar

    2012-10-01

    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.

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

    Institute of Scientific and Technical Information of China (English)

    Robert I McLachlan; Csilla Krausz

    2012-01-01

    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.

  6. Clinical evaluation of therapeutic success in rabbits with suspected encephalitozoonosis.

    Science.gov (United States)

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

    2012-06-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Aarthi Kannan

    2016-07-01

    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

  8. European multicentre evaluation of the ABBOTT Spectrum clinical chemistry analyzer.

    Science.gov (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

    1989-06-01

    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.

  9. Axon clinical chemistry analyzer evaluated according to ECCLS protocol.

    Science.gov (United States)

    Brenna, S; Prencipe, L

    1992-10-01

    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.

  10. Economic evaluation in long-term clinical trials.

    Science.gov (United States)

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

    2002-10-15

    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.

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

    Directory of Open Access Journals (Sweden)

    Sandro Contini

    2011-01-01

    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.

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

    OpenAIRE

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

    2010-01-01

    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...

  13. Psychometric validation of satisfaction with simulated clinical learning experience evaluation – corrections (SSCLEE-C

    Directory of Open Access Journals (Sweden)

    Desiree A. Díaz

    2016-03-01

    Originality/value: The Satisfaction with Simulated Clinical Learning Experience Evaluation – Corrections (SSCLEE-C is the only instrument available for ongoing assessment of correctional nurse satisfaction with simulated clinical learning experiences.

  14. 75 FR 28686 - Clinical Science Research and Development Service; Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2010-05-21

    ... 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...

  15. Neurofibromatosis: Evaluation of Clinical Features of 11 Cases

    OpenAIRE

    Gülşen Akoğlu; Ali Serhan Gazyağcı; İbrahim Kutluer

    2013-01-01

    Objective: Neurofibromatosis (NF) is one of the most commonly seen autosomal dominantly inherited neurocutaneous syndromes. The most common subtypes are NF1 and NF2. The clinical course of NF may be heterogeneous.In this study, clinical features of patients with NF and its rare manifestations were described. Methods: Records of 11 patients with NF diagnosed between May 2008 and August 2011 were retrospectively reviewed. Demographic and clinical features of patients were detailed. Result...

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

    OpenAIRE

    Ids H Boersma; Oranje, Arnold P; Ramon Grimalt; Matilde Iorizzo; Bianca M Piraccini; Emiel H Verdonschot

    2014-01-01

    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 typ...

  17. Outcomes of 3-Year-Old Children With Hearing Loss and Different Types of Additional Disabilities

    OpenAIRE

    Cupples, Linda; Ching, Teresa Y. C.; Crowe, Kathryn; Seeto, Mark; Leigh, Greg; Street, Laura; Day, Julia; Marnane, Vivienne; Thomson, Jessica

    2013-01-01

    This research investigated the speech, language, and functional auditory outcomes of 119 3-year-old children with hearing loss and additional disabilities. Outcomes were evaluated using direct assessment and caregiver report. Multiple regressions revealed that type of additional disability and level of maternal education were significant predictors of language outcomes. Poorer outcomes were achieved in a combined group of children with autism, cerebral palsy, and/or developmental delay (DD) (...

  18. 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)

    张磊

    2015-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Zhijuan Liu

    2013-04-01

    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.

  20. The Reliability and Validity of the Clinical Competence Evaluation Scale in Physical Therapy

    OpenAIRE

    Yoshino, Jun; Usuda, Shigeru

    2014-01-01

    [Purpose] To examine the internal consistency, criterion-related validity, factorial validity, and content validity of the Clinical Competence Evaluation Scale in Physical Therapy (CEPT). [Subjects] The subjects were 278 novice physical therapy trainees and 119 tutors from 21 medical facilities. [Methods] The trainees self-evaluated their clinical competences and the tutors evaluated trainee competences using the CEPT. Overall trainee autonomy was evaluated using a visual analog scale (VAS) f...

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

    International Nuclear Information System (INIS)

    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)

  2. Extrinsic Rewards Diminish Costly Sharing in 3-Year-Olds.

    Science.gov (United States)

    Ulber, Julia; Hamann, Katharina; Tomasello, Michael

    2016-07-01

    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. PMID:27084549

  3. GRB 030329: 3 years of radio afterglow monitoring.

    Science.gov (United States)

    van der Horst, A J; Kamble, A; Wijers, R A M J; Resmi, L; Bhattacharya, D; Rol, E; Strom, R; Kouveliotou, C; Oosterloo, T; Ishwara-Chandra, C H

    2007-05-15

    Radio observations of gamma-ray burst (GRB) afterglows are essential for our understanding of the physics of relativistic blast waves, as they enable us to follow the evolution of GRB explosions much longer than the afterglows in any other wave band. We have performed a 3-year monitoring campaign of GRB 030329 with the Westerbork Synthesis Radio Telescopes and the Giant Metrewave Radio Telescope. Our observations, combined with observations at other wavelengths, have allowed us to determine the GRB blast wave physical parameters, such as the total burst energy and the ambient medium density, as well as to investigate the jet nature of the relativistic outflow. Further, by modelling the late-time radio light curve of GRB 030329, we predict that the Low-Frequency Array (30-240 MHz) will be able to observe afterglows of similar GRBs, and constrain the physics of the blast wave during its non-relativistic phase. PMID:17293318

  4. 3-year experience with US QML: lessons learned

    Science.gov (United States)

    Leseur, M.

    2002-12-01

    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.

  5. Clinical and audiological evaluation of hearing impaired children

    Directory of Open Access Journals (Sweden)

    Zafarullah Beigh

    2012-01-01

    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

  6. Causes and 3-year-incidence of blindness in Jing-An District, Shanghai, China 2001-2009

    OpenAIRE

    Zhou Xingtao; Sun Xinghuai; Wu Liangcheng; Weng Chenghai

    2011-01-01

    Abstract Background Registered data can provide valuable information regarding blindness. The purpose of this study was to evaluate the main causes and 3-year incidence of registered blindness in Jing-An district in Shanghai, China. Methods Data from the blindness registry (age, gender and cause of visual disability) were collected and analyzed. The prevalence of blindness for 2003, 2007, 2009 and the 3-year incidence of blindness were calculated. Results The reported blindness increased sign...

  7. SUITO Index for Evaluation of Clinical Islet Transplantation

    OpenAIRE

    Takita, Morihito; Matusmoto, Shinichi

    2012-01-01

    The major endpoints for clinical islet transplantation for type 1 diabetes are insulin independence and reduction of hypoglycemic episodes. Both endpoints are influenced by patients’ and physicians’ preferences regarding the use of exogenous insulin. Therefore, development of an objective endpoint for assessing clinical islet transplantation is desirable. HOMA-beta score is useful in assessing functional β-cell mass. However, this score uses blood insulin levels that are influenced by exogeno...

  8. Evaluating clinical competence during nursing education: A comprehensive integrative literature review.

    Science.gov (United States)

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

    2016-04-01

    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. PMID:26369943

  9. [The importance of clinical data management in improvement of drug evaluation].

    Science.gov (United States)

    Huang, Qin; Wang, Jun

    2015-11-01

    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.

  10. [The importance of clinical data management in improvement of drug evaluation].

    Science.gov (United States)

    Huang, Qin; Wang, Jun

    2015-11-01

    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. PMID:26911033

  11. Clinical and Ultrasonographic Evaluation of Lower-extremity Vein Thrombosis in Behcet Syndrome

    OpenAIRE

    Seyahi, Emire; Cakmak, Osman Serdal; Tutar, Burcin; Arslan, Caner; Dikici, Atilla Suleyman; Sut, Necdet; Kantarci, Fatih; Tuzun, Hasan; Melikoglu, Melike; Yazici, Hasan

    2015-01-01

    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...

  12. Making the Case for Simulation-Based Assessments to Overcome the Challenges in Evaluating Clinical Competency.

    Science.gov (United States)

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

    2016-05-13

    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.

  13. 78 FR 70102 - Clinical Science Research and Development Service Cooperative Studies; Scientific Evaluation...

    Science.gov (United States)

    2013-11-22

    ... 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...

  14. 76 FR 65781 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2011-10-24

    ... 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...

  15. 77 FR 72438 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2012-12-05

    ... 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 13, 2012, at the Hamilton...

  16. 78 FR 53015 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2013-08-27

    ... 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...

  17. 78 FR 41198 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2013-07-09

    ... 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...

  18. 77 FR 31072 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2012-05-24

    ... 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...

  19. 76 FR 73781 - Clinical Science Research and Development Service; Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2011-11-29

    ... 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...

  20. 76 FR 19189 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2011-04-06

    ... 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...

  1. Clinical Observed Performance Evaluation: A Prospective Study in Final Year Students of Surgery

    Science.gov (United States)

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

    2011-01-01

    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…

  2. FORENSIC-CLINICAL INTERVIEW: RELIABILITY AND VALIDITY FOR THE EVALUATION OF PSYCHOLOGICAL INJURY

    OpenAIRE

    Francisca Fariña; Manuel Vilariño; Ramón Arce

    2013-01-01

    Forensic evaluation of psychological injury involves the use of a multimethod approximation i.e., a psychometric instrument, normally the MMPI-2, and a clinical interview. In terms of the clinical interview, the traditional clinical interview (e.g., SCID) is not valid for forensic settings as it does not fulfil the triple objective of forensic evaluation: diagnosis of psychological injury in terms of Post Traumatic Stress Disorder (PTSD), a differential diagnosis of feigning, and establishing...

  3. The relation between personality and anxiety: findings from a 3-year prospective study.

    Science.gov (United States)

    Gershuny, B S; Sher, K J

    1998-05-01

    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.

  4. SMOS Instrument Performance and Calibration after 3 Years in Orbit

    Science.gov (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

    2013-04-01

    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

  5. Iranian Effective Clinical Nurse Instructor evaluation tool: Development and psychometric testing

    OpenAIRE

    Shahsavari, Hooman; Yekta, Zohreh Parsa; Zare, Zahra; Sigaroodi, Abdolhossain Emami

    2014-01-01

    Background: Clinical education is the heart of the nursing education program. Effective nursing clinical instructors are needed for graduating the future qualified nurses. There is a well-developed body of knowledge about the effectiveness of clinical teaching and the instructors. However, translating this knowledge into a context-based evaluation tool for measuring the effectiveness of Iranian clinical nursing instructors remains a deficiency. The purpose of this study is to describe the dev...

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

    Directory of Open Access Journals (Sweden)

    Ids H Boersma

    2014-01-01

    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.

  7. 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.

    2015-01-01

    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

  8. [Extension bridges. A bibliographic evaluation and the clinical indications].

    Science.gov (United States)

    Irato, A; Garrone, P; Catapano, S; Carossa, S

    1990-11-01

    Extension bridges are a valid alternative to partial and implanted prostheses for the rehabilitation of small intercalary or distal lacunae. Following a critical review of published reports on the subject and the assessment of longitudinal studies, the authors examine the clinical parameters and technical procedures used to implement these prosthetic reconstructions. PMID:2084528

  9. Asthma and coagulation: A clinical and pathophysiological evaluation

    NARCIS (Netherlands)

    C.J. Majoor

    2016-01-01

    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,

  10. 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.

    2008-01-01

    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

  11. Development and Psychometric Evaluation of the Nursing Instructors’ Clinical Teaching Performance Inventory

    OpenAIRE

    2014-01-01

    Evaluation of nursing instructors’ clinical teaching performance is a prerequisite to the quality assurance of nursing education. One of the most common procedures for this purpose is using student evaluations. This study was to develop and evaluate the psychometric properties of Nursing Instructors’ Clinical Teaching Performance Inventory (NICTPI). The primary items of the inventory were generated by reviewing the published literature and the existing questionnaires as well as consulting wit...

  12. 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

    2005-01-01

    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

  13. RCT comparing implants with turned and anodically oxidized surfaces: a pilot study, a 3-year follow-up

    NARCIS (Netherlands)

    E.A. Nicu; N. van Assche; W. Coucke; W. Teughels; M. Quirynen

    2012-01-01

    This 3-year prospective randomized controlled trial compared the clinical, microbiological and biochemical outcome of minimally (Turned, Tur) and moderately rough (TiUnite®, TiU) implant surfaces in a split-mouth design. The study population included 14 subjects: nine fully edentulous and five parti

  14. Combined Individual Cognitive Behavior Therapy and Parent Training for Childhood Depression: 2- to 3-Year Follow-up

    Science.gov (United States)

    Eckshtain, Dikla; Gaynor, Scott T.

    2013-01-01

    Fourteen children with significant depressive symptoms from an open clinical trial of Primary and Secondary Control Enhancement Training augmented with Caregiver-Child Relationship Enhancement Training, participated in a 2- to 3-year follow-up assessment. The results suggested that the significant decreases in depressive symptoms observed at…

  15. Clinical evaluation of cytological diagnosis of nasopharyngeal malignancies.

    Science.gov (United States)

    Molinari, R; Pilotti, S; Rilke, F

    1978-01-01

    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

  16. Evaluation of Clinical and Communication Skills of Pharmacy Students and Pharmacists with an Objective Structured Clinical Examination.

    Science.gov (United States)

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

    2015-10-25

    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.

  17. 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...

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

    OpenAIRE

    Sefer Varol; Hasan Huseyin Ozdemir; Esref Akil; Demet Arslan; M. Ufuk Aluclu; Demir, Caner F.; Yavuz Yucel

    2015-01-01

    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) her...

  19. 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.

    2007-01-01

    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

  20. Japan and Fukushima 3 years after the tsunami

    International Nuclear Information System (INIS)

    After a comment of aerial photographs of the Fukushima region after the tsunami, and some observations about the condition of the different reactor buildings of the power station, the author recalls some design and architecture characteristics of Japanese BWR reactors and outlines some peculiarities, notably the absence of secondary circuit. He discusses the accident process, the issue of residual power, and how explosions occurred. He describes the situation 3 years after the accident by giving indications on the status of the reactor: its residual power, its core temperature, and water injection. The main tasks to be performed have been: to safely stop the reactors, to remove radioactive debris, to decontaminate the site, to manage waters, to restore confinements, to remove the numerous (more than 12.000) more or less molten fuel assemblies, to manage contaminated waters. The author discusses the issue of underground waters. He addresses the issue of site dismantling with its different steps which are planned over 40 years. While recalling the Japanese regulation in case of nuclear accident, and proposing a map from the evacuation plan with its different areas, the author recalls the initial area evacuation timing during the first weeks. He indicates the evolution of radioactivity for different radionuclides, evokes the issue of storage of contaminated soils and plants. He addresses the issue of dosimetry and of the health impact (regulatory levels, staff dose levels), the issues of food products and internal doses and the opinion of the HWO on the health impact, and the issue of a return of populations. The status and condition of nuclear energy in Japan is evoked

  1. CONTROL CLINICAL EVALUATION OF KULATTHADI YOGA AS ASHMARIBHEDAN IN MUTRASHMARI

    OpenAIRE

    Jangle Vidya Muralidhar; Reddy Govind R; Waghmare Suryakant Dnyaneshwar

    2012-01-01

    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...

  2. Evaluation of Candida strains isolated from clinical specimens

    Directory of Open Access Journals (Sweden)

    Hafize Sav

    2014-01-01

    [¤]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.[¤

  3. Asthma and coagulation: A clinical and pathophysiological evaluation

    OpenAIRE

    Majoor, C.J.

    2016-01-01

    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, this study aimed to determine if any relationship between asthma and venous thromboembolic events could be attributed to asthma severity, viral infections or the use of asthma medication. The acti...

  4. Evaluation of Clinical Features of Female Patients with Macroprolactinemia

    OpenAIRE

    Göksun Ayvaz; Alev Eroğlu Altınova; Leyla Mollamahmutoğlu; Metin Arslan; Sevim Güllü; Müjde Aktürk

    2011-01-01

    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 o...

  5. Ultrasound Image Quality Assessment: A framework for evaluation of clinical image quality

    DEFF Research Database (Denmark)

    Hemmsen, Martin Christian; Pedersen, Mads Møller; Nikolov, Svetoslav Ivanov;

    2010-01-01

    Improvement of ultrasound images should be guided by their diagnostic value. Evaluation of clinical image quality is generally performed subjectively, because objective criteria have not yet been fully developed and accepted for the evaluation of clinical image quality. Based on recommendation 500...... and is applicable for clinical use. The free access to all system parameters enables the ability to capture standardized images as found in the clinic and experimental data from new processing or beamformation methods. The length of the data sequences is only restricted by the memory of the external PC. Data may...

  6. Evaluating the students' perspectives of a clinic mentoring programme.

    Science.gov (United States)

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

    2014-08-01

    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. PMID:24118706

  7. Evaluating the students' perspectives of a clinic mentoring programme.

    Science.gov (United States)

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

    2014-08-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Robson Frederico Cunha

    2009-09-01

    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.

  9. A case of localized juvenile periodontitis: treatment and 3 years follow-up with superimposable radiographs.

    Science.gov (United States)

    Dubrez, B; Baehni, P; Cimasoni, G

    1996-06-01

    A 17-year-old male patient with localized juvenile periodontitis was treated by subgingival instrumentation with full thickness flap on the lower molars, combined with a 3-week course of systemic tetracycline, and a programme of supervised oral hygiene. The treatment was rapidly followed by dramatic clinical and microbiological improvement. However, despite good oral hygiene, gingival inflammation recurred at regular intervals. It was necessary to maintain the clinical results by periodic subgingival instrumentation with an ultrasonic scaler. Healing of alveolar bone was monitored in the lower 1st molar regions over 3 years by using superimposable radiographs. Quantitative analysis of bone density performed with a high-resolution digitalisation technique showed a considerable improvement 1 year after therapy. However, continuous remodelling, probably related to variations in inflammation, occurred during the 3 postoperative years. PMID:8811475

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

    International Nuclear Information System (INIS)

    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.

  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

    2012-11-01

    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

    2015-12-01

    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. A clinical evaluation on adhesive posts in extensive composite restorations

    Directory of Open Access Journals (Sweden)

    Ghavamnasiri M. Associate Professor

    2003-06-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Ayşe Serap Karadağ

    2013-03-01

    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.

  15. Selection and Evaluation Guidelines for Clinical Education Settings in Athletic Training.

    Science.gov (United States)

    Weidner, Thomas G.; Laurent, Tim

    2001-03-01

    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.

  16. Selection and Evaluation Guidelines for Clinical Education Settings in Athletic Training.

    Science.gov (United States)

    Weidner, Thomas G.; Laurent, Tim

    2001-03-01

    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. PMID:12937517

  17. Determinants of physician antibiotic prescribing behavior: a 3 year cohort study in Portugal.

    Science.gov (United States)

    Teixeira Rodrigues, António; Ferreira, Mónica; Piñeiro-Lamas, Maria; Falcão, Amílcar; Figueiras, Adolfo; Herdeiro, Maria T

    2016-05-01

    Objectives Antibiotic misprescription is a major driver of resistance, which is a worldwide public health problem. Therefore, our aim is to assess the influence of the determinants of physician prescribing on the quality of antibiotic use. Methods A 3 year cohort study including all primary-care physicians working in Portugal's Central Regional Health Administration (n = 1094) was conducted. We assessed the determinants of prescribing using a pre-validated, personally addressed, reply-paid, self-administered questionnaire (sent four times to non-responders, between September 2011 and February 2012) designed to collect information on physicians' attitudes to and knowledge of antibiotic prescribing as well as their socio-demographic and professional data. To evaluate antibiotic prescribing, we've calculated ESAC 12 quality indicators per physician per year, allowing us to stratify them as good or poor prescribers according to their performance on those indicators. Associations between determinants and outcomes were fitted with generalized linear mixed models. Results The overall response rate was 46.1%. Emergency activity (OR [95% CI] = 0.29 [0.16-0.54]; p < 0.05) and workload (number of patients seen per day: OR [95% CI] = 0.97 [0.94-1.00]; p < 0.05; number of patients seen per week in emergencies: OR [95% CI] = 0.98 [0.97-0.99]; p < 0.05) were both related to poor quality of antibiotic prescribing. Statistically significant odds ratios were also obtained for ignorance (IqOR [95% CI] = 2.14 [1.31-3.52]), complacency (1/IqOR [95% CI] = 1.19 [1.01-1.41]) and responsibility of others (1/IqOR [95% CI] = 1.78 [1.10-3.06]). Conclusions The above results serve to emphasize workload, working at emergency departments and physicians' attitudes identified as critical factors affecting antibiotic prescribing. This provides new insights for clinicians, researchers and policy makers when it comes to developing and improving the clinical and

  18. Clinical evaluation of coded excitation in medical ultrasound

    DEFF Research Database (Denmark)

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

    2003-01-01

    -K Medical model 3535) with transmitter and receiver boards developed in our group and a mechanical 4 MHz transducer were used. The system acquired coded and conventional US image frames interleaved, yielding identical acquisitions with the two techniques. Cine-loop sequences were evaluated by three...

  19. 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

    2011-01-01

    [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.

  20. Clinical evaluation of a membrane-based voice-producing element for laryngectomized women

    NARCIS (Netherlands)

    Tack, Johannes W.; Qiu, Qingjun; Schutte, Harm K.; Kooijman, Piet G. C.; Meeuwis, Cees A.; van der Houwen, Eduard B.; Mahieu, Hans F.; Verkerke, Gijsbertus J.

    2008-01-01

    Background. A newly developed artificial voice source was clinically evaluated in laryngectomized women for voice quality improvements. The prosthesis was placed in a commercially available, tracheoesophageal shunt valve. Methods. In 17 subjects, voice-producing element (VPE) prototypes were compare

  1. Evaluating the effectiveness of clinical medical librarian programs: a systematic review of the literature*

    OpenAIRE

    Wagner, Kay Cimpl; Byrd, Gary D.

    2004-01-01

    Objective: This study was undertaken to determine if a systematic review of the evidence from thirty years of literature evaluating clinical medical librarian (CML) programs could help clarify the effectiveness of this outreach service model.

  2. Multiple risk factor evaluation in a hypertension clinic.

    Science.gov (United States)

    Thom, S; Bunker, J; Callister, W; Poulter, N; Sever, P; Zographos, D

    1989-12-01

    Hypertension is associated with abnormal lipoprotein metabolism, which may be exacerbated by some groups of antihypertensive drugs and represents an additional powerful coronary heart disease risk factor. Of our Hypertension Clinic population, 75% had a total fasting serum cholesterol greater than 5.2 mmol/l. Dietary advice and adjustment of antihypertensive therapy has achieved significant reductions in total cholesterol, serum triglycerides and body weight (14%, 18% and 4.3%, respectively) in a cohort of 65 patients reassessed over a period of 3-21 months. The reduction in cholesterol is likely to represent at least a 28% reduction in the risk of a major coronary heart disease event, even before taking account of any improvement in other coronary heart disease risk factors. PMID:2632734

  3. Evaluation of measurement parameters in clinical cerebral MR angiography

    International Nuclear Information System (INIS)

    A three-dimensional MR angiography technique was developed in patients and volunteers that can produce clinically useful studies of the cerebral vasculature with multiple views possible from a single data set acquisition. A low-flip angle, three-dimensional fast imaging with steady precessing sequence was found to provide the optimal vessel/soft-tissue contrast related to the tissues' relaxation parameters and inflow. The inflowing unsaturated spins and vessel orientation made an axial acquisition most effective. The flow-related phase dispersion could be largelly corrected with the appropriate orientation, strength, order, and combination of refocusing gradients with the shortest possible echo times. Reduced voxel size also affected the phase dispersion due to motion and field inhomogeneities. Postprocessing yielded projection images of vessels throughout the three-dimensional volume

  4. Clinical and radiological evaluation in vertebral artery dissections

    Directory of Open Access Journals (Sweden)

    Murat Çabalar

    2013-04-01

    Full Text Available In recent years, vertebral artery dissection (VAD is reported more frequently as a cause of young cerebrovascular accidents. It can occur spontaneously or following a neck manipulation and trauma. The patients were 3 females (mean age: 35±26 years and 7 males (mean age: 37.71±4.96 years. Only 2 patients described neck trauma. Cerebellar findings were prominent in all cases. On radiological investigation, vascular changes of vertebral arteries were detected bilaterally in 2 cases, right in 5 and left in 3 cases. All the cases were treated with anticoagulant therapy and cured but 1 with sequela. Prognosis of vertebral artery dissection is generally good by early diagnosis and treatment. In this article, we reported clinical and radiological properties of 10 vertebral artery dissection cases.

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

    CERN Document Server

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

    2007-01-01

    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.

  6. Clinical evaluation of amitraz for treatment of canine scabies.

    Science.gov (United States)

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

    1984-08-01

    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%.

  7. Prostate needle biopsies: interobserver variation and clinical consequences of histopathological re-evaluation

    DEFF Research Database (Denmark)

    Berg, Kasper Drimer; Toft, Birgitte Grønkaer; Brasso, Klaus;

    2011-01-01

    Histopathological grading of prostate cancer (PCa) is associated with significant interobserver variability. This, as well as clinical consequences of histopathological re-evaluation, was investigated. In 350 patients, histopathological re-evaluations of prostate biopsies were compared with primary...... 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...

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

    Directory of Open Access Journals (Sweden)

    Zarrati S

    2011-02-01

    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.

  9. Evaluation of radiological service of Dental Clinic, Uberlandia Federal University (MG-Brazil)

    International Nuclear Information System (INIS)

    The management related problems and the quality of dental radiographs of the Radiographic Service of the Dental Clinic, Uberlandia Federal University (MG-Brazil) are evaluated. The results are based on the examinations of 404 dental files from patients atending the Dental Clinic in 1983. Frequency distribution, mean and percentages were computed for the variables studied. (M.A.C.)

  10. Post graduate clinical placements:evaluating benefits and challenges with a mixed methods cross sectional design

    OpenAIRE

    Yiend, Jenny; Tracy, Derek K.; Sreenan, Brian; Cardi, Valentina; Foulkes, Tina; Koutsantoni, Katerina; Kravariti, Eugenia; Tchanturia, Kate; Willmott, Lucy; Shergill, Sukhi; Reedy, Gabriel

    2016-01-01

    Background: Systematic evaluations of clinical placements are rare, especially when offered alongside academic postgraduate courses. An evidence-based approach is important to allow pedagogically-driven provision, rather than that solely governed by opinion or market demand. Our evaluation assessed a voluntary clinical placement scheme allied to a mental health course.Methods: Data were collected over academic years 2010/11- 2013/14, from participating students (n = 20 to 58) and clinician su...

  11. Effects of PBBs on cattle. I. Clinical evaluations and clinical chemistry.

    Science.gov (United States)

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

    1978-04-01

    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.

  12. Clinical trial of pantomography for the evaluation of mandibular trauma.

    Science.gov (United States)

    Johnston, C C; Doris, P E

    1980-08-01

    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.

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

    OpenAIRE

    Teive Hélio A.G.; Germiniani Francisco M.B.; Della Coletta Marcus V.; Werneck Lineu César

    2001-01-01

    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 c...

  14. Evaluation of measurement uncertainty of glucose in clinical chemistry.

    Science.gov (United States)

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

    2007-04-01

    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.

  15. Initial clinical evaluation of stationary digital chest tomosynthesis

    Science.gov (United States)

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

    2016-03-01

    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.

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

    Science.gov (United States)

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

    2013-01-01

    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

    Directory of Open Access Journals (Sweden)

    Soheila Alyasin

    2004-09-01

    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. Lead intoxication: clinic and diagnostic evaluation in children

    Directory of Open Access Journals (Sweden)

    Martínez-Riera Nora

    2012-03-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Rajasekhar Moka

    2013-01-01

    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.

  20. Clinical and morphological evaluation of tuberculosis peripheral lymphadenopathy

    International Nuclear Information System (INIS)

    Objective: To analyze clinical presentations in patient of tuberculosis peripheral lymphadenopathy. Subjects and Methods: Patients presenting with peripheral lymphadenopathy with the confirmed diagnosis of tuberculosis were included in the study. The diagnosis of tuberculosis was made on finding acid fast bacilli on smear examination and / or histological demonstration of caseating epithelioid cell granulomas in the specimen obtained by fine needle aspiration cytology (FNAC) or excision biopsy. Patients in whom definite diagnosis of tuberculosis was not established on the basis of microscopy or histopathology examination were excluded from the study. History and physical examination findings were recorded on pre-designed proforma. Results: The maximum number of patients (68.75%) was in pediatric age group. The duration of illness was more than a year in 43.75% of the patients. Cervical region was the commonest affected in 70.83% patients. In majority of cases (89.58%) glands were multiple and in 66.7% glands were matted. In 83% cases diagnosis was achieved by FNAC subjected to cytology and acid fast bacilte (AFB) smear examination. Conclusion: In local setting tuberculosis etiology should be strongly suspected in a young patient presenting with peripheral lymphadenopathy, with prolonged duration of illness, and involvement of cervical glands with multiple and matted appearance. FNA is a reliable tool of diagnosis. (author)

  1. Breast imaging with SoftVue: initial clinical evaluation

    Science.gov (United States)

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

    2014-03-01

    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.

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

    CERN Document Server

    Scheurecker, G

    2001-01-01

    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...

  3. Evaluation of a Potential Clinical Interaction between Ceftriaxone and Calcium▿

    Science.gov (United States)

    Steadman, Emily; Raisch, Dennis W.; Bennett, Charles L.; Esterly, John S.; Becker, Tischa; Postelnick, Michael; McKoy, June M.; Trifilio, Steve; Yarnold, Paul R.; Scheetz, Marc H.

    2010-01-01

    In April 2009, the FDA retracted a warning asserting that ceftriaxone and intravenous calcium products should not be coadministered to any patient to prevent precipitation events leading to end-organ damage. Following that announcement, we sought to evaluate if the retraction was justified. A search of the FDA Adverse Event Reporting System was conducted to identify any ceftriaxone-calcium interactions that resulted in serious adverse drug events. Ceftazidime-calcium was used as a comparator agent. One hundred four events with ceftriaxone-calcium and 99 events with ceftazidime-calcium were identified. Adverse drug events were recorded according to the listed description of drug involvement (primary or secondary suspect) and were interpreted as probable, possible, unlikely, or unrelated. For ceftriaxone-calcium-related adverse events, 7.7% and 20.2% of the events were classified as probable and possible for embolism, respectively. Ceftazidime-calcium resulted in fewer probable embolic events (4%) but more possible embolic events (30.3%). Among cases that considered ceftriaxone or ceftazidime and calcium as the primary or secondary drug, one case was classified as a probable embolic event. That patient received ceftriaxone-calcium and died, although an attribution of causality was not possible. Our analysis suggests a lack of support for the occurrence of ceftriaxone-calcium precipitation events in adults. The results of the current analysis reinforce the revised FDA recommendations suggesting that patients >28 days old may receive ceftriaxone and calcium sequentially and provide a transparent and reproducible methodology for such evaluations. PMID:20086152

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

    Directory of Open Access Journals (Sweden)

    Neha A Kajale

    2015-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Pandya J

    2010-01-01

    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.

  6. De novo ocular hypertension after Descemet stripping endothelial keratoplasty: comparative 3-year incidence, risk factors, and outcomes

    Directory of Open Access Journals (Sweden)

    Chan EW

    2013-09-01

    Full Text Available Errol W Chan,1 Tina T Wong,2,3 Hla M Htoon,3 Ching L Ho,2 Donald T Tan,1,2,3 Jodhbir S Mehta2,3,4 1Department of Ophthalmology, National University Health System, Singapore; 2Singapore National Eye Centre, Singapore; 3Singapore Eye Research Institute, Singapore; 4Department of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore Objective: To compare the 3-year incidence of de novo ocular hypertension (OHT after Descemet stripping automated endothelial keratoplasty (DSAEK and penetrating keratoplasty (PK. For DSAEK, to evaluate predictors for OHT and 2-year outcomes after OHT development. Methods: This was a review of the prospective Singapore Corneal Transplant Study at a single tertiary referral center. Consecutive DSAEKs and PKs for Fuchs’ endothelial dystrophy (FED and pseudophakic bullous keratopathy (PBK in eyes without pre-existing glaucoma were analyzed. OHT incidence after DSAEK and PK were compared using Kaplan–Meier survival analysis, and OHT risk factors identified using Cox proportional regression. OHT was defined: intraocular pressure (IOP ≥ 24 mmHg or ≥ 10 mmHg from baseline. Secondary outcomes 2 years after OHT development in DSAEK were rates of glaucoma medical therapy failure, IOP success, graft failure and rejection, and best-spectacle corrected visual acuity (BSCVA. Results: There were 108 (96.4% DSAEKs and 216 (96% PKs. The 1-, 2- and 3-year de novo OHT incidence was not significantly different between DSAEK (36.1%, 47.2%, 47.2%, respectively and PK (35.7%, 44.9%, 45.8%, respectively; P = 0.914. OHT incidence did not differ in subgroup analyses of multiple clinical variables (P > 0.1. OHT predictors after DSAEK were: fellow eye glaucoma (hazard ratio [HR] 3.20, P = 0.004, age <60 years (HR 2.41, P = 0.016, concurrent goniosynechiolysis (HR 3.29, P = 0.021, post-graft complications or procedures (HR 2.85, P = 0.006. Two years after OHT onset, 29.7% of DSAEKs failed glaucoma medical therapy requiring

  7. Feasibility of Automatic Extraction of Electronic Health Data to Evaluate a Status Epilepticus Clinical Protocol.

    Science.gov (United States)

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

    2016-05-01

    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. PMID:26518205

  8. Feasibility of Automatic Extraction of Electronic Health Data to Evaluate a Status Epilepticus Clinical Protocol.

    Science.gov (United States)

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

    2016-05-01

    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.

  9. Two-year clinical evaluation of resin composite in posterior teeth: A randomized controlled study

    Science.gov (United States)

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

    2016-01-01

    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.

  10. Two-year clinical evaluation of resin composite in posterior teeth: A randomized controlled study

    Science.gov (United States)

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

    2016-01-01

    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

  11. Long-term evaluation of the clinical effectiveness of community milk fluoridation in Bulgaria

    DEFF Research Database (Denmark)

    Petersen, P E; Kwan, S; Ogawa, H

    2015-01-01

    OBJECTIVE: To determine the clinical effectiveness of a community milk fluoridation programme. BASIC RESEARCH DESIGN: Parallel arm 5-year cohort study, with final cross-sectional comparisons between groups. PARTICIPANTS: 3-year-olds in 8 Bulgarian cities/towns entered the cohort study with random......-olds from control cities were baseline examined for caries, then 276 children at the age 8 years in 2009. INTERVENTIONS: In six intervention communities: 1,498 examined children received 0.5 mg F in 100 or 200 ml school milk or yogurt provided each school day; a further 180 received non-fluoridated milk. In...... two control communities, fluoride was not added to 284 children's school milk. MAIN OUTCOME MEASURES: Dental caries experience of primary, and permanent teeth. RESULTS: For primary teeth, caries increments were 46% (p < 0.001) and 30% (p < 0.01) lower in the fluoridated milk groups compared with non...

  12. Results of a 3-Year, Nutrition and Physical Activity Intervention for Children in Rural, Low-Socioeconomic Status Elementary Schools

    Science.gov (United States)

    King, Kristi McClary; Ling, Jiying

    2015-01-01

    Improving children's nutrition and physical activity have become priorities in the United States. This quasi-experimental study evaluated the longitudinal effects of a 3-year, school-based, health promotion intervention (i.e. nutrition and physical education, classroom physical activity, professional development and health promotion for teachers…

  13. 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

    2000-01-01

    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...

  14. [Clinical evaluation of congenital cholesteatoma of the middle ear].

    Science.gov (United States)

    Kikuchi, Masahiro; Yamamoto, Etsuo; Shinohara, Shogo; Shiomi, Yousaku; Fujiwara, Keizo; Shiomi, Yoshiko; Watanabe, Futoshi; Tanabe, Makito

    2003-08-01

    We conducted a retrospective study to identify the clinical features and surgical observations of congenital cholesteatoma. Sixty patients were diagnosed and underwent surgery for congenital cholesteatoma between April 1987 and May 2002. All diagnoses were made on the basis of two operative findings: 1. the tympanic membrane manifested neither retraction, perforation, nor granulation. 2. the tympanic membrane was not continuous with the cholesteatoma. In this series, congenital cholesteatoma accounted for 7% of all cholesteatomas (853 ears). The patient age ranged from 2 to 48 years. The male to female ratio was 4:1. Seventeen patients had multiple cholesteatoma. Fifty-three patients exhibited closed-type cholesteatomas, while the remaining 7 patients had open-type cholesteatomas that had formed as a flat surface of the epidermis. Patients with open-type cholesteatomas presented with a much more pronounced conductive hearing loss and ossicular erosion or malformation. Twenty-two patients with relatively small cholesteatomas were analyzed to estimate the origin of their cholesteatomas. Of the 22 patients, 13 had anterior superior quadrant (ASQ-type) and 9 had posterior superior quadrant (PSQ-type) cholesteatomas. The mean age at the time of detection was older in the PSQ-type group than in the ASQ-type group and the frequency of ossicular erosion or malformation was more prominent in the PSQ-type group than in the ASQ-type group. The primary site of origin was thought to be the portion between the tympanic ostium of the auditory canal and the semicanal for tensor tympani in the ASQ-type group and near the incudostapedial joint in the PSQ-type group. A planned staged procedure was performed in 29 patients, 15 patients (52%) had residual lesions situated mostly on the oval window, the round window, an exposed facial nerve or an exposed lateral semicircular canal. The frequency of residual lesions in patients who presented with extended, multiple cholesteatoma and

  15. Case studies on clinical evaluation of biosimilar monoclonal antibody: scientific considerations for regulatory approval.

    Science.gov (United States)

    Kudrin, Alex; Knezevic, Ivana; Joung, Jeewon; Kang, Hye-Na

    2015-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Teive Hélio A.G.

    2001-01-01

    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. CLINICAL EVALUATION OF FAILED ENDONASAL DCR OPERATIONS AND THEIR MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Mohammed Naveed

    2014-09-01

    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.

  18. [Clinical evaluation of gingival tissue restored with stainless steel crown].

    Science.gov (United States)

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

    1992-12-01

    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.

  19. Clinical evaluation of physical fitness in male obese Japanese

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    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. CLINICAL APPLICATION AND EVALUATION OF SALIVAFERNING TEST IN SJOGREN'S SYNDROME

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    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.

  1. CLINICAL EVALUATION OF TRIKATU AS APPETITE STIMULENT (AGNIVARDHAN

    Directory of Open Access Journals (Sweden)

    Singh Akhilesh Kumar

    2012-02-01

    Full Text Available Context: Human beings, in order to adjust themselves in the modest era, have been compelled to become fast and mechanical. This is the reason why they can’t give proper attention to daily and seasonal regimes, exercise and diet. This change in lifestyle is responsible for Agnimandya. According to them Mandagni is Root cause of every disease. Agni plays the key role in the process of bio-transformation. Aim: This study was designed to evaluate the role of Trikatu (Pippali, Maricha and Shunthi as appetite stimulent (Agnivardhan.Methods and Material: This was a prospective randomized active control trial. A total of 60 participants showing classical symptoms of Agnimandya between 20 and 60 years of age were randomly assigned to receive treatments. One group received Trikatu churna while another group received Agnitundi Vati. Both groups practiced supervised intervention for 3 weeks. The signs and symptoms like Avipak, Prasek, Kshudhamandya, Shirogaurav, Amashay Pradeshi gaurav, Antrakujan, Pravahan were graded and interpreted at the end of the trial.Results: The result was found effective for treating Avipak, Prasek, Kshudhamandya, Shirogaurav, Amashay Pradeshi gaurav, Antrakujan, Pravahan of Agnimandya in the group treated with Trikatu Churna. The results for the above criteria for the assessment was found statically highly significant.Conclusions: Trikatu Churna is highly effective in treating Agnimandya.

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

    Science.gov (United States)

    Teive, H A; Germiniani, F M; Della Coletta, M V; Werneck, L C

    2001-09-01

    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. PMID:11593273

  3. Is it the time to rethink clinical decision-making strategies? From a single clinical outcome evaluation to a Clinical Multi-criteria Decision Assessment (CMDA).

    Science.gov (United States)

    Migliore, Alberto; Integlia, Davide; Bizzi, Emanuele; Piaggio, Tomaso

    2015-10-01

    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

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

    Directory of Open Access Journals (Sweden)

    Rossana Pascual Dabán

    2015-01-01

    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.

  5. Epidermoid cyst in the floor of the mouth of a 3-year-old.

    Science.gov (United States)

    Pascual Dabán, Rossana; García Díez, Eloy; González Navarro, Beatriz; López-López, José

    2015-01-01

    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. PMID:25694831

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

    Directory of Open Access Journals (Sweden)

    Pio Liberatore

    2012-06-01

    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.

  7. Clinical evaluation of a '3-in-1' intravenous nutrient solution.

    Science.gov (United States)

    O'Keefe, S J; Bean, E; Symmonds, K; Smit, R; Delport, I; Dicker, J

    1985-07-20

    Eighty-five consecutive general hospital patients requiring total parenteral nutrition (TPN) were prospectively studied in order to evaluate the safety and efficacy of a '3-in-1' nutrient mixture. All formulas were individualized to estimated requirements (average composition nitrogen 14 g, glucose 350 g, fat 50 g), mixed in the hospital pharmacy, contained within 3-litre EVA plastic bags, and given to the patients as a continuous 24-hour infusion. The average duration of TPN was 19 days per patient (range 8 - 84 days). Judging by nitrogen balance and plasma protein concentrations, the system was effective in maintaining or improving nutritional status in patients in a relatively stable condition but not in those who were critically ill (e.g. those in an intensive care unit). Development of magnesium and iron deficiencies was common during the period of TPN (25% of patients developing magnesium deficiency and 40% developing iron deficiency) despite daily supplementation with commercial trace element mixtures, but these states were easily corrected by high-dose administration. 'Creaming' of less than 5 mm on the surface of the emulsion was common, whereas that of more than 10 mm was rare (12 bags) and invariably associated with excessive addition of polyvalent cation or glucose. Deposition of lipid on the internal surface of the catheter was a common problem after 2 weeks' continuous administration. Temporary problems with faulty bag connections resulted in excessive catheter sepsis (14%) due to Staphylococcus epidermidis. Mild reversible disturbances in liver function occurred in one-third of the patients. The system appears safe and effective for the management of most patients requiring long-term TPN.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3925569

  8. An economic evaluation of antihypertensive therapies based on clinical trials

    Directory of Open Access Journals (Sweden)

    Rosana Lima Garcia Tsuji

    2012-01-01

    Full Text Available OBJECTIVE: Hypertension is a major issue in public health, and the financial costs associated with hypertension continue to increase. Cost-effectiveness studies focusing on antihypertensive drug combinations, however, have been scarce. The cost-effectiveness ratios of the traditional treatment (hydrochlorothiazide and atenolol and the current treatment (losartan and amlodipine were evaluated in patients with grade 1 or 2 hypertension (HT1-2. For patients with grade 3 hypertension (HT3, a third drug was added to the treatment combinations: enalapril was added to the traditional treatment, and hydrochlorothiazide was added to the current treatment. METHODS: Hypertension treatment costs were estimated on the basis of the purchase prices of the antihypertensive medications, and effectiveness was measured as the reduction in systolic blood pressure and diastolic blood pressure (in mm Hg at the end of a 12-month study period. RESULTS: When the purchase price of the brand-name medication was used to calculate the cost, the traditional treatment presented a lower cost-effectiveness ratio [US$/mm Hg] than the current treatment in the HT1-2 group. In the HT3 group, however, there was no difference in cost-effectiveness ratio between the traditional treatment and the current treatment. The cost-effectiveness ratio differences between the treatment regimens maintained the same pattern when the purchase price of the lower-cost medication was used. CONCLUSIONS: We conclude that the traditional treatment is more cost-effective (US$/mm Hg than the current treatment in the HT1-2 group. There was no difference in cost-effectiveness between the traditional treatment and the current treatment for the HT3 group.

  9. Clinical evaluations for transfer of juveniles to criminal court: current practices and future research.

    Science.gov (United States)

    Kruh, I P; Brodsky, S L

    1997-01-01

    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.

  10. Clinical and radiographic evaluation of a polyester prosthesis in dogs with cranial cruciate ligament rupture

    International Nuclear Information System (INIS)

    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

  11. An Evaluation on Medical Students' Satisfaction with Clinical Education and its Effective Factors

    Directory of Open Access Journals (Sweden)

    Vahid Ziaee

    2004-05-01

    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.

  12. Clinical governance: the need for new directions in Canada: [includes principles to guide changes and evaluation].

    Science.gov (United States)

    Carlow, Donald R

    2010-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Mayank Dhamija

    2013-01-01

    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.

  14. Evaluation of clinical pharmacist recommendations in the geriatric ward of a Belgian university hospital

    Directory of Open Access Journals (Sweden)

    Somers A

    2013-06-01

    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

  15. 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...

  16. 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.

    2009-09-09

    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

  17. Recognition and Evaluation of Clinical Section Headings in Clinical Documents Using Token-Based Formulation with Conditional Random Fields

    Directory of Open Access Journals (Sweden)

    Hong-Jie Dai

    2015-01-01

    Full Text Available 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.

  18. Participation in clinical supervision (PACS): an evaluation of student nurse clinical supervision facilitated by mental health service users.

    Science.gov (United States)

    Maplethorpe, Fran; Dixon, Julie; Rush, Brenda

    2014-03-01

    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. PMID:23981566

  19. Mini-clinical evaluation exercise til evaluering af kommunikation og samarbejde i ambulatoriet

    DEFF Research Database (Denmark)

    Eriksen, Jesper Grau; Simonsen, Dorit; Bastholt, Lars;

    2009-01-01

    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...

  20. Self-discrepancy: structural differences between clinical and non-clinical populations evaluated with MCMI-II

    Directory of Open Access Journals (Sweden)

    Ângela Brandão

    2014-10-01

    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.

  1. A framework to support preceptors' evaluation and development of new nurses' clinical judgment.

    Science.gov (United States)

    Nielsen, Ann; Lasater, Kathie; Stock, Mary

    2016-07-01

    In today's complex, fast-paced world of hospital nursing, new graduate nurses do not have well-developed clinical judgment skills. Nurse preceptors are charged with bridging the gap between new graduates' learning in school and their autonomous practice as RNs. In one large, urban medical center in the U.S., a clinical judgment model and rubric were used as a framework for a new evaluation and orientation process. Preceptors of new graduate nurses who had used the former and new processes described their experiences using the framework. The findings indicated that having a structured framework provided objective ways to evaluate and help develop new graduate nurses' clinical judgment. It is hypothesized that academic clinical supervisors may find such a framework useful to prepare students for transition to practice. PMID:27428698

  2. Clinical Significance of Lymphoscintigraphy Findings in the Evaluation of Lower Extremity Lymphedema

    OpenAIRE

    Seyhan Karaçavuş; Yunus Keser Yılmaz; Hasan Ekim

    2015-01-01

    Objective: The purpose of this study was to investigate the clinical significance of lymphoscintigraphy imaging in the evaluation of lower extremity lymphedema. Methods: Technetium-99m-labeled nanocolloid was injected subcutaneously in the first web spaces of both feet of 123 patients (M/F: 43/80, mean age 57.5±13.1 years, range 16-78 years) who had clinical evidence of lower extremity swelling with suspicion of lymphedema, and were referred for routine lymphoscintigraphy. Lymphos...

  3. Evaluation of Clinical and Administrative Data to Augment Public Health Surveillance

    OpenAIRE

    Egger, Joseph R.; Lowe, Brooks; Johnson, Erica; Durbin, Randy; Griffin, Erica; Dhakal, Sanjaya; Dey, Achintya; Groseclose, Sam

    2013-01-01

    Objective To assess the utility of inpatient and ambulatory clinical data compiled by public and commercial sources to enhance the Centers for Disease Control and Prevention’s surveillance activities. Introduction Medical claims and EHR data sources offer the potential to ascertain disease and health risk behavior prevalence and incidence, evaluate the use of clinical services, and monitor changes related to public health interventions. Passage of the HITECH Act of 2009 supports the availabil...

  4. Evaluation of a nonradiometric system (BACTEC 9000 MB) for detection of mycobacteria in human clinical samples.

    OpenAIRE

    ZANETTI, S.; Ardito, F; SECHI, L.; Sanguinetti, M.; Molicotti, P.; Delogu, G.; Pinna, M P; NACCI, A.; Fadda, G.

    1997-01-01

    This study was carried out to evaluate the rate of recovery and time required for detection of mycobacteria from pulmonary and extrapulmonary human clinical samples, by using a fluorescence-quenching-based oxygen sensor (BACTEC 9000 MB; Becton Dickinson Microbiology Systems, Sparks, Md.). The results were compared with those obtained by microscopy, conventional culture in Lowenstein-Jensen (LJ) medium, and a BACTEC radiometric system (BACTEC 460 TB; Becton Dickinson). Of the 779 clinical samp...

  5. Evaluation of clinical pharmacist recommendations in the geriatric ward of a Belgian university hospital

    OpenAIRE

    Somers A; Robays H; De Paepe P; Van Maele G; Perehudoff K; Petrovic M

    2013-01-01

    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 recom...

  6. Fluoroscope guided epidural needle insertioin in midthoracic region: clinical evaluation of Nagaro's method

    OpenAIRE

    Kim, Won Joong; Kim, Tae Hwa; Shin, Hwa Yong; Kang, Hyun; Baek, Chong Wha; Jung, Yong Hun; Woo, Young Cheol; Kim, Jin Yun; Koo, Gill Hoi; Park, Sun Gyoo

    2012-01-01

    Background In the midthoracic region, a fluroscope guided epidural block has been proposed by using a pedicle as a landmark to show the height of the interlaminar space (Nagaro's method). However, clinical implication of this method was not fully evaluated. We studied the clinical usefulness of a fluoroscope guided thoracic epidural block in the midthoracic region. Methods Twenty four patients were scheduled to receive an epidural block at the T6-7 intervertebral space. The patients were plac...

  7. Economic evaluation alongside pragmatic randomised trials: developing a standard operating procedure for clinical trials units

    OpenAIRE

    Russell Ian T; Linck Pat; Hounsome Barry; Edwards Rhiannon T

    2008-01-01

    Abstract Background There is wide recognition that pragmatic randomised trials are the best vehicle for economic evaluation. This is because trials provide the best chance of ensuring internal validity, not least through the rigorous prospective collection of patient-specific data. Furthermore the marginal cost of collecting economic data alongside clinical data is typically modest. UK Clinical Research Collaboration (UKCRC) does not require a standard operating procedure (SOP) for economic e...

  8. Psoriatic Arthritis in Psoriasis Patients: Evaluation of Clinical and Radiological Features

    Directory of Open Access Journals (Sweden)

    Hatice Reşorlu

    2016-08-01

    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.

  9. Evaluating research for clinical significance: using critically appraised topics to enhance evidence-based neuropsychology.

    Science.gov (United States)

    Bowden, Stephen C; Harrison, Elise J; Loring, David W

    2014-01-01

    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.

  10. [Evaluation of secondary care in oral health: a study of specialty clinics in Brazil].

    Science.gov (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

    2012-01-01

    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.

  11. METHODOLOGICAL EVALUATION ON CLINICAL RESEARCH LITERATURE OF ACUPUNCTURE TREATMENT OF FACIAL PARALYSIS

    Institute of Scientific and Technical Information of China (English)

    梁繁荣; 李瑛

    2003-01-01

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

    OpenAIRE

    Patki, Pralhad

    2010-01-01

    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...

  13. STP Best Practices for Evaluating Clinical Pathology in Pharmaceutical Recovery Studies.

    Science.gov (United States)

    Tomlinson, Lindsay; Ramaiah, Lila; Tripathi, Niraj K; Barlow, Valerie G; Vitsky, Allison; Poitout-Belissent, Florence M; Bounous, Denise I; Ennulat, Daniela

    2016-02-01

    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.

  14. Uniform Evaluation of Clinical Teaching - an instrument for specific feedback and cross comparison between Departments

    Directory of Open Access Journals (Sweden)

    Pernilla Kihlberg

    2011-06-01

    Full Text Available The quality of clinical teaching in Swedish medical schools has recently been questioned by student representatives at the medical schools in Sweden. The clinical teaching at Uppsala University Medical School has previously only been sparsely evaluated and with varying instruments. Our aim was to develop a simple assessment instrument and implement it uniformly, enabling cross comparisons between different departments. Further we wanted to investigate students’ response rate and analyze their response pattern.A questionnaire inspired by a concept from Stanford University was created and introduced at hospital departments performing clinical teaching of medical students. Ten questions reflecting different aspects of clinical teaching were used. The outcome was used for specific feedback to the clinical teachers, cross comparison and official ranking of the departments.The evaluation instrument has been successfully developed and uniformly implemented throughout the departments of the hospital. The students have with a relatively high response rate graded the items with a great deal of variation between and within the clinical rotations. Altogether, this has provided specific feedback to the clinical teachers and enabled cross comparison between departments. Our belief is that the instrument also applies to other educations involving supervision.

  15. A semi-automated tool for treatment plan-quality evaluation and clinical trial quality assurance

    Science.gov (United States)

    Wang, Jiazhou; Chen, Wenzhou; Studenski, Matthew; Cui, Yunfeng; Lee, Andrew J.; Xiao, Ying

    2013-07-01

    The goal of this work is to develop a plan-quality evaluation program for clinical routine and multi-institutional clinical trials so that the overall evaluation efficiency is improved. In multi-institutional clinical trials evaluating the plan quality is a time-consuming and labor-intensive process. In this note, we present a semi-automated plan-quality evaluation program which combines MIMVista, Java/MATLAB, and extensible markup language (XML). More specifically, MIMVista is used for data visualization; Java and its powerful function library are implemented for calculating dosimetry parameters; and to improve the clarity of the index definitions, XML is applied. The accuracy and the efficiency of the program were evaluated by comparing the results of the program with the manually recorded results in two RTOG trials. A slight difference of about 0.2% in volume or 0.6 Gy in dose between the semi-automated program and manual recording was observed. According to the criteria of indices, there are minimal differences between the two methods. The evaluation time is reduced from 10-20 min to 2 min by applying the semi-automated plan-quality evaluation program.

  16. Acute undifferentiated febrile illness in rural Cambodia: a 3-year prospective observational study.

    Directory of Open Access Journals (Sweden)

    Tara C Mueller

    Full Text Available In the past decade, malaria control has been successfully implemented in Cambodia, leading to a substantial decrease in reported cases. Wide-spread use of malaria rapid diagnostic tests (RDTs has revealed a large burden of malaria-negative fever cases, for which no clinical management guidelines exist at peripheral level health facilities. As a first step towards developing such guidelines, a 3-year cross-sectional prospective observational study was designed to investigate the causes of acute malaria-negative febrile illness in Cambodia. From January 2008 to December 2010, 1193 febrile patients and 282 non-febrile individuals were recruited from three health centers in eastern and western Cambodia. Malaria RDTs and routine clinical examination were performed on site by health center staff. Venous samples and nasopharyngeal throat swabs were collected and analysed by molecular diagnostic tests. Blood cultures and blood smears were also taken from all febrile individuals. Molecular testing was applied for malaria parasites, Leptospira, Rickettsia, O. tsutsugamushi, Dengue- and Influenza virus. At least one pathogen was identified in 73.3% (874/1193 of febrile patient samples. Most frequent pathogens detected were P. vivax (33.4%, P. falciparum (26.5%, pathogenic Leptospira (9.4%, Influenza viruses (8.9%, Dengue viruses (6.3%, O. tsutsugamushi (3.9%, Rickettsia (0.2%, and P. knowlesi (0.1%. In the control group, a potential pathogen was identified in 40.4%, most commonly malaria parasites and Leptospira. Clinic-based diagnosis of malaria RDT-negative cases was poorly predictive for pathogen and appropriate treatment. Additional investigations are needed to understand their impact on clinical disease and epidemiology, and the possible role of therapies such as doxycycline, since many of these pathogens were seen in non-febrile subjects.

  17. A Quantitative and Qualitative Evaluation of Sentence Boundary Detection for the Clinical Domain.

    Science.gov (United States)

    Griffis, Denis; Shivade, Chaitanya; Fosler-Lussier, Eric; Lai, Albert M

    2016-01-01

    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 http://github.com/drgriffis/SBD-Evaluation. PMID:27570656

  18. Comparative heart failure profile over a 3-year period in a Romanian general hospital

    Directory of Open Access Journals (Sweden)

    Pop D

    2013-07-01

    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

  19. Math Skills and Executive Functioning in Preschool: Clinical and Ecological Evaluation

    OpenAIRE

    Presentación Herrero, María Jesús; Siegenthaler Hierro, Rebeca; Pinto Tena, Vicente; Mercader, Jessica; Miranda Casas, Ana

    2015-01-01

    This study compares the relationship between executive functioning, analyzed with clinical and ecological tests, and math skills in preschoolers. The children (255 children 5 to 6 years old) were evaluated using neuropsychological tests of inhibition, and working memory and the TEDI-MATH to estimate basic mathematical skills. The ecological evaluation of the executive functioning by the parents and teachers was carried out with the Behavioral Rating Inventory of Executive Function (BRIEF). Co...

  20. Clinical evaluation of a wireless ECG sensor system for arrhythmia diagnostic purposes

    OpenAIRE

    Fensli, Rune; Gundersen, Torstein; Snaprud, Tormod; Heljesen, Ole

    2013-01-01

    In a clinical study, a novel wireless electrocardiogram (ECG) recorder has been evaluated with regard to its ability to perform arrhythmia diagnostics. As the ECG recorder will detect a "non-standard" ECG signal, it has been necessary to compare those signals to "standard" ECG recording signals in order to evaluate the arrhythmia detection ability of the new system. Simultaneous recording of ECG signals from both the new wireless ECG recorder and a conventional Holter recorder was compared by...

  1. Computer-Assisted Interpretation of the EEG Background Pattern: A Clinical Evaluation

    OpenAIRE

    Lodder, Shaun S.; Jessica Askamp; Michel J A M van Putten

    2014-01-01

    OBJECTIVE: Interpretation of the EEG background pattern in routine recordings is an important part of clinical reviews. We evaluated the feasibility of an automated analysis system to assist reviewers with evaluation of the general properties in the EEG background pattern. METHODS: Quantitative eeg methods were used to describe the following five background properties: posterior dominant rhythm frequency and reactivity, anterior-posterior gradients, presence of diffuse slow-wave activity and ...

  2. A review of methods of clinical image quality evaluation in mammography

    International Nuclear Information System (INIS)

    Purpose: Consistency in evaluation of mammography images in research and clinical practice is dependent on a standardised clinical image quality evaluation system. Currently two such systems are available-one developed by the American College of Radiology (ACR) and the other by the European Commission (EU guidelines). The purpose of this study was to review mammography clinical evaluation methods in research studies and their adherence to these systems. Method: A total of 23 research articles were reviewed from the period 2000-2006, 11 of these studies used digital images. The focus of the review was the criteria and rating scales used. Results: Only 5 studies used either the ACR (3) or EU guidelines (2). The remainder included aspects of these systems together with a range of other criteria and rating scales. Variation was found in the categories of criteria used, number of criteria, the descriptors of the criteria and the instructions used to evaluate the criteria. Instructions were frequently not specific and open to individual interpretation. Although breast density is an important criterion of image quality and contributes to perception of breast lesions, inclusion of this criterion was not universal, and even when used the area of breast density to be evaluated was not identified, thus enhancing inter-observer variability. Scales that were absolute or relative were used for evaluation, all of which incorporated inconsistent numbers of steps. Conclusion: Low adherence to ACR and EU Guidelines has resulted in considerable variation in the evaluation methods used in research studies. The implications of this variability are considerable both for evaluation of image quality in research outcomes and clinical practice.

  3. Development of a New O&M Clinical Competency Evaluation Tool and Examination of Validity and Reliability Evidence

    Science.gov (United States)

    Renshaw, Rebecca L.

    2010-01-01

    The goal of this study was to create an evaluation tool that would be the new standard for evaluating clinical competencies of interns in the field of orientation and mobility (O&M). Using results from previous research in this area, specific competency skills were identified and the O&M Clinical Competency Evaluation Matrix (CCEM) was developed.…

  4. Evaluation of children's dental anxiety levels at a kindergarten and at a dental clinic.

    Science.gov (United States)

    Kilinç, Gulser; Akay, Aynur; Eden, Ece; Sevinç, Nilgün; Ellidokuz, Hülya

    2016-08-18

    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.

  5. Integrating economic evaluation methods into clinical and translational science award consortium comparative effectiveness educational goals.

    Science.gov (United States)

    Iribarne, Alexander; Easterwood, Rachel; Russo, Mark J; Wang, Y Claire

    2011-06-01

    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.

  6. The Alpha Stem Cell Clinic: a model for evaluating and delivering stem cell-based therapies.

    Science.gov (United States)

    Trounson, Alan; DeWitt, Natalie D; Feigal, Ellen G

    2012-01-01

    Cellular therapies require the careful preparation, expansion, characterization, and delivery of cells in a clinical environment. There are major challenges associated with the delivery of cell therapies and high costs that will limit the companies available to fully evaluate their merit in clinical trials, and will handicap their application at the present financial environment. Cells will be manufactured in good manufacturing practice or near-equivalent facilities with prerequisite safety practices in place, and cell delivery systems will be specialized and require well-trained medical and nursing staff, technicians or nurses trained to handle cells once delivered, patient counselors, as well as statisticians and database managers who will oversee the monitoring of patients in relatively long-term follow-up studies. The model proposed for Alpha Stem Cell Clinics will initially use the capacities and infrastructure that exist in the most advanced tertiary medical clinics for delivery of established bone marrow stem cell therapies. As the research evolves, they will incorporate improved procedures and cell preparations. This model enables commercialization of medical devices, reagents, and other products required for cell therapies. A carefully constructed cell therapy clinical infrastructure with the requisite scientific, technical, and medical expertise and operational efficiencies will have the capabilities to address three fundamental and critical functions: 1) fostering clinical trials; 2) evaluating and establishing safe and effective therapies, and 3) developing and maintaining the delivery of therapies approved by the Food and Drug Administration, or other regulatory agencies.

  7. Evaluation of a new clinical performance assessment tool : A reliability study

    Directory of Open Access Journals (Sweden)

    C. Joseph

    2012-12-01

    Full Text Available Clinical practice is an essential requirement of any graduatephysiotherapy programme. For this purpose, valid and reliable assessment toolsare paramount for the measurement of key competencies in the real-worldsetting. This study aims to determine the internal consistency and inter-raterreliability of a newly developed and validated clinical performance assessmentform. A cross-sectional quantitative research design was used, which includedpaired evaluations of 32 (17 treatment and 15 assessment student examinationsperformed by two independent clinical educators. Chronbachs alpha was computedto assess internal consistency and intraclass correlation coefficient (ICC’s withconfidence intervals of 95% were computed to determine the percentage agreement between paired examiners. Thedegree of internal consistency was substantial for all key performance areas of both examinations, except for timeand organisational management (0.21 and professionalism (0.42 in the treatment and evaluation examinationsrespectively. The overall internal consistency was 0.89 and 0.73 for both treatment and assessment examinations,indicating substantial agreement. With regard to agreement between raters, the ICC’s for the overall marks were0.90 and 0.97 for both treatment and assessment examinations. Clinical educators demonstrated a high level ofreliability in the assessment of students’ competence using the newly developed clinical performance assessment form.These findings greatly underscore the reliability of results obtained through observation of student examinations, andadd another tool to the basket of ensuring quality assurance in physiotherapy clinical practice assessment.

  8. Portfolio assessment and evaluation: Implications and guidelines for clinical nursing education

    Directory of Open Access Journals (Sweden)

    M.M. Chabeli

    2002-09-01

    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.

  9. 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.

    2008-01-01

    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

  10. A CIS (Clinical Information System) Quality Evaluation Tool for Nursing Care Services

    Science.gov (United States)

    Lee, Seon Ah

    2010-01-01

    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…

  11. Clinical Evaluation of the PCA3 Assay in Guiding Initial Biopsy Decisions

    NARCIS (Netherlands)

    A. de la Taille; J. Irani; M. Graefen; F. Chun; T. de Reijke; P. Kil; P. Gontero; A. Mottaz; A. Haese

    2011-01-01

    Purpose: We evaluated the clinical utility of the PCA3 assay in guiding initial biopsy decisions in prostate cancer. Materials and Methods: A European, prospective, multicenter study enrolled men with a serum total prostate specific antigen of 2.5 to 10 ng/ml scheduled for initial biopsy. After digi

  12. Evaluation of clinical pharmacist interventions on drug interactions in outpatient pharmaceutical HIV-care

    NARCIS (Netherlands)

    de Maat, M M R; de Boer, A; Koks, C H W; Mulder, J W; Meenhorst, P L; van Gorp, E C M; Mairuhu, A T A; Huitema, A D R; Beijnen, J H

    2004-01-01

    OBJECTIVE: To evaluate the usefulness of intervention in drug interactions of antiretroviral drugs with coadministered agents by a clinical pharmacist in outpatient HIV-treatment. METHODS: The study design included two intervention arms (A and B), which were both preceded by a control observation pe

  13. Evaluation of clinical pharmacist interventions on drug interactions in outpatient pharmaceutical HIV-care.

    NARCIS (Netherlands)

    Maat, M.M. de; Boer, A.T. den; Koks, C.H.W.; Mulder, J.W.; Meenhorst, P.L.; Gorp, E. van; Mairuhu, A.T.; Huitema, A.D.; Beijnen, J.H.

    2004-01-01

    OBJECTIVE: To evaluate the usefulness of intervention in drug interactions of antiretroviral drugs with coadministered agents by a clinical pharmacist in outpatient HIV-treatment. METHODS: The study design included two intervention arms (A and B), which were both preceded by a control observation pe

  14. Clinical evaluation of a dynamic test for lateral ankle ligament laxity

    NARCIS (Netherlands)

    J.S. de Vries; G.M.M.J. Kerkhoffs; L. Blankevoort; C.N. van Dijk

    2010-01-01

    The dynamic anterior ankle tester (DAAT) has shown a good reliability in testing anterior talar translation in earlier studies. The goal of the present study was first to evaluate the reliability of the DAAT in a clinical setting and second to analyze its ability to detect increased ligament laxity.

  15. [Establish research model of post-marketing clinical safety evaluation for Chinese patent medicine].

    Science.gov (United States)

    Zheng, Wen-ke; Liu, Zhi; Lei, Xiang; Tian, Ran; Zheng, Rui; Li, Nan; Ren, Jing-tian; Du, Xiao-xi; Shang, Hong-cai

    2015-09-01

    The safety of Chinese patent medicine has become a focus of social. It is necessary to carry out work on post-marketing clinical safety evaluation for Chinese patent medicine. However, there have no criterions to guide the related research, it is urgent to set up a model and method to guide the practice for related research. According to a series of clinical research, we put forward some views, which contained clear and definite the objective and content of clinical safety evaluation, the work flow should be determined, make a list of items for safety evaluation project, and put forward the three level classification of risk control. We set up a model of post-marketing clinical safety evaluation for Chinese patent medicine. Based this model, the list of items can be used for ranking medicine risks, and then take steps for different risks, aims to lower the app:ds:risksrisk level. At last, the medicine can be managed by five steps in sequence. The five steps are, collect risk signal, risk recognition, risk assessment, risk management, and aftereffect assessment. We hope to provide new ideas for the future research. PMID:26983223

  16. An Antipodean Evaluation of Problem-Based Learning by Clinical Educators.

    Science.gov (United States)

    Williams, Allison F.

    1999-01-01

    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)

  17. Assessing students' English language proficiency during clinical placement: A qualitative evaluation of a language framework.

    Science.gov (United States)

    San Miguel, Caroline; Rogan, Fran

    2015-06-01

    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.

  18. Evaluation of clinical pathology data: correlating changes with other study data.

    Science.gov (United States)

    Everds, Nancy E

    2015-01-01

    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.

  19. Evaluation of undergraduate nursing students' clinical confidence following a mental health recovery camp.

    Science.gov (United States)

    Cowley, Thomas; Sumskis, Sue; Moxham, Lorna; Taylor, Ellie; Brighton, Renee; Patterson, Chris; Halcomb, Elizabeth

    2016-02-01

    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.

  20. 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)

    2015-10-15

    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.)

  1. Maternal evaluations of young children’s developmental status: A comparison of clinic- and non-clinic-groups

    Directory of Open Access Journals (Sweden)

    Pia Deimann

    2011-06-01

    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

  2. A new method of real-time skin dose visualization. Clinical evaluation of fluoroscopically guided interventions

    International Nuclear Information System (INIS)

    We have conducted a prospective study to clinically evaluate a new radiation dose observing tool that displays patient's peak skin dose (PSD) map in real time. The skin dose map (SDM) prototype quantifies the air kerma based on exposure parameters from the X-ray system. The accuracy of this prototype was evaluated with radiochromic films, which were used as a mean for PSD measurement. The SDM is a reliable tool that provides an accurate PSD estimation and location. SDM also has many advantages over the radiochromic films, such as real-time dose evaluation and easy access to critical operational parameters for physicians and technicians. (orig.)

  3. Clinical and Ultrasonographic Evaluation of Lower-extremity Vein Thrombosis in Behcet Syndrome

    Science.gov (United States)

    Seyahi, Emire; Cakmak, Osman Serdal; Tutar, Burcin; Arslan, Caner; Dikici, Atilla Suleyman; Sut, Necdet; Kantarci, Fatih; Tuzun, Hasan; Melikoglu, Melike; Yazici, Hasan

    2015-01-01

    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

  4. 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.;

    2008-01-01

    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...... and new lacunes were counted per region. WMH and lacunes at baseline and vascular risk factors were evaluated as predictors of WMH progression and new lacunes. RESULTS: WMH progressed (mean+/-SD=1.9+/-1.8) mostly in the subcortical white matter, where WMH was also most prevalent at baseline. The majority......, 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...

  5. Consensus Recommendations for Systematic Evaluation of Drug-Drug Interaction Evidence for Clinical Decision Support

    Science.gov (United States)

    Scheife, Richard T.; Hines, Lisa E.; Boyce, Richard D.; Chung, Sophie P.; Momper, Jeremiah; Sommer, Christine D.; Abernethy, Darrell R.; Horn, John; Sklar, Stephen J.; Wong, Samantha K.; Jones, Gretchen; Brown, Mary; Grizzle, Amy J.; Comes, Susan; Wilkins, Tricia Lee; Borst, Clarissa; Wittie, Michael A.; Rich, Alissa; Malone, Daniel C.

    2015-01-01

    Background Healthcare organizations, compendia, and drug knowledgebase vendors use varying methods to evaluate and synthesize evidence on drug-drug interactions (DDIs). This situation has a negative effect on electronic prescribing and medication information systems that warn clinicians of potentially harmful medication combinations. Objective To provide recommendations for systematic evaluation of evidence from the scientific literature, drug product labeling, and regulatory documents with respect to DDIs for clinical decision support. Methods A conference series was conducted to develop a structured process to improve the quality of DDI alerting systems. Three expert workgroups were assembled to address the goals of the conference. The Evidence Workgroup consisted of 15 individuals with expertise in pharmacology, drug information, biomedical informatics, and clinical decision support. Workgroup members met via webinar from January 2013 to February 2014. Two in-person meetings were conducted in May and September 2013 to reach consensus on recommendations. Results We developed expert-consensus answers to three key questions: 1) What is the best approach to evaluate DDI evidence?; 2) What evidence is required for a DDI to be applicable to an entire class of drugs?; and 3) How should a structured evaluation process be vetted and validated? Conclusion Evidence-based decision support for DDIs requires consistent application of transparent and systematic methods to evaluate the evidence. Drug information systems that implement these recommendations should be able to provide higher quality information about DDIs in drug compendia and clinical decision support tools. PMID:25556085

  6. Formative clinical evaluation of first-year students in fundamental nursing science

    Directory of Open Access Journals (Sweden)

    I. Wannenburg

    1989-09-01

    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.

  7. The Impact of Nutrition on Child Development at 3 Years in a Rural Community of India

    OpenAIRE

    Syed Sadat Ali; Dhaded; Shivprasad Goudar

    2014-01-01

    Background: In India, child malnutrition is mostly the result of high levels of exposure to infection and inappropriate infant and young child feeding and caring practices and has its origins almost entirely during the first 2 to 3 years of life. This study aims in assessing the impact of breast feeding on child development of children at 3 years. Methods: About 530 children at 3 years were assessed for developmental delay by Ages and Stages Questionnaire (ASQ). Growth measurements and he...

  8. Developing a Framework for Evaluating Ethical Outcomes of Good Participatory Practices in TB Clinical Drug Trials.

    Science.gov (United States)

    MacQueen, Kathleen M; Eley, Natalie T; Frick, Mike; Mingote, Laia Ruiz; Chou, Alicia; Seidel, Stephanie S; Hannah, Stacey; Hamilton, Carol

    2016-07-01

    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. PMID:27368311

  9. Developing a Framework for Evaluating Ethical Outcomes of Good Participatory Practices in TB Clinical Drug Trials.

    Science.gov (United States)

    MacQueen, Kathleen M; Eley, Natalie T; Frick, Mike; Mingote, Laia Ruiz; Chou, Alicia; Seidel, Stephanie S; Hannah, Stacey; Hamilton, Carol

    2016-07-01

    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.

  10. Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Juul-Kristensen, Birgit; Lund, Hans;

    2014-01-01

    The aims were to compile a schematic overview of clinical scapular assessment methods and critically appraise the methodological quality of the involved studies. A systematic, computerassisted literature search using Medline, CINAHL, SportDiscus and EMBASE was performed from inception to October...... excluded for evaluation due to no/few clinimetric results, leaving 35 studies for evaluation. Graded according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN checklist), the methodological quality in the reliability and validity domains was ‘‘fair’’ (57%) to......) reliability; (2) validity; and (3) responsiveness. Observational evaluation systems and assessment of scapular upward rotation seem suitably evidence-based for clinical use. Future studies should test and improve the clinimetric properties, and especially diagnostic accuracy and responsiveness, to increase...

  11. Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Juul-Kristensen, Birgit; Lund, Hans;

    2014-01-01

    Abstract The aims were to compile a schematic overview of clinical scapular assessment methods and critically appraise the methodological quality of the involved studies. A systematic, computer-assisted literature search using Medline, CINAHL, SportDiscus and EMBASE was performed from inception to...... excluded for evaluation due to no/few clinimetric results, leaving 35 studies for evaluation. Graded according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN checklist), the methodological quality in the reliability and validity domains was "fair" (57%) to......; (2) validity; and (3) responsiveness. Observational evaluation systems and assessment of scapular upward rotation seem suitably evidence-based for clinical use. Future studies should test and improve the clinimetric properties, and especially diagnostic accuracy and responsiveness, to increase...

  12. Effects of 6 Months ALL Treatment on Psychosocial Development and Emotional Status in Children Aged 1 to 3 Years

    OpenAIRE

    Arzu Kantarcıoğlu; Melike Evim Sezgin; Birol Baytan; Adalet Meral Güneş

    2012-01-01

    In­tro­duc­ti­on: The aim of the current study was to evaluate possible effects of cancer treatment on psychosocial development and emotional state among children who was diagnosed as acute lymphoblastic leukemia (ALL) before hospitalization and six months after treatment process.Materials and Methods: Twelve patients aged 1 to 3 years were screened before and six months after treatment. AGTE (Ankara Developmental Screening Inventory) and BITSEA (Brief Infant Toddler Social Emotional Assessme...

  13. Psychometric properties of the Spanish version of the Clinical Outcomes in Routine Evaluation – Outcome Measure

    Science.gov (United States)

    Trujillo, Adriana; Feixas, Guillem; Bados, Arturo; García-Grau, Eugeni; Salla, Marta; Medina, Joan Carles; Montesano, Adrián; Soriano, José; Medeiros-Ferreira, Leticia; Cañete, Josep; Corbella, Sergi; Grau, Antoni; Lana, Fernando; Evans, Chris

    2016-01-01

    Objective The objective of this paper is to assess the reliability and validity of the Spanish translation of the Clinical Outcomes in Routine Evaluation – Outcome Measure, a 34-item self-report questionnaire that measures the client’s status in the domains of Subjective well-being, Problems/Symptoms, Life functioning, and Risk. Method Six hundred and forty-four adult participants were included in two samples: the clinical sample (n=192) from different mental health and primary care centers; and the nonclinical sample (n=452), which included a student and a community sample. Results The questionnaire showed good acceptability and internal consistency, appropriate test–retest reliability, and acceptable convergent validity. Strong differentiation between clinical and nonclinical samples was found. As expected, the Risk domain had different characteristics than other domains, but all findings were comparable with the UK referential data. Cutoff scores were calculated for clinical significant change assessment. Conclusion The Spanish version of the Clinical Outcomes in Routine Evaluation – Outcome Measure showed acceptable psychometric properties, providing support for using the questionnaire for monitoring the progress of Spanish-speaking psychotherapy clients.

  14. Improving information availability in vascular surgical clinics. A service evaluation and improvement project.

    Science.gov (United States)

    Hurst, Katherine; Kreckler, Simon; Handa, Ashok; Handa, Ashok

    2016-01-01

    This prospective service evaluation was designed to assess the availability of critical information required in vascular surgical clinics. All the data was collected via a repeated questionnaire, and the outcomes from each cycle were used to highlight where intervention was required to improve the surgical clinic experience. The first audit identified outpatient clinic deficiencies and allowed for problem analysis. Two Plan-Do-Check-Act (PDCA) cycles then were undertaken. Interventions following each cycle included consultant access to online duplex scans and secretarial access to referral letters. Results from the first cycle showed that approximately 20% of clinic appointments were missing information and only 30% of these issues were resolved during the clinic using a work around. Following the first intervention; the numbers of missing patient notes reduced to 4.3% (10.5%), and referral letters to 3.6% (4.6%). Although the numbers of missing duplex scan results increased to 6.5% (3.3%), the new system of online scan results allowed for all scans to be accessed during the clinic. Following results of a second PDCA cycle, vascular surgical secretaries were given access to 'choose and book', a database of GP referral letters. Post intervention, all missing referral letters (2%) could be accessed immediately within the clinic setting. Data driven interventions and repeated PDCA cycles can improve hospital systems for minimal cost. With an annual clinic turnaround of 2500 patients, these interventions can reduce clinic delays and potential harm caused by unavailable records for up to 500 patients a year. PMID:26893887

  15. 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

    2014-01-01

    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.

  16. Clinical and Radiographic Evaluation of Immediate Loaded Dental Implants With Local Application of Melatonin: A Preliminary Randomized Controlled Clinical Trial.

    Science.gov (United States)

    El-Gammal, Mona Y; Salem, Ahmed S; Anees, Mohamed M; Tawfik, Mohamed A

    2016-04-01

    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 < 0.05) was found between both groups at 1 month of 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.

  17. Evaluating, understanding and improving the quality of clinical placements for undergraduate nurses: A practice development approach.

    Science.gov (United States)

    Courtney-Pratt, Helen; Ford, Karen; Marlow, Annette

    2015-11-01

    Supervision and support is central to sustainability of clinical placement experiences of undergraduate nurses, but open to influences that impact nurses' capacity to undertake the role. Whilst supervision of learners is integral to the role of health care professionals, the primary responsibility is to deliver safe and effective care. Supervision of learners in practice is impacted by low levels of organisational support, variable individual preparedness, and lack of feedback and recognition for the role from education and industry partners. Over a period of five years the Quality Clinical Placement Evaluation research team, consisting of a partnership between health care and tertiary sectors have developed, and utilised a practice development approach to understand and support the quality of clinical placement for undergraduates and supervising ward nurses involved in Tasmanian clinical placement programs. Importantly, the approach evolved over time to be a flexible three step program supporting the translation of findings to practice, comprised of an education session related to supervision support; survey distribution to undergraduates and supervising ward nurses following clinical placement; and workshops where stakeholders come together to consider findings of the survey, their experience and the local context, with resultant actions for change. This paper reports on findings from the program after successful implementation in urban tertiary hospitals as it was implemented in non-traditional clinical placement settings, including community, aged care and rural settings. Feedback from clinicians identifies the utility of the three step program across these settings. The unique partnerships and approach to evaluating, understanding and improving quality of clinical placements has potential for transferability to other areas, with the value of findings established for all stakeholders. PMID:26256817

  18. Mini clinical evaluation exercise in undergraduate dermatovenereology education: an experience of University of Pamukkale, Medical Faculty

    Directory of Open Access Journals (Sweden)

    Şeniz Ergin

    2013-03-01

    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

  19. Effect of filming errors committed by nursing students to evaluate simulated clinical situations

    Directory of Open Access Journals (Sweden)

    Carme Sansalvador-Comas

    2014-07-01

    Full Text Available Clinic simulation as a training and knowledge method allows people experiment a real event representation with the aim of acquiring knowledge, abilities and aptitudes. The filming of the staging represents a useful tool to review the decisions taken and the actions they did, with the purpose to highlight the strengths, weaknesses and the areas for improvement. The article describes a study carried out by a group of students in second course of nursing, and it tries to evaluate if there is any influence if somebody is filming you during the clinic simulation, does it make you do more errors or not?

  20. Etiology, classification and clinical evaluation of partial-thickness tears of rotator cuff

    Institute of Scientific and Technical Information of China (English)

    TANG Kang-lai 唐康来; Peter Habermeryer; LI Qi-hong 李起鸿; Sven Lichtenberg; YANG Liu 杨柳

    2003-01-01

    @@ Since partial thickness tears of the rotator cuff were described well by Codman 1 in 1934, they have been extensively discussed in all kinds of literatures.Partial thickness tears of the rotator cuff are now considered to play a more significant role than previously in inducing patients disability. Partialthickness cuff tears deserve more clinical attention. Both accurate diagnosis and proper surgical repair are very essential. The cognition of partialthickness tears has been deepened in the last decades. In this paper we will review the etiology, classification and clinical evaluation of partial thickness tears of the rotator cuff.

  1. Evaluation of the Dade Behring Dimension RxL clinical chemistry analyzer.

    Science.gov (United States)

    Cuka, S; Dvornik, S; Drazenović, K; Mihić, J

    2001-01-01

    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.

  2. Laboratory evaluation of the Beckman Synchron CX3 clinical chemistry analyzer.

    Science.gov (United States)

    Peake, M J; Pejakovic, M; White, G H

    1988-02-01

    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.

  3. Role of the clinical pathology laboratory in the evaluation of endometrial carcinomas for Lynch syndrome.

    Science.gov (United States)

    Djordjevic, Bojana; Broaddus, Russell R

    2014-05-01

    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.

  4. Disabled children (0-3 years) and integrated services--the impact of Early Support.

    Science.gov (United States)

    Young, Alys; Temple, Bogusia; Davies, Linda; Parkinson, Gillian; Bolton, Joanna

    2008-05-01

    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.

  5. Evaluation of the NEG Coating Saturation Level after 3 Years of LHC Beam Operation

    CERN Document Server

    Bregliozzi, G; Jimenez, J M; Lanza, G; Porcelli, T

    2013-01-01

    The room temperature vacuum system of the Large Hadron Collider (LHC) at CERN has been designed to ensure vacuum stability and beam lifetime of 100 h with nominal current of 0.56 A per beam at 7 TeV of energy. The requirements for the interaction regions are moreover driven to minimize the background noise of the experiments, to keep the equivalent hydrogen gas density below 1013 molecules of H2 per m3. \

  6. Evaluation of moxifloxacin for the treatment of tuberculosis : 3 years of experience

    NARCIS (Netherlands)

    Pranger, A. D.; van Altena, R.; Aarnoutse, R. E.; van Soolingen, D.; Uges, D. R. A.; Kosterink, J. G. W.; van der Werf, T. S.; Alffenaar, J. W. C.

    2011-01-01

    Moxifloxacin (MFX) is a powerful second-line anti-tuberculosis (TB) agent, but the optimal dose has not yet been established and long-term safety data are scarce. We retrospectively reviewed the medical charts of TB patients treated at the Tuberculosis Centre Beatrixoord, University Medical Centre G

  7. [Results evaluations 3 years after our first experience with the laparoscopic treatment of Hirschsprung disease].

    Science.gov (United States)

    Polliotto, S; Heinen, F; Andina, G; Korman, R

    2001-04-01

    The laparoscopic approach has been successfully used during the recent last years in pediatric surgery. We describe the first experience in Argentina using laparoscopic surgery in November 4th in 1996, for the treatment of a Hirschsprung disease case. We used the technique of Soave's modified by Georgenson. Details of the surgical procedure are given. Hospitalization time took 5 days and immediated postoperatory cares were well done. Soave-Georgeson technique seems to be a safe and effective possibility for the Hirschsprung disease treatment, and it is completely achieveable by laparoscopy. The present experience does not show advantages in terms of a lower hospitalization time, however it really shows the benefits of laparoscopic surgery, such as post-operatory comfort and better cosmetic results, both highly superior than those obtained with classical surgery. PMID:11480199

  8. 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

    2008-01-01

    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.

  9. Clinical and Radiographic Evaluation of Pulpotomized Primary Molars Restored with Stainless Steel Crown and Amalgam

    Directory of Open Access Journals (Sweden)

    Haghgoo R.

    2011-08-01

    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.

  10. Conservative management of external root resorption after tooth reimplantation: a 3-year follow-up.

    Science.gov (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

    2016-01-01

    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. PMID:27367632

  11. 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

    2014-11-01

    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.

  12. Large ameloblastic fibro-odontoma in a 3 year- old child: case report

    Directory of Open Access Journals (Sweden)

    Laurindo Moacir Sassi

    2011-01-01

    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.

  13. Effects of structured written feedback by cards on medical students’ performance at mini clinical evaluation exercise (Mini-CEX) in an outpatient clinic

    OpenAIRE

    FARIBA HAGHANI; MOHAMMAD HATEF KHORAMI; MOHAMMAD FAKHARI

    2016-01-01

    Introduction: Feedback cards are recommended as a feasible tool for structured written feedback delivery in clinical education while effectiveness of this tool on the medical students’ performance is still questionable. The purpose of this study was to compare the effects of structured written feedback by cards as well as verbal feedback versus verbal feedback alone on the clinical performance of medical students at the Mini Clinical Evaluation Exercise (Mini-CEX) test in...

  14. Predicting caregiver-reported behavior problems in cocaine-exposed children at 3 years.

    Science.gov (United States)

    Warner, Tamara Duckworth; Behnke, Marylou; Hou, Wei; Garvan, Cynthia Wilson; Wobie, Kathleen; Eyler, Fonda Davis

    2006-04-01

    Predictors of caregiver-reported behavior problems for 3-year-olds with prenatal cocaine exposure (PCE) and matched controls were examined using structural equation modeling. We tested whether PCE had a direct effect on child behavior problems in a model that included other prenatal drug exposure, child sex, caregiver depression, and the quality of the child's home environment. The sample (N = 256) was drawn from a longitudinal, prospective study of children of (predominantly crack) cocaine-using women and controls matched on race, socioeconomic status, parity, and pregnancy risk. Child Behavior Problems was modeled as a latent variable composed of the 48-item Conners' Parent Report Scale Conduct Problem and Impulsive-Hyperactive scales and the Eyberg Child Behavior Inventory Intensity scale. Caregiver depression was the only significant predictor of Child Behavior Problems. Mean levels of caregiver self-reported depression and reported child behavior problems did not differ between groups. Mean depression scores were well above the recommended clinical cutoff while mean child behavior problems scores were within normal limits. The model explained 21% of the variance in caregiver-reported child behavior problems in our sample of rural African American, low SES youngsters. Non-maternal caregivers of cocaine-exposed children had significantly lower mean depression scores and mean child behavior problems ratings for 2 of 3 scales used in the study compared to biological mothers of children with PCE and controls. For all groups, much larger proportions of children were rated as having clinically significant behavior problems than would be expected based on the prevalence of behavior problems in the general population. PMID:16682870

  15. Perception and Production of Lexical Tones by 3-Year-Old, Mandarin-Speaking Children

    Science.gov (United States)

    Wong, Puisan; Schwartz, Richard G.; Jenkins, James J.

    2005-01-01

    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…

  16. 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

    2007-01-01

    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

  17. Allocation of Resources to Collaborators and Free-Riders in 3-Year-Olds

    Science.gov (United States)

    Melis, Alicia P.; Altrichter, Kristin; Tomasello, Michael

    2013-01-01

    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…

  18. Agreement between Therapists, Parents, Patients, and Independent Evaluators on Clinical Improvement in Pediatric Obsessive-Compulsive Disorder

    Science.gov (United States)

    Lewin, Adam B.; Peris, Tara S.; De Nadai, Alessandro S.; McCracken, James T.; Piacentini, John

    2012-01-01

    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…

  19. PRE-MARKET CLINICAL EVALUATIONS OF INNOVATIVE HIGH-RISK MEDICAL DEVICES IN EUROPE

    DEFF Research Database (Denmark)

    Hulstaert, F.; Neyt, M.; Vinck, I.;

    2012-01-01

    data are available? We studied the premarket clinical evaluation of innovative high-risk medical devices in Europe compared with the US, and with medicines, where appropriate. Methods: The literature and regulatory documents were checked. Representatives from industry, Competent Authorities, Notified...... Bodies, Ethics Committees, and HTA agencies were consulted. We also discuss patient safety and the transparency of information. Results: In contrast to the US, there is no requirement in Europe to demonstrate the clinical efficacy of high-risk devices in the premarket phase. Patients in Europe can thus...... have earlier access to a potentially lifesaving device, but at the risk of insufficiently documented efficacy and safety. Variations in the stringency of clinical reviews, both at the level of Notified Bodies and Competent Authorities, do not guarantee patient safety. We tried to document the design...

  20. Evaluation of the William S. Hall Psychiatric Institute Clinical Psychology Internship: a replication and extension.

    Science.gov (United States)

    Stader, Sandra R; Myers, DeRosset; Forand, Angela Q; Holmes, George R; McNulty, George F; Frey, Linda; Bolton, Staci S

    2010-12-01

    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.

  1. Implementation and evaluation of a clinical data management programme in a primary care centre.

    LENUS (Irish Health Repository)

    Sweeney, J

    2014-11-01

    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.

  2. Health impact assessment and evaluation of a clinical waste management policy for Cameroon

    Directory of Open Access Journals (Sweden)

    Gabriel Gulis

    2013-09-01

    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.

  3. AUDIOLOGICAL EVALUATION IN AUTO - IMMUNE SKIN DISEASES : A CLINICAL STUDY OF 124 PATIENTS

    Directory of Open Access Journals (Sweden)

    Sesha Prasad

    2015-04-01

    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

  4. Rotational laxity after anterior cruciate ligament injury by kinematic evaluation of clinical tests.

    Science.gov (United States)

    Zaffagnini, S; Martelli, S; Falcioni, B; Motta, M; Marcacci, M

    2000-01-01

    Despite the numerous studies on anterior cruciate ligament biomechanics and clinical tests, some disagreements still exist in the literature on the role of ACL in restraining rotations and which kinematic test after ACL injuries is the most suitable to evaluate this instability. This work analyses the capability of passive clinical and stress tests to detect an ACL state quantifying rotational instability. The study was conducted on animal knees with a new protocol. We found that an internal-external stress test can give a useful indication on the ACL state when used to estimate the side to side differences while varus-valgus laxity and secondary motions in standard kinematic tests did not seem to be affected by ACL injury. The kinematic protocol performed could be used intra-operatively to quantify rotations, allowing a more accurate evaluation of knee instability to guide surgical reconstruction and improve its final outcome. PMID:11204247

  5. Dissemination of behavioural activation for depression to mental health nurses: training evaluation and benchmarked clinical outcomes.

    Science.gov (United States)

    Ekers, D M; Dawson, M S; Bailey, E

    2013-03-01

    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.

  6. Evaluating Creative Thinking of Rn-Bsn Students in the Course of Clinical Case Study and Practicum

    Science.gov (United States)

    Ku, Ya-Lie

    2015-01-01

    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…

  7. Evaluation of clinical parameters and lesions in pig organs during post-weaning period

    OpenAIRE

    Mejía Medina, Julián; Rincón Ruiz, Juan; Gutiérrez Vergara, Cristian; Correa Londoño, Guillermo; López Herrera, Albeiro; Parra Suescún, Jaime

    2012-01-01

    To evaluate the effect of early weaning on clinical parameters, development and occurrence of lesions in organs of systemic importance, and weight gain in pigs evaluations were carried out. The experiment was conducted in the San Pablo Production Research Center of the Universidad Nacional de Colombia (Medellín). We used 16 weaned pigs at 21 days of age. The animals were fed for 10 days with a basal diet (milk). Four pigs were slaughtered on days 1, 5, 7 and 10 post-weaning and samples of int...

  8. Clinical and roentgenographic evaluation of hydroxyapatite-augmented and nonaugmented porous total hip arthroplasty.

    Science.gov (United States)

    Ciccotti, M G; Rothman, R H; Hozack, W J; Moriarty, L

    1994-12-01

    Sixty osteoarthritic patients undergoing primary, uncemented total hip arthroplasty were matched for age and weight and randomized into one of four groups with respect to implant coating and postoperative, protected weight-bearing status: group 1, hydroxyapatite-augmented, 12 weeks; group 2, nonaugmented, 12 weeks; group 3, hydroxyapatite-augmented, 6 weeks; and group 4, nonaugmented, 6 weeks. Tantalum spheres were implanted periprosthetically into the femur at the time of the arthroplasty, thus providing constant references for stereoscopic radiographs. Patients were then evaluated over a 2-year period with clinical examination, plain radiography, and roentgen stereophotogrammetric analysis. Clinical evaluation using the Charnley scoring system showed no significant preoperative or postoperative intergroup differences, whereas visual analog testing noted less thigh pain with hydroxyapatite-augmented stems at the 12-week and 6-month follow-up evaluations. Plain radiographic analysis produced no significant differences, with no instability detected, and bony ingrowth was uniform in all groups. Stereographic evaluation showed migration in all groups, but there were no significant differences between the augmented and nonaugmented stems or the 6-week and 12-week partial weight-bearing protocols. Charnley, plain radiographic, and stereogrammetric evaluations all suggest that migration is unaltered by enhanced surfaces and early, unprotected weight bearing does not jeopardize implant fixation regardless of coating design. The lower incidence of visual analog thigh pain with the hydroxyapatite-augmented stems, however, may be a reflection of bony ingrowth and, as such, add some validity to the theoretic advantages of enhanced surface prostheses. PMID:7699376

  9. Continuing education program evaluation for course improvement, participant effect and utilization in clinical practice.

    Science.gov (United States)

    Faulk, L G

    1984-04-01

    An evaluation of a single continuing education (CE) program was conducted by the presenter to assess impact of the offering and gather information for course improvement. The purpose of this evaluation was to document if and to what extent the learners attained the program's objectives and also to systematically examine the program to see how it might be improved. The third purpose was to document if participants' interest was stimulated by the program and if they actually used the information in clinical practice or at least found it helpful. Fifty-five nurses participated in completing a pretest and posttest, reactionnaire at the conclusion of the program and follow-up questionnaire. Participants made significantly (p less than .05) better scores on the posttests as compared to the pretest. On the evaluation form, 98% of the nurses responded that they had learned new facts, and 75% indicated that information was moderately new. In addition, a slight majority (58%) responded that they changed their beliefs about assertiveness. Of returned follow-up questionnaires, 95% told others about the program, and 59% read articles. All nurses indicated they had found the information useful, and 87% had actually used the information in clinical practice. This study documents a method for CE administrators and educators to evaluate the impact of CE and provide information for course improvement. The evaluation supports the program's worth. Participants benefited in terms of knowledge and interest. In addition, program strengths/weaknesses were identified. PMID:6325622

  10. Economic evaluation alongside pragmatic randomised trials: developing a standard operating procedure for clinical trials units

    Directory of Open Access Journals (Sweden)

    Russell Ian T

    2008-11-01

    Full Text Available Abstract Background There is wide recognition that pragmatic randomised trials are the best vehicle for economic evaluation. This is because trials provide the best chance of ensuring internal validity, not least through the rigorous prospective collection of patient-specific data. Furthermore the marginal cost of collecting economic data alongside clinical data is typically modest. UK Clinical Research Collaboration (UKCRC does not require a standard operating procedure (SOP for economic evaluation as a prerequisite for trial unit registration. We judge that such a SOP facilitates the integration of health economics into trials. Methods A collaboration between health economists and trialists at Bangor University led to the development of a SOP for economic evaluation alongside pragmatic trials, in addition to the twenty SOPs required by UKCRC for registration, which include randomisation, data management and statistical analysis. Results Our recent telephone survey suggests that no other UKCRC-registered trials unit currently has an economic SOP. Conclusion We argue that UKCRC should require, from all Trials Units undertaking economic evaluation and seeking registration or re-registration, a SOP for economic evaluation as one of their portfolio of supporting SOPs.

  11. Clinical and radiographic evaluation of maxillary central incisors exposure in patients undergoing maxillary advancement

    Directory of Open Access Journals (Sweden)

    Guilherme dos Santos Trento

    2015-12-01

    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.

  12. Evaluation of children's dental anxiety levels at a kindergarten and at a dental clinic.

    Science.gov (United States)

    Kilinç, Gulser; Akay, Aynur; Eden, Ece; Sevinç, Nilgün; Ellidokuz, Hülya

    2016-01-01

    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 dentist at the 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. PMID:27556551

  13. Integrating research and clinical neuroimaging for the evaluation of traumatic brain injury recovery

    Science.gov (United States)

    Senseney, Justin; Ollinger, John; Graner, John; Lui, Wei; Oakes, Terry; Riedy, Gerard

    2015-03-01

    Advanced MRI research and other imaging modalities may serve as biomarkers for the evaluation of traumatic brain injury (TBI) recovery. However, these advanced modalities typically require off-line processing which creates images that are incompatible with radiologist viewing software sold commercially. AGFA Impax is an example of such a picture archiving and communication system(PACS) that is used by many radiology departments in the United States Military Health System. By taking advantage of Impax's use of the Digital Imaging and Communications in Medicine (DICOM) standard, we developed a system that allows for advanced medical imaging to be incorporated into clinical PACS. Radiology research can now be conducted using existing clinical imaging display platforms resources in combination with image processingtechniques that are only available outside of the clinical scanning environment. We extracted the spatial and identification elements of theDICOM standard that are necessary to allow research images to be incorporatedinto a clinical radiology system, and developed a tool that annotates research images with the proper tags. This allows for the evaluation of imaging representations of biological markers that may be useful in theevaluation of TBI and TBI recovery.

  14. Evaluation of nisin-β-lactam antibiotics against clinical strains of Salmonella enterica serovar Typhi.

    Science.gov (United States)

    Rishi, Praveen; Preet Singh, Aman; Garg, Neha; Rishi, Madhuri

    2014-12-01

    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.

  15. An interdisciplinary methodology for the comparative evaluation of splinting materials (orthotics, thermoplastics, clinical research).

    Science.gov (United States)

    Shimeld, A; Campbell, G; Ernest, M

    1982-06-01

    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.

  16. The clinical effectiveness of various adhesive systems: an 18-month evaluation.

    Science.gov (United States)

    Moosavi, H; Kimyai, S; Forghani, M; Khodadadi, R

    2013-01-01

    The aim of this clinical trial was to compare the clinical performance of three different adhesive systems over 18 months in noncarious cervical lesions (NCCLs). Thirty patients, with at least three noncarious cervical lesions, were enrolled in the study. One operator randomly restored a total of 90 lesions with resin composite (Herculite XRV). The restorations were bonded with either Optibond FL (OF), three-step total-etch; Optibond Solo Plus (OS), two-step total-etch; or Optibond All-In-One (OA), one step self-etch. The restorations were clinically evaluated at baseline and after six, 12, and 18 months using the eight United States Public Health Services criteria. Data were analyzed using Friedman and Wilcoxon signed ranks tests (padhesive systems for evaluated criteria were not observed in comparison of the mean Alfa score percentages. There was a significant increase in marginal discoloration for (OA) adhesive after 18 months compared with baseline (p=0.011). Other restoration criteria had no statistically significant differences among the three adhesives (p>0.05). With the exception of marginal discoloration, the clinical effectiveness of three types of adhesive systems in NCCLs was acceptable after 18 months. However, using the one-step self-etch adhesive may lead to some marginal discolorations. PMID:22917442

  17. Evaluation and management of diabetic patients in a primary healthcare clinic / Jana Luttig

    OpenAIRE

    Luttig, Jana

    2007-01-01

    In many African countries, including South Africa, much attention has been centred on the management of HIV/AIDS and tuberculosis epidemics. However, there is growing awareness in South Africa that life-style related non-communicable conditions, such as diabetes and obesity, represent an important health priority (Pirie, 2005:42). The general objective of this study was to evaluate the treatment of diabetic patients in clinics on primary healthcare level and to determine what contribution...

  18. Clinical Evaluation and Cost-Effectiveness Analysis of Serum Tumor Markers in Lung Cancer

    OpenAIRE

    Rong Wang; Guoqing Wang; Nan Zhang; Xue Li; Yunde Liu

    2013-01-01

    The detection of serum tumor markers is valuable for the early diagnosis of lung cancer. Tumor markers are frequently used for the management of cancer patients. However, single markers are less efficient but marker combinations increase the cost, which is troublesome for clinics. To find an optimal serum marker combination panel that benefits the patients and the medical management system as well, four routine lung cancer serum markers (SCCA, NSE, CEA, and CYFRA21-1) were evaluated individua...

  19. Clinical evaluation of the modified tension band wiring technique for the fractured patella

    OpenAIRE

    Gudapati, Dr Dinesh; V.R, Dr Chandrakanth; Reddy.P, Dr Praveen Kumar; T. M.; K.N, Dr Arun; Mugadlimath, Anand Basayya

    2014-01-01

    The patella is of importance for the extension of the knee joint. It increases the force of the quadriceps apparatus by improving the leverage. In addition, it protects the anterior articular surface of the distal femur against external violence, but may easily be injured due to its unprotected position.Several methods of internal fixation of fractured patella have been advocated. This dissertation is directed towards the clinical evaluation of the modified tension band wiring technique for t...

  20. Clinical evaluation of cardiac effects of experimental doxycycline overdosing in healthy calves

    OpenAIRE

    Amory Hélène; Detilleux Johann; Desmecht Daniel; Rollin Frédéric; Brihoum Mounir

    2011-01-01

    Abstract Background Cardiac morphologic and functional changes consistent with cardiomyopathy have been reported in field cases of calves with accidental doxycycline overdosing. The purpose of this study was to evaluate clinically the cardiac effects of an experimentally-induced doxycycline overdosing in healthy calves. Twelve 2 months-old healthy Belgian Blue calves were studied. Six of them (group 1) received the normal dose (5 mg/kg, BID) and the six others (group 2) received five times th...

  1. EVALUATION OF VITEK 2 SYSTEM FOR CLINICAL IDENTIFICATION OF CANDIDA SPECIES AND THEIR ANTIFUNGAL SUSCEPTIBILITY TEST

    OpenAIRE

    Mohan,, V.; Ram Murugan

    2016-01-01

    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....

  2. Controlled clinical evaluations of chlorine dioxide, chlorite and chlorate in man.

    OpenAIRE

    Lubbers, J R; Chauan, S; Bianchine, J. R.

    1982-01-01

    To assess the relative safety of chronically administered chlorine water disinfectants in man, a controlled study was undertaken. The clinical evaluation was conducted in the three phases common to investigational drug studies. Phase I, a rising dose tolerance investigation, examined the acute effects of progressively increasing single doses of chlorine disinfectants to normal healthy adult male volunteers. Phase II considered the impact on normal subjects of daily ingestion of the disinfecta...

  3. Clinical pathological evaluation and risk factors of oral cancer cases of east coast of peninsular Malaysia

    OpenAIRE

    Farini, M. S.; Azlina, A; Rushdan, I.; Manoharan, M; Zain, R. B.; Samsudin, A. R.

    2005-01-01

    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 ...

  4. Comparative evaluation of probing depth and clinical attachment level using a manual probe and Florida probe

    OpenAIRE

    Amandeep Kour; Ashish Kumar; Komal Puri; Manish Khatri; Mansi Bansal; Geeti Gupta

    2016-01-01

    Background: To compare and evaluate the intra- and inter-examiner efficacy and reproducibility of the first-generation manual (Williams) probe and the third-generation Florida probe in terms of measuring pocket probing depth (PD) and clinical attachment level (CAL). Materials and Methods: Forty subjects/4000 sites were included in this comparative, cross-sectional study. Group- and site-wise categorizations were done. Based on gingival index, PD, and CAL, patients were divided into four group...

  5. Clinical evaluation of the Nucleus® 6 cochlear implant system: Performance improvements with SmartSound iQ

    OpenAIRE

    Mauger, Stefan J.; Warren, Chris D; Knight, Michelle R; Goorevich, Michael; Nel, Esti

    2014-01-01

    Objective: This paper provides a detailed description of the Nucleus 6 system, and clinically evaluates user performance compared to the previous Nucleus 5 system in cochlear implant recipients. Additionally, it clinically evaluates a range of Nucleus 6 and Nucleus 5 programs to determine the performance benefits provided by new input processing technologies available in SmartSound iQ. Design Speech understanding tests were used to clinically validate the default Nucleus 6 program, by compari...

  6. Summary of Medipix Technology's 3-Years in Space and Plans for Future Developments

    Science.gov (United States)

    Pinsky, Lawrence

    2016-07-01

    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.

  7. The role of 3DCT for the evaluation of chop injuries in clinical forensic medicine.

    Science.gov (United States)

    Wittschieber, Daniel; Beck, Laura; Vieth, Volker; Hahnemann, Maria L

    2016-09-01

    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.

  8. Criteria for evaluating response and outcome in clinical trials for children with juvenile myelomonocytic leukemia.

    LENUS (Irish Health Repository)

    Niemeyer, Charlotte M

    2015-01-01

    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

    Directory of Open Access Journals (Sweden)

    M. Teoli

    2012-01-01

    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

    Science.gov (United States)

    Weng, Chao; Dong, Hongjuan; Chu, Hong; Lu, Zuneng

    2016-01-01

    [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. Ideas and Methods of Research on Measurement and Evaluation of Clinical Effects of Traditional Chinese Medicine in Treating Tumor

    Institute of Scientific and Technical Information of China (English)

    程剑华

    2002-01-01

    @@ Traditional Chinese medicine (TCM) has a glorious history of over 3000 years. The daily increasing demand of Chinese herbal medicine in the world has urged the international society to pay more attention to TCM, which also means a new opportunity for and challenge to the study and development of TCM. Clinical therapeutic effect is the lifeline of TCM, but the present measurement for clinical effect evaluation fails to reflect the essential effect of TCM. Therefore, how to measure and evaluate objectively the clinical effect of TCM becomes a problem we have to study studiously. World Health Organization (WHO)is very much concerned about the clinical effect evaluation of traditional medicines, and has formulated the "Guidance of Researches on Safety and Validity Evaluation of Phyto-Drugs"(1). In this paper,the authors would mainly discuss the ideas and methods in studying measurement and evaluation of clinical effect of TCM (MECE-TCM) in treating malignant tumor.

  12. A clinical evaluation of comprehensive dental treatment for children under general anesthesia.

    Science.gov (United States)

    Su, H L; Chen, P S

    1992-12-01

    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. PMID:1295652

  13. A clinical evaluation of comprehensive dental treatment for children under general anesthesia.

    Science.gov (United States)

    Su, H L; Chen, P S

    1992-12-01

    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.

  14. Evaluation of clinical, laboratory, and electrophoretic profiles for diagnosis of malnutrition in hospitalized dogs

    Directory of Open Access Journals (Sweden)

    Andrei Kelliton Fabretti

    2015-02-01

    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.

  15. Re-Evaluation of Clinical Dementia Diagnoses with Pittsburgh Compound B Positron Emission Tomography

    Directory of Open Access Journals (Sweden)

    M. Degerman Gunnarsson

    2013-12-01

    Full Text Available Objectives: There is an overlap regarding Pittsburgh compound B (PIB retention in patients clinically diagnosed as Alzheimer's disease (AD and non-AD dementia. The aim of the present study was to investigate whether there are any differences between PIB-positive and PIB-negative patients in a mixed cohort of patients with neurodegenerative dementia of mild severity regarding neuropsychological test performance and regional cerebral glucose metabolism measured with [18F]fluoro-2-deoxy-D-glucose (FDG positron emission tomography (PET. Methods: Eighteen patients clinically diagnosed as probable AD or frontotemporal dementia were examined with PIB PET, FDG PET and neuropsychological tests and followed for 5-9 years in a clinical setting. Results: The PIB-positive patients (7 out of 18 had slower psychomotor speed and more impaired visual episodic memory than the PIB-negative patients; otherwise performance did not differ between the groups. The initial clinical diagnoses were changed in one third of the patients (6 out of 18 during follow-up. Conclusions: The subtle differences in neuropsychological performance, the overlap of hypometabolic patterns and clinical features between AD and non-AD dementia highlight the need for amyloid biomarkers and a readiness to re-evaluate the initial diagnosis.

  16. Clinical and Radiographic Evaluation of a Resin-Based Root Canal Sealer: 10-Year Recall Data

    Directory of Open Access Journals (Sweden)

    Osvaldo Zmener

    2012-01-01

    Full Text Available Objectives. This retrospective clinical and radiographical study evaluated the 10-year outcome of one-visit endodontic treatment with gutta-percha and a methacrylate resin-based sealer. Methods. From an initial sample size of 180 patients, 89 patients with 175 root canals responded to a recall. Treatment outcome was based on predetermined clinical and radiographic criteria. Results. Root canals had been adequately filled to the working length in 80 teeth (89.88%, short in 6 instances (6.74%, while 3 (3.37% with extrusion immediate postoperatively, showed no sealer in periradicular tissues. The difference in the outcomes of treatments with respect to age, gender, preoperative pulp or periapical status, the size of periapical lesions and the type of permanent restorations were not statistically significantly different (>0.05. Overall, 7 (7.86% cases were considered clinically and radiographically a failure. A life table analysis showed a cumulative probability of success of 92.13% after 10 years with a 95% confidence interval of 83.0 to 94.0. Conclusions. The results of this retrospective clinical and radiographical study suggest that the tested methacrylate-resin based sealer used with gutta-percha performed similarly to other root canal sealers over a period 10 years. Clinical Implications. Considering the success rate after 10 years of this methacrylate resin-based sealer can be recommended as an alternative to other commonly used root canal sealers.

  17. Evaluation of clinical teaching and professional development in a problem and community-based nursing module

    Directory of Open Access Journals (Sweden)

    J.C de Villiers

    2004-09-01

    Full Text Available In South Africa the main focus is on primary health care. This affects the education and training of nurses, and training schools must respond by developing appropriate teaching modules. A school of nursing developed, implemented and revised a problem- and community- based learning module over a period of three years (1996-1998. This student-centered module focuses on students’ needs, active participation, collaboration, accountability, self-assessment, self-study, life-long learning and appropriate skills. In the formal clinical teaching environment PBL was the main approach. However, this approach was also supported by a variety of strategies, for example group discussions and scenarios. The knowledge, attitudes and professional development skills acquired in the PBL approach were then applied informally in the community setting (CBE. The purpose of the study was to evaluate a first year clinical teaching module as part of an extensive programme. A quantitative research method, a descriptive design, and a variety of data collection techniques were used. Conclusions were that clinical teaching was effective within the problem- (PBL and community-based (CBE approaches; 78% of respondents were positive about the clinical learning environment; 61 % stated that expectations were met; 81% preferred group activities, and 67% indicated that they had developed professional skills. Facilitators agreed that clinical teaching met the requirements of PBL & CBE. The pass rate also improved.

  18. Effects of treatment with bimatoprost 0.03% for 3 years in patients with normal-tension glaucoma

    Directory of Open Access Journals (Sweden)

    Inoue K

    2014-06-01

    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

  19. Multiple trait genetic evaluation of clinical mastitis in three dairy cattle breeds.

    Science.gov (United States)

    Govignon-Gion, A; Dassonneville, R; Baloche, G; Ducrocq, V

    2016-04-01

    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

  20. Multiple trait genetic evaluation of clinical mastitis in three dairy cattle breeds.

    Science.gov (United States)

    Govignon-Gion, A; Dassonneville, R; Baloche, G; Ducrocq, V

    2016-04-01

    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

  1. 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;

    2004-01-01

    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...

  2. Amorphous and crystalline polyetheretherketone: Mechanical properties and tissue reactions during a 3-year follow-up.

    Science.gov (United States)

    Nieminen, Tuomo; Kallela, Ilkka; Wuolijoki, Erkki; Kainulainen, Heikki; Hiidenheimo, Ilmari; Rantala, Immo

    2008-02-01

    The study was aimed to test the mechanical strength, structural stability, and tissue reactions of optically amorphous and crystalline polyetheretherketone (PEEK) plates during a 3-year follow-up in vivo and in vitro. The injection-moulded PEEK plates were implanted to the dorsal subcutis of 12 sheep, which were sacrificed at 6-156 weeks. Thereafter, the plates were subjected to tensile tests, and levels of crystallinity were assessed by differential scanning calorimetry (DSC). Histological evaluation was carried out using the paraffin technique. In vitro properties were examined with the tensile test and DSC at 0-156 weeks. Tissue reactions were mild and fairly similar for the amorphous and crystalline plates at corresponding points in time. The mechanical characteristics of the plates remained stable over the entire follow-up. The tensile yield load and elongation at the yield load of the crystalline plates were roughly double ( approximately 500 vs. 270 N and 2.4 vs. 1.4 mm, respectively) in comparison to the amorphous plates. The elongation at break load of the crystalline plates was smaller than that of the amorphous ones (6 vs. 10). The level of crystallinity in both the optically amorphous ( approximately 15%) and crystalline (32-34%) plates remained invariable during the follow-up. The in vitro and in vivo data coincided remarkably well. In conclusion, both optically amorphous and crystalline PEEK plates are suitable for the fixation of fractures and osteotomies. PMID:17618477

  3. An evaluation of remote communication versus face-to-face in clinical dental education.

    Science.gov (United States)

    Martin, N; Lazalde, O Martínez; Stokes, C; Romano, D

    2012-03-01

    Distance learning and internet-based delivery of educational content are becoming very popular as an alternative to real face-to-face delivery. Clinical-based discussions still remain greatly face-to-face despite the advancement of remote communication and internet sharing technology. In this study we have compared three communication modalities between a learner and educator: audio and video using voice over internet protocol (VoIP) alone [AV]; audio and video VoIP with the addition of a three dimensional virtual artefact [AV3D] and physical face-to-face [FTF]. Clinical case discussions based on fictitious patients were held between a 'learner' and an 'expert' using the three communication modalities. The learner presented a clinical scenario to the experts, with the aid of a prop (partially dentate cast, digitised for AV3D), to obtain advice on the management of the clinical case. Each communication modality was tested in timed exercises in a random order among one of three experts (senior clinical restorative staff) and a learner (from a cohort of 15 senior clinical undergraduate students) all from the School of Clinical Dentistry, University of Sheffield. All learners and experts used each communication modality in turn with no prior training. Video recording and structured analysis were used to ascertain learner behaviour and levels of interactivity. Evaluation questionnaires were completed by experts and learners immediately after the experiment to ascertain effectiveness of information exchange and barriers/facilitators to communication. The video recordings showed that students were more relaxed with AV and AV3D than FTF (p = 0.01). The evaluation questionnaires showed that students felt they could provide (p = 0.03) and obtain (p = 0.003) more information using the FTF modality, followed by AV and then AV3D. Experts also ranked FTF better than AV and AV3D for providing (p = 0.012) and obtaining (p = 0) information to/from the expert. Physical face

  4. [Sample size calculation in clinical post-marketing evaluation of traditional Chinese medicine].

    Science.gov (United States)

    Fu, Yingkun; Xie, Yanming

    2011-10-01

    In recent years, as the Chinese government and people pay more attention on the post-marketing research of Chinese Medicine, part of traditional Chinese medicine breed has or is about to begin after the listing of post-marketing evaluation study. In the post-marketing evaluation design, sample size calculation plays a decisive role. It not only ensures the accuracy and reliability of post-marketing evaluation. but also assures that the intended trials will have a desired power for correctly detecting a clinically meaningful difference of different medicine under study if such a difference truly exists. Up to now, there is no systemic method of sample size calculation in view of the traditional Chinese medicine. In this paper, according to the basic method of sample size calculation and the characteristic of the traditional Chinese medicine clinical evaluation, the sample size calculation methods of the Chinese medicine efficacy and safety are discussed respectively. We hope the paper would be beneficial to medical researchers, and pharmaceutical scientists who are engaged in the areas of Chinese medicine research. PMID:22292397

  5. Clinical evaluation of CT discography in the diagnosis of lumbar disc herniation

    International Nuclear Information System (INIS)

    The CT discographic findings of 56 discs in 43 patients with low-back and/or leg pain were evaluated mainly from the clinical standpoint including pain provocation during the injection of the contrast material, correlation between the type of the herniation and symptoms and clinical course after the examination. The clinical value of CT discography is controversial, but it is well recognized that CT discography is the diagnostic method of choice for equivocal situations as patients showing negative myelography and significant symptoms and for the preoperative evaluation of patient thought to have the extreme lateral disc herniation. Exact provoked pain response was noted in 72 % of 43 pathologic discs and almost all discs especially in patients showing positive SLR test at less than 70 deg. So this pain response seems to provide additional information indicating the true pathologic disc level. Sciatic pain in the legs was much more frequently seen in the paramedian or lateral type herniation, but there was no relation between low-back pain and central type herniation. Majority of either type of disc herniation showed both low-back and leg pains. This suggests that clinical symptoms are based on not only disc herniation but also disc degeneration itself. We injected steroid (4 mg of Decadron) and local anesthetic (1 ml of 1 % Carbocain) into the disc after the examination for the purpose of improving the clinical symptoms as the first attempt. Definite improvement of various degree was noted in 56 % of total 43 cases after the procedure and CT discography was thought to be a valuable method of diagnosis in proper indications despite risky needle puncture. (author)

  6. Clinical evaluation of endodotic therapy on periodontal tissue healing in chronic advanced periodontitis

    Directory of Open Access Journals (Sweden)

    Sadeghi R.

    2004-08-01

    Full Text Available Statement of Problem: There is a controversy about the relationship between pulpal and periodontal diseases. The interrelationship between pulp and periodontium could have an important effect on the treatment plan of the tooth. Purpose: The aim of the present research is to evaluate root canal therapy effects on periodontal healing of teeth with chronic advanced periodontitis. Materials and Methods: In this randomized controlled clinical trial 32 single rooted teeth which had necrotic pulp or irreversible pulpitis in 7 patients with chronic advanced periodontitis were selected based on specific criteria. Using a split mouth design, teeth were randomly put in two groups of test and control. In the test group root canal therapy ,scaling & root planing were done.In the control group, only scaling & root planing were performed. Clinical parameters including Pocket Depth (PD, Clinical Attachment Level (CAL, mobility, pattern of bone destruction and plaque index (PI were evaluated in two groups at base line, 1 and 3 months after treatment. Appropriate tests such as paired Wilcoxon and Mann-Whitney were performed. Results: Statistically significant reductions were found in the test group when comparing baseline and one-month post treatment values for Clinical Attachment level (CAL but not after 3-months. In the control group the CAL reductions were not statistically significant between baseline and one month post-treatment, but a increase were observed between one month and three months after treatment. There was a statstically significant difference between the test and the control groups. Other parameters didn’t show any significant differences in each group and between two groups. Conclusion: Since clinical attachment level was the most important parameter we found it can high lighted the role of pathogene with pulpal origin in progression of periodeontal disease and it is concluded that beside periodontal treatment in some advanced periodontal

  7. Nitrous oxide emissions from Chinese maize-wheat rotation systems: A 3-year field measurement

    Science.gov (United States)

    Cai, Yanjiang; Ding, Weixin; Luo, Jiafa

    2013-02-01

    Nitrous oxide (N2O) fluxes were measured over a 3-year period (2004-2007) in a long-term experimental field. The objectives of the study were to evaluate the interannual variation of N2O emissions from a maize-wheat rotation, under different fertilizer regimes and to determine the key controlling factors. The study involved four treatments: compost (OM), half compost N plus half inorganic fertilizer-N (HOM), inorganic fertilizer-N (NPK), and control (CK) where no N application. The mean annual N2O emission over a 3-year period was 0.30 ± 0.11 kg N2O-N ha-1 in the CK treatment, but increased to 1.61 ± 0.10 kg N2O-N ha-1 in the HOM treatment, 2.13 ± 0.15 kg N2O-N ha-1 in the OM treatment, and 2.76 ± 0.19 kg N2O-N ha-1 in the NPK treatment. Differences were significant among treatments. The N2O emission factors of the applied OM, NPK and HOM were 0.61 ± 0.02, 0.82 ± 0.10 and 0.44 ± 0.04%, respectively, at a rate of 300 kg N ha-1 year-1, indicating that the combined application of compost with inorganic fertilizer significantly reduced N2O emission. Over a maize-wheat rotation year, more than 65% of the annual N2O emission occurred during the maize growing season. There was a large interannual variation in N2O emission in all treatments, albeit not significant either during the maize growing season or at an inter-year scale. This interannual variation was mainly attributable to differences in soil moisture after basal fertilizer application, and irrigation and/or heavy rainfall events immediately following basal fertilization could induce more N2O production than pre-irrigation before plowing. The HOM treatment had higher N fertilizer use efficiency and lowest yield-scaled N2O emissions compared with the OM and NPK treatments. We therefore argue that the combined application of half compost N plus half fertilizer-N will mitigate N2O emissions from soils in the North China plain.

  8. Clinical and diagnostic methods for evaluation of sharp foreign body syndrome in buffaloes

    Directory of Open Access Journals (Sweden)

    Nasr-Eldin M. Aref

    2013-06-01

    Full Text Available Aim: The present study was designed to evaluate clinically and under laboratory condition the sharp foreign body syndrome (SFBS in buffaloes with special emphasis on the diagnostic value of radiography, ultrasonography and blood gases and acidbase balance. Materials and Methods: 196 buffaloes with a history of anorexia, reduction of milk production and no response to previous medical treatment were included in the present study. These animals were subjected to clinical and radiographical examinations. Positive cases for SFBS were further evaluated by sonography, hemato-biochemical and blood gas and acid base balance analysis.Results: Out of 196 admitted cases, 49 (25% cases were confirmed as SFBS by clinical and radiographical examination. Positive cases were subsequently divided into two main categories (complicated and non complicated according to radiographical and sonographical findings. SFBS with no complication was diagnosed in 16 cases while 33 cases showed various degrees of complication including reticular adhesion (abdominal and diaphragmatic, n= 23, diaphragmatic hernia (n = 6 and traumatic pericarditis (n = 4. Leukocytosis, hyperprotenemia and increased activity of AST and ALT were of additional values in the diagnosis of SFBS. A consistent finding of primary metabolic alkalosis was recorded in all cases except one with advanced traumatic pericarditis that showed metabolic acidosis. Conclusion: While there is no substitution for clinical examination, using of ultrasonography and radiography simultaneously are essential for proper evaluation and differentiation between various sequelae of SFBS in buffaloes. Radiography is an efficient tool for visualization of metallic foreign body while ultrasonography is an excellent device in assessing fibrinous deposits. Hemato-biochemical and blood gases and acid base balance are of additional values in discriminating between various outcomes of SFBS.

  9. Clinical characteristics, diagnostic evaluation, and antibiotic prescribing patterns for skin infections in nursing homes

    Directory of Open Access Journals (Sweden)

    Norihiro Yogo

    2016-07-01

    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.

  10. A clinical evaluation of the Cobas Fara clinical chemistry analyzer for some routine serum enzymes and glucose.

    Science.gov (United States)

    Moses, G C; Lightle, G O; Tuckerman, J F; Henderson, A R

    1987-11-01

    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 2.6.1.1; and ALT; EC 2.6.1.2); alkaline phosphatase (AP; EC 3.1.3.1); gamma-glutamyltransferase (GGT; EC 2.3.1.2); lactate dehydrogenase (LD; EC 1.1.1.17); creatine kinase (CK; EC 2.7.3.1); 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.

  11. 3D kinematic analysis and clinical evaluation of neck movements in patients with whiplash injury.

    Science.gov (United States)

    Antonaci, F; Bulgheroni, M; Ghirmai, S; Lanfranchi, S; Dalla Toffola, E; Sandrini, G; Nappi, G

    2002-09-01

    In recent decades whiplash injuries, being a major reason for compensation claims, have become increasingly important in forensic medicine. In view of this, a reliable diagnostic method of assessing cervical range of motion (ROM) is needed. The aim of the present study was to evaluate neck function with a 3D kinematic method compared with clinical evaluation in whiplash injury. Seventy consecutive patients (M/F = 18/52) with a history of whiplash injury (WH) and 46 healthy volunteers (M/F = 24/22), mean age, respectively 33 +/- 9 and 28 +/- 6 years (mean+/-SD) entered the study. Patients suffered from neck pain and/or unilateral headache. A computerized kinematic analysis of the ROM (Elite system) using passive markers and two infrared TV cameras was used. Clinical evaluation of active ROM was also performed both in patients and in 61 controls (M/F = 23/38; mean age 47 +/- 18 years). Thirty out of 70 patients were tested at the time of their first consultation (T0) and 6 months later (T6), and 12 were also followed up after a year (T12). All neck movements, except extension, were significantly reduced in WH subjects compared with controls, in particular lateral bending. Comparing ROM at T0, T6 and T12, no significant differences were found. A global index of motion (GIM), obtained by calculating the sum of ROM in absolute value for all the movements acquired, was significantly reduced in WH compared with control subjects. The interobserver reliability of the clinical evaluation was globally acceptable. On the basis of the clinical evaluation, a significantly reduced ROM was found in all movements in WH subjects compared with an age-matched population. Computing the number of impaired cervical movements (ICMs), a significantly higher number was observed in WH patients than in controls, showing a decreasing trend at T6 and T12, with a significant improvement at T6 vs. T0. The computerized study of neck ROM may constitute a useful tool in the evaluation of WH at

  12. Oral S-adenosylmethionine in primary fibromyalgia. Double-blind clinical evaluation

    DEFF Research Database (Denmark)

    Jacobsen, Søren; Danneskiold-Samsøe, B; Andersen, R B

    1991-01-01

    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...

  13. Report on the use of non-clinical studies in the regulatory evaluation of oncology drugs.

    Science.gov (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

    2016-02-01

    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.

  14. One-year clinical evaluation of compomer restorations in cervical lesions of different aetiology

    Directory of Open Access Journals (Sweden)

    Premović Milica

    2012-01-01

    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.

  15. CLINICAL AND RADIOLOGICAL EVALUATION ON DEVELOPMENTAL HIP DYSPLASIA AFTER SALTER AND OMBRÉDANNE PROCEDURE

    Science.gov (United States)

    da Rocha, Válney Luiz; Thomé, André Luiz Coelho; da Silva Castro, Daniel Labres; de Oliveira, Leandro Zica; de Moraes, Frederico Barra

    2015-01-01

    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

  16. Evaluation of features to support safety and quality in general practice clinical software

    Directory of Open Access Journals (Sweden)

    Schattner Peter

    2011-05-01

    Full Text Available Abstract Background Electronic prescribing is now the norm in many countries. We wished to find out if clinical software systems used by general practitioners in Australia include features (functional capabilities and other characteristics that facilitate improved patient safety and care, with a focus on quality use of medicines. Methods Seven clinical software systems used in general practice were evaluated. Fifty software features that were previously rated as likely to have a high impact on safety and/or quality of care in general practice were tested and are reported here. Results The range of results for the implementation of 50 features across the 7 clinical software systems was as follows: 17-31 features (34-62% were fully implemented, 9-13 (18-26% partially implemented, and 9-20 (18-40% not implemented. Key findings included: Access to evidence based drug and therapeutic information was limited. Decision support for prescribing was available but varied markedly between systems. During prescribing there was potential for medicine mis-selection in some systems, and linking a medicine with its indication was optional. The definition of 'current medicines' versus 'past medicines' was not always clear. There were limited resources for patients, and some medicines lists for patients were suboptimal. Results were provided to the software vendors, who were keen to improve their systems. Conclusions The clinical systems tested lack some of the features expected to support patient safety and quality of care. Standards and certification for clinical software would ensure that safety features are present and that there is a minimum level of clinical functionality that clinicians could expect to find in any system.

  17. A new cognitive evaluation battery for Down syndrome and its relevance for clinical trials

    Directory of Open Access Journals (Sweden)

    Susana ede Sola

    2015-06-01

    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

  18. A Required Course in the Development, Implementation, and Evaluation of Clinical Pharmacy Services

    Science.gov (United States)

    Kamal, Khalid M.; Berdine, Hildegarde J.

    2008-01-01

    Objective To develop, implement, and assess a required pharmacy practice course to prepare pharmacy students to develop, implement, and evaluate clinical pharmacy services using a business plan model. Design Course content centered around the process of business planning and pharmacoeconomic evaluations. Selected business planning topics included literature evaluation, mission statement development, market evaluation, policy and procedure development, and marketing strategy. Selected pharmacoeconomic topics included cost-minimization analysis, cost-benefit analysis, cost-effectiveness analysis, cost-utility analysis, and health-related quality of life (HRQoL). Assessment methods included objective examinations, student participation, performance on a group project, and peer evaluation. Assessment One hundred fifty-three students were enrolled in the course. The mean scores on the objective examinations (100 points per examination) ranged from 82 to 85 points, with 25%-35% of students in the class scoring over 90, and 40%-50% of students scoring from 80 to 89. The mean scores on the group project (200 points) and classroom participation (50 points) were 183.5 and 46.1, respectively. The mean score on the peer evaluation was 30.8, with scores ranging from 27.5 to 31.7. Conclusion The course provided pharmacy students with the framework necessary to develop and implement evidence-based disease management programs and to assure efficient, cost-effective utilization of pertinent resources in the provision of patient care. PMID:19214263

  19. Prospective clinical evaluation of 273 modified acid-etched dental implants: 1- to 5- year results

    Directory of Open Access Journals (Sweden)

    Michele De Franco

    2012-03-01

    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.

  20. Evaluation of pharmacy students’ clinical interventions on a general medicine practice experience

    Directory of Open Access Journals (Sweden)

    Jones JD

    2011-03-01

    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.

  1. Evaluation of thermoluminescent dosimeters using water equivalent phantoms for application in clinical electrons beams dosimetry

    International Nuclear Information System (INIS)

    The dosimetry in Radiotherapy provides the calibration of the radiation beam as well as the quality control of the dose in the clinical routine. Its main objective is to determine with greater accuracy the dose absorbed by the tumor. This study aimed to evaluate the behavior of three thermoluminescent dosimeters for the clinical electron beam dosimetry. The performance of the calcium sulfate detector doped with dysprosium (CaSO4: Dy) produced by IPEN was compared with two dosimeters commercially available by Harshaw. Both are named TLD-100, however they differ in their dimensions. The dosimeters were evaluated using water, solid water (RMI-457) and PMMA phantoms in different exposure fields for 4, 6, 9, 12 and 16 MeV electron beam energies. It was also performed measurements in photon beams of 6 and 15 MV (2 and 5 MeV) only for comparison. The dose-response curves were obtained for the 60Co gamma radiation in air and under conditions of electronic equilibrium, both for clinical beam of photons and electrons in maximum dose depths. The sensitivity, reproducibility, intrinsic efficiency and energy dependence response of dosimeters were studied. The CaSO4: Dy showed the same behavior of TLD-100, demonstrating only an advantage in the sensitivity to the beams and radiation doses studied. Thus, the dosimeter produced by IPEN can be considered a new alternative for dosimetry in Radiotherapy departments. (author)

  2. Er:YAG laser ablation: evaluation after a two-year clinical treatment

    Science.gov (United States)

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

    1998-04-01

    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.

  3. Topical Turmeric Microemulgel in the Management of Plaque Psoriasis; A Clinical Evaluation.

    Science.gov (United States)

    Sarafian, Golnaz; Afshar, Minoo; Mansouri, Parvin; Asgarpanah, Jinous; Raoufinejad, Kosar; Rajabi, Mehdi

    2015-01-01

    Psoriasis is an autoimmune and recurrent chronic inflammatory skin disease. About 1-3% of the world wide populations are affected. The characteristic features are hyperprolifration of keratinocytes leading to redness, thickening and scaling of epidermis followed with itching and appearance of the lesions which in most cases bother the patients medically and psychologically. Psoriasis is symptomatically treated by the range of oral and topical medications, however, major side effects in some cases are associated with them. Based on several studies, Curcuma longa can inhibit several inflammatory enzymes mainly involved in the inflammatory process of Psoriasis. Therefore, we decided to target this well-known herbal agent with fantastic safety profile to be formulated as a novel topical microemulgel. The clinical and therapeutic benefit of this novel topical formulation was evaluated on 34 patients with mild to moderate plaque psoriasis in a randomized, prospective intra-individual, right-left comparative, placebo-controlled, double-blind clinical trial. The Dermatology Life Quality Index (DLQI) Questionnaire and Psoriasis area & severity index (PASI) score as well as photos before and after treatment was used to evaluate the outcomes. The results show that the clinical and quality of life parameters in treated lesions in comparison with untreated lesions have improved (Ppatients and most likely as an add-on therapeutic option for many patients suffering with plaque psoriasis. PMID:26330875

  4. Evaluation of Clinical Interest of Anti-Aquaporin-4 Autoantibody Followup in Neuromyelitis Optica

    Directory of Open Access Journals (Sweden)

    Jean-Baptiste Chanson

    2013-01-01

    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.

  5. Evaluation of an eportfolio for the assessment of clinical competence in a baccalaureate nursing program.

    Science.gov (United States)

    Garrett, Bernard M; MacPhee, Maura; Jackson, Cathryn

    2013-10-01

    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.

  6. Latin America Zika Outbreak Should 'Burn Out' Within 3 Years, Scientists Say

    Science.gov (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 ...

  7. Clinical and parasitological evaluation of pour-on fluazuron and ivermectin for treating canine demodicosis

    Directory of Open Access Journals (Sweden)

    Clarissa P. Souza

    2014-11-01

    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

  8. Real-time interactive MR imaging system. Sequence optimization, and basic and clinical evaluations

    International Nuclear Information System (INIS)

    A real-time interactive MR imaging system (real-time MRI) is an MR scanner which has a fast image updating cycle and the ability to freely change slice orientation, just like an ultrasound imaging system. Recently, such a system has been developed and installed on a clinical 1.5-Tesla system. The purpose of this study was to optimize the pulse sequences for clinical use and to evaluate the clinical usefulness and basic functionality of real-time MRI. For T1-weighted imaging, FLASH (fast low angle shot) can be selected, and up to 5 frames per second can be acquired depending on the matrix size. For T2-weighted imaging, true FISP (fast imaging with steady-state precession) can be selected, and up to 4 frames per second can be acquired. Maximum C/N between liver and spleen was obtained at a flip angle of 20 degrees on FLASH. Maximum C/N between cardiac cavity and wall was obtained at a flip angle of 60 degrees on true FISP. Localization of the right and left coronary arteries could be performed within 30 seconds in three volunteers. Although the present real-time MRI system has drawbacks such as low spatial resolution and relatively low contrast resolution, we expect real-time MRI to be one of the most important tools for future clinical MRI. (author)

  9. Clinical and Laboratory evaluation of measleslike rash in children and young adults

    Directory of Open Access Journals (Sweden)

    Stewien Klaus Eberhard

    2000-01-01

    Full Text Available A clinical and laboratory evaluation of 11 children and young adults with measleslike rash was done during the measles outbreak in the Greater São Paulo Metropolitan area at the end of 1996 and spread over the country during 1997. Measles was laboratory confirmed in 07 patients by specific IgM detection in acute serum specimens using an IgM-capture EIA, by specific IgG seroconversion in serum pairs, and by reverse transcription PCR and virus isolation in peripheral blood lymphocytes. Clinical presentations were not always classic; one of the 07 cases had received measles vaccine and corresponded to modified clinical case of measles. The 4 remaining cases were negative for measles and were diagnosed as exanthem subitum (2 cases, scarlet fever and Kawasaki disease. The present study reinforces the view that clinical features alone are not sufficient for establishing an accurate diagnosis in the post-vaccine era, and a surveillance system based on sensitive laboratory results is needed so that it can confirm IgM-negative measles cases.

  10. Comprehensive evaluation and validation of targeted next-generation sequencing performance in two clinical laboratories.

    Science.gov (United States)

    Mendez, Pedro; Dang, Jennifer; Kim, James Wansoo; Lee, Sharon; Yoon, Jun-Hee; Kim, Thomas; Sailey, Charles J; Jablons, David M; Kim, Il-Jin

    2016-07-01

    Next-generation sequencing (NGS) has led to breakthroughs for genetic and genomic analyses and personalized medicine approaches for many diseases. More and more clinical laboratories are using NGS as a genetic screening tool for providing mutation information that is used to select the best treatment regimens for cancer patients. However, several obstacles prevent the routine implementation of NGS technology into the clinical molecular diagnosis setting: the sophisticated sample preparation process, high cost, time-consuming data analyses, as well as the reproducibility and accuracy of interpretation. To systematically evaluate the performance and quality of targeted NGS cancer panel analyses in clinical laboratories, we performed three different tests: i) laboratory-to-laboratory accuracy test, ii) intra-laboratory precision validation, and iii) limit of detection test, using formalin-fixed, paraffin-embedded cancer tissue specimens, cell lines and mutation positive DNA. A laboratory-to-laboratory accuracy test performed using 51 samples showed 100% sensitivity and 99.97% specificity. For the intra-laboratory precision test, 100% reproducibility was observed. For the limit of detection test, KRAS mutations from samples diluted from 70 to 2% of mutant allele frequencies were detected correctly. We believe that the present study demonstrated the feasibility of clinical implementation of a targeted NGS cancer panel analysis for personalized medicine. PMID:27121194

  11. An evaluation of wait-times at an interprofessional student-run free clinic.

    Science.gov (United States)

    Hu, Tina; Leung, Fok-Han

    2016-07-01

    Student-run free clinics (SRFCs) are becoming increasingly popular programmes in schools for promoting interprofessional education and service learning. Despite their prevalence, little research has been done surrounding SRFCs and wait-times. SRFCs may experience long wait-times because patients are often seen on a drop-in basis and time has to be allotted for interprofessional case discussion and teaching. The purpose of this study was to evaluate the wait-times for patients being seen at an interprofessional SRFC and determine potential improvements. Wait-times, total treatment room times, total time per patient, and whether a referral and/or prescription was given were tracked from May 2014 to July 2015 at an SRFC. A total of 268 patients were seen in 52 clinics. On average, five patients were seen per clinic. Patients waited for an average time of 21 minutes before they were seen by the team. Average treatment time per patient was 69 minutes. Patients were generally at the clinic for a total of 91 minutes before being discharged. Several improvements for managing client flow at interprofessional SRFCs are discussed. PMID:27332500

  12. Clinical evaluation of medetomidine, a novel sedative and analgesic drug for dogs and cats.

    Science.gov (United States)

    Vähä-Vahe, T

    1989-01-01

    Medetomidine, a potent alpha 2-adrenoceptor agonist, was investigated in open, multicenter clinical trials with patients of various canine and feline breeds (1736 dogs and 678 cats). The purpose of the study was to find an optimal dose of medetomidine for sedation and analgesia in clinical practice and to study how well the intended procedure could be performed under the influence of the drug. The mean dose (i.m.) of medetomidine used for examinations, clinical procedures and minor surgical interventions was 40 micrograms/kg, and for radiography 30 micrograms/kg. In cats the dose was 80-110 micrograms/kg. On the doses chosen, almost all animals were recumbent and 72% of the dogs and 85% of the cats were in a slight anaesthetic stage, unable to rise. The evaluation of the overall suitability of medetomidine (% of cases) in different indications was "very satisfactory" or "satisfactory" in 95% of dogs and 81-96% of cats. Side effects reported were limited almost exclusively to vomiting and muscle jerking in dogs (12% and 0.5% of the cases) and to vomiting in cats (65%). Medetomidine seems to suffice for pharmacological restraint of dogs and cats. The concomitant use of medetomidine (80-100 micrograms/kg) and ketamine (7 mg/kg) in cats (n = 295) provided a good anaesthesia (20-40 min). The recovery was smooth. The present study shows that medetomidine provides an effective level of sedation and analgesia for clinical use. PMID:2698057

  13. Active multimodal psychotherapy in children and adolescents with suicidality: description, evaluation and clinical profile.

    Science.gov (United States)

    Högberg, Goran; Hällström, Tore

    2008-07-01

    The aim of this study was to describe and evaluate the clinical pattern of 14 youths with presenting suicidality, to describe an integrative treatment approach, and to estimate therapy effectiveness. Fourteen patients aged 10 to 18 years from a child and adolescent outpatient clinic in Stockholm were followed in a case series. The patients were treated with active multimodal psychotherapy. This consisted of mood charting by mood-maps, psycho-education, wellbeing practice and trauma resolution. Active techniques were psychodrama and body-mind focused techniques including eye movement desensitization and reprocessing. The patients were assessed before treatment, immediately after treatment and at 22 months post treatment with the Global Assessment of Functioning Scale. The clinical pattern of the group was observed. After treatment there was a significant change towards normality in the Global Assessment of Functioning scale both immediately post-treatment and at 22 months. A clinical pattern, post trauma suicidal reaction, was observed with a combination of suicidality, insomnia, bodily symptoms and disturbed mood regulation. We conclude that in the post trauma reaction suicidality might be a presenting symptom in young people. Despite the shortcomings of a case series the results of this study suggest that a mood-map-based multimodal treatment approach with active techniques might be of value in the treatment of children and youth with suicidality.

  14. The evaluation of a successful collaborative education model to expand student clinical placements.

    Science.gov (United States)

    Barnett, Tony; Cross, Merylin; Shahwan-Akl, Lina; Jacob, Elisabeth

    2010-01-01

    Worldwide, universities have been encouraged to increase the number of students enrolled in nursing courses as a way to bolster the domestic supply of graduates and address workforce shortages. This places pressure on clinical agencies to accommodate greater numbers of students for clinical experience who, in Australia, may often come from different educational institutions. The aim of this study was to develop and evaluate a collaborative model of clinical education that would increase the capacity of a health care agency to accommodate student placements and improve workplace readiness. The project was undertaken in a medium sized regional hospital in rural Australia where most nurses worked part time. Through an iterative process, a new supported preceptorship model was developed by academics from three institutions and staff from the hospital. Focus group discussions and interviews were conducted with key stakeholders and clinical placement data analysed for the years 2004 (baseline) to 2007. The model was associated with a 58% increase in the number of students and a 45% increase in the number of student placement weeks over the four year period. Students reported positively on their experience and key stakeholders believed that the new model would better prepare students for the realities of nursing work. PMID:19243994

  15. Causes and 3-year-incidence of blindness in Jing-An District, Shanghai, China 2001-2009

    Directory of Open Access Journals (Sweden)

    Zhou Xingtao

    2011-05-01

    Full Text Available Abstract Background Registered data can provide valuable information regarding blindness. The purpose of this study was to evaluate the main causes and 3-year incidence of registered blindness in Jing-An district in Shanghai, China. Methods Data from the blindness registry (age, gender and cause of visual disability were collected and analyzed. The prevalence of blindness for 2003, 2007, 2009 and the 3-year incidence of blindness were calculated. Results The reported blindness increased significantly from 113.7 per 100,000 in 2003 to 145.8 per 100,000 in 2006 to 165.9 per 100,000 in 2009 (P Conclusions The 3-year incidence and prevalence of registered blindness increased in the past 9 years. The leading causes of new blindness were myopic macular degeneration, glaucoma and age-related macular degeneration. The pattern of causes has changed little in the past 9 years and is different from other locations in China. The pattern is similar to that of Taiwan, Hongkong, and Western countries.

  16. Parental Styles and Religious Values among Teenagers: A 3-Year Prospective Analysis

    Science.gov (United States)

    Heaven, Patrick C. L.; Ciarrochi, Joseph; Leeson, Peter

    2010-01-01

    The authors examined the effect of Grade 7 parental styles on Grade 10 religious values. The authors surveyed 784 participants (382 boys, 394 girls; 8 unreported) in Grade 7. The mean age of the group at Time 1 was 12.3 years (SD = 0.5 years). Time 2 occurred 3 years later when students were in Grade 10 (372 boys, 375 girls). In addition to…

  17. Traumatic brain injury in infants and toddlers, 0–3 years old

    OpenAIRE

    Ciurea, AV; Gorgan, MR; Tascu, A; Sandu, AM; Rizea, RE

    2011-01-01

    Object: Children 0–3 years old present a completely different neurotraumatic pathology. The growing and the development processes in this age group imply specific anatomical and pathophysiological features of the skull, subarachnoid space, CSF flow, and brain. Most common specific neurotraumatic entities in children 0–3 years old are cephalhematoma, subaponeurotic (subgaleal) hematoma, diastatic skull fracture, grow skull fracture, depressed (‘ping–pong’) skull fracture, and extradural hemato...

  18. A peripheral ameloblastic fibro-odontoma in a 3-year-old girl: case report, immunohistochemical analysis, and literature review.

    Science.gov (United States)

    Lin, Yi-Chun; Hsu, Hsiu-Ming; Liu, Chiang-Shin; Yuan, Kuo

    2014-01-01

    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.

  19. Synergism of clinical evaluation and penile sonographic imaging in diagnosis of penile fracture: a case report

    Directory of Open Access Journals (Sweden)

    Bello Jibril

    2012-09-01

    Full Text Available Abstract Introduction Penile fracture is an uncommon urologic emergency, and is the traumatic rupture of the tunica albuginea covering the corpus cavernosa. This usually occurs following blunt trauma sustained during coitus, masturbation or self-manipulations to hide or suppress an erection. Clinical diagnosis can often be easily made with typical history and examination findings. However, the patient may present atypically and/or with a suspicion of associated urethral injury. The roles of various diagnostic investigations are being evaluated in these situations. Case presentation We report the case of a 31-year-old African man with penile fracture and suspected associated urethral injury that occurred after self-manipulations to hide an erection. Conclusions Penile ultrasound and sonourethrography provide useful additional diagnostic information to supplement clinical history and physical examination findings and can be performed easily, at low cost and with no delays to surgery.

  20. Guidance on Evaluating Options for Representing Clinical Data within Health Information Systems.

    Science.gov (United States)

    Hardiker, Nicholas R; Hynes, Brenda

    2012-01-01

    The health information system PlunketPlus is a clinical initiative of Plunket (the Royal New Zealand Plunket Society) with a goal of further improving the health outcomes for children in New Zealand. The success of PlunketPlus depends heavily on how data is represented within the system. The purpose of the study described in this paper was to use PlunketPlus as a case study to inform the development of guidance on evaluating options for representing clinical data within health information systems, with a particular focus on automating existing informational processes. It has been possible to take some of the lessons learned to inform the development of initial more generic guidance that might be applicable across a range of domains. This paper concludes with a description of how Plunket applied the guidance as part of the development of PlunketPlus.

  1. Evaluation of clinical and electrocardiographic changes during the euthanasia of horses

    DEFF Research Database (Denmark)

    Buhl, Rikke; Andersen, L.O.F.; Karlshøj, M.;

    2013-01-01

    The objective of this prospective field study was to investigate whether commonly used criteria for clinical death occurred at the same time as cardiac death, as determined by electrocardiography. Specific ECG changes during euthanasia were also studied. Twenty-nine horses were euthanized...... with pentobarbital at two different dose rates and 15 of the 29 horses also received detomidine hydrochloride for sedation. ECG was recorded prior to and during euthanasia. Time to collapse, cessation of reflexes, heart sounds and asystole were recorded. ECG recordings were used to calculate RR intervals, PQ...... duration, QRS duration, distance from QRS complex to end of T wave corrected for HR (QTc interval), duration of T-wave from peak to end (TpeakTend) and amplitudes of T wave (Tpeak) before and during euthanasia. Differences between groups and ECG changes were evaluated using analysis of variance. Clinical...

  2. The role of a clinical nurse consultant dementia specialist: A qualitative evaluation.

    Science.gov (United States)

    Duane, Fleur M; Goeman, Dianne P; Beanland, Chris J; Koch, Susan H

    2015-07-01

    Delay in diagnosis and difficulties in accessing appropriate health care services plague dementia care delivery in the community setting, potentiating the risk for misdiagnosis, inappropriate management, poor psychological adjustment and reduced coping capacity and ability to forward plan. We evaluated a clinical nurse consultant role with a speciality in dementia to provide person-centred pre-diagnosis support in the community. Clients, with a six-month history of cognitive and functional decline in the absence of delirium but no formal diagnosis of dementia, were recruited from a Home Care Nursing Service and an Aged Care Assessment Service located in the Western Suburbs of Melbourne, Victoria, Australia. The role of a clinical nurse consultant was highly regarded by clients and other health professionals. This paper discussing the CNC role and the outcomes of the role suggests it was successful in providing timely assistance and support for consumers and support for other health professionals. PMID:24339107

  3. Assessing clinical trials of Internet addiction treatment: a systematic review and CONSORT evaluation.

    Science.gov (United States)

    King, Daniel L; Delfabbro, Paul H; Griffiths, Mark D; Gradisar, Michael

    2011-11-01

    Although there is ongoing debate concerning the clinical status of Internet addiction, and the quality of the extant literature in this emerging field is not optimal, several clinical trials of both pharmacological and psychological treatments for Internet addiction have been published in recent years. A systematic review investigating the reporting quality of eight treatment studies is presented. Reporting quality was defined according to the 2010 Consolidating Standards of Reporting Trials (CONSORT) statement. An evaluation of the reviewed studies highlighted several key limitations, including (a) inconsistencies in the definition and diagnosis of Internet addiction, (b) a lack of randomization and blinding techniques, (c) a lack of adequate controls or other comparison groups, and (d) insufficient information concerning recruitment dates, sample characteristics, and treatment effect sizes. It is concluded that improvements in future studies' design and reporting would be of significant benefit to both researchers and clinicians, and to the overall positioning of Internet addiction in the behavioral addiction field.

  4. Clinical evaluation of synthetic aperture harmonic imaging for scanning focal malignant liver lesions.

    Science.gov (United States)

    Brandt, Andreas Hjelm; Hemmsen, Martin Christian; Hansen, Peter Møller; Madsen, Signe Sloth; Krohn, Paul Suno; Lange, Theis; Hansen, Kristoffer Lindskov; Jensen, Jørgen Arendt; Nielsen, Michael Bachmann

    2015-09-01

    The purpose of the study was to perform a clinical comparison of synthetic aperture sequential beamforming tissue harmonic imaging (SASB-THI) sequences with a conventional imaging technique, dynamic receive focusing with THI (DRF-THI). Both techniques used pulse inversion and were recorded interleaved using a commercial ultrasound system (UltraView 800, BK Medical, Herlev, Denmark). Thirty-one patients with malignant focal liver lesions (confirmed by biopsy or computed tomography/magnetic resonance) were scanned. Detection of malignant focal liver lesions and preference of image quality were evaluated blinded off-line by eight radiologists. In total, 2,032 evaluations of 127 image sequences were completed. The sensitivity (77% SASB-THI, 76% DRF-THI, p = 0.54) and specificity (71% SASB-THI, 72% DRF-THI, p = 0.67) of detection of liver lesions and the evaluation of image quality (p = 0.63) did not differ between SASB-THI and DRF-THI. This study indicates the ability of SASB-THI in a true clinical setting. PMID:26095533

  5. Employing New Mathematical Models and Equations to Evaluate Risk-Benefit Criteria of Clinical Therapeutics

    Directory of Open Access Journals (Sweden)

    Da Y. Lu

    2007-01-01

    Full Text Available Current preclinical and clinical evaluation of a drugs or therapy is at first to find out a maximum toxicity tolerance, which is overall fixed. The potential therapeutic dosage will be ranged just lower or within the periphery of these maximum tolerant data. A hidden acceptance among general researchers lies as the toxicity concentration of a drug is always the same and can be referred as a fixed data. However, practical therapeutics is not very strictly following this doctrine. Even using many strict well-formed mathematical models and toxicity evaluating systems, the disputes and lawsuits of some newly-developed drugs are increasing dramatically nowadays. In this work, a mathematical equation and a dynamic parameter  are generated to help improving this situation. This new mathematic model combines and integrates effective, toxicity and no effective data as a whole, which fits to evaluate the risk-benefits of therapeutics in dynamic and changeable states. We need no more to deduce therapeutic dosage from fixed tolerance data regardless different therapeutic modes of action and toxicity of drugs acting on different organs and physiological systems. We hypothesize and equation that risk-benefit ratios are varied with drug dosages. It is a new start to help the understanding of effects and toxicities of therapeutic same time in a single clinical practice and well compliment with previous mathematical models.

  6. Evaluation of Demographic and Clinical Characteristics of First Febrile Seizures in Children

    Directory of Open Access Journals (Sweden)

    F Mir-Naseri

    2009-01-01

    Full Text Available Introduction: Febrile seizure is the most common problem in pediatric neurology that occur s in 3– 4% of children. The purpose of this study was to evaluate demographic and clinical characteristics of first febrile seizures in children admitted to the hospital. Methods: In a descriptive retrospective study, medical records of children with first febrile seizure, admitted between March 2004and August 2005 toYazd Shaheed Sadoughi Hospital were evaluated for demographic and clinical characteristics of first febrile seizures . Results: 76 boys and 63 girls with mean age of 2.03 ± 1.21 years were evaluated. Febrile seizure type was complex in 33% and simple in 67 %. On the whole, 66 % occurred in less than two year olds and 6 % in more than four year olds. The most common form of seizure was generalized tonic colonic (79cases and URI was the most prevalent etiology of fever. Mean temperature on admission was 38.5o C. Mean seizure time and hospital stay (days was 6.7 minutes and 2.3 days, both of which were statistically more significant in complex febrile seizure. Conclusion: There were a significant number of complex febrile seizures in this study that necessitates more aggressive handling. As antipyretic use is ineffective in prevention of febrile seizures, undue stress on parents can be avoided by not emphasizing on antipyretic consumption.

  7. OTOSCLEROSI S - AN EVALUATION OF CLINICAL AND AUDIOLOGIC FINDINGS; OUTCOME AND COMPLICATIONS OF SMALL FENESTRA STAPEDOTOMY

    Directory of Open Access Journals (Sweden)

    Sunil Kumar

    2015-05-01

    Full Text Available INTRODUCTION: Otosclerosis is one of the commonest non infective causes of acquired deafness in adults’. ‘Otosclerosis’ literally means hardening of the ear. It is a primary and exclusive disease of otic capsule of human temporal bone. Otosclerosis is characterised by alternate phases of bone resorption and formation. If the location of bony changes produces evident clinical manifestations term “C linical Otosclerosis” is used. If bony changes are not translated into clinical manifestations, the term used is “histologica l Otosclerosis”. Antonio Valsalva in 1735 gave first description of ankylosis of stapes to margins of oval window. Von Troltsch in 1881 coined the term ‘Otosclerosis’. Politzer in 1893 first described Otosclerosis as a primary disease of otic capsule. Alth ough the clinical course of the disease is well documented, its aetiology remains unclear; thus, multiple theories are available. But none of them has established a definite cause. Otosclerosis usually manifests as a progressive conductive or mixed hearing loss occurring clinically to varying degrees in 0.5% - 1% of the general population. The clinical diagnosis of Otosclerosis, as clarified by Bezold in 1908, requires a careful history, physical examination, tuning fork evaluation and audiometric testing. Radiographic examinations can be done as adjuncts when needed. Therapeutic options for Otosclerosis include medical, surgical and use of hearing aids, alone or in combination. Stapes surgery is an effective treatment for hearing loss and tinnitus of Otoscl erosis and stapedectomy is the current treatment of choice for conductive component of Otosclerosis. The first stapes mobilization was employed by Kessel in 1878. The procedure of extracting the stapes for Otosclerosis was first performed by Jack of Boston in 1892 but was beset with obvious difficulties because he lacked proper magnification and antibiotic coverage. In 1956 Dr. John Shea revived the

  8. A pilot study evaluating alternative approaches of academic detailing in rural family practice clinics

    Directory of Open Access Journals (Sweden)

    Hartung Daniel M

    2012-12-01

    Full Text Available Abstract Background Academic detailing is an interactive, convenient, and user-friendly approach to delivering non-commercial education to healthcare clinicians. While evidence suggests academic detailing is associated with improvements in prescribing behavior, uncertainty exists about generalizability and scalability in diverse settings. Our study evaluates different models of delivering academic detailing in a rural family medicine setting. Methods We conducted a pilot project to assess the feasibility, effectiveness, and satisfaction with academic detailing delivered face-to-face as compared to a modified approach using distance-learning technology. The recipients were four family medicine clinics within the Oregon Rural Practice-based Research Network (ORPRN. Two clinics were allocated to receive face-to-face detailing and two received outreach through video conferencing or asynchronous web-based outreach. Surveys at midpoint and completion were used to assess effectiveness and satisfaction. Results Each clinic received four outreach visits over an eight month period. Topics included treatment-resistant depression, management of atypical antipsychotics, drugs for insomnia, and benzodiazepine tapering. Overall, 90% of participating clinicians were satisfied with the program. Respondents who received in person detailing reported a higher likelihood of changing their behavior compared to respondents in the distance detailing group for five of seven content areas. While 90%-100% of respondents indicated they would continue to participate if the program were continued, the likelihood of participation declined if only distance approaches were offered. Conclusions We found strong support and satisfaction for the program among participating clinicians. Participants favored in-person approaches to distance interactions. Future efforts will be directed at quantitative methods for evaluating the economic and clinical effectiveness of detailing in rural

  9. Clinical utility of breath ammonia for evaluation of ammonia physiology in healthy and cirrhotic adults.

    Science.gov (United States)

    Spacek, Lisa A; Mudalel, Matthew; Tittel, Frank; Risby, Terence H; Solga, Steven F

    2015-12-01

    Blood ammonia is routinely used in clinical settings to assess systemic ammonia in hepatic encephalopathy and urea cycle disorders. Despite its drawbacks, blood measurement is often used as a comparator in breath studies because it is a standard clinical test. We sought to evaluate sources of measurement error and potential clinical utility of breath ammonia compared to blood ammonia. We measured breath ammonia in real time by quartz enhanced photoacoustic spectrometry and blood ammonia in 10 healthy and 10 cirrhotic participants. Each participant contributed 5 breath samples and blood for ammonia measurement within 1 h. We calculated the coefficient of variation (CV) for 5 breath ammonia values, reported medians of healthy and cirrhotic participants, and used scatterplots to display breath and blood ammonia. For healthy participants, mean age was 22 years (±4), 70% were men, and body mass index (BMI) was 27 (±5). For cirrhotic participants, mean age was 61 years (±8), 60% were men, and BMI was 31 (±7). Median blood ammonia for healthy participants was within normal range, 10 μmol L(-1) (interquartile range (IQR), 3-18) versus 46 μmol L(-1) (IQR, 23-66) for cirrhotic participants. Median breath ammonia was 379 pmol mL(-1) CO2 (IQR, 265-765) for healthy versus 350 pmol mL(-1) CO2 (IQR, 180-1013) for cirrhotic participants. CV was 17  ±  6%. There remains an important unmet need in the evaluation of systemic ammonia, and breath measurement continues to demonstrate promise to fulfill this need. Given the many differences between breath and blood ammonia measurement, we examined biological explanations for our findings in healthy and cirrhotic participants. We conclude that based upon these preliminary data breath may offer clinically important information this is not provided by blood ammonia.

  10. Evaluating clinical abdominal scoring system in predict- ing the necessity of laparotomy in blunt abdominal trauma

    Directory of Open Access Journals (Sweden)

    Erfantalab-Avini Peyman

    2011-06-01

    Full Text Available 【Abstract】 Objectives: Trauma is among the lead- ing causes of death. Medical management of blunt abdomi- nal trauma (BAT relies on judging patients for whom lap- arotomy is mandatory. This study aimed to determine BAT patients’ signs, as well as paraclinical data, and to clarify the accuracy, sensitivity, specificity, positive and negative predictive value of clinical abdominal scoring system (CASS, a new scoring system based on clinical signs, in predicting whether a BAT patient needs laparotomy or not. Methods: Totally 400 patients suspected of BAT that arrived at the emergency department of two university hos- pitals in Tehran from March 20, 2007 to March 19, 2009 were included in this study. They were evaluated for age, sex, type of trauma, systolic blood pressure, Glasgow coma scale (GCS, pulse rate, time of presentation after trauma, abdomi- nal clinical findings, respiratory rate, temperature, hemoglo- bin (Hb concentration, focused abdominal sonography in trauma (FAST and CASS. Results: Our measurements showed that CASS had an accuracy of 94%, sensitivity of 100%, specificity of 88%, positive predictive value of 90% and negative predictive value of 100% in determining the necessity of laparotomy in BAT patients. Moreover, in our analysis, systolic blood pressure, GCS, pulse rate, Hb concentration, time of presen- tation after trauma, abdominal clinical findings and FAST were also shown to be helpful in confirming the need for laparotomy (P<0.05. Conclusion: CASS is a promising scoring system in rapid detection of the need for laparotomy as well as in minimizing auxiliary expense for further evaluation in BAT patients, thus to promote the cost-benefit ratio and accu- racy of diagnosis. Key words: Abdominal injuries; Laparotomy; Patients; Wounds, nonpenetrating

  11. Development of the clinical learning evaluation questionnaire for undergraduate clinical education: Factor structure, validity, and reliability study

    OpenAIRE

    AlHaqwi, Ali I; Kuntze, Jeroen; van der Molen, Henk

    2014-01-01

    textabstractBackground: Teaching and learning of clinical skills for undergraduate medical students usually takes place during the clinical clerkship. Therefore, it is of vital importance to ensure the effectiveness of the rotations within this clerkship. The aims of this study were to develop an instrument that measures the effectiveness of the clinical learning environment, to determine its factor structure, and to find first evidence for the reliability and validity of the total scale and ...

  12. Medical Evaluation Processes in Clinical settings. Qualitative Analysis through the Experience of Teachers and Students

    Directory of Open Access Journals (Sweden)

    Juan Fernando Cediel Becerra

    2007-09-01

    Full Text Available Evaluation processes in clinical practice havenot been well, being their study focused on the technical issues concerning these processes.This study tried an approach to the evaluationprocesses through the analysis of perceptionsfrom teachers and students about the methodologyof evaluation considering the teachinglearningprocesses performed in a clinicalpractice of the Medicine Program –UniversidadEl Bosque from Bogota. With this purpose weconducted interviews with teachers and studentssearching the manner in which the evaluative,learning and teaching processes are done; thenwe analyzed the perception from both agentsconcerning the way these processes are related.The interviews were categorized bath deductivelyand inductively, and then contrasted withsome current theories of learning, teaching andevaluation in medicine. The study showed thatnowadays the evaluation and, in general, theeducative processes are affected by several factorswhich are associated to the manner theprofessional practice is developed, and the educativeprocess of the current teachers. We concludedthere is no congrency between theapproach of the evaluation, mainly conductivist,and the learning and teaching strategiesmainly constructivist. This fact cause dissent inteachers and students.

  13. The role of peer-assisted learning in building evaluative judgement: opportunities in clinical medical education.

    Science.gov (United States)

    Tai, Joanna Hong-Meng; Canny, Benedict J; Haines, Terry P; Molloy, Elizabeth K

    2016-08-01

    This study explored the contribution of peer-assisted learning (PAL) in the development of evaluative judgement capacity; the ability to understand work quality and apply those standards to appraising performance. The study employed a mixed methods approach, collecting self-reported survey data, observations of, and reflective interviews with, the medical students observed. Participants were in their first year of clinical placements. Data were thematically analysed. Students indicated that PAL contributed to both the comprehension of notions of quality, and the practice of making comparisons between a given performance and the standards. Emergent themes included peer story-telling, direct observation of performance, and peer-based feedback, all of which helped students to define 'work quality'. By participating in PAL, students were required to make comparisons, therefore using the standards of practice and gaining a deeper understanding of them. The data revealed tensions in that peers were seen as less threatening than supervisors with the advantage of increasing learners' appetites for thoughtful 'intellectual risk taking'. Despite this reported advantage of peer engagement, learners still expressed a preference for feedback from senior teachers as more trusted sources of clinical knowledge. While this study suggests that PAL already contributes to the development of evaluative judgement, further steps could be taken to formalise PAL in clinical placements to improve learners' capacity to make accurate judgements on the performance of self and others. Further experimental studies are necessary to confirm the best methods of using PAL to develop evaluative judgement. This may include both students and educators as instigators of PAL in the workplace. PMID:26662035

  14. Evaluation of dengue NS1 antigen rapid tests and ELISA kits using clinical samples.

    Directory of Open Access Journals (Sweden)

    Subhamoy Pal

    Full Text Available Early diagnosis of dengue virus (DENV infection can improve clinical outcomes by ensuring close follow-up, initiating appropriate supportive therapies and raising awareness to the potential of hemorrhage or shock. Non-structural glycoprotein-1 (NS1 has proven to be a useful biomarker for early diagnosis of dengue. A number of rapid diagnostic tests (RDTs and enzyme-linked immunosorbent assays (ELISAs targeting NS1 antigen (Ag are now commercially available. Here we evaluated these tests using a well-characterized panel of clinical samples to determine their effectiveness for early diagnosis.Retrospective samples from South America were used to evaluate the following tests: (i "Dengue NS1 Ag STRIP" and (ii "Platelia Dengue NS1 Ag ELISA" (Bio-Rad, France, (iii "Dengue NS1 Detect Rapid Test (1st Generation" and (iv "DENV Detect NS1 ELISA" (InBios International, United States, (v "Panbio Dengue Early Rapid (1st generation" (vi "Panbio Dengue Early ELISA (2nd generation" and (vii "SD Bioline Dengue NS1 Ag Rapid Test" (Alere, United States. Overall, the sensitivity of the RDTs ranged from 71.9%-79.1% while the sensitivity of the ELISAs varied between 85.6-95.9%, using virus isolation as the reference method. Most tests had lower sensitivity for DENV-4 relative to the other three serotypes, were less sensitive in detecting secondary infections, and appeared to be most sensitive on Day 3-4 post symptom onset. The specificity of all evaluated tests ranged from 95%-100%.ELISAs had greater overall sensitivity than RDTs. In conjunction with other parameters, the performance data can help determine which dengue diagnostics should be used during the first few days of illness, when the patients are most likely to present to a clinic seeking care.

  15. Mediastinal lymphadenopathy in congestive heart failure: a sequential CT evaluation with clinical and echocardiographic correlations

    Energy Technology Data Exchange (ETDEWEB)

    Chabbert, Valerie; Canevet, Guillaume; Otal, Philippe; Joffre, Francis [Department of Radiology, University of Toulouse, Avenue Jean-Poulhes, 31403, Toulouse (France); Baixas, Cecile; Galinier, Michel [Department of Cardiology, University of Toulouse, Avenue Jean-Poulhes, 31403, Toulouse (France); Deken, Valerie; Duhamel, Alain [Department of Medical Statistics, University of Lille, Place de Verdun, 59037, Lille Cedex (France); Remy, Jacques; Remy-Jardin, Martine [Department of Radiology, Hospital Calmette, University Center of Lille, Boulevard Jules Leclerc, 59037, Lille Cedex (France)

    2004-05-01

    The aim of this study was to evaluate the frequency and evolution after treatment of mediastinal lymphadenopathy associated with congestive left heart failure on CT scans in correlation with clinical and echocardiographic findings. Thirty-one consecutive patients with subacute left heart failure underwent a clinical evaluation using the NYHA classification, a CT examination, and transthoracic echocardiography at the time of initial presentation (T1). After initiation of medical treatment (T2), follow-up CT scans were systematically obtained together with a clinical evaluation. At T1, all patients showed severe (type III: n=12, 39%; type IV: n=12, 39%) to moderate (type I, n=1, 3%; type II, n=6, 19%) dyspnea with a mean ejection fraction of 39% (range 22-74%). On initial CT scans, enlarged mediastinal lymph nodes were seen in 13 patients (42%) with blurred contours in 5 patients (16%) and hazy mediastinal fat in 1 patient (3%). Significant decrease in the size of lymphadenopathy was observed between T1 and T2 (T1, n=13, 42% vs T2, n=10, 32%; p<0.05) with a concurrent decrease in the severity of dyspnea (grade III-IV dyspnea at T1, n=24, 78% vs grade I-II dyspnea at T2, n=26, 83.5%). Patients with enlarged lymph nodes at T1 showed: (a) a significantly lower ejection fraction at echocardiography than those without lymphadenopathy (mean{+-}SD value: 34{+-}12.9 vs 43{+-}13.8%; p=0.04); (b) a significantly larger diameter of the right superior pulmonary vein (mean{+-}SD value: 17{+-}2.75 vs 14{+-}3.9 mm; p=0.04); and (c) a higher frequency of abnormal peribronchovascular thickening (n=5 vs n=1; p=0.06). Mediastinal lymphadenopathy associated with subacute left heart failure was observed in 13 patients (42%), showing regression after initiation of treatment in 8 of 13 patients (62%). (orig.)

  16. Clinical observed performance evaluation: a prospective study in final year students of surgery.

    LENUS (Irish Health Repository)

    Markey, G C

    2010-06-24

    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 of assessments in a 25-week teaching programme. Over time, several clinicians from a pool of 16 surgical consultants and registrars evaluated each student by direct observation. A structured rating form was used for assessment data. Variance component analysis (VCA), internal consistency and inter-rater agreement were used to estimate reliability. The predictive and convergent validity of COPE in relation to summative OSCE, long case, and overall final examination was estimated. Median number of COPE assessments per student was 7. Generalisability of a mean score over 7 COPE assessments was 0.66, equal to that of an 8 x 7.5 min station final OSCE. Internal consistency was 0.88-0.97 and inter-rater agreement 0.82. Significant correlations were observed with OSCE performance (R = 0.55 disattenuated) and long case (R = 0.47 disattenuated). Convergent validity was 0.81 by VCA. Overall final examination performance was linearly related to mean COPE score with standard error 3.7%. COPE permitted efficient serial assessment of a large cohort of final year students in a real world setting. Its psychometric quality compared well with conventional assessments and with other direct observation instruments as reported in the literature. Effect on learning, and translation to clinical care, are directions for future research.

  17. Omega-3 fatty acids and inflammation: a perspective on the challenges of evaluating efficacy in clinical research.

    Science.gov (United States)

    Skulas-Ray, Ann C

    2015-01-01

    Chronic inflammation is a common underpinning of many diseases. There is a strong pre-clinical evidence base demonstrating the efficacy of omega-3 fatty acids for ameliorating inflammation and thereby reducing disease burden. Clinically, C-reactive protein (CRP) serves as both a reliable marker for monitoring inflammation and a modifiable endpoint for studies of anti-inflammatory pharmaceuticals. However, clinical omega-3 fatty acid supplementation trials have not replicated pre-clinical findings in terms of consistent CRP reductions. Methodological differences present numerous challenges in translating pre-clinical evidence to clinical results. It is crucial that future clinical nutrition research clearly distinguish between the reversal of established inflammation and preventing the development of inflammation. Future clinical studies evaluating the ability of omega-3 fatty acids to attenuate an excessive inflammatory response, may be advanced by employing new statistical approaches and utilizing models of induced inflammation, such as low-dose human endotoxemia.

  18. Efficacy of panoramic radiography as a screening procedure in dental examination compared with clinical evaluation

    Energy Technology Data Exchange (ETDEWEB)

    An, Seo Young; An, Chang Hyeon; Choi, Karp Shik [Kyungpook National Univ. School of Dentistry, Daegu (Korea, Republic of)

    2007-06-15

    To evaluate the efficacy of panoramic radiography by comparing the results of clinical examination with radiographic findings. We studied 190 patients (20 men and 170 women; mean age, 40 years; range, 22 to 68 years) who visited the health promotion center of Korea Medical Science Institute and were examined both clinically and by panoramic radiography. We compared results from both examinations. Treatment options by clinical examination were described as 'no treatment indicated', 'treatment of dental caries', 'removal of calculus', 'treatment of periodontal disease'. 'prothodonic treatment' and 'extraction of the third molar'. Findings taken from the panoramic radiography were: dental caries, peroapical lesion, alveolar bone loss, calculus deposition, retained root, impaction of the third molar, disease of maxillary sinus, bony change of mandibular condyle, etc. The prevalence of panoramic findings were: 37.9% of dental caries, 17.4% of periapical lesions, 44.7% of alveolar bone losses, 62.6% of calculi deposition. 7.9% of retained roots, 26.8% of third molar impactions, 6.3% of disease of maxillary sinus, 2.1% of bony changes of mandibular condlye and 35.8% of miscellaneous lesions. Abnormal conditions revealed by panoramic radiography which had not been discovered on clinical examination were: 24.2% of the patients had dental caries, 17.4% had periapical lesions, 7.4% had calculi deposition, 5.3% had retained roots, 15.3% had third molar impactions. The opposite cases were: 5.2% had dental caries, 12.6% had calculi deposition, and 9.5% had third molar impactions. The use of panoramic radiography as a supplement to the clinical examination might be a valuable screening technique.

  19. Evaluating cognitive impairment in the clinical setting: practical screening and assessment tools.

    Science.gov (United States)

    Valcour, Victor G

    2011-12-01

    HIV-associated neurocognitive disorders (HAND) remain a substantial problem in the era of combination antiretroviral therapy. Neither the Mini Mental State Exam nor the HIV Dementia Scale is sufficiently sensitive for HAND. The Montreal Cognitive Assessment shows promise, but current data suggest that adding an additional test will be needed to improve sensitivity for the clinical setting. Patient reporting of symptoms is insensitive as most cases of HAND are asymptomatic. Examination of cerebrospinal fluid (CSF) is sometimes warranted in select patients to evaluate for CSF HIV RNA detectability. CSF escape of virus, when CSF HIV RNA is detectable but plasma HIV RNA is not, appears to be a relatively uncommon event in the clinical setting where the level of detectability for typical clinical assays is around 50 copies/mL. In cases of CSF escape, cognitive improvement has been linked to changes in antiretroviral regimens that are aimed at either overcoming antiretroviral resistance or improving central nervous system (CNS) penetration-effectiveness. Currently, for most patients with HAND in the absence of unusual features, there are insufficient data for a recommendation to routinely intensify therapy with a neurointensive antiretroviral regimen; however, there is considerable uncertainty given emerging data and variability in approach among experts in the field. This article summarizes a case-based presentation by Victor G. Valcour, MD, at the 14th Annual Clinical Conference for the Ryan White HIV/AIDS Program held in Tampa, Florida, in June 2011. The Clinical Conference is sponsored by the IAS-USA under the Health Resources and Services Administration (HRSA) contract number HHSH250200900010C.

  20. Evaluating Fluoroquinolone Use in Patients Admitted to the Tuberculosis Outpatient Clinic

    Directory of Open Access Journals (Sweden)

    Sinem İliaz

    2016-08-01

    Full Text Available Objective: Inelaborate use of new quinolones with strong anti-tuberculosis (TB activity leads to difficulty in diagnosis and more importantly, quinolone-resistant Mycobacterium tuberculosis. We aimed to determine the frequency of quinolone use in patients who were referred to our hospital for suspected TB and to evaluate the association between quinolone use and different clinical laboratory parameters. Methods: Between November 15 and December 15, 2013, all patients who were admitted to the TB outpatient clinic with no previous diagnosis of TB were included in this study. Demographic and clinical laboratory findings and history of antibiotic use were recorded. Patients’ quinolone use were questioned by showing fluoroquinolone antibiotic boxes’ photographs available on the market. The departments of the doctors who prescribed quinolones were recorded. Results: The mean age of 179 patients included in the study was 37±16 (15–89 years. Among these, 113 patients (63.1% were male. Seventy five patients (41.9% were diagnosed as tuberculosis according to the clinical-radiological and/or bacteriological findings. Of 179 patients, 58.1% (n=104 had been prescribed antibiotics for current complaints before referral to our clinic. Sixteen patients (15% had been recommended fluoroquinolones. Fluoroquinolones were prescribed by seven internal medicine specialists, five pulmonologists, three emergency medicine specialists, and one family medicine practitioner. Among 16 fluoroquinolones prescribed, nine were moxifloxacin, four were levofloxacin, and three were gemifloxacin. Quinolone use revealed a significant inverse relationship only with the presence of hemoptysis (p=0.04. Conclusion: Besides increased educational activities regarding the rational use of antibiotics in recent years, the quinolone group of antibiotics is still prescribed for suspected TB cases. To avoid quinolone-resistant M. tuberculosis strains, further education is required.

  1. Caries risk and prevention: Evaluation of a preventive program in a clinic for children

    Directory of Open Access Journals (Sweden)

    Fábio Correia Sampaio

    2008-01-01

    Full Text Available Objective: The aim of this study was to verify the use of the Nexø caries risk assessment system together with the Cariogram® (School of Dentistry, Malmö, Sweden, in a preventive program for children at the cariology clinic at Federal University of Paraíba. Methods: A sample of 107 children (2- to 14-year-old was attended on two occasions. The patients’ clinical data (DMF-T, dmf-t, Bleeding index, OHI-S and those from the preventive procedures performed (professional cleaning, fluoride application, Cariogram® (School of Dentistry, Malmö, Sweden, Nexø caries risk were collected twice: first from the clinical record cards and on the second occasion by exams. Parents and guardians evaluated the clinical attendance in an interview and the children, by means of a VAS scale. According to the Nexø caries risk assessment system, 53 children (49.5% were classified at low risk (6. Data analysis was carried out using SPSS (11.0. Results: A positive correlation was observed between the two risk systems: Nexø and Cariogram® (School of Dentistry, Malmö, Sweden of chances of avoiding new caries lesions. The possibility of avoiding new caries lesions increased 5% in both groups and a discrete increase was observed in the other parameters. Conclusion: It can be concluded that the Nexø system associated with the Cariogram® (School of Dentistry, Malmö, Sweden, contributed to the assessment of the patients’ caries risk profile and to the success of the preventive program for children at the cariology clinic at Universidade Federal da Paraíba.

  2. Decision theory and the evaluation of risks and benefits of clinical trials.

    Science.gov (United States)

    Bernabe, Rosemarie D C; van Thiel, Ghislaine J M W; Raaijmakers, Jan A M; van Delden, Johannes J M

    2012-12-01

    Research ethics committees (RECs) are tasked to assess the risks and the benefits of a clinical trial. In previous studies, it was shown that RECs find this task difficult, if not impossible, to do. The current approaches to benefit-risk assessment (i.e. Component Analysis and the Net Risk Test) confound the various risk-benefit tasks, and as such, make balancing impossible. In this article, we show that decision theory, specifically through the expected utility theory and multiattribute utility theory, enable for an explicit and ethically weighted risk-benefit evaluation. This makes a balanced ethical justification possible, and thus a more rationally defensible decision making. PMID:22819925

  3. Clinical value of radiological methods in evaluation and therapy of severe thoracic trauma

    International Nuclear Information System (INIS)

    Plain chest radiographs allow the diagnosis of most intrathoracic injuries. However, they are only momentary pictures and give no information on the respiratory function. A tension pneumothorax, rib fractures and subcutaneous emphysema should be diagnosed clinically before radiographs are taken. Computed tomography is helpful in evaluation of intrapulmonary lesions, hemothorax, rupture of the diaphragm and dislocation of the heart. Further diagnostic tools include aortography in suspected aortic rupture, sonography in cardiac injuries and hemopericardium, bronchoscopy in suspected bronchial or tracheal rupture, ECG and enzyme determinations in cardiac contusion, and eventually pneumoperitoneum in suspected rupture of the diaphragm. (orig.)

  4. Clinical evaluation of CpG oligonucleotides as adjuvants for vaccines targeting infectious diseases and cancer.

    Science.gov (United States)

    Scheiermann, Julia; Klinman, Dennis M

    2014-11-12

    Synthetic oligonucleotides (ODN) that express unmethylated "CpG motifs" trigger cells that express Toll-like receptor 9. In humans this includes plasmacytoid dendritic cells and B cells. CpG ODN induce an innate immune response characterized by the production of Th1 and pro-inflammatory cytokines. Their utility as vaccine adjuvants was evaluated in a number of clinical trials. Results indicate that CpG ODN improve antigen presentation and the generation of vaccine-specific cellular and humoral responses. This work provides an up-to-date overview of the utility of CpG ODN as adjuvants for vaccines targeting infectious agents and cancer. PMID:24975812

  5. Clinical evaluation of marginal fracture of amalgam restorations: one-year report.

    Science.gov (United States)

    Osborne, J W; Friedman, S J

    1986-03-01

    Fourteen dental amalgam alloys were used in this study. After 1 year, amalgam restorations were evaluated for fracture at the margins. The clinical results indicated that Dispersalloy, Indiloy, a high-copper blend by Syntex, Cluster, and Unison had the least marginal failure. This was followed by Premalloy, Cupralloy, Tytin, Cupralloy ESP, and Contour. Velvalloy and Sybraloy and Orosphere II were the third major grouping with Summalloy having the most fracture at the margins. Different batches of the same alloy performed similarly. The correlation between creep and ridit means (fracture at the margins) was not found to be statistically significant. PMID:3457164

  6. [Performance evaluation of VITEK 2 system in meropenem susceptibility testing of clinical Pseudomonas aeruginosa isolates].

    Science.gov (United States)

    Acuner, Ibrahim Cağatay; Bayramoğlu, Gülçin; Birinci, Asuman; Cekiç Cihan, Ciğdem; Bek, Yüksel; Durupınar, Belma

    2011-07-01

    Pseudomonas aeruginosa is an important opportunistic pathogen associated with various community-acquired or nosocomial infections. Multi-drug resistant P.aeruginosa strains increasingly cause epidemics and spread in various hospital wards and geographic regions. Carbapenems are among the most effective antimicrobials in the treatment of multi-drug resistant P.aeruginosa infections, and meropenem is the most successful among alternatives in initial therapy. Particularly in severe infections, inappropriate or inadequate initial antimicrobial therapy is independently associated with adverse clinical and economic outcomes. Availability of accurate and rapid susceptibility testing is a priority. Most of the automated microbiology systems can provide rapid results within 8 to 12 hours. In comparison to standard methods, problems in the antimicrobial susceptibility testing of particular microorganisms and antimicrobial agents have been reported for automated microbiology systems. Failures have been reported previously especially in the susceptibility testing of P.aeruginosa versus carbapenem. Most of these studies are designed according to the Food and Drug Administration (FDA, USA) performance analysis scheme (Class II Special Controls Guidance Document: Antimicrobial Susceptibility Test Systems) in a simplified form. However, there are many lacking issues in the design of most of these studies. Among these, insufficient sample size, use of inappropriate reference method, lack of reproducibility testing, and inadequate distribution of study isolates in interpretative categories are of notice. There are only few studies in the literature that evaluate the performance of automated systems in antimicrobial susceptibility testing of carbapenems in clinical P.aeruginosa isolates with a sufficient sample size (n ? 100). However, most of these studies still have one or more major deficiencies in the study design. Furthermore, none of these studies evaluate the performance of

  7. Developing and Evaluating Clinical Written Assignment in Clinical Teaching for the Senior B.S. Nursing Students: An action research

    Directory of Open Access Journals (Sweden)

    Leila Valizadeh

    2012-12-01

    Full Text Available Introduction: In a four-year undergraduate level , the nursing students have to get prepared in the patients education, designing care plans, applying nursing processes and exercise the clinical decisions, in addition to learning practical skills. Therefore, multiple clinical teaching strategies in nursing must be applied. In this study the sheets for the mentioned fields were designed and used. Methods: In this action research in Tabriz University of Medical Sciences, 64 nursing senior students and related instructors participated. Clinical written assignment included the patient’s health condition sheet, tables showing the used medicines and the precautions, the clinical and paraclinical tests and the results, identifying the patient problems, designing and implementing care plan and writing nursing reports with SOAPIE method. The instructors’ viewpoints were achieved through the group discussions and their notes taken. The perceived competency of the students was obtained through a questionnaire. The qualitative data was analyzed by the content analysis and quantitative using SPSS. Results: Both the students and the instructors agreed with the clinical written assignment. The desired care competency of the students before and after assignment was statistically significant (p<0.05. According to the instructors, intervention was useful for the senior students who have passed the courses needed for completing and using the different parts of these forms. Conclusion: Since a need is always felt in the trends of the nursing clinical teaching, the researchers recommend the clinical written assignment and their application along with other strategies for senior nursing students in clinical teaching.

  8. Clinical scale preparation and evaluation of 131I-Rituximab for Non-Hodgkin's lymphoma

    International Nuclear Information System (INIS)

    Radioimmunotherapy (RIT) with anti CD20 MoAb conjugated to a β- emitting radioisotope like 131I or 90Y has the added advantage of delivering radiation not only to tumor cells that bind the antibody but also due to a crossfire effect, to neighboring tumor cells inaccessible to the antibody. In order to make available an indigenous radioimmunotherapeutic agent for Non Hodgkin's Lymphoma (NHL), radioiodinated Rituximab has been prepared and evaluated at a clinical scale. Radioiodination of Rituximab was performed by the conventional Chloramine T method using 7.4 GBq Na131I in a lead shielded plant. Six batches of radioiodination were prepared and characterized by electrophoresis and HPLC to evaluate the reproducibility of the product. The product remained stable retaining the radiochemical purity > 95% upto 5 days after radioiodination. In vitro cell binding studies and biodistribution studies in normal Swiss mice have indicated the potential of this molecule as a radioimmunotherapeutic agent for NHL. (orig.)

  9. Usability Evaluation of Clinical Guidelines on the Web Using Eye-Tracker.

    Science.gov (United States)

    Khodambashi, Soudabeh; Gilstad, Heidi; Nytrø, Øystein

    2016-01-01

    Publishing clinical guidelines (GLs) on the web increases their accessibility. However, evaluating their usability and understanding how users interact with the websites has been neglected. In this study we used Tobii eye-tracker to analyse users' interaction with five commercial and public GL sites popular in Norway (four in Norwegian and one English of US origin (UpToDate)). We measured number of clicks and usage rate for search functions, task completion time, users' objective and perception of task success rate. We also measured learning effect for inexperienced users. We found a direct correlation between participant's satisfaction regarding website usability and the time spent, number of mouse clicks and use of search function to obtain the desired results. Our study showed that users' perceived success rate was not reliable and GL publishers should evaluate their website regarding presentation format, layout, navigation bar and search function.

  10. Clinical evaluation of simple fixed space maintainers bonded with flow composite resin.

    Science.gov (United States)

    Simsek, Sera; Yilmaz, Yucel; Gurbuz, Taskin

    2004-01-01

    The aim of this study was to evaluate the clinical performance of simple fixed space maintainers bonded by using a flow composite resin (Tetric Flow) to prevent space resulting from early extracted primary teeth. For that reason, 64 fixed space maintainers (34 in the lower jaw and 30 in the upper jaw) were applied to 45 patients. The patients followed up for 12 to 18 months. Survival rate, prevention ability of that space, and whether damage to the abutment teeth occurred were evaluated. Five percent of space maintainers were determined to be unsuccessful at the end of the control period. During this period, loss of space among the abutment teeth was found to be statistically insignificant (P > .05). Finally, it was observed that the use of simple fixed space maintainers was successful due to operator experience and the choosing of favorable patient groups.

  11. Computer-aided assessment of transient ischemic attacks. A clinical evaluation.

    Science.gov (United States)

    Reggia, J A; Tabb, D R; Price, T R; Banko, M; Hebel, R

    1984-12-01

    We developed and evaluated a computer-based system to assist with the difficult problem of assessing the conditions of patients with transient ischemic attacks (TIAs). The program used criteria to classify a patient's illness localize the neurologic deficit, screen for 46 causative or mimicking disorders, recommend additional tests, and suggest management steps. We evaluated this program in 103 patients with TIAs. The TIA program's localization and classification of patients generally agreed with those made by stroke specialists at our institution, demonstrating that computer programs can reproduce the decision criteria of stroke specialists. With revisions, the TIA program or similar systems could be useful for objective disease classification in clinical trials or epidemiologic studies. In contrast, the TIA program's treatment recommendations were often found to differ significantly from the actual treatments administered by non-stroke specialists.

  12. Clinical evaluation of Moro (Citrus sinensis (L.) Osbeck) orange juice supplementation for the weight management.

    Science.gov (United States)

    Cardile, Venera; Graziano, Adriana Carol Eleonora; Venditti, Alessandro

    2015-01-01

    In the last years, several studies have recently evaluated the beneficial effects of red orange juice (Citrus sinensis (L.) Osbeck) and its active components in weight management and obesity. Moro orange is a cultivar of red orange, particularly rich in active compounds such as anthocyanins, hydroxycinnamic acids, flavone glycosides and ascorbic acid, which displays anti-obesity effects in in vitro and in vivo studies. In this clinical study, the effect of a Moro juice extract (Morosil(®), 400 mg/die) supplementation was evaluated in overweight healthy human volunteers for 12 weeks. Results showed that Moro juice extract intake was able to induce a significant reduction in body mass index (BMI) after 4 weeks of treatment (p juice have a synergistic effect on fat accumulation in humans and Moro juice extract can be used in weight management and in the prevention of human obesity.

  13. Evaluation of Microarray Preprocessing Algorithms Based on Concordance with RT-PCR in Clinical Samples

    DEFF Research Database (Denmark)

    Hansen, Kasper Lage; Szallasi, Zoltan Imre; Eklund, Aron Charles;

    2009-01-01

    Several preprocessing algorithms for Affymetrix gene expression microarrays have been developed, and their performance on spike-in data sets has been evaluated previously. However, a comprehensive comparison of preprocessing algorithms on samples taken under research conditions has not been...... that were most consistent with RT-PCR measurements, although the difference in performance between most of the algorithms was not statistically significant. CONCLUSIONS/SIGNIFICANCE: Our results support the choice of PLIER+16 for the preprocessing of clinical Affymetrix microarray data. However, other...... performed. METHODOLOGY/PRINCIPAL FINDINGS: We used TaqMan RT-PCR arrays as a reference to evaluate the accuracy of expression values from Affymetrix microarrays in two experimental data sets: one comprising 84 genes in 36 colon biopsies, and the other comprising 75 genes in 29 cancer cell lines. We...

  14. Usability Evaluation of Clinical Guidelines on the Web Using Eye-Tracker.

    Science.gov (United States)

    Khodambashi, Soudabeh; Gilstad, Heidi; Nytrø, Øystein

    2016-01-01

    Publishing clinical guidelines (GLs) on the web increases their accessibility. However, evaluating their usability and understanding how users interact with the websites has been neglected. In this study we used Tobii eye-tracker to analyse users' interaction with five commercial and public GL sites popular in Norway (four in Norwegian and one English of US origin (UpToDate)). We measured number of clicks and usage rate for search functions, task completion time, users' objective and perception of task success rate. We also measured learning effect for inexperienced users. We found a direct correlation between participant's satisfaction regarding website usability and the time spent, number of mouse clicks and use of search function to obtain the desired results. Our study showed that users' perceived success rate was not reliable and GL publishers should evaluate their website regarding presentation format, layout, navigation bar and search function. PMID:27577349

  15. Evaluation of Sialic Acid and Acute Phase Proteins (Haptoglobin and Serum Amyloid A) in Clinical and Subclinical Bovine Mastitis

    OpenAIRE

    S. Nazifi*, M. Haghkhah1, Z. Asadi, M. Ansari-Lari2, M. R. Tabandeh3, Z. Esmailnezhad and M. Aghamiri

    2011-01-01

    The present study was conducted to evaluate the concentrations of sialic acids (total, lipid bound and protein bound) and their correlation with acute phase proteins (haptoglobin and serum amyloid A) in clinical and subclinical mastitis of cattle. Thirty subclinical mastitic cows with positive California mastitis test (CMT) test and no clinical signs of mastitis, 10 clinical mastitic cows and 10 healthy cows with negative CMT test and normal somatic cell count were selected. Milk and blood sa...

  16. Clinical Evaluation and Cost-Effectiveness Analysis of Serum Tumor Markers in Lung Cancer

    Directory of Open Access Journals (Sweden)

    Rong Wang

    2013-01-01

    Full Text Available The detection of serum tumor markers is valuable for the early diagnosis of lung cancer. Tumor markers are frequently used for the management of cancer patients. However, single markers are less efficient but marker combinations increase the cost, which is troublesome for clinics. To find an optimal serum marker combination panel that benefits the patients and the medical management system as well, four routine lung cancer serum markers (SCCA, NSE, CEA, and CYFRA21-1 were evaluated individually and in combination. Meanwhile, the costs and effects of these markers in clinical practice in China were assessed by cost-effectiveness analysis. As expected, combinations of these tumor markers improved their sensitivity for lung cancer and different combination panels had their own usefulness. NSE + CEA + CYFRA21-1 was the optimal combination panel with highest Youden’s index (0.64, higher sensitivity (75.76%, and specificity (88.57%, which can aid the clinical diagnosis of lung cancer. Nevertheless, the most cost-effective combination was SCCA + CEA, which can be used to screen the high-risk group.

  17. Repeatability Evaluation of a Contrast Sensitivity System for Transfer to the Eye Clinic

    Science.gov (United States)

    Alcalde, N. G.; Castillo, L. R.; Filgueira, C. Paz; Colombo, E. M.

    2016-04-01

    The Contrast Sensitivity Function (CSF) is a valuable tool which can be used to characterize functional vision and also for the diagnosis and management of patients with different eye diseases. In spite of its usefulness, the CSF is currently hardly ever used in clinical practice. The aim of this study was to validate the use of the system called FVC-100 (Tecnovinc-UNT-CONICET, Argentina), which calculates the CSF, in order to transfer this important tool to ophthalmological clinics. The validation was carried out through the design of a repeatability test and the subsequent analysis of the results. Furthermore, we evaluated the impact of different factors influencing the repeatability of the measurements such as age and previous training. The tests were based on the discrimination of sinusoidal gratings for different spatial frequencies (1, 4 and 12 c/°) in both eyes of 12 people, aged between 20 and 70. The results show that the calculated values of SC of each subject have a high repeatability and are not dependent on age or training. These results allow us to conclude positively regarding the effectiveness of the FVC-100, and to validate its use in clinics for the calculation of the FSC as a standard measure of functional vision quality.

  18. Clinical evaluation of normal tissue toxicity induced by ionizing radiation in cases of laryngeal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Ramos, Adriano de Paula; Marques, Gustavo Inacio de Gomes; Soares, Renata da Bastos Ascenco; Dourado, Juliana Castro Dourado [Pontificia Universidade Catolica de Goias (PUCGO), Goiania, GO (Brazil). Dept. of Medicine; Mendonca, Yuri de Abreu, E-mail: renata.soares@pucgoias.edu.br [Goias Association Against Cancer, Goiania, GO (Brazil). Lab. of Radiobiology and Oncogenetics

    2012-07-01

    Laryngeal cancer is the second most frequent head and neck cancer in the Brazilian male population. For treatment, radiotherapy combined with chemotherapy is now used in substitution for total laryngectomy, becoming the standard treatment for advanced larynx cancer cases, with the aim of organ preservation. However, this method needs assessment of the side effects caused to normal tissue and organ functionality after treatment and the relation of these clinical factors to the individual characteristics of patients. Thus, the clinical characteristics of 229 patients with laryngeal cancer treated with radiotherapy were evaluated by medical records analysis in relation to normal tissue radiosensibility. Significant relations between smoking (p = 0.018) and combined chemoradiotherapy assistance (p = 0.03) were identified with high frequency of treatment suspension cases. The application of combined chemoradiotherapy also resulted in a higher incidence of oral mucositis (p = 0.04), xerostomia (p = 0.001) and treatment side effects to GIT (p = 0.04). Advanced clinical staging was associated with worse prognosis (p = 0.002) and a higher occurrence of treatment failure (p < 0.001). Radiotherapy was also less effective depending on the primary tumor location (p = 0.001). (author)

  19. A Proposed New Index for Clinical Evaluation of Interproximal Soft Tissues: The Interdental Pressure Index

    Directory of Open Access Journals (Sweden)

    Checchi Luigi

    2014-01-01

    Full Text Available The interdental pressure index (IPI is introduced to specifically evaluate clinical interproximal-tissue conditions and assess the effect of interproximal hygiene stimulation. This index scores clinical responses of periodontal tissues to the apical pressure of a horizontally placed periodontal probe. It is negative when gingival tissues are firm, bleeding-free, and slightly ischemic by the stimulation; otherwise it is positive. The clinical validation showed high intraoperator agreement (0.92; 95% CI: 0.82–0.96; P=0.0001 and excellent interoperator agreement (0.76; 95% CI: 0.14–1.38; P=0.02. High internal consistency with bleeding on probing (κ=0.88 and gingival index (Cronbach’s α=0.81 was obtained. Histological validation obtained high sensitivity (100% and specificity (80% for IPI+ toward inflammatory active form. The same results were recorded for IPI− toward chronic inactive form. IPI results as a simple and noninvasive method with low error probability and good reflection of histological condition that can be applied for oral hygiene motivation. Patient compliance to oral hygiene instructions is essential in periodontal therapy and IPI index can be a practical and intuitive tool to check and reinforce this important aspect.

  20. Clinical evaluation of Ashokarishta, Ashwagandha Churna and Praval Pishti in the management of menopausal syndrome

    Science.gov (United States)

    Modi, Mansi B.; Donga, Shilpa B.; Dei, Laxmipriya

    2012-01-01

    Menopause is a gradual and natural transitional phase of adjustment between the active and inactive ovarian function and occupies several years of a women's life and involves biological and psychological changes adjustments. The present clinical trial was designed as per Ayurveda clinical trials protocol to evaluate the efficacy of Ashokarishta, Ashwagandha Churna and Praval Pishti in the management of menopausal syndrome. It was directed by Central Council for Research in Ayurvedic Sciences as randomized open clinical trial. Total 52 patients were registered in the study, out of which 51 patients completed the study. Specialized rating scales like Kupperman Index Score as well as Menopause Rating Scale (MRS) and Menopause Specific Quality of Life (MENQOL) questionnaires were adopted for diagnostic as well as assessment criteria. The effects were examined based on MRS and MENQOL. Results were analyzed statistically using Wilcoxon matched paired test and ‘t’ test. Highly significant (P < 0.01) reduction was found in the symptoms of MRS as well as MENQOL. Finally, it can be stated that combined treatment of above drugs gives better result in both somatic as well as psychological complaints in women with mild to moderate symptoms of menopausal syndrome. PMID:23723668